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Sample records for latissimus dorsi musculocutaneous

  1. Combined Use of the Latissimus Dorsi Musculocutaneous Flap and the Anterolateral Thigh Flap to Reconstruct an Extensive Shoulder Defect in an NF-1 Patient

    PubMed Central

    Fujiki, Masahide; Sakisaka, Masanobu; Kawai, Akira

    2016-01-01

    Summary: Soft tissue coverage after the resection of a large malignant peripheral neural sheath tumor (MPNST) is a challenge. We report the successful reconstruction of an extensive shoulder defect after MPNST resection in a patient with a type 1 neurofibromatosis with a novel combination of flaps. A 70-year-old man with type 1 neurofibromatosis presented with a recurrent MPNST on his right shoulder. He underwent a wide excision of the tumor, which resulted in a huge soft tissue defect around the shoulder joint. The resultant defect was reconstructed with a pedicled latissimus dorsi musculocutaneous flap and a free anterolateral thigh flap. The flaps survived, and the wounds healed uneventfully. His affected arm was useful. The combination of a pedicled latissimus dorsi musculocutaneous flap and a free anterolateral thigh flap is a versatile option for the reconstruction of an extensive shoulder defect. PMID:27200231

  2. The evolving breast reconstruction: from latissimus dorsi musculocutaneous flap to a propeller thoracodorsal fasciocutaneous flap

    PubMed Central

    Gunnarsson, Gudjon Leifur

    2014-01-01

    The aim of this editorial is to give an update on the use of the propeller thoracodorsal artery perforator flap (TAP/TDAP-flap) within the field of breast reconstruction. The TAP-flap can be dissected by a combined use of a monopolar cautery and a scalpel. Microsurgical instruments are generally not needed. The propeller TAP-flap can be designed in different ways, three of these have been published: (I) an oblique upwards design; (II) a horizontal design; (III) an oblique downward design. The latissimus dorsi-flap is a good and reliable option for breast reconstruction, but has been criticized for morbidity and complications. The TAP-flap does not seem to impair the function of the shoulder or arm and the morbidity appears to be scarce. However, an implant is often needed in combination with the TAP-flap, which results in implant related morbidity over time. The TAP-flap seems to be a promising tool for oncoplastic and reconstructive breast surgery and will certainly become an invaluable addition to breast reconstructive methods. PMID:25207206

  3. Modified free latissimus dorsi musculocutaneous flap in the reconstruction of extensive postoncologic defects in the head and neck region.

    PubMed

    Zhu, Guiquan; Li, Chunhua; Chen, Jin; Cai, Yongcong; Li, Ling; Wang, Zhaohui

    2015-03-01

    Oncological resection of advanced carcinoma in the head and neck region results in vast defects. The free latissimus dorsi musculocutaneous flap (FLDMF) is one of the most commonly used flaps for the repair of complex head and neck defects. We tried to modify FLDMF to multiple segments or combine it with acellular dermis to fit through-and-through defects in the oral-facial region during the last decade. A retrospective review of patients with FLDMF reconstruction between 2004 and 2012 was undertaken. Demographics, histology, surgical management, disease control and overall survival, complications, radiotherapy, aesthetic outcome, as well as economic results were analyzed. The majority of the patients (66.7%) had recurrent tumors, and the rest of the patients had primary tumor with stage IV. Fourteen patients (38.9%) had a history of prior radiation therapy, whereas 27.8% of the patients had postoperative radiation therapy. The areas of the defects vary from 52 cm to 180 cm (mean, 86.4 cm). The flap failed in 1 of the 37 patients. The complications at the recipient site include hematoma (n = 6, 16.7%), venous insufficiency (n = 4, 11.1%), infection (n = 3, 8.3), and partial flap necrosis (n = 2, 5.5%). The donor-site complications include delayed healing, necrosis of skin graft, and limited shoulder function. The 5-year overall survival rate was 39.1%, and the 5-year disease-free survival rate was 22.1%. In conclusion, the FLDMF could be modified to fit vast defects where voluminous tissue is needed to be transferred in the head and neck region. PMID:25723665

  4. A case of post-upper lobectomy empyema treated by serratus anterior muscle and pedicled latissimus dorsi musculocutaneous flaps plombage via open-window thoracostomy.

    PubMed

    Kitami, Akihiko; Suzuki, Takashi; Suzuki, Shuichi; Noriyoshi, Sumiya

    2004-06-01

    A 62-year-old male was admitted to our hospital for operation for Aspergillus empyema with a fungus ball in the right upper lobe. We performed a right upper lobectomy and decortication of the middle and lower lobes through a standard posterolateral thoracotomy with dissection of the latissimus dorsi and serratus anterior muscles, in October 2000. Twenty-one days postoperatively (POD), he developed an empyema and a bronchopleural fistula. We performed open-window thoracostomy through the axilla with removal of the third and fourth ribs at 41 POD, and sterilized the open drainage cavity in the out-patient clinic 11 months after discharge. Although the condition of the bronchopleural fistulas was not improved, and methicillin-resistant Staphylococcus aureus (MRSA) was found in the purulent discharge, the discharge decreased. Finally, a pedicled latissimus dorsi musculocutaneous and serratus anterior muscle flap plombage was performed 11 months after initial operation. The patient is now well and works as a driver 21 months after discharge. We conclude that muscle flaps of the pedicled latissimus dorsi and serratus anterior muscles can be useful for plombage of the cavity in cases of post-standard thoracotomy. PMID:15312015

  5. Reconstruction of severely infected gluteal osteoradionecrosis using negative-pressure wound therapy and latissimus dorsi musculocutaneous flaps.

    PubMed

    Kim, Sang Wha; Youn, Dong Geun; Hwang, Kyu Tae; Kim, Jeong Tae; Kim, Youn Hwan

    2016-01-01

    Radiotherapy is mandatory for aggressive cancer treatment. Unfortunately, the high-energy radiation used can lead to severe osteoradionecrosis. Radical debridement of devitalized bone and soft tissue coupled with reconstruction using well-vascularized tissues is the accepted treatment for this condition. However, osteoradionecrosis cannot be controlled easily or rapidly. The aim of this study was to present the results of the use of serial negative-pressure wound therapy (NPWT) in combination with a latissimus dorsi myocutaneous flap for treatment of gluteal osteoradionecrosis in a consecutive series of patients. Between January 2003 and December 2012, nine patients underwent reconstruction using serial NPWT and latissimus dorsi myocutaneous flaps. We applied negative-pressure dressings for at least 8 weeks. Final reconstruction was performed after the infection was controlled. The superior gluteal artery and vein were used as recipient vessels in all the cases. The mean interval between operation and radiation therapy was 28.3 ± 8.3 years, and the mean number of debridement performed was 6.3 ± 1. NPWT dressings were applied for 8-12 weeks (mean, 9.3 ± 2 weeks). The defects ranged in size from 14 × 8 cm to 18 × 15 cm. The flap size ranged from 15 × 10 cm to 18 × 15 cm. All flaps survived uneventfully except in one patient who experienced chronic seroma and wound dehiscence. There were no recurrences of osteomyelitis during the follow-up periods (mean, 14 ± 6.1 months). Based on the results obtained from this consecutive series of patients, we suggest that this methodology may provide an alternative approach for the treatment of severe osteoradionecrosis of the gluteal region. PMID:25641653

  6. Early Management, With a Minimal Initial Hospitalization Length, of Major Self-inflicted Rifle Wounds to the Face by a Single Latissimus Dorsi Free Musculocutaneous Flap: A 10-Year Experience

    PubMed Central

    Danino, A. M.; Hariss, P. G.; Servant, J. M.

    2009-01-01

    Objective: Severe ballistic injuries to the face create complex, composite defects of 2 facial subunits. These injuries have an extremely high economic impact for the Medicare system. The surgical goal with these patients is to restore basic functions of the face with a rapid morphological improvement. Our hypothesis is as follows: Early restoration of facial segments with a single free multiple island latissimus dorsi flap without primary bone reconstruction can significantly reduce hospitalization time and allow earlier psychiatric therapy with good morphological results. Surgical method: (1) Large debridement, bony stabilization with external fixation, and tracheotomy. (2) Definitive early reconstruction of soft tissue with composite free latissimus dorsi-scapular musculocutaneous flap. (3) Several refinements will optimize the results. Study design: Retrospective case series of lower- and middle-face composite facial close-range high-energy gunshot wound patients were evaluated. Age, gender, mechanism of injury, anatomic subsites involved, surgical procedures, flaps utilized, complications, functional outcomes, time of tracheotomy closure, hospitalization duration, and beginning of psychiatric treatment were analyzed. Results: Twelve defects were gunshot wounds, 12 free latissimus dorsi flaps, and no flap losses. Patients received psychiatric treatment after 22 days (7–29); the tracheotomy was removed in 10 patients with normal alimentation in all cases. Mean hospitalization duration was 21 days. Conclusions: Free tissue transfer techniques allow early reconstruction of the soft tissue framework of the face with a single multiple-island flap. Rapid restitution of facial compartments at a soft tissue level can dramatically reduce duration of hospitalization. PMID:19587777

  7. Development of a free latissimus dorsi muscle flap in cats.

    PubMed

    Nicoll, S A; Fowler, J D; Remedios, A M; Clapson, J B; George, D

    1996-01-01

    Anatomic and experimental evaluation of the feline latissimus dorsi muscle was performed to assess its potential use as a free muscle flap. In the anatomic study, nonselective angiography of the subscapular artery was performed in nine heparinized feline cadavers. The muscle dimensions and vascular anatomy of the dissected latissimus dorsi muscle were recorded. In the experimental study four cats underwent heterotopic transplantation of a partial latissimus dorsi flap, and three cats underwent orthotopic transplantation of a complete latissimus dorsi flap. The mean length and width of the latissimus dorsi muscle was 19.0 and 5.4 cm, respectively. The dominant vascular pedicle was the thoracodorsal artery and vein. The average length and diameter of the thoracodorsal artery was 2.7 cm and 0.6 mm, respectively. Minor vascular pedicles were provided by branches of the intercostal arteries. Numerous choke anastomoses existed between the two pedicle systems. Viability of muscle flaps based on subjective evaluation, angiography, and histopathology, was 66% and 100% in the heterotopic and orthotopic studies, respectively. Flap failure seemed to be caused by both arterial and venous thrombosis. The latissimus dorsi muscle flap met criteria required for application in microvascular reconstruction. The vascular pattern was appropriate and consistent. Donor site morbidity was low, whereas surgical accessibility was high. The muscle satisfied the physical criteria of a free flap. Long-term anastomotic patency and flap viability was shown. PMID:8719085

  8. Coverage of Amputation Stumps Using a Latissimus Dorsi Flap With a Serratus Anterior Muscle Flap: A Comparative Study.

    PubMed

    Kim, Sang Wha; Jeon, Seung Bae; Hwang, Kyu Tae; Kim, Youn Hwan

    2016-01-01

    Amputation of the extremities is a definitive reconstructive option, and surgeons should aim to preserve maximum overall function. If the exposed bone cannot be adequately covered using local tissues, the stump can be reconstructed using a number of well-described free flap transfer techniques. Between January 2002 and December 2011, 31 patients with severe injuries to the lower extremities underwent above-the-knee, below-the-knee, and Chopart and Ray amputations. Bony stumps were covered using latissimus dorsi myocutaneous flaps alone (group 1), or together with serratus anterior muscle flaps (group 2). The groups were compared with respect to age, flap survival, skin flap size, immediate complications, wound sloughing, deep ulceration, need for bone amputation, limb visual analog scale score, time to prosthesis, and follow-up duration. The mean area of the latissimus dorsi skin flap was 255.9 cm, and immediate complications occurred in 8 (25.8%) patients. In the double-padding group, there were fewer cases of deep ulceration than in the single-flap group, and prostheses could be worn sooner. There were no statistically significant differences in other parameters. Successful reconstruction of amputation stumps requires an adequate, durable, weight-bearing, and well-contoured soft tissue cover. A latissimus dorsi musculocutaneous flap together with a serratus anterior muscle flap provides well-vascularized muscle tissue and a durable skin paddle, leading to less ulceration than conventional flap techniques. PMID:25003415

  9. Latissimus dorsi pedicle flap for coverage of soft tissue defects about the elbow.

    PubMed

    Stevanovic, M; Sharpe, F; Thommen, V D; Itamura, J M; Schnall, S B

    1999-01-01

    Sixteen consecutive patients who were treated with a pedicled latissimus dorsi flap for complex soft tissue defects about the elbow were reviewed. The average defect size was 100 cm2. Thirteen of the 16 patients achieved stable wound healing with a single procedure. Three patients had partial necrosis of the latissimus and required additional coverage procedures. We recommend that the latissimus dorsi flap should not be routinely used to cover defects more than 8 cm distal to the olecranon. The flap should be closely monitored in the first 48 hours, drains should be routinely used at the recipient and donor sites, and the elbow should be maintained in an extended position for the first 5 days after the procedure. The latissimus dorsi flap may also have a prophylactic role in selected patients with compromised soft tissue coverage about the elbow. The pedicled latissimus flap can be performed under loupe magnification and requires no microsurgical skills or equipment. PMID:10633903

  10. Fetal reconstructive surgery: experimental use of the latissimus dorsi flap to correct myelomeningocele in utero.

    PubMed

    Meuli-Simmen, C; Meuli, M; Hutchins, G M; Harrison, M R; Buncke, H J; Sullivan, K M; Adzick, N S

    1995-10-01

    A recent study in human fetuses with myelomeningocele produced evidence that nonclosure of the spine leads to progressive damage of the exposed spinal cord during pregnancy. Thus in utero coverage might spare function. We tested the use of the latissimus dorsi flap for fetal myelomeningocele repair. In seven sheep fetuses, a lumbar myelomeningocele type of lesion was created at 75 days' gestation and was covered with a "reversed" latissimus dorsi flap at 100 days. At term, the three survivors had healed cutaneous wounds and normal hindlimb function. The vascular pedicle of the latissimus dorsi flap was patent, the viable flap covered the entire lesion, and the underlying spinal cord was grossly intact. We conclude that the latissimus dorsi flap repair is suitable for fetal surgery and provides efficient coverage of the lesion. These results have clinical implications, since fetal myelomeningocele repair may be a compelling way to reduce the severe neurologic deficit in humans. PMID:7568473

  11. Latissimus dorsi free flap for coverage of sacral radiodermatitis in the ambulatory patient

    SciTech Connect

    Stark, D.; Tofield, J.J.; Terranova, W.; Hurley, D.; Kenney, J.

    1987-07-01

    Ambulatory patients with large sacral ulcers can represent extremely challenging coverage problems. Technical options become fewer when sacral ulcers are coupled with radiation dermatitis. Latissimus dorsi free flap transfer, with direct anastomoses to sacral vessels, is described in 2 patients.

  12. Activity of latissimus dorsi muscle during inspiratory threshold loads.

    PubMed

    Orozco-Levi, M; Gea, J; Monells, J; Aran, X; Aguar, M C; Broquetas, J M

    1995-03-01

    The ability of the latissimus dorsi muscle (LD) to participate as an accessory inspiratory muscle has been the subject of controversy. Electromyographic (EGM) activity of LD was evaluated in 11 healthy subjects (aged 30 +/- 2 yrs; forced expiratory volume in one second (FEV1) 106 +/- 5% predicted; maximal inspiratory pressure (Pmax), 120 +/- 6 cmH2O) under different breathing conditions. The ipsilateral biceps brachii was chosen as the control muscle. The EMG was recorded from surface electrodes, but needle electrodes were also used for LD evaluation in a subset of three subjects. The EMG signal from both muscles was recorded simultaneously, rectified and integrated, with subtraction of the electrocardiographic signal. Situations evaluated were: 1) maximal voluntary contraction (MVC); 2) apnoea; and 3) breathing under progressive inspiratory threshold loads (20-100% Pmax, at 20% intervals). A close relationship was evident between LD recordings from surface and needle electrodes (r = 0.975). Activity of LD at baseline was 1.8 +/- 0.4% MVC, and showed a phasic increase during inspiration under loads. This change had a linear tendency and was significant for loads corresponding to 40, 60, 80 and 100% of Pmax when compared to the control muscle. At this latter level, LD activity was equivalent to 32 +/- 5% MVC (range 11-61%), whereas mean activity of the control muscle was less than 7.5% MVC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7789491

  13. Activity Patterns in Latissimus Dorsi and Sternocleidomastoid in Classical Singers

    PubMed Central

    Watson, Alan H.D.; Williams, Caitlin; James, Buddug V.

    2012-01-01

    Summary Objectives The aim of this study was to investigate and compare the roles of the accessory respiratory muscles, latissimus dorsi (LD), and sternocleidomastoid, in classical singing. Methods Electromyography was used to record the activity of these muscles in six classically trained female singers carrying out a number of singing and nonsinging tasks. Movements of the chest and abdominal walls were monitored simultaneously using inductive plethysmography, and the sound of the phonations was recorded. Results In normal breathing, LD is active transiently during very deep inhalations and in inhalation against resistance. During exhalation it becomes active again as residual capacity is approached or when air is expelled with great force. Sternocleidomastoid (SCM) supports inhalation when lung volume nears 100% vital capacity or when this is very rapid. All singers engaged LD in supported singing where it was associated with maintaining an expanded thorax. In coloratura singing, pulses of activity of increasing amplitude were often seen in LD toward the end of the breath. These were synchronized with each note. During a short phrase typical of the end of an aria, which was sung at full volume with the projected voice, both LD and SCM were active simultaneously. Spectral analysis of muscle activity demonstrated that in some singers, activity in LD and more rarely SCM, fluctuated in phase with vibrato. Conclusions LD appears to play a significant role in maintaining chest expansion and the dynamic processes underlying vibrato and coloratura singing in classically trained singers. PMID:21724365

  14. Architectural analysis and predicted functional capability of the human latissimus dorsi muscle

    PubMed Central

    Gerling, Michael E; Brown, Stephen H M

    2013-01-01

    The latissimus dorsi is primarily considered a muscle with actions at the shoulder, despite its widespread attachments at the spine. There is some dispute regarding the potential contribution of this muscle to lumbar spine function. The architectural design of a muscle is one of the most accurate predictors of muscle function; however, detailed architectural data on the latissimus dorsi muscle are limited. Therefore, the aim of this study was to quantify the architectural properties of the latissimus dorsi muscle and model mechanical function in light of these new data. One latissimus dorsi muscle was removed from each of 12 human cadavers, separated into regions, and micro-dissected for quantification of fascicle length, sarcomere length, and physiological cross-sectional area. From these data, sarcomere length operating ranges were modelled to determine the force–length characteristics of latissimus dorsi across the spine and shoulder ranges of motion. The physiological cross-sectional area of latissimus dorsi was 5.6 ± 0.5 cm2 and normalized fascicle length was 26.4 ± 1.0 cm, indicating that this muscle is designed to produce a moderate amount of force over a large range of lengths. Measured sarcomere length in the post-mortem neutral spine posture was nearly optimal at 2.69 ± 0.06 μm. Across spine range of motion, biomechanical modelling predicted latissimus dorsi acts across both the ascending and descending limbs of the force–length curve during lateral bend, and primarily at or near the plateau region (where maximum force generation is possible) during flexion/extension and axial twist. Across shoulder range of motion, latissimus dorsi acts primarily on the plateau region and descending limbs of the force length curve during both flexion/extension and abduction/adduction. These data provide novel insights into the ability of the latissimus dorsi muscle to generate force and change length throughout the spine and shoulder ranges of motion. In addition

  15. Architectural analysis and predicted functional capability of the human latissimus dorsi muscle.

    PubMed

    Gerling, Michael E; Brown, Stephen H M

    2013-08-01

    The latissimus dorsi is primarily considered a muscle with actions at the shoulder, despite its widespread attachments at the spine. There is some dispute regarding the potential contribution of this muscle to lumbar spine function. The architectural design of a muscle is one of the most accurate predictors of muscle function; however, detailed architectural data on the latissimus dorsi muscle are limited. Therefore, the aim of this study was to quantify the architectural properties of the latissimus dorsi muscle and model mechanical function in light of these new data. One latissimus dorsi muscle was removed from each of 12 human cadavers, separated into regions, and micro-dissected for quantification of fascicle length, sarcomere length, and physiological cross-sectional area. From these data, sarcomere length operating ranges were modelled to determine the force-length characteristics of latissimus dorsi across the spine and shoulder ranges of motion. The physiological cross-sectional area of latissimus dorsi was 5.6±0.5 cm2 and normalized fascicle length was 26.4±1.0 cm, indicating that this muscle is designed to produce a moderate amount of force over a large range of lengths. Measured sarcomere length in the post-mortem neutral spine posture was nearly optimal at 2.69±0.06 μm. Across spine range of motion, biomechanical modelling predicted latissimus dorsi acts across both the ascending and descending limbs of the force-length curve during lateral bend, and primarily at or near the plateau region (where maximum force generation is possible) during flexion/extension and axial twist. Across shoulder range of motion, latissimus dorsi acts primarily on the plateau region and descending limbs of the force length curve during both flexion/extension and abduction/adduction. These data provide novel insights into the ability of the latissimus dorsi muscle to generate force and change length throughout the spine and shoulder ranges of motion. In addition, these

  16. The Scarless Latissimus Dorsi Flap Provides Effective Lower Pole Prosthetic Coverage in Breast Reconstruction

    PubMed Central

    Miteff, Kirstin G.

    2014-01-01

    Background: The evolution of surgical breast cancer treatment has led to the oncologically safe preservation of greater amounts of native skin, yet we are still often using flaps with large skin paddles, thereby resulting in significant donor-site scars. This explains the increasing appeal of acellular dermal matrix reconstructions. Acellular dermal matrices can, however, have significant problems, particularly if there is any vascular compromise of the mastectomy skin flaps. We have developed a method of raising the latissimus dorsi flap through the anterior mastectomy incisions without requiring special instruments or repositioning. This can provide autologous vascularized cover of the prosthesis. Methods: A clear surgical description of the scarless latissimus dorsi flap harvest is provided, and our results of a retrospective cohort review of 20 consecutive patients with 27 traditional latissimus dorsi breast reconstructions were compared with those of 20 consecutive patients with 30 scarless latissimus dorsi breast reconstructions. Results: Operative time, length of stay, and complication rates were reduced in the scarless group. Patients Breast-Q scores were equivalent in each group. The aesthetic assessment was good/excellent in 77% of both groups; however, subscale assessment was better in the scarless group. This was statistically significant (P = 0.0). Conclusions: Breast reconstruction using the scarless latissimus dorsi flap is time effective, requires no patient repositioning, and uses standard breast instrumentation. It is safe and versatile while reducing the risk of exposed prosthesis if native skin necrosis occurs. It is a vascularized alternative to acellular dermal matrices. PMID:25289340

  17. Structure of the latissimus dorsi muscle and respiratory function.

    PubMed

    Orozco-Levi, M; Gea, J; Sauleda, J; Corominas, J M; Minguella, J; Aran, X; Broquetas, J M

    1995-03-01

    The aim of this study was to evaluate whether respiratory function influences the structure of the latissimus dorsi muscle (LD). Twelve patients (58 +/- 10 yr) undergoing thoracotomy were studied. Lung and respiratory muscle function were evaluated before surgery. Patients showed a forced expired volume in 1 s (FEV1) of 67 +/- 16% of the reference value, an FEV1-forced vital capacity ratio of 69 +/- 9%, a maximal inspiratory pressure of 101 +/- 21% of the reference value, and a tension-time index of the diaphragm (TTdi) of 0.04 +/- 0.02. When patients were exposed to 8% CO2 breathing, TTdi increased to 0.06 +/- 0.03 (P < 0.05). The structural analysis of LD showed that 51 +/- 5% of the fibers were type I. The diameter was 56 +/- 9 microns for type I fibers and 61 +/- 9 microns for type II fibers, whereas the hypertrophy factor was 87 +/- 94 and 172 +/- 208 for type I and II fibers, respectively. Interestingly, the histogram distribution of the LD fibers was unimodal in two of the three individuals with normal lung function and bimodal (additional mode of hypertrophic fibers) in seven of the nine patients with chronic obstructive pulmonary disease. An inverse relationship was found between the %FEV1-forced vital capacity ratio and both the diameter of the fibers (type I: r = -0.773, P < 0.005; type II: r = -0.590, P < 0.05) and the hypertrophy factors (type I: r = -0.647, P < 0.05; type II: r = -0.575, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7775307

  18. Acute Traumatic Tear of Latissimus Dorsi Muscle in an Elite Track Athlete

    PubMed Central

    Çelebi, Mehmet Mesut; Ergen, Emin; Üstüner, Evren

    2013-01-01

    Soft tissue injuries constitute 30-50% of all sports related injuries; however, injury to the latissimus dorsi muscle is quite rare with only a few cases reported in the literature. Herein, we describe an acute traumatic tear of the latissimus dorsi muscle in an elite track athlete, which has not been reported in the track and field sports before. The injury was caused by forceful resisted arm adduction that took place at hurdling and starting from the block. A pseudotumor appearance in the axillary region was misdiagnosed as a mass. The diagnosis was made by ultrasound alone and the patient was managed conservatively. PMID:24765503

  19. Split latissimus dorsi muscle flap repair of acquired, nonmalignant, intrathoracic tracheoesophageal and bronchoesophageal fistulas.

    PubMed

    Hammoudeh, Ziyad S; Gursel, Eti; Baciewicz, Frank A

    2015-06-01

    The development of a fistula between the tracheobronchial tree and oesophagus due to nonmalignant causes is uncommon. Division of the fistula with muscle flap interposition eliminates contact between the tracheobronchial segment and the oesophagus, theoretically decreasing the chance of recurrence as well as providing a robust blood supply to aid in healing. The split latissimus dorsi muscle flap is a well-suited flap for such repairs because of the ability to simultaneously cover two separate apertures (tracheobronchial and oesophageal). The authors describe the split latissimus dorsi muscle flap with step-by-step technique for repair of intrathoracic aerodigestive fistulas. PMID:25697381

  20. Latissimus dorsi tendon transfer for massive, irreparable posterosuperior rotator cuff tears: surgical technique.

    PubMed

    Qadir, Rabah; Romine, Lucas; Yao, David C; Duncan, Scott F M

    2014-09-01

    Massive rotator cuff tears remain a complex and challenging problem for both the patient and the surgeon. Although significant advancements in surgical techniques as well as technology for arthroscopic and mini-open rotator cuff repairs have been made, many massive tears result in failed repair with continued progressive tendon retraction and degeneration. In cases when primary tendon to bone healing is impractical, latissimus dorsi tendon transfer provides promising and reproducible clinical results. Herein, we present a latissimus tendon transfer surgical technique, a procedure we have used as a salvage operation for failed arthroscopic/mini-open primary rotator cuff repair. PMID:24854152

  1. Inspiratory muscle fatigue affects latissimus dorsi but not pectoralis major activity during arms only front crawl sprinting.

    PubMed

    Lomax, Mitch; Tasker, Louise; Bostanci, Ozgur

    2014-08-01

    The purpose of this study was to determine whether inspiratory muscle fatigue (IMF) affects the muscle activity of the latissimus dorsi and pectoralis major during maximal arms only front crawl swimming. Eight collegiate swimmers were recruited to perform 2 maximal 20-second arms only front crawl sprints in a swimming flume. Both sprints were performed on the same day, and IMF was induced 30 minutes after the first (control) sprint. Maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) were measured before and after each sprint. The median frequency (MDF) of the electromyographic signal burst was recorded from the latissimus dorsi and pectoralis major during each 20-second sprint along with stroke rate and breathing frequency. Median frequency was assessed in absolute units (Hz) and then referenced to the start of the control sprint for normalization. After IMF inducement, stroke rate increased from 56 ± 4 to 59 ± 5 cycles per minute, and latissimus dorsi MDF fell from 67 ± 11 Hz at the start of the sprint to 61 ± 9 Hz at the end. No change was observed in the MDF of the latissimus dorsi during the control sprint. Conversely, the MDF of the pectoralis major shifted to lower frequencies during both sprints but was unaffected by IMF. As the latter induced fatigue in the latissimus dorsi, which was not otherwise apparent during maximal arms only control sprinting, the presence of IMF affects the activity of the latissimus dorsi during front crawl sprinting. PMID:24402450

  2. [Latissimus dorsi myocutaneous flap combined with implant in breast reconstruction: The technique of the dorsal bra].

    PubMed

    Bruant-Rodier, C; Chiriac, S; Baratte, A; Dissaux, C; Bodin, F

    2016-06-01

    The latissimus dorsi myocutaneous flap combined with an implant is an effective breast reconstruction solution especially in irradiated patients. The authors describe the specific technical aspects that allow them to optimize the results of this intervention. In the back, the skin paddle is drawn in the shape of a horizontal spindle so as to conceal the residual scar under the bra. In breast area, a J-shaped contraincision barring the mastectomy scar ensures a harmonious positioning of the skin paddle to the inferolateral part of the breast. After a 180° rotation, the latissimus dorsi muscle envelops the implant like a bra. Its upper edge is attached at the bottom to define the new submammary fold. Under the pectoralis major muscle, its distal end comes to fill the décolleté above the implant. PMID:26117706

  3. The pedicled latissimus dorsi myocutaneous flap in head and neck reconstruction.

    PubMed

    Ong, Hui Shan; Ji, Tong; Zhang, Chen Ping

    2014-08-01

    The pedicled latissimus dorsi myocutaneous flap (PLDMF) is not the first-line reconstructive option for most clinicians; however, when treating salvage patients or those with depleted neck vessels, the PLDMF provides a valuable armamentarium. Unlike the pectoralis major myocutaneous flap or the lower island trapezius flap, the PLDMF has greater versatility in soft tissue design and a longer arc of rotation. These advantages are of great importance in managing advanced reconstructive cases. PMID:24958381

  4. Traumatic Tear of the Latissimus Dorsi Myotendinous Junction: Case Report of a CrossFit-Related Injury.

    PubMed

    Friedman, Michael V; Stensby, J Derek; Hillen, Travis J; Demertzis, Jennifer L; Keener, Jay D

    2015-01-01

    A case of a latissimus dorsi myotendinous junction strain in an avid CrossFit athlete is presented. The patient developed acute onset right axillary burning and swelling and subsequent palpable pop with weakness while performing a "muscle up." Magnetic resonance imaging examination demonstrated a high-grade tear of the right latissimus dorsi myotendinous junction approximately 9 cm proximal to its intact humeral insertion. There were no other injuries to the adjacent shoulder girdle structures. Isolated strain of the latissimus dorsi myotendinous junction is a very rare injury with a scarcity of information available regarding its imaging appearance and preferred treatment. This patient was treated conservatively and was able to resume active CrossFit training within 3 months. At 6 months postinjury, he had only a mild residual functional deficit compared with his preinjury level. PMID:26502450

  5. Treatment of the severely infected frontal sinus with latissimus dorsi myocutaneous free flaps.

    PubMed

    Kim, Youn Hwan; Youn, Seung Ki; Kim, Jeong Tae; Kim, Sang Wha; Yi, Hyeong Joong; Kim, Chang Yeon

    2011-05-01

    In trauma patients with severe intracranial hemorrhaging, diagnosing facial bone fractures can be delayed. In frontal sinus fractures with nasofrontal duct obstruction, obliteration of the nasofrontal duct and the sinus is the current treatment of choice. But with inadequate management, ascending infections happen, and widely spread infections can involve the entire frontal soft tissues, which result in meningitis, encephalitis, and subcutaneous abscess pockets creating skin defects. In the treatment of these infections, radical debridement of all infected tissues including galea, pericranium, and surrounding soft tissues is obligatory; hence, available local vascularized flap options for obliteration of the postdebridement defect are scarce. In these situations, free-tissue transfer can be a treatment option. Although there have been numerous reports of using nonvascularized materials for obliteration of the frontal sinus, the material itself can serve as a nidus for infection, and it is generally accepted that well-vascularized tissues have greater ability to withstand local soft-tissue infection and osteomyelitis. Hence, we report 3 cases where we performed latissimus dorsi myocutaneous flaps for severe frontal sinus infections after frontal cranioplasty for severe hemorrhaging. Large bulks of muscle obliterated the nasofrontal duct and the dead space surrounding the entire frontal sinus. The latissimus dorsi myocutaneous flap is not a permanent solution for frontal sinus reconstruction, which requires a secondary bony reconstruction. However, when we face acute stages of intractable infections of the frontal sinus, it can control the infection and result in saving the patient's life. PMID:21558912

  6. Reconstruction of a Severely Crushed Leg with Interpositional Vessel Grafts and Latissimus Dorsi Flap

    PubMed Central

    Park, Chan Woo; Hwang, Kyu Tae; Kim, Jeong Tae

    2012-01-01

    We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time. PMID:22872848

  7. Reconstruction of the pelvis and perineum with a free latissimus dorsi myocutaneous flap: a case report.

    PubMed

    Kieran, I; Nugent, N; Riordain, M Ó; Kelly, J

    2012-11-01

    Reconstruction of the perineum and pelvic cavity in continuity is an uncommon and difficult challenge. This case describes a 66-year-old man who presented following recurrence of a Dukes' B rectosigmoid adenocarcinoma that had been treated nine years previously by anterior resection, 5-fluorouracil and radiotherapy. His recurrent disease was treated with radical pelvic exenteration with formation of an end colostomy and urinary ileal conduit. A post-operative pelvic collection necessitated incisional drainage via the perineum. This resulted in a perineal defect in continuity with the pelvic cavity, neither of which healed in spite of alternate day packing with antiseptic dressings. The perineum and cavity were reconstructed successfully with a microvascular transfer of the latissimus dorsi using the primary gracilis pedicle as recipient donor vessels. PMID:23131218

  8. Latissimus Dorsi and Teres Major Injuries in Major League Baseball Pitchers: A Systematic Review.

    PubMed

    Mehdi, Syed K; Frangiamore, Salvatore J; Schickendantz, Mark S

    2016-01-01

    Injuries to the upper extremity in baseball pitchers are not uncommon, with extensive literature on shoulder and elbow pathology. However, there is minimal literature on isolated teres major (TM) and latissimus dorsi (LD) injuries. As a result, there is no consensus on an optimal treatment method. An extensive Medline search on studies focusing on the treatment of isolated LD and TM injuries in professional baseball pitchers was performed to explore this topic. Of the 20 retrieved articles, 5 met our inclusion criteria. There were a total of 29 patients who underwent conservative treatment and 1 who underwent surgical treatment. The average time required to return to pitching was 99.8 days in the conservative group and 140 days in the surgically treated group. Five patients in the conservative group suffered from complications and/or setbacks during their treatment and rehabilitation. The lone surgical patient suffered no complications, returned to preinjury form, and was elected an all-star the following year. The goal of this review is to provide a concise summary of the current literature in order to assist physicians when discussing treatment options with their patients. PMID:26991570

  9. Video-assisted thoracic surgery lobectomy preserves more latissimus dorsi muscle than conventional surgery.

    PubMed

    Karasaki, Takahiro; Nakajima, Jun; Murakawa, Tomohiro; Fukami, Takeshi; Yoshida, Yukihiro; Kusakabe, Masashi; Ohtsu, Hiroshi; Takamoto, Shinichi

    2009-03-01

    Video-assisted thoracic surgery (VATS) lobectomy for early lung cancer has become technically feasible. We sought to determine if VATS preserved chest wall muscle postoperatively better than thoracotomy. Consecutive patients who underwent lobectomy between 2004 and 2006 for clinical Stage IA non-small cell lung cancer through VATS (VATS group) or posterolateral thoracotomy (PLT group) at our institution were eligible for the study. The cross-sectional areas of bilateral latissimus dorsi muscle (LDM) at the lower end of the scapula were obtained by computed tomography preoperatively and one year after surgery. These were quantified with image analysis by two researchers in a blinded manner. Fourteen patients in the VATS group (mean age, 68 years; 8 men, 6 women) and 24 patients in the PLT group (mean age, 62 years; 14 men, 10 women) were assessed. Postoperative/preoperative ratios of the LDM cross-section areas on the surgical side were 89+/-20% (Mean+/-S.D.) in the VATS group and 57+/-16% in the PLT group (P<0.001). Those on the non-surgical side were 89+/-23% in the VATS group and 97+/-16% in the PLT group (P=0.23). We conclude that VATS may prevent atrophy of LDM on the surgical side better than conventional thoracotomy. PMID:19059949

  10. Changes in Activation of Serratus Anterior, Trapezius and Latissimus Dorsi With Slouched Posture

    PubMed Central

    Lee, Seok Tae; Moon, Jinkyoo; Lee, Seung Hoon; Cho, Kye Hee; Im, Sang Hee; Kim, MinYoung

    2016-01-01

    Objective To compare quantitative muscle activation between erect and slouched sitting postures in the muscles around the scapula, and to investigate the correlation between the angle of thoracic kyphosis and the alteration of muscle activity depending on two different sitting postures. Methods Ten healthy males participated in the study. Unilateral surface electromyography (SEMG) was performed for serratus anterior, middle trapezius (MT), and lower trapezius (LT), which are scapular stabilizer muscles, as well as latissimus dorsi. Participants elevated their shoulders for 3 seconds up to 90° abduction in the scapular plane, tilting 30° anterior in the coronal plane. They were told to hold the position for 10 seconds and voluntary isometric contractions were recorded by SEMG. These movement procedures were conducted for three times each for erect and slouched sitting postures and data were averaged. Results Activities of MT and LT increased significantly more in the slouched sitting posture than in the erect one. There was no significant correlation between kyphotic angle and the area under curve of each muscle. Conclusion Because MT and LT are known as prime movers of scapular rotation, the findings of this study support the notion that slouched sitting posture affects scapular movement. Such scapular dyskinesis during arm elevation leads to scapular stabilizers becoming overactive, and is relevant to muscle fatigue. Thus, slouched sitting posture could be one of the risk factors involved in musculoskeletal pain around scapulae. PMID:27152283

  11. Do surface electrode recordings validly represent latissimus dorsi activation patterns during shoulder tasks?

    PubMed

    Ginn, Karen A; Halaki, Mark

    2015-02-01

    Because of its superficial location surface electrodes are commonly used to record latissimus dorsi (LD) activity. Despite the fact that the recommended electrode placement is over the belly where LD is quite thin no studies have investigated the possibility of signal contamination from muscles lying deep to LD. Therefore, the aim of this study was to determine the validity of using surface electrodes to record activity from LD. Eight asymptomatic subjects performed ramped isometric (0-100% maximum load) and dynamic (70% maximum load) shoulder tasks. Intramuscular electrodes were inserted into LD and the adjacent erector spinae. Surface electrodes were placed over LD around the intramuscular electrodes. Results indicated that while there was no difference in activity level or activation pattern (ICC>0.94) recorded by the two electrode types during shoulder tasks in which LD would be expected to be active (extension and adduction), significantly lower (p<0.05) LD activity was recorded via intramuscular electrodes during the shoulder flexion and abduction tasks. Therefore, recordings of LD activity by surface electrodes overestimate LD activity during shoulder tasks when this muscle would be expected to be activated at minimum levels. Erector spinae immediately deep to LD was confirmed as a source of crosstalk contamination. PMID:25467544

  12. A computer simulation study of isometric contraction of latissimus dorsi muscle used for cardiac assistance.

    PubMed

    Minoura, T; Mizuhara, H; Tsutsumi, S; Nishimura, K; Ban, T

    1997-01-01

    This study was designed to investigate the feasibility of a skeletal muscle pump employing latissimus dorsi muscle (LDM) for cardiac assistance. We developed and used a 2-dimensional mathematical model for LDM to investigate how the size of pneumatic balloons (30, 38, and 45 ml) and the three different locations (proximal, center, and distal) affect the pressure applied to the balloon by LDM. The computer simulation was performed by coding a visco-elastic and nonlinear 2-dimensional program that employed the finite element method (FEM). The muscle specific parameters of LDM were obtained from animal experiment results. The model is based on Hill's characteristic equation and composed of a contractile component and a passive element. The simulation results indicated that the intermediate and largest sized balloon lead to the highest and the lowest power (volume reduction per unit time interval), respectively. On the other hand, when the balloon is inserted in the distal LDM, the power is lower than in the other two positions, regardless of the balloon size. The above results suggest that the optimal size of the balloon should be selected depending on the muscle specific parameters of the actuator, and that the balloon should be inserted either in the proximal portion or center of the actuator. PMID:9360153

  13. Myosin Isoforms and Contractile Properties of Single Fibers of Human Latissimus Dorsi Muscle

    PubMed Central

    Pacelli, Quirico F.; Cancellara, Pasqua; Toniolo, Luana; Moro, Tatiana; Canato, Marta; Miotti, Danilo; Reggiani, Carlo

    2013-01-01

    The aim of our study was to investigate fiber type distribution and contractile characteristics of Latissimus Dorsi muscle (LDM). Samples were collected from 18 young healthy subjects (9 males and 9 females) through percutaneous fine needle muscle biopsy. The results showed a predominance of fast myosin heavy chain isoforms (MyHC) with 42% of MyHC 2A and 25% of MyHC 2X, while MyHC 1 represented only 33%. The unbalance toward fast isoforms was even greater in males (71%) than in females (64%). Fiber type distribution partially reflected MyHC isoform distribution with 28% type 1/slow fibers and 5% hybrid 1/2A fibers, while fast fibers were divided into 30% type 2A, 31% type A/X, 4% type X, and 2% type 1/2X. Type 1/slow fibers were not only less abundant but also smaller in cross-sectional area than fast fibers. During maximal isometric contraction, type 1/slow fibers developed force and tension significantly lower than the two major groups of fast fibers. In conclusion, the predominance of fast fibers and their greater size and strength compared to slow fibers reveal that LDM is a muscle specialized mainly in phasic and powerful activity. Importantly, such specialization is more pronounced in males than in females. PMID:23971027

  14. Myofascial force transmission between the latissimus dorsi and gluteus maximus muscles: an in vivo experiment.

    PubMed

    Carvalhais, Viviane Otoni do Carmo; Ocarino, Juliana de Melo; Araújo, Vanessa Lara; Souza, Thales Rezende; Silva, Paula Lanna Pereira; Fonseca, Sérgio Teixeira

    2013-03-15

    There are extensive connections between the latissimus dorsi (LD) and gluteus maximus (GMax) muscles and the thoracolumbar fascia (TLF), which suggests a possible pathway for myofascial force transmission. The present study was designed to provide empirical evidence of myofascial force transmission from LD to contralateral GMax through TFL in vivo. To accomplish this goal, we evaluated whether active or passive tensioning of the LD results in increased passive tension of the contralateral GMax, indexed by changes in the hip resting position (RP) or passive stiffness. The hip RP was defined as the angular position in which the passive joint torque equals zero, and passive hip stiffness was calculated as the change in passive torque per change in joint angle. Thirty-seven subjects underwent an assessment of their passive hip torque against medial rotation by means of an isokinetic dynamometer. These measures were carried out under three test conditions: (1) control, (2) passive LD tensioning and (3) active LD tensioning. Electromyography was used to monitor the activity of the hip muscles and the LD under all conditions. Repeated measures analyses of variance demonstrated that passive LD tensioning shifted the hip RP towards lateral rotation (p=0.009) but did not change the passive hip stiffness (p>0.05). Active LD tensioning shifted the hip RP towards lateral rotation (p<0.001) and increased the passive hip stiffness (p≤0.004). The results demonstrated that manipulation of the LD tension modified the passive hip variables, providing evidence of myofascial force transmission in vivo. PMID:23394717

  15. Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right

    PubMed Central

    Feng, Jiajun; Pardoe, Cleone I; Mota, Ashley Manuel; Chui, Christopher Hoe Kong

    2016-01-01

    Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach. PMID:27018318

  16. Intraoperative hemodynamic evaluation of the latissimus dorsi muscle flap: a prospective study.

    PubMed

    Lorenzetti, Fulvio; Giordano, Salvatore; Tukiainen, Erkki

    2012-05-01

    The aim of this study was to assess intraoperatively the hemodynamic changes in the donor vessel of free latissimus dorsi (LD) flap before and after denervation and to analyze flow changes after flap transfer. Twenty-seven patients underwent LD muscle microvascular reconstruction for lower-limb soft tissue defects. Measurements of blood flow were performed intraoperatively by using a 2- to 5-mm probe ultrasonic transit-time flowmeter around the dissected vessels. Registrations were made in the thoracodorsal artery before and after harvesting the flap, after compressing and cutting the motor nerve, and after anastomosis. Mean blood flow of in situ harvested thoracodorsal artery as measured intraoperatively by transit-time flowmeter was (mean ± standard deviation) 16.6 ± 11 mL/min and was significantly increased after raising the flap to 24.0 ± 22 mL/min (p <0.05); it was 25.6 ± 23 mL/min after compressing the motor nerve and was significantly increased after cutting the motor nerve to 32.5 ± 26 mL/min (p <0.05). A significant increase of blood flow to 28.1 ± 19 mL/min was also detected in the thoracodorsal artery after flap transplantation with end-to-side anastomosis (p <0.05). Vascular resistance in the thoracodorsal artery significantly decreased after flap raising and anastomosis (from 7.5 ± 3.4 to 4.0 ± 1.9 and to 4.5 ± 2.4, respectively, p <0.05). LD flap harvesting increases blood flow and decreases resistance in the thoracodorsal artery, especially after denervation. PMID:22492006

  17. Effects of high intensity canoeing training on fibre area and fibre type in the latissimus dorsi muscle.

    PubMed Central

    Baker, S J; Hardy, L

    1989-01-01

    A high intensity short duration exercise training programme was undertaken by nine subjects on three occasions each week for nine weeks. Muscle samples from the latissimus dorsi were taken by needle biopsy, at rest, before and after training. The results revealed that there was no change in either Type I or Type II muscle fibre distribution following training. Type I fibre area did not alter significantly as a result of the training stress. Mean cross-sectional area of Type II fibres was 82 per cent greater post-training than pre-training. Images Figure 1 Figure 2 PMID:2730995

  18. [Evaluation of patients' satisfaction after breast reconstruction with latissimus dorsi myocutaneous flap and immediate permanent breast implant].

    PubMed

    Bognár, Gábor; Gőgh, Bettina; Novák, András; István, Gábor

    2014-04-01

    Current surgical treatment modalities for breast reconstruction include latissimus dorsi mycotaneous flap with immediate permanent breast implant (LDI). The aim of the present study was to analyze reconstruction with LDI in terms of quality of life, cosmesis and patient satisfaction. A chart analysis was carried out with the first ten patients who underwent breast reconstruction with LDI. The patients were interviewed and self-assessment quality of life was administered. They also underwent assessment of satisfaction and cosmesis. The high satisfaction and cosmesis scores in the breast reconstruction group indicate the superior results that can be achieved with breast reconstruction. PMID:24747404

  19. Primary Combined Latissimus Dorsi and Serratus Anterior Flap Repair of Right-Sided Congenital Diaphragmatic Agenesis in a Neonate

    PubMed Central

    Samuel, Madan; Parapurath, Rajiv

    2016-01-01

    Large diaphragmatic defects can be repaired with latissimus dorsi and serratus anterior muscle flaps. We report the first successful primary repair of complete congenital diaphragmatic agenesis using a combination of autologous living bio-tissue and synthetic mesh in a neonate born in the NMC Specialty Hospital in Dubai, United Arab Emirates, in May 2014. Poor Apgar scores, a scaphoid abdomen and absent breath sounds over the right hemithorax were observed at birth. Chest and abdominal X-rays revealed a diaphragmatic hernia. The neonate was stabilised using high-frequency oscillatory ventilation, nitric oxide and sildenafil. The right diaphragm was reconstructed using combined latissimus dorsi and serratus anterior muscle flaps reinforced by a flexible composite mesh. At 12 months old, the infant had normal respiratory function and the diaphragm was intact. No disabilities of the shoulder or scapula were observed. This case indicates that a combination of living tissue and synthetic mesh can be used to reconstruct a functional diaphragm with efficient pleuroperitoneal separation. PMID:26909223

  20. The outcome of Jarcho–Levin syndrome treated with a functional latissimus dorsi flap – A series of three cases

    PubMed Central

    Gangurde, Bipin A.; Raut, Binita; Mehta, Rujuta; Thatte, Mukund R.

    2012-01-01

    Introduction: Jarcho-Levin syndrome is manifested by vertebral body and rib malformations. Large rib defects with paradoxical chest motion lead to early deathdue to progressive respiratory insufficiency, hence it is a lethal syndrome. The only means of improving survival is early stabilisation of the chest wall defect by containing the thoracic herniation. Nitcher et al. and Thatte et al. showed that reconstruction of the chest wall was life saving. Thatte et al. had postulated that early coverage of the lungs and thoracic contents with functional latissimus dorsi may prevent the visceral overgrowth and secondary pleural changes. Materials and Methods: Our three cases which had medium- and long-term follow-up help to support this postulation. Three patients were assessed retrospectively. Their ages at surgery were 6 months, 8 months and 1 year, respectively. All had laboured breathing and paradoxical respiration. All of them were operated with ipsilateral latissimus dorsi flap. Results: The results were evaluated clinically. The patients had reduced or no respiratory infections. The lung compliance improved and they had no tachypnoea on walking, running or playing. Conclusion: Hence, this can be used as a life-saving procedure for Jarcho-Levin syndrome on a long-term basis. PMID:22754151

  1. Bipolar Latissimus Dorsi Transfer through a Single Incision: First Key-Step in Poland Syndrome Chest Deformity.

    PubMed

    Watfa, William; di Summa, Pietro G; Raffoul, Wassim

    2016-08-01

    Poland syndrome is a rare congenital anomaly characterized by a unilateral congenital absence of the sternocostal head of the pectoralis major muscle. The absence of the pectoralis major does not only result in chest asymmetry but also in a missing anterior axillary fold, which is essential for natural anatomical appearance in both male and female patients. In Poland syndrome patients, we perform bipolar latissimus dorsi flap transfer, which can be associated with a sublatissimus implant in women. All procedures are performed through a single short midaxillary incision, and tendon translocation in this technique allows the creation of the anterior axillary fold and thus a natural chest appearance. Moreover, this technique can be performed by any plastic surgeon operating under a basic operating room setting. PMID:27622115

  2. Squamous cell carcinoma of the heel with free latissimus dorsi myocutaneous flap reconstruction: case report and technical note.

    PubMed

    Al Maksoud, Ahmed Mahmoud; Barsoum, Adel K; Moneer, Mohammed

    2016-01-01

    Squamous cell carcinoma (SCC) is the second most common skin cancer; however, it is relatively rare on the foot. Wide excision of SCC is the recommended surgical treatment. The extent of the excision may involve resection of muscles and bone in cases of deep lesions. The functional and anatomic properties and lack of sufficient locally available tissues make the reconstruction of post-oncosurgical defects of the foot a challenging process. Heel reconstruction poses the biggest challenge due to the unique weight-bearing requirements. We present a case of a Marjolin's ulcer on the heel in a 62-year-old woman complicating a chronic non-healing wound. The heel defect was reconstructed with a free latissimus dorsi myocutaneous flap with delayed secondary closure. The outcome was successful both functionally and cosmetically. No further procedures were needed. PMID:27161144

  3. Bronchopleural fistula after pneumonectomy: interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy.

    PubMed

    Wolter, A; Scholz, T; Diedrichson, J; Arens-Landwehr, A; Schroeder-Finckh, R; Liebau, J

    2013-11-01

    Post-pneumonectomy bronchopleural fistula (BPF) remains a rare but often life-threatening complication and therapeutic challenge. Traditional surgical procedures include chronic open drainage, attempts at direct stump closure, thoracoplasty with or without chest wall muscle transposition and trans-sternal bronchial closure. We describe a case with successful closure of a chronic BPF after pneumonectomy by intrathoracic transposition of a pedicled latissimus dorsi muscle flap circumferentially fixed on the surrounding pleural tissue under continuous video-assisted thoracoscopic overview. The postoperative course was without complications; no tumour, empyema or fistula re-occurred. In this article we want to present the potential advantages of video-assisted thoracoscopic support and interdisciplinary teamwork to improve the outcome of patients with BPFs after pneumonectomy. PMID:23587680

  4. Squamous cell carcinoma of the heel with free latissimus dorsi myocutaneous flap reconstruction: case report and technical note

    PubMed Central

    Al Maksoud, Ahmed Mahmoud; Barsoum, Adel K.; Moneer, Mohammed

    2016-01-01

    Squamous cell carcinoma (SCC) is the second most common skin cancer; however, it is relatively rare on the foot. Wide excision of SCC is the recommended surgical treatment. The extent of the excision may involve resection of muscles and bone in cases of deep lesions. The functional and anatomic properties and lack of sufficient locally available tissues make the reconstruction of post-oncosurgical defects of the foot a challenging process. Heel reconstruction poses the biggest challenge due to the unique weight-bearing requirements. We present a case of a Marjolin’s ulcer on the heel in a 62-year-old woman complicating a chronic non-healing wound. The heel defect was reconstructed with a free latissimus dorsi myocutaneous flap with delayed secondary closure. The outcome was successful both functionally and cosmetically. No further procedures were needed. PMID:27161144

  5. Bipolar Latissimus Dorsi Transfer through a Single Incision: First Key–Step in Poland Syndrome Chest Deformity

    PubMed Central

    di Summa, Pietro G.; Raffoul, Wassim

    2016-01-01

    Summary: Poland syndrome is a rare congenital anomaly characterized by a unilateral congenital absence of the sternocostal head of the pectoralis major muscle. The absence of the pectoralis major does not only result in chest asymmetry but also in a missing anterior axillary fold, which is essential for natural anatomical appearance in both male and female patients. In Poland syndrome patients, we perform bipolar latissimus dorsi flap transfer, which can be associated with a sublatissimus implant in women. All procedures are performed through a single short midaxillary incision, and tendon translocation in this technique allows the creation of the anterior axillary fold and thus a natural chest appearance. Moreover, this technique can be performed by any plastic surgeon operating under a basic operating room setting. PMID:27622115

  6. An extensive defect on the tibia covered by a free cross flap using m. latissimus dorsi.

    PubMed

    Tvrdek, M; Kletenský, J; Pros, Z; Stehlík, J

    1992-01-01

    Using a clinical case, the authors demonstrate the technique of covering an extensive tibial defect unmanageable, due to blood supply to the limb and extent of the defect, by conventional methods. The required amount of tissue was provided by a flap obtained from m. latissimus dorst transferred to the site of defect as a free cross flap. PMID:1284265

  7. Use of Latissimus Dorsi Pedicled Myocutaneous Flap for Reconstruction in the Chest Area of an 8-Month-Old Female Infant with Ectopia Cordis

    PubMed Central

    Dastagir, Khaled; Breymann, Thomas; Heckmann, Andreas; Horke, Alexander; Vogt, Peter Maria

    2014-01-01

    Ectopia cordis (EC) is characterized by a complete or partial malposition of the heart outside the thorax. Despite the interdisciplinary treatment, the repair of EC is still very difficult and offers new surgical challenges because of its complexity and various combinations with other anomalies. We report the successful outcome after using a pedicled latissimus dorsi flap in reconstructive surgery in the setting of chronic wound dehiscence in an 8-month-old female infant born with a thoracic EC and omphalocele. PMID:25798359

  8. Recurrent cystosarcoma phylloides of breast: extensive full-thickness excision of chest wall with immediate repair using steel mesh and a latissimus dorsi myocutaneous flap.

    PubMed

    Mindikoğlu, A N; Aktan, K

    1983-10-01

    The case of a young woman with a massive recurrent cystosarcoma phylloides of the breast is presented in whom a full thickness excision of the chest wall was carried out en bloc together with four ribs. The large full-thickness defect of the chest wall was reconstructed with stainless steel mesh and covered by a latissimus dorsi myocutaneous flap. The management of post-operative paradoxical movement is also described. PMID:6313105

  9. The Effects of Bag Style on Muscle Activity of the Trapezius, Erector Spinae and Latissimus Dorsi During Walking in Female University Students

    PubMed Central

    Hardie, Rebecca; Haskew, Rachel; Harris, Joel; Hughes, Gerwyn

    2015-01-01

    Back pain is common in adolescents which has been associated with carrying a bag. However, there is little research examining the effects of bag style in female adolescents. The aim of the study was to investigate the effects of different bag conditions on muscle activity of the trapezius, erector spinae and latissimus dorsi muscles in female university students during walking. Twelve female university students walked on a treadmill for 5 minutes at 1.1 m/s during five conditions; control, 1 strapped rucksack, 2 strapped rucksack, ipsilateral shoulder strap and contralateral shoulder strap, each containing 10% bodyweight. Electromyography for the trapezius, erector spinae and latissimus dorsi was recorded for the last 30 s of each condition. Two-way ANOVA and paired t-tests were used to identify differences between right and left muscles and between bag conditions. Results showed that muscle activity of the left trapezius was significantly higher than the right trapezius during the 1 strap rucksack condition. For the left trapezius, the 2 strapped rucksack and the control condition had significantly lower muscle activity compared to the 1 strapped rucksack and the ipsilateral shoulder strap. For the left erector spinae muscle, there was significantly greater muscle activity when wearing the contralateral shoulder strap compared to the control. For the right erector spinae, significantly lower muscle activity was observed when wearing the 2 strapped rucksack compared to the ipsilateral shoulder strap and contralateral shoulder strap. There were no significant differences in muscle activity of the latissimus dorsi muscles between any of the bag conditions. These findings suggest that a two strapped rucksack should be used when carrying loads to reduce spinal muscle activity which may, in turn, reduce reports of back pain in female adolescents. PMID:25964808

  10. Arthroscopic fixation with a minimally invasive axillary approach for latissimus dorsi transfer using an endobutton in massive and irreparable postero-superior cuff tears

    PubMed Central

    Goldstein, Yariv; Grimberg, Jean; Valenti, Philippe; Chechik, Ofir; Drexler, Michael; Kany, Jean

    2013-01-01

    Arthroscopically assisted latissimus dorsi transfer is a viable option for treatment of patients in their 50s to 70s, without arthritis of the glenohumeral joint, who suffer from massive rotator cuff tears that are not amendable to primary repair due to fatty changes in the muscle tissue, or that have failed previous repair attempts. This procedure offers immediate and dramatic pain relief and is not as technically demanding as one might think. Understanding and respecting the principles of tendon transfer is a key to the success of this procedure. PMID:23960367

  11. Reconstruction of large defect of foot with extensive bone loss exclusively using a latissimus dorsi muscle free flap: a potential new indication for this flap.

    PubMed

    Gomez, Manuel Macemino; Casal, Diogo

    2012-01-01

    In cases of extensive damage to the foot, with significant bone loss, it is generally accepted that reconstruction must include bone flaps or grafts either in the emergency setting or subsequently. In this report, we describe the case of an 18-year-old student with an avulsion injury of the dorsum of his right foot. Consequently, he lost most of the soft tissue over the dorsum of the foot and the cuboid, navicular, and cuneiform bones. A latissimus dorsi free flap was used to reconstruct the defect. A functional pseudoarthrosis developed between the remaining bones of the foot, and the patient experienced satisfactory foot function after rehabilitation. For this reason, no additional reconstructive procedure was undertaken. This case suggests that it might be adequate to use the latissimus dorsi muscle flap more liberally than previously reported in the reconstruction of extensive defects of the dorsum of the foot, including cases with significant bone loss. This option could avoid the morbidity and inconvenience of a second surgery and the need to harvest a bone flap or graft. PMID:21945400

  12. Patch-Augmented Latissimus Dorsi Transfer and Open Reduction–Internal Fixation of Unstable Os Acromiale for Irreparable Massive Posterosuperior Rotator Cuff Tear

    PubMed Central

    Petri, Maximilian; Greenspoon, Joshua A.; Bhatia, Sanjeev; Millett, Peter J.

    2015-01-01

    Latissimus dorsi transfer is a reasonable treatment option for massive posterosuperior rotator cuff tears that can substantially improve chronically painful and dysfunctional shoulders. This report and accompanying video describe the treatment of an active 43-year-old man with severe pain and weakness in the right shoulder after 3 failed rotator cuff repairs. Preoperative imaging showed a massive posterosuperior rotator cuff tear retracted to the glenoid as well as a hypermobile os acromiale likely causing dynamic impingement and recurrent rotator cuff tears. After diagnostic arthroscopy, the latissimus tendon is harvested and augmented with a 3-mm human acellular dermal patch (ArthroFlex; Arthrex, Naples, FL). The native rotator cuff tissue is repaired as much as possible, and the latissimus tendon is passed underneath the deltoid and posterior to the teres minor. The patch-augmented tendon is then integrated into a double-row SpeedBridge repair of eight 4.75-mm BioComposite SwiveLock anchors (Arthrex). The bony surface of the os acromiale is prepared and then fixed to the acromion with 2 cannulated partially threaded screws and additional tension-band wiring. Postoperative rehabilitation initially focuses on early passive range of motion, followed by active and active-assisted motion and a biofeedback program starting at 6 weeks postoperatively. PMID:26697309

  13. [Reconstruction of the anterior chest wall by a sandwich-type combination of a synthetic support and a muscle flap from the latissimus dorsi. Apropos of a case].

    PubMed

    Lanfrey, E; Grolleau, J L; Glock, Y; Chavoin, J P; Costagliola, M

    1996-04-01

    Reconstruction of the chest wall after balistic or other trauma requires good and muscle cover and creation of a new, stable and airtight wall. The authors present a case of balistic trauma of the right anterolateral chest wall which was urgently debrided and subsequently reconstructed by sandwich combination of a latissimus dorsi muscle flap and synthetic material composed of a sheet of PTFE and creation of two methylmethylacrylate ribs. The advantage of this technique is that it avoids the use of autologous tissue from an already weakened chest wall and confers a new chest stability in several sites corresponding to the wall defect with easily available and easy-to-use materials. PMID:8761064

  14. [Myocutaneous latissimus dorsi sliding flap in reconstruction of the lower thoracic wall in chronic fistula caused by cystic echinococcosis of the liver].

    PubMed

    Mouton, W; Schweizer, W; Zuber, J C; Tschopp, H; Blumgart, L H

    1991-07-01

    We report the successful treatment of a 47-year-old man who had a 22-year history of chronic discharge from a hepatic echinococcal cyst. Before treatment in our unit there had been 8 previous attempts to control the fistula. By means of a right thoracoabdominal incision (with resection of the 7th and 8th ribs) it was possible to perform a cystectomy with subsequent marsupialisation of the residual cyst wall to the skin. However, after 2 weeks subsequent treatment with maximal Albendazol therapy there was still a big persistent cavity which required further débridement. This resulted in resolution of the infection and allowed a definitive closure of the big cavity and the thoracoabdominal wall using a myocutaneous latissimus dorsi flap. The patient's subsequent course has been uneventful with no recurrence of the fistula. PMID:1938443

  15. Immediate nipple reconstruction with thoracodorsal artery perforator flap in breast reconstruction by latissimus dorsi myocutaneous flap in patients with Poland's syndrome.

    PubMed

    He, Jinguang; Xu, Hua; Wang, Tao; Qiao, Yufei; Zhang, Yi; Dong, Jiasheng

    2016-01-01

    Loss of long-term projection is the major disadvantage of nipple reconstruction using local flaps. We report a technique of immediate perforator flap nipple reconstruction in breast reconstruction by latissimus dorsi (LD) myocutaneous flap in patients with Poland's syndrome. From March 2007 to July 2012, 12 female patients (age range, 15-21 years) underwent breast reconstructions and immediate nipple reconstructions. A thoracodorsal artery perforator (TAP) flap was simultaneously raised on the LD muscle flap and folded by itself to form the nipple. Both the LD flap and TAP flaps survived postoperatively. The nipple projection was measured by a caliper, and the average loss was 29% by the 1-year follow-up. Eleven patients considered the aesthetic appearance of reconstructed breast and nipple to be very good or good. The immediate nipple reconstruction with TAP flap could be safely performed and results in considerable satisfaction in breast reconstruction by LD myocutaneous flap in patients with Poland's syndrome. PMID:25752505

  16. Evaluation of elbow flexion following free muscle transfer from the medial gastrocnemius or transfer from the latissimus dorsi, in cases of traumatic injury of the brachial plexus☆

    PubMed Central

    de Moraes, Frederico Barra; Kwae, Mário Yoshihide; da Silva, Ricardo Pereira; Porto, Celmo Celeno; de Paiva Magalhães, Daniel; Paulino, Matheus Veloso

    2015-01-01

    Objective To compare the gain in elbow flexion in patients with traumatic injury of the brachial plexus following muscle transfer from latissimus dorsi with the gain following free muscle transfer from the medial belly of the gastrocnemius. Methods This was a retrospective study in which the medical files of a convenience sample of 13 patients operated between 2000 and 2010 were reviewed. Group 1 comprised seven patients who underwent transfers from the gastrocnemius and group 2 (controls) comprised six patients who underwent transfers from the latissimus dorsi. The following functions were evaluated: (1) range of motion (ROM) of elbow flexion, in degrees, using manual goniometry and (2) grade of elbow flexion strength, using a muscle strength scale. Satisfactory results were defined as: (1) elbow flexion ROM ≥ 80° and (2) elbow flexion strength ≥ M3. The Fisher exact and Kruskal–Wallis tests were used (p < 0.05). Results The patients’ mean age was 32 years (range: 17–56) and 72% had been involved in motorcycle accidents. Elbow flexion strength ≥ M3 was observed in seven patients (100%) in group 1 and in five patients (83.3%) in group 2 (p = 0.462). None of the patients presented M5, and one patient (16.7%) in group 2 had a poor result (M2). Elbow flexion ROM with a gain ≥ 80° (daily functions) was found in six patients (86%) in group 1 and in three patients (50%) in group 2 (p = 0.1). Conclusion The patients in group 1 had greater gains in strength and ROM than did those in group 2, but without statistical significance. Thus, transfers from the gastrocnemius become a new surgical option, if other techniques cannot be used. PMID:27218077

  17. Pediatric Arm Reconstruction after Shot-gun Injury Using Peroneal Free-flap and Pedicled Latissimus Dorsi Muscle Flap: Late Follow-up

    PubMed Central

    Ortiz-Dominguez, Abel

    2016-01-01

    Summary: A 15-year-old patient harmed himself upon firing a shotgun that he was carrying when he slipped and fell, causing a destructive wound in the right arm with a medial entry hole and a posterolateral exit hole. The biceps, coracobrachialis, triceps, deltoids, skin cover, and humerus were injured; however, the blood vessels and major nerves of the area were surprisingly not affected. The residual skin muscle defect after debridements was 16 × 5 cm medially and posteriorly, and the bone loss was 7 cm. The wound was reconstructed during a single surgery with a free fibula flap and a pedicled flap of latissimus dorsi. Ten years after surgery, the patient presents neither functional deficit of the injured limb (shoulder, arm, forearm, and hand) nor sequelae in the donor areas; he performs his daily activities without any limitations. This case confirms that the use of free bone flaps and pedicled muscle flaps in pediatric patients can provide excellent long-term results. PMID:27622112

  18. A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

    PubMed Central

    Konarik, Marek; Kachlik, David; Baca, Vaclav

    2014-01-01

    A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”). Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus. PMID:25428677

  19. Pediatric Arm Reconstruction after Shot-gun Injury Using Peroneal Free-flap and Pedicled Latissimus Dorsi Muscle Flap: Late Follow-up.

    PubMed

    Olvera-Caballero, Carlos; Ortiz-Dominguez, Abel

    2016-08-01

    A 15-year-old patient harmed himself upon firing a shotgun that he was carrying when he slipped and fell, causing a destructive wound in the right arm with a medial entry hole and a posterolateral exit hole. The biceps, coracobrachialis, triceps, deltoids, skin cover, and humerus were injured; however, the blood vessels and major nerves of the area were surprisingly not affected. The residual skin muscle defect after debridements was 16 × 5 cm medially and posteriorly, and the bone loss was 7 cm. The wound was reconstructed during a single surgery with a free fibula flap and a pedicled flap of latissimus dorsi. Ten years after surgery, the patient presents neither functional deficit of the injured limb (shoulder, arm, forearm, and hand) nor sequelae in the donor areas; he performs his daily activities without any limitations. This case confirms that the use of free bone flaps and pedicled muscle flaps in pediatric patients can provide excellent long-term results. PMID:27622112

  20. Management of giant inferior triangle lumbar hernia (Petit's triangle hernia): A rare complication following delayed breast reconstruction with extended latissimus dorsi myocutaneous flap

    PubMed Central

    Munhoz, Alexandre Mendonça; Montag, Eduardo; Arruda, Eduardo Gustavo; Sturtz, Gustavo; Gemperli, Rolf

    2014-01-01

    INTRODUCTION Lumbar triangle hernia after breast reconstruction with latissimus dorsi flap (LDMF) is a very rare complication and few cases were previously described. Muscle mobilization and iatrogenic fascia defect are related etiologic factors. PRESENTATION OF CASE The authors describe a rare case of lumbar hernia in a 58-year-old woman who underwent delayed left breast reconstruction with LDMF. Two months after surgery, a progressive symptomatic lower left lumbar bulge was observed. The CT scan confirmed the diagnosis and delineated an 18 cm lumbar defect filled with lower and large bowel. At operation, the defect was exposed and the hernia sac reduced. In order to obtain stability, the remained local muscle and fascia flaps were mobilized into the defect. Additional strength was achieved with a two-layer closure of prosthetic mesh (intra/extra peritoneal). The patient is currently in the 10th postoperative year of hernia repair and satisfactory lumbar wall contour was achieved. Neither the recurrence of lumbar hernia nor symptoms compliance was noted. DISCUSSION Lumbar hernia is an uncommon complication of LDMF harvest. Although it is a rare disease, general and plastic surgeons must be on alert to avoid complications and misdiagnosis. Seroma differential diagnosis is important in order to avoid bowel perforation due to aspiration. Defect reconstruction is necessary with a muscular and fascia flaps mobilization and synthetic mesh in order to obtain a stable repair. CONCLUSION The knowledge of this rare post-operative complication following delayed breast reconstruction is crucial to its surgical management. Early surgical intervention is warranted in order to avoid severe complications. PMID:24794025

  1. What Is the Ideal Free Flap for Soft Tissue Reconstruction? A Ten-Year Experience of Microsurgical Reconstruction Using 334 Latissimus Dorsi Flaps From a Universal Donor Site.

    PubMed

    Kim, Jeong Tae; Kim, Sang Wha; Youn, Seungki; Kim, Youn Hwan

    2015-07-01

    Microsurgical free tissue transfer is regarded as the best available method of tissue reconstruction for intractable defects. The ideal soft tissue flap is thought to be the anterolateral thigh flap. On the basis of 334 procedures involving the latissimus dorsi (LD) flap, we discuss the advantages of the LD flap over the current universal option, and we aimed to establish whether the LD could also gain universal status in all reconstructive fields.Three hundred thirty-four reconstructive procedures using the LD flap were performed in 322 patients between September 2002 and July 2012. In accordance with defect characteristics, we performed 334 procedures using flaps, which included the LD muscle flap with skin graft, the myocutaneous flap, the muscle-sparing flap, the perforator flap, the chimeric flap, and the 2-flap technique using the serratus anterior branch.Flap-related complications occurred in 21 patients (6.3%), including total and partial flap failure. In 253 cases, the donor site was closed primarily, and in the remaining cases, we used split-thickness skin grafts. Donor-site complications occurred in 20 cases (6%). In 11 of the 182 cases, no suitable perforators were identified during surgery.The advantages of the LD as a donor site include the possibility of various harvesting positions without position change, versatility of components, availability of muscle to fill extensive defects, and presence of thick fascia to enable full abdominal reconstruction. On the basis of our experience, we concluded that this flap has the potential to be used as widely as, or in preference to, the anterolateral thigh flap in most reconstructive areas. PMID:25785382

  2. Long-term results of oncoplastic breast surgery with latissimus dorsi flap reconstruction: a pilot study of the objective cosmetic results and patient reported outcome

    PubMed Central

    Kim, Kyeong-Deok; Kim, Zisun; Kuk, Jung Cheol; Jeong, Jaehong; Choi, Kyu Sung; Hur, Sung Mo; Jeong, Gui Ae; Chung, Jun Chul; Cho, Gyu Seok; Shin, Eung Jin; Kim, Hyung Chul; Kang, Sang-Gue; Lee, Min Hyuk

    2016-01-01

    Purpose The goal of oncoplastic breast surgery is to restore the appearance of the breast and improve patient satisfaction. Thus, the assessment of cosmetic results and patient-reported outcomes (PROs) using appropriately constructed and validated instruments is essential. The aim of the present study was to assess the long-term objective cosmetic results and corresponding PROs after oncoplastic breast surgery. Methods Cosmetic results were assessed by the patients, a medical panel, and a computer program (BCCT.core). PROs were assessed using BREAST-Q, a questionnaire that measures the perception of patients having breast surgery. The cosmetic results and PROs were analyzed in patients who underwent quadrantectomy and partial breast reconstruction utilizing the latissimus dorsi flap. Results The mean duration of the follow-up period was 91.6 months (range, 33.3–171.0 months), and mean age of the patients was 51 years old (range, 33–72 years). The mean tumor size was 2.1 cm (range, 0.9–5.5 cm). There was fair agreement between the medical panel and BCCT.core score (K = 0.32, P < 0.001), and a statistically significant correlation between the BCCT.core score and medical panel cosmetic results was identified (r = 0.606, P < 0.001). A better BCCT.core result was related to a higher PRO of each BREAST-Q domain—satisfaction with breasts (R2 = 0.070, P = 0.039), satisfaction with outcome (R2 = 0.087, P = 0.021), psychosocial well-being (R2 = 0.085, P = 0.023), sexual well-being (R2 = 0.082, P = 0.029), and satisfaction with information (R2 = 0.064, P = 0.049). Conclusion Our long-term results of oncoplastic surgery achieved a high level of patient satisfaction with good cosmetic results. The medical panel and BCCT.core results correlated well with the PROs of the patients using valid, reliable, and procedure-specific measures. PMID:26942154

  3. Protein Supplementation Does Not Further Increase Latissimus Dorsi Muscle Fiber Hypertrophy after Eight Weeks of Resistance Training in Novice Subjects, but Partially Counteracts the Fast-to-Slow Muscle Fiber Transition.

    PubMed

    Paoli, Antonio; Pacelli, Quirico F; Cancellara, Pasqua; Toniolo, Luana; Moro, Tatiana; Canato, Marta; Miotti, Danilo; Neri, Marco; Morra, Aldo; Quadrelli, Marco; Reggiani, Carlo

    2016-01-01

    The response to resistance training and protein supplementation in the latissimus dorsi muscle (LDM) has never been investigated. We investigated the effects of resistance training (RT) and protein supplementation on muscle mass, strength, and fiber characteristics of the LDM. Eighteen healthy young subjects were randomly assigned to a progressive eight-week RT program with a normal protein diet (NP) or high protein diet (HP) (NP 0.85 vs. HP 1.8 g of protein·kg(-1)·day(-1)). One repetition maximum tests, magnetic resonance imaging for cross-sectional muscle area (CSA), body composition, and single muscle fibers mechanical and phenotype characteristics were measured. RT induced a significant gain in strength (+17%, p < 0.0001), whole muscle CSA (p = 0.024), and single muscle fibers CSA (p < 0.05) of LDM in all subjects. Fiber isometric force increased in proportion to CSA (+22%, p < 0.005) and thus no change in specific tension occurred. A significant transition from 2X to 2A myosin expression was induced by training. The protein supplementation showed no significant effects on all measured outcomes except for a smaller reduction of 2X myosin expression. Our results suggest that in LDM protein supplementation does not further enhance RT-induced muscle fiber hypertrophy nor influence mechanic muscle fiber characteristics but partially counteracts the fast-to-slow fiber shift. PMID:27258300

  4. Protein Supplementation Does Not Further Increase Latissimus Dorsi Muscle Fiber Hypertrophy after Eight Weeks of Resistance Training in Novice Subjects, but Partially Counteracts the Fast-to-Slow Muscle Fiber Transition

    PubMed Central

    Paoli, Antonio; Pacelli, Quirico F.; Cancellara, Pasqua; Toniolo, Luana; Moro, Tatiana; Canato, Marta; Miotti, Danilo; Neri, Marco; Morra, Aldo; Quadrelli, Marco; Reggiani, Carlo

    2016-01-01

    The response to resistance training and protein supplementation in the latissimus dorsi muscle (LDM) has never been investigated. We investigated the effects of resistance training (RT) and protein supplementation on muscle mass, strength, and fiber characteristics of the LDM. Eighteen healthy young subjects were randomly assigned to a progressive eight-week RT program with a normal protein diet (NP) or high protein diet (HP) (NP 0.85 vs. HP 1.8 g of protein·kg−1·day−1). One repetition maximum tests, magnetic resonance imaging for cross-sectional muscle area (CSA), body composition, and single muscle fibers mechanical and phenotype characteristics were measured. RT induced a significant gain in strength (+17%, p < 0.0001), whole muscle CSA (p = 0.024), and single muscle fibers CSA (p < 0.05) of LDM in all subjects. Fiber isometric force increased in proportion to CSA (+22%, p < 0.005) and thus no change in specific tension occurred. A significant transition from 2X to 2A myosin expression was induced by training. The protein supplementation showed no significant effects on all measured outcomes except for a smaller reduction of 2X myosin expression. Our results suggest that in LDM protein supplementation does not further enhance RT-induced muscle fiber hypertrophy nor influence mechanic muscle fiber characteristics but partially counteracts the fast-to-slow fiber shift. PMID:27258300

  5. Bilateral elastofibroma dorsi: a case report of an uncommon and under-diagnosed tumor

    PubMed Central

    Braun, Stefanie; Richter, Matthias; Ernst, Tom; Flade, Andreas

    2015-01-01

    Elastofibroma dorsi is a rare benign tumor of the back, located between the latissimus dorsi and the rhomboid muscle. In most cases it is unilateral, but in up to 10% it occurs on both sides. The etiology is still in discussion. Here we report a case of a 51-year-old man with bilateral elastofibroma dorsi. The therapy of choice was surgical resection. No long-term complications were reported in a 6-month follow-up. PMID:26855655

  6. Muscular axillary arch accompanying variation of the musculocutaneous nerve: axillary arch

    PubMed Central

    Jung, Soo-Jung; Lee, Hyunsu; Choi, In-Jang

    2016-01-01

    Continuous attention has been developed on the anatomical variations of the axilla in anatomist and surgeon due to their clinical importance. The axillary region is an anatomical space between the lateral part of the chest wall and the medial aspect of the upper limb. During the routine dissection of embalmed cadavers, we found variant muscular slip originating from the lateral border of tendinous part of the latissimus dorsi and continuing 9 cm more crossing the axilla. And then, it inserted into the superior margin of the insertion of the pectoralis major. We considered this muscular variation as axillary arch muscle. Correct identification of the relevant anatomy and subsequent simple surgical division is curative, paying special attention to anatomical variations in this region and its clinical importance due to its close relationship to the neurovascular elements of the axilla. PMID:27382519

  7. [PELVIC FLOOR RECONSTRUCTION AFTER PELVIC EVISCERATION USING GRACILIS MUSCULOCUTANEOUS FLAP].

    PubMed

    Pavlov, V N; Bakirov, A A; Kabirov, I R; Izmajlov, A A; Kutlijarov, L M; Safiullin, R L; Urmancev, M F; Sultanov, I M; Abdrahimov, R V

    2015-01-01

    Evisceration of the pelvic organs (EPO) is a fairly uncommon surgical treatment that removes all organs from a patient's pelvic cavity. We use gracilis musculocutaneous flap to repair pelvic floor after EPO. Over the period from November 2013 to December 2014 we carried out EPO with reconstructive repair of the pelvic floor with gracilis musculocutaneous flap in 10 patients with locally advanced pelvic tumors. We describe the surgical procedure and surgical outcomes in these patients. Mean age of the patients was 55 years. Mean duration of EPO with the pelvic floor repair was 285 min., mean blood loss--595 mL and the average length of hospital stay--19 days. Gracilis musculocutaneous flap has a sufficient arterial supply and mobility for pelvic floor reconstruction. Necrosis of flap's distal edge occurred in one of the 10 clinical cases, while the remaining flaps were fully preserved. Complete healing of wounds with no signs of weakening of the pelvic floor muscles was observed in all cases. Pelvic floor reconstruction is an essential procedure in order to reduce complications associated with the evisceration of the pelvic organs. The Gracilis musculocutaneous flap is the logical alternative to repair pelvic floor defect. It does not contribute to complications like functional deficiency of the lower limbs, complications of stoma formation or weakening of the muscles of the anterior abdominal wall. PMID:26390558

  8. Free microvascular transplantation of the trapezius musculocutaneous flap in dogs.

    PubMed

    Philibert, D; Fowler, J D; Clapson, J B

    1992-01-01

    A musculocutaneous flap based on the prescapular branch of the superficial cervical artery and including the cervical part of the trapezius muscle and overlying skin was transplanted over a defect created on the medial side of the contralateral tibia in four dogs by using microvascular technique. The donor and recipient sites in three dogs were examined clinically for 21 days, after which they were examined angiographically and histologically. All dogs were free of lameness by hour 48. Seromas formed at the donor site between days 7 and 15. One vascular pedicle was traumatized at hour 40, and the dog was euthanatized. Three flaps survived with minimal necrosis. Edema of the flaps was severe from days 5 to 11. Angiograms showed complete perfusion of the flaps, and survival was confirmed histologically. Esthetic appearance and function were good in one dog at month 7. PMID:1455645

  9. Cutaneous reinnervation of the rectus abdominis musculocutaneous flap after chest wall reconstruction: development of herpes zoster in the transplanted musculocutaneous flap.

    PubMed

    Tomita, K; Inoue, K

    1998-08-01

    We report a patient in whom herpes zoster developed in the transplanted rectus abdominis musculocutaneous flap 14 months after a chest wall reconstruction for recurrent breast cancer. Based on the distribution of the varicella zoster virus spreading along the sensory nerve fibers, we concluded that the virus spread along the reinnervated sensory nerves from the dorsal ganglia, through the intercostal nerves, and into the flap skin. It is suggested that this finding demonstrates the pathway of reinnervation into the transferred musculocutaneous flap on the chest wall. PMID:9718154

  10. Tracheoesophageal puncture site closure with sternocleidomastoid musculocutaneous transposition flap

    PubMed Central

    Jaiswal, Dushyant; Yadav, Prabha; Shankhdhar, Vinay Kant; Gujjalanavar, Rajendra Suresh; Puranik, Prashant

    2015-01-01

    Introduction: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods for closure have been described. Surgical methods are used when non-surgical methods fail. We present the use of the sternocleidomastoid musculocutaneous (SCMMC) transposition flap for the closure of tracheoesophageal fistula. Materials and Methods: An incision is made at the mucocutaneous junction circumferentially around the tracheostoma. Tracheoesophageal space is dissected down to and beyond the fistula. The tracheoesophageal tract is divided. The oesophageal mucosa is closed with simple sutures. Then SCMMC transposition flap is raised and transposed to cover sutured oesophagus and the defect between the oesophagus and the trachea. Results: This study was done prospectively over a period of 1 year from June 2012 to May 2013. This technique was used in patients with pliable neck skin. In nine patients, this procedure was done (inferior based flap in nine cases) and it was successful in eight patients. In one case, there was dehiscence at the leading edge of flap with oesophageal dehiscence, which required a second procedure. In two cases, there was marginal necrosis of flap, which healed without any intervention. Nine patients in this series were post-radiation. Conclusion: This method of closure is simple and effective for patients with pliable neck skin, who require permanent closure of the tracheoesophageal fistula. PMID:26933281

  11. Reconstruction of posterior neck and skull with vertical trapezius musculocutaneous flap

    SciTech Connect

    Mathes, S.J.; Stevenson, T.R.

    1988-10-01

    The vertical trapezius musculocutaneous flap has been successfully utilized for reconstruction in 13 patients with complex posterior skull and neck defects. This flap based on its vascular pedicle, the descending branch of the transverse cervical artery, provides well-vascularized tissue for coverage of defects related to chronic osteomyelitis, tumor extirpation, osteoradionecrosis, and dehisced cervical laminectomy wounds. Emphasis on flap design, including the location of the skin island, allows adequate wound coverage, direct donor site closure, and muscle function preservation. With its large size and wide arc of rotation, the vertical trapezius musculocutaneous flap provides reliable coverage for posterior trunk, cervical, and skull defects.

  12. Ghrelin protects musculocutaneous tissue from ischemic necrosis by improving microvascular perfusion.

    PubMed

    Rezaeian, F; Wettstein, R; Scheuer, C; Bäumker, K; Bächle, A; Vollmar, B; Menger, M D; Harder, Y

    2012-02-01

    Persistent ischemia in musculocutaneous tissue may lead to wound breakdown and necrosis. The objective of this experimental study was to analyze, whether the gastric peptide ghrelin prevents musculocutaneous tissue from necrosis and to elucidate underlying mechanisms. Thirty-two C57BL/6 mice equipped with a dorsal skinfold chamber containing ischemic musculocutaneous tissue were allocated to four groups: 1) ghrelin; 2) N(ω)-nitro-l-arginine methyl ester (l-NAME); 3) ghrelin and l-NAME; and 4) control. Microcirculation, inflammation, angiogenesis, and tissue survival were assessed by fluorescence microscopy. Inducible and endothelial nitric oxide synthase (iNOS I and eNOS), vascular endothelial growth factor (VEGF), as well as nuclear factor κB (NF-κB) were assessed by Western blot analysis. Ghrelin-treated animals showed an increased expression of iNOS and eNOS in critically perfused tissue compared with controls. This was associated with arteriolar dilation, increased arteriolar perfusion, and a sustained functional capillary density. Ghrelin further upregulated NF-κB and VEGF and induced angiogenesis. Finally, ghrelin reduced microvascular leukocyte-endothelial cell interactions, apoptosis, and overall tissue necrosis (P < 0.05 vs. control). Inhibition of nitric oxide by l-NAME did not affect the anti-inflammatory and angiogenic action of ghrelin but completely blunted the ghrelin-induced tissue protection by abrogating the arteriolar dilation, the improved capillary perfusion, and the increased tissue survival. Ghrelin prevents critically perfused tissue from ischemic necrosis. Tissue protection is the result of a nitric oxide synthase-mediated improvement of the microcirculation but not due to induction of angiogenesis or attenuation of inflammation. This might represent a promising, noninvasive, and clinically applicable approach to protect musculocutaneous tissue from ischemia. PMID:22159999

  13. Free anterolateral thigh flap raised on musculocutaneous perforators of rectus femoris muscle.

    PubMed

    Ehtesham-ul-Haq; Aslam, Ayesha; Hameed, Shahid; Ahmad, Rao Saood; Majid, Abdul; Waqas, Muhammad

    2011-08-01

    The anterolateral thigh flap (ALTF) has been in wide clinical use for the last two decades, its major disadvantage has been its variable anatomy. We are presenting a case in which no substantial perforators were found to be arising from either the lateral septum of thigh or Vastus Laterlis muscle. In this case, instead of raising another flap, we used the same skin paddle raised on the musculocutaneous perforators of rectus femoris muscle. PMID:21798144

  14. ANATOMICAL STUDY OF THE MUSCULOCUTANEOUS NERVE IN RELATION TO THE CORACOID PROCESS

    PubMed Central

    Rebouças, Fabiano; Filho, Romulo Brasil; Filardis, Cantidio; Pereira, Renato Rodrigues; Cardoso, Alessandro Alvarenga

    2015-01-01

    Objective: The authors performed an anatomical study on the path of the musculocutaneous nerve by dissecting 20 shoulders from 10 fresh adult cadavers. Method: The distance from the lower edge of the coracoid process to the point of penetration of the most proximal branch of the musculocutaneous nerve in the coracobrachialis muscle was measured and named the base. Starting from the inferomedial edge of the coracoid process, a second measurement was made to the point at which the lateral fascicle of the brachial plexus crossed the subclavius muscle, and was named the height. The third measurement was of the triangular area formed by the two first measurements, and was named the area. Results: The mean base length was 3.42 cm, ranging from 2.38 cm to 4.40 cm. The mean height measurement was 2.74 cm, ranging from 1.03 cm to 3.80 cm. The mean area was 4.92 cm2, ranging from 1.22 cm2 to 7.99 cm2. Conclusion: These measurements are very important because of the risk of injury to the musculocutaneous nerve in surgical approaches to the shoulder. PMID:27022570

  15. Reconstruction of full-thickness chest wall defects using rectus abdominis musculocutaneous flap: A report of fifteen cases

    SciTech Connect

    Miyamoto, Y.; Hattori, T.; Niimoto, M.; Toge, T. )

    1986-02-01

    In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects.

  16. Long-term survival after chest-wall reconstruction with musculocutaneous flaps

    SciTech Connect

    Kroll, S.S.; Schusterman, M.A.; Larson, D.L.; Fender, A. )

    1990-10-01

    Reconstruction of chest-wall defects with musculocutaneous flaps permits resection of advanced chest-wall tumors and of tissues severely damaged by radiotherapy in patients who in a previous era were not surgically treatable. To determine the long-term outcome from this surgery, the records of 96 patients who had undergone chest-wall resection with musculocutaneous flap reconstruction were reviewed. Median survival for the entire group was 20.5 months, but a more accurate prediction of outcome could be obtained by dividing the patients into three groups. In group I, patients free of known malignancy and undergoing resection of radionecrotic tissues, median survival was 60.0 months. In group II, patients with resectable disease and free of tumor following surgery, median survival was 31.1 months. In group III, patients incompletely resected or known to have metastatic disease following surgery, median survival was only 12.5 months. Even in group III, however, some individuals achieved prolonged survival and lasting benefits from the surgery, so these data should not be used to exclude patients from undergoing necessary palliative procedures.

  17. A successful reconstruction using a frozen autograft and a pedicled latissimus dorsi flap after a S12345B shoulder girdle resection in a patient with osteosarcoma.

    PubMed

    Shimizu, Takamasa; Kido, Akira; Honoki, Kanya; Murata, Keiichi; Fujii, Hiromasa; Higuchi, Banryoku; Ishihara, Takashi; Takeshita, Yasufumi; Shima, Midori; Yajima, Hiroshi; Akahane, Manabu; Tanaka, Yasuhito

    2012-03-01

    We present a case of high-grade osteosarcoma in the proximal humerus in an 8-year-old boy. Massive tumor expansion required a S12345B shoulder girdle resection according to the system of the Musculoskeletal Tumor Society. After wide resection, only a small portion of the distal humerus and none of the rotator cuff muscles would be spared. Because the humeral portion would be too short to support the stem and the soft tissue would be insufficient to cover prosthetic components, we designed a composite reconstruction using a frozen autograft and a pedicled muscle flap. At 2 years postoperatively, our patient exhibited good adaptation and had acquired fine dexterity of the upper limb. To our knowledge, this is the first report regarding a successful composite reconstruction after a S12345B shoulder girdle resection. PMID:22131107

  18. A Case of Congenital Bilateral Absence of Elbow Flexor Muscles: Review of Differential Diagnosis and Treatment

    PubMed Central

    Aliu, Oluseyi; Samra, Saleh; Lewis, Eric

    2007-01-01

    A 1-year-old boy presented to us with congenital inability to flex his elbow. He had bilaterally absent biceps brachii and brachialis muscles, a rare condition. We performed pedicle latissimus dorsi musculocutaneous flaps to the left and right volar upper arm at 21 and 24 months of age, respectively, to create elbow flexors. By 4 years of age, he had excellent elbow flexion bilaterally with strength grade in excess of 4.5. In addition to discussing our patient’s treatment options, we discuss other potential causes of weak elbow flexion when faced with this clinical dilemma. PMID:18780113

  19. Modified total thigh musculocutaneous flap: 'operation of last resort' for massive pressure ulcers.

    PubMed

    Cheng, Paul Ting-Yuan; Adams, Brandon Michael; Chunilal, Ashwin

    2014-02-01

    Massive bilateral pressure ulcers of dependent areas may complicate spinal cord injuries. These may be life threatening to patients and challenging for reconstructive surgeons. In massive recurrent ulcers, local tissue is either inadequate or previously exhausted. The total thigh musculocutaneous flap is an operation of last resort; we present a new variation of this procedure and a case of life threatening pressure ulcers with underlying osteomyelitis. A paraplegic patient had recurrent, extensive, bilateral pressure areas with some preserved tissue bridges. The nature of the pressure areas and lack of local options in this patient required modification of previously described total thigh flaps. An extended total thigh flap was partially de-epithelialised to fill the extensive sacral defect and a tunnelled extension was fashioned to cover the contralateral trochanteric defect. The timing of surgery was determined by balancing pre-operative nutritional optimisation against life-threatening drug resistance of infective organisms. The total thigh flap can close massive bilateral pressure ulcers. Modifications are presented which preserve viable local tissue and demonstrate the versatility of this technique. It remains a 'last-resort' salvage procedure. PMID:23806262

  20. Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study.

    PubMed

    Suominen, S; Asko-Seljavaara, S; Kinnunen, J; Sainio, P; Alaranta, H

    1997-09-01

    A prospective study was designed to evaluate the possible changes in abdominal wall strength following free transverse rectus abdominis musculocutaneous (TRAM) flap surgery for breast reconstruction. Twenty-two patients were examined 1 day before surgery, and at 3, 6, and 12 months postoperatively. Trunk muscle strength was measured by the same physiotherapist using an isokinetic dynamometer (Lido Multi Joint II, Loredan Biomedical Inc., Davies, CA). The peak torque and average torque for both flexion and extension at 60 degrees per second angular velocity were recorded from the curves obtained. There was a significant reduction in trunk flexion strength at 3 months postoperatively (peak torque mean, 92% of the preoperative value; p = 0.04), but this was corrected by 6 months (mean, 96%), and improved to 98% by 12 months. The patient's ability to do curled trunk sit-ups was evaluated by the same physiotherapist and graded on a scale from 1 to 6. In 9 of 19 patients the operation had no effect on sit-up performance during follow-up. In 10 of 19 patients there was a reduction of one or two grades at 3 months that did not improve by 12 months. Magnetic resonance imaging of the abdominal wall was performed on 9 patients. The mean area of the upper third of both rectus muscles was measured on the axial images. At 3 months postoperatively the mean area of the upper third of the donor muscle was significantly larger than the contralateral (p = 0.03). There was no difference in size at 6 months, and by 12 months the donor side was smaller. This prospective study shows that harvesting of a free TRAM flap can cause a subclinical reduction in abdominal strength, although this was not noticed by the patients themselves. PMID:9326701

  1. Differential impact of visual feedback on plantar- and dorsi-flexion maximal torque output.

    PubMed

    Toumi, Anis; Jakobi, Jennifer M; Simoneau-Buessinger, Emilie

    2016-05-01

    The effect of visual feedback on enhancing isometric maximal voluntary contractions (MVC) was evaluated. Twelve adults performed plantar-flexion and dorsi-flexion MVCs in 3 conditions (no visual feedback, visual feedback, and visual feedback with target). There was no significant effect of visual conditions on dorsi-flexion MVC but there was an effect on plantar-flexion. Irrespective of whether a target was evident, visual feedback increased plantar-flexion MVC by ∼15%. This study highlights the importance of optimal feedback to enhance MVC. PMID:27031663

  2. Effects of quantitative trait loci on mineral content 1 of bovine longissimus dorsi muscle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Beef cattle require dietary minerals to maintain their health, production and reproduction. Concentrations of minerals in tissues are at least partially genetically determined. Mapping genomic regions related to the mineral content of the bovine longissimus dorsi muscle may help in the identificatio...

  3. The radix nasi island flap: a versatile musculocutaneous flap for defects of the eyelids, nose, and malar region.

    PubMed

    Seyhan, Tamer

    2009-03-01

    A versatile musculocutan flap from the radix nasi region, the radix nasi island flap, is described. The flap has an axial blood supply derived from the dorsal nasal branch of the ophthalmic artery which is anastomosed to the terminal branch of the facial artery. The flap includes the skin, subcutaneous tissue, and procerus muscle. Ten patients, aged 50 to 86 years, have been reconstructed with this flap for defects in the nose (in 4 cases), midface (in 4 cases) and lower eyelids (in 2 cases). The mean flap size was 17 x 23 mm (range: 15 x 20 to 20 x 27 mm). All flaps fully survived. Additional complications and morbidity were not observed. The donor sites were closed a primarily closure in all cases. Follow-up ranged from 3 to 12 months (mean: 8.2 months). The radix nasi flap is a safe flap, has minimal donor site morbidity, and is especially suited for nasal and midface reconstruction in terms of attaining a suitable color and thickness. PMID:19305249

  4. Neurotization of free gracilis transfer with the brachialis branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury: an anatomical study and case report

    PubMed Central

    Yang, Yi; Zou, Xue-jun; Fu, Guo; Qin, Ben-Gang; Yang, Jian-Tao; Li, Xiang-Ming; Hou, Yi; Qi, Jian; Li, Ping; Liu, Xiao-Lin; Gu, Li-Qiang

    2016-01-01

    OBJECTIVE: To investigate the feasibility of using free gracilis muscle transfer along with the brachialis muscle branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury according to an anatomical study and a case report. METHODS: Thirty formalin-fixed upper extremities from 15 adult cadavers were used in this study. The distance from the point at which the brachialis muscle branch of the musculocutaneous nerve originates to the midpoint of the humeral condylar was measured, as well as the length, diameter, course and branch type of the brachialis muscle branch of the musculocutaneous nerve. An 18-year-old male who sustained an injury to the left brachial plexus underwent free gracilis transfer using the brachialis muscle branch of the musculocutaneous nerve as the donor nerve to restore finger and thumb flexion. Elbow flexion power and hand grip strength were recorded according to British Medical Research Council standards. Postoperative measures of the total active motion of the fingers were obtained monthly. RESULTS: The mean length and diameter of the brachialis muscle branch of the musculocutaneous nerve were 52.66±6.45 and 1.39±0.09 mm, respectively, and three branching types were observed. For the patient, the first gracilis contraction occurred during the 4th month. A noticeable improvement was observed in digit flexion one year later; the muscle power was M4, and the total active motion of the fingers was 209°. CONCLUSIONS: Repairing injury to the lower trunk of the brachial plexus by transferring the brachialis muscle branch of the musculocutaneous nerve to the anterior branch of the obturator nerve using a tension-free direct suture is technically feasible, and the clinical outcome was satisfactory in a single surgical patient. PMID:27166768

  5. Tenderization of Bovine Longissimus Dorsi Muscle using Aqueous Extract from Sarcodon aspratus.

    PubMed

    Kim, Ho-Kyoung; Lee, Sang-Hoon; Ryu, Youn-Chul

    2015-01-01

    The aim of this study was to investigate the effects of aqueous extract from Sarcodon aspratus on tenderization of the bovine longissimus dorsi muscles in comparison with commercial proteolytic enzymes. Furthermore, meat quality and muscle protein degradation were examined. We marinated meat with 2% Sarcodon aspratus extract, 2% kiwi extract, and 0.2% papain. Beef chunks (3×3×3 cm(3)) were marinated with distilled water (control), Sarcodon aspratus extract (T1), kiwi extract (T2) or papain (T3) for 48 h at 4℃. There were no significant differences in muscle pH and lightness between control and treated samples. T1 had the lowest redness (p<0.01), and higher cooking loss and water holding capacity than control and T2 (p<0.05). T1 and T3 exhibited lower shear force values than control (p<0.05). Total protein solubility did not differ significantly between T1 and control, but T1 had less myofibrillar protein solubility than control and T2 (p<0.001). The degradation of myosin heavy chain in T1 and T3 was observed. This degradation of myofibrillar protein suggests that Sarcodon aspratus extract could influence tenderization. These results show that aqueous extract of Sarcodon aspratus extract actively affect the tenderness of the bovine longissimus dorsi muscle. PMID:26761876

  6. Tenderization of Bovine Longissimus Dorsi Muscle using Aqueous Extract from Sarcodon aspratus

    PubMed Central

    Kim, Ho-Kyoung; Lee, Sang-Hoon

    2015-01-01

    The aim of this study was to investigate the effects of aqueous extract from Sarcodon aspratus on tenderization of the bovine longissimus dorsi muscles in comparison with commercial proteolytic enzymes. Furthermore, meat quality and muscle protein degradation were examined. We marinated meat with 2% Sarcodon aspratus extract, 2% kiwi extract, and 0.2% papain. Beef chunks (3×3×3 cm3) were marinated with distilled water (control), Sarcodon aspratus extract (T1), kiwi extract (T2) or papain (T3) for 48 h at 4℃. There were no significant differences in muscle pH and lightness between control and treated samples. T1 had the lowest redness (p<0.01), and higher cooking loss and water holding capacity than control and T2 (p<0.05). T1 and T3 exhibited lower shear force values than control (p<0.05). Total protein solubility did not differ significantly between T1 and control, but T1 had less myofibrillar protein solubility than control and T2 (p<0.001). The degradation of myosin heavy chain in T1 and T3 was observed. This degradation of myofibrillar protein suggests that Sarcodon aspratus extract could influence tenderization. These results show that aqueous extract of Sarcodon aspratus extract actively affect the tenderness of the bovine longissimus dorsi muscle. PMID:26761876

  7. Proteomic changes involved in tenderization of bovine Longissimus dorsi muscle during prolonged ageing.

    PubMed

    Polati, Rita; Menini, Michele; Robotti, Elisa; Millioni, Renato; Marengo, Emilio; Novelli, Enrico; Balzan, Stefania; Cecconi, Daniela

    2012-12-01

    To study proteomic changes involved in tenderization of bovine Longissimus dorsi four Charolaise heifers and four Charolaise bull's muscles were sampled at slaughter after early and long ageing (2-4°C for 12 and 26days respectively). Descriptive sensory evaluation of samples were performed and their tenderness evaluated by Warner-Bratzler shear force test. Protein composition of fresh muscle and of meat aged was analysed by cartesian and polar 2-D electrophoresis. Student's t-test and Ranking-PCA analyses were performed to detect proteomic modulation, and the selected protein spots were identified by nano-HPLC-Chip MS/MS. This research has demonstrated that there are no differences between proteomic patterns of male and females Longissimus dorsi muscle, and that the extension of ageing beyond 12days, did not brings any concrete advantage in terms of sensory quality. Furthermore, the data presented here demonstrated that meat maturation caused changes of the abundance of proteins involved in metabolic, structural, and stress related processes. PMID:22953957

  8. Face transplant: is it feasible in developing countries?

    PubMed

    González-García, Ignacio; Lyra-González, Iván; Medina-Preciado, David; Guerrero-Torres, Alejandro; Ramos-Gallardo, Guillermo; Armendáriz-Borunda, Juan

    2013-01-01

    This article is based on the case of a 28-year-old woman who was involved in a car accident, with diagnosis of polytrauma, loss of left eye, and second- and third-degree burns over the left midface, rendering an exposed area of 8 cm wide and 19 cm length, ranging from glabella to mandible, with skull exposure and loss of left eye.A latissimus dorsi musculocutaneous free flap was transferred into the defect; left eye and nose prosthetics were necessary to restore normal appearance. Excellent results were obtained; reinsertion to patient's normal life and reinstatement of facial appearance were achieved with minimal costs and no postsurgical complications.Analysis of the current situation in developing countries demonstrates that technique and infrastructure do not represent a real challenge to carry on face transplants. However, socioeconomic reality in these societies makes it difficult to establish face transplant as a feasible therapeutic opportunity for the overwhelming majority of patients who are victims of severe facial damage.Therefore, strategies such as latissimus dorsi free flap remains as an excellent therapy to face off our complex facial reconstructive challenges in developing countries such as Mexico. PMID:23348307

  9. [Chest wall reconstruction after resection of malignant chest wall tumors].

    PubMed

    Ayabe, H; Oka, T; Akamine, S; Takahashi, T; Nagayasu, T

    1998-05-01

    Full-thickness chest wall resection is performed for complete removal of primary and secondary malignant chest wall tumors. Large defects of the chest wall after resection must be repaired to maintain adequate ventilation, to protect important intrathoracic structures, and to preserve cosmetic integrity. Various materials have been utilized over the years to replace the rigid chest wall. At present, Marlex mesh and a composite of Marlex mesh and methylmethacrylate are frequently used to reconstruct rigid chest wall defects. On the other hand, to replace the soft part of the chest wall and cover the rigid materials, pedicled muscle flaps, myocutaneous flaps, or omentum are used. Major pedicled flaps include the pectoralis major, rectus abdominis and latissimus dorsi muscular, and musculocutaneous flaps. Techniques are now available to repair any chest wall site, and to restore chest continuity in patients whose tumors are curatively resected. PMID:9656244

  10. Lambeau musculocutané infra hyoidien à palette cutané horizontale pour un angiomyxome agressif de la face interne de la joue

    PubMed Central

    Kettani, Mounir; Touihem, Nabil; Attifi, Hicham; Hmidi, Mounir; Boukhari, Ali; Zalagh, Mohamed; Messary, Abdelhamid

    2014-01-01

    Décrit par Wang en 1986, le lambeau musculocutané infra hyoidien est vascularisé par l'artère thyroïdienne supérieure et comporte les muscles sternohyoïdien, sternothyroïdien et le chef supérieur du muscle Omo hyoïdien. Le prélèvement horizontal de la palette cutanée ne modifie pas la fiabilité du lambeau et permet d’éviter des cicatrices supplémentaires. L'angiomyxome agressif est une tumeur mésenchymateuse développée aux dépens du tissu conjonctif avec un site de prédilection pour les parties molles du périné féminin. Cette tumeur croit progressivement mais n'est pas métastatique. Le traitement indiqué actuellement est l'exérèse chirurgicale large. La tumeur a une tendance à la récidive locale, qui est fréquente, liée à la difficulté d'une exérèse initiale complète. Nous rapportons le cas d'un angiomyxome agressif de la joue chez un patient de 63 ans, qui a été traité par chirurgie avec reconstruction par un lambeau musculocutané infra hyoidien à palette cutanée horizontale. Les aspects cliniques, histologiques et thérapeutiques de la tumeur ont été discutés. PMID:25469203

  11. Comparative proteomic analysis of longissimus dorsi muscle in immuno- and surgically castrated male pigs.

    PubMed

    Shi, Xuebin; Li, Chunbao; Cao, Miaodan; Xu, Xinglian; Zhou, Guanghong; Xiong, Youling L

    2016-05-15

    We compared proteomic profiles of male pig muscles after active immunization against gonadotropin releasing hormone (GnRH) and surgical castration. Longissimus dorsi samples were collected from immunocastration (IC) and surgical castration (SC) groups (n=15 each). Muscle proteins were extracted and then identified by data-independent label-free nano LC-MS/MS. A total of 610 proteins were identified, 50 of which were differentially expressed (P<0.05) between immuno- and surgical castration. Twenty-two of 50 differentially expressed proteins were higher in abundance for IC group and 27 proteins with abundance change folds greater than 1.5 differed with castration methods. Proteins involved in cytoskeleton and immunity were abundant in IC group. Several heat shock proteins (HSPs) and laminins were abundant in SC group. PMID:26776048

  12. Unusual Presentation of Elastofibroma Dorsi on 18F-FDG-PET/CT

    PubMed Central

    Martin, Steve P.; Gariani, Joanna; Tabouret Viaud, Claire

    2016-01-01

    Abstract A 70-year-old male patient underwent an Fluorodeoxyglucose-positron emission tomography-computed tomography for staging of a left parahilar lung neoplasm found during work-up for fatigue and asthenia. The scan demonstrated a hypermetabolic lung tumor, a hypermetabolic pleural effusion and 4 hypermetabolic bilateral soft tissue lesions of the chest wall corresponding to 4 elastofibroma dorsi. Initially, the oncologic disease was classified as stage IV because of the hypermetabolic pleural effusion. A transbronchial biopsy showed squamous cell carcinoma and the cytology of the pleural effusion revealed no malignant cells. As the other 4 hypermetabolic thoracic wall lesions were correctly diagnosed as benign despite their unusual presentation, the patient underwent surgery by left pneumonectomy and mediastinal lymphadenectomy. The lymph node involvement required adjuvant chemotherapy. Diagnostic confidence of the benignity of the hypermetabolic chest wall lesions allowed a more aggressive treatment with a better outcome after a malignant pleural effusion was excluded. PMID:26886641

  13. Changes in meat quality of ovine longissimus dorsi muscle in response to repeated freeze and thaw.

    PubMed

    Qi, Jun; Li, Chunbao; Chen, Yinji; Gao, Feifei; Xu, Xinglian; Zhou, Guanghong

    2012-12-01

    Changes in eating and technological quality attributes of ovine longissimus dorsi muscle during repeated freeze and thaw were investigated. Shear force value, L* value, a* value and fiber diameter decreased (P<0.05) but lipid oxidation increased (P<0.05) with repeated freeze-thaw cycles. Sarcomere length and pH decreased (P<0.05) within the first 10 freeze-thaw cycles but increased (P<0.05) after 5 further cycles. Total and myofibrillar protein solubility, and intramuscular free fatty acids concentration decreased (P<0.05) after 1 cycle of freeze and thaw but then increased (P<0.05) gradually with further cycles. Hardness, chewiness, cohesiveness and resilience of comminuted lamb products decreased (P<0.05) with increased freeze-thaw cycles. And therefore, repeated freeze and thaw should be minimized in terms of meat color for commercial value and water holding capacity for further processing. PMID:22749539

  14. Advances in breast reconstruction after mastectomy.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Faulkner, Brent C; Bill, Timothy J; Lin, Kant Y

    2005-01-01

    Over the past 40 years, surgical reconstruction of the breast following mastectomy has become an important aspect of the cancer patient's rehabilitation process. While the surgical emphasis remains on a cure for the cancer, experience with breast reconstruction has not demonstrated any increased rate of cancer recurrence, even when reconstruction is performed immediately following tumor resection. Advances in surgical technique and biotechnology have made post-mastectomy reconstruction possible. The development of silicone gel and saline-filled implants as well as tissue expanders has revolutionized breast reconstruction. The elucidation of musculocutaneous flaps now provides the surgeon with the ability to transfer adequate quantities of vascularized tissue to reconstruct the surgical defects. The advent of microsurgical techniques has provided an additional reconstructive option, with free tissue transfer allowing the plastic surgeon to move musculocutaneous flaps from remote or distant sites to reconstruct the defect. The option of having the reconstruction immediately following the mastectomy procedure is now available to the patient. When reviewing the anatomy of the breast region, the surgeon must consider the mammary gland, its vascular supply, and its lymphatic system. The surgical techniques involved in reconstruction after mastectomy include the use of breast implants and tissue expansion, as well as reconstruction with autogenous tissues. Reconstruction with autogenous tissues includes the use of latissimus dorsi musculocutaneous flap, transverse rectus abdominus musculocutaneous flap, free flap transfer, as well as nipple-areola reconstruction. Breast reconstruction after mastectomy should be undertaken by a plastic and reconstructive surgeon with considerable training and experience with these diversified procedures. PMID:15777171

  15. Anabolic and Catabolic Signaling Pathways in mouse Longissimus Dorsi after 30-day BION-M1 Spaceflight and Subsequent Recovery

    NASA Astrophysics Data System (ADS)

    Mirzoev, Timur; Blottner, Dieter; Shenkman, Boris; Lomonosova, Yulia; Vilchinskaya, Natalia; Nemirovskaya, Tatiana; Salanova, Michele

    The aim of the study was to analyze some of the key markers regulating anabolic and catabolic processes in mouse m. longissimus dorsi, an important back muscle system for trunk stabilization, following 30-day spaceflight and 8-day recovery period. C57/black mice were divided into 3 groups: 1) Vivarium Control (n=7), 2) Flight (n=5), 3) Recovery (n=5). The experiment was carried out in accordance with the rules of biomedical ethics certified by the Russian Academy of Sciences Committee on Bioethics. Using Western-blotting analysis we determined the content of IRS-1, p-AMPK, MURF-1 and eEF2 in m. longissimus dorsi. The content of IRS-1 in mice m. longissimus dorsi after the 30-day flight did not differ from the control group, however, in the Recovery group IRS-1 level was 80% higher (p<0.05) as compared to Control. Phospho-AMPK content remained unchanged. In the Recovery group there was an increase of eEF2 by 75% compared to the Control (p<0.05). After spaceflight MuRF-1 content was increased more than 2 times compared to the control animals. Thus, our findings showed that the work of the IRS-1 - dependent signaling pathway is only active in the recovery period. The content of the ubiquitin-ligase MURF-1 that takes parts in degrading myosin heavy chain was increased after the spaceflight, however, after 8-day recovery period MURF-1 level did not exceed the control indicating normalization of protein degradation in m. longissimus dorsi. The work was supported by the program of basic research of RAS and Federal Space Program of Russia for the period of 2006-2015.

  16. CT scanning carcases has no detrimental effect on the colour stability of M. longissimus dorsi from beef and sheep.

    PubMed

    Jose, C G; Pethick, D W; Jacob, R H; Gardner, G E

    2009-01-01

    This study investigated the effect of computerised tomography imaging (CT scan), for carcase composition determination, on the oxy/metmyoglobin ratio, hue and L(∗), a(∗) and b(∗) scores of M. longissimus dorsi from both beef and lamb. Beef and lamb M. longissimus dorsi were divided into four proportions and randomly allocated to one of the following treatments; CT 30 day aged; CT fresh; control 30 day aged; control fresh. Colour measurements were made over a 96h retail display period. CT scan had little effect on the colour of both lamb and beef across all colour parameters. There was a small negative affect observed in CT aged samples (P<0.05) for ratio, hue, a(∗) and b(∗) values, however these differences were so small that they are unlikely to impact upon the commercial shelf-life of the product. Other factors such as aging, species and vitamin E concentration play a much greater role in colour stability than CT. Aged M. longissimus dorsi clearly had a worse colour stability than the fresh packaged samples, while beef was a lot more colour stable than lamb. It appears that CT scan for the purpose of body composition determination will not have any commercially relevant impact on colour stability of both beef and lamb. PMID:22063980

  17. Expression of MMP-1, -2, and -8 in longissimus dorsi muscle and their relationship with meat quality traits in cattle.

    PubMed

    Qi, Y X; Zhang, X H; Wang, Y Q; Pang, Y Z; Zhang, Z B; Zhang, T L; Zhang, Z X

    2016-01-01

    The extracellular matrix (ECM) is the major macromolecule in skeletal muscle, which affects meat quality greatly. The remodeling of the ECM is mainly regulated by matrix metalloproteinases (MMPs). The expression patterns of MMP-1, -2, and -8 in longissimus dorsi muscle were explored using quantitative real-time polymerase chain reaction. The results show that the expression of MMP-1, -2, and -8 decreased significantly from 135 days of pregnancy to postnatal 30 months. While the expression of MMP-1, -2, and -8 showed no significant relationships with intramuscular fat contents, MMP-1 and -2 showed significant negative correlations with the shearing force of the longissimus dorsi muscle in cattle. The expression of MMP-1 also showed a significant negative correlation with cooking loss and a positive correlation with water holding capacity. The expression levels of MMP-1 and -2 were usually higher in fat than in skeletal muscle tissue. The expression of MMP-8 was significantly higher in the mammary fat pad and the longissimus dorsi muscle than in all other tissues. This study indicates that the remodeling of the ECM has important effects both on the development of postnatal skeletal muscle and on meat quality. PMID:26985938

  18. Elastofibroma dorsi: a case report with an immunohistochemical and ultrastructural studies.

    PubMed

    Kakudo, Natsuko; Morimoto, Naoki; Ogawa, Takeshi; Hihara, Masakatsu; Koseki, Rina; Kusumoto, Kenji

    2016-03-01

    Elastofibroma is a rare, benign, fibrous tumor formed by the proliferation of characteristic elastic fibers that commonly occurs between the lower margin of the scapula and the ribcage. We undertook a histochemical, immunohistochemical, and ultrastructural study of an elastofibroma dorsi beneath the right scapula of a 77-year-old woman. Tumor cells comprised collagen fiber bundles, numerous elastic fibers, and spindle cells resembling fibroblasts. The elastic and collagen fibers in the tumor were stained positively with Elastic van Gieson and Masson trichrome staining, respectively. Immunostaining showed that the fibroblasts were strongly positive for CD34, positive for vimentin, and weakly positive for α-smooth muscle actin. Ultrastructural observations revealed elastin and microfibrils between numerous irregularly arranged collagen fiber bundles. Signs suggestive of elastin deposition were also evident in the tangled collagen fibers themselves. The fibroblasts contained a large amount of rough endoplasmic reticulum and were surrounded on the outside of cells by microfibrils and collagen fibers. Although fibroblasts may produce large quantities of elastin, microfibrils, and collagen, our findings suggested that the deposition of elastin on collagen fibers may be involved in the formation of abnormal elastic fibers. PMID:26040573

  19. Spectral absorption index in hyperspectral image analysis for predicting moisture contents in pork longissimus dorsi muscles.

    PubMed

    Ma, Ji; Sun, Da-Wen; Pu, Hongbin

    2016-04-15

    Spectral absorption index was proposed to extract the morphological features of the spectral curves in pork meat samples (longissimus dorsi) under the conditions including fresh, frozen-thawed, heated-dehydrated and brined-dehydrated. Savitzky-Golay (SG) smoothing and multiplicative scatter correction (MSC) were used for calibrating both the spectral reflectance and absorbance values. The absorption values were better than the reflectance values and the calibrated spectra by MSC were better than the raw and SG smoothing corrected spectra in building moisture content predictive models. The optimized partial least square regression (PLSR) model attained good results with the MSC calibrated spectral absorption values based on the spectral absorption index features (R(2)P=0.952, RMSEP=1.396) and the optimal wavelengths selected by regression coefficients (R(2)P=0.966, RMSEP=0.855), respectively. The models proved spectral absorption index was promising in spectral analysis to predict moisture content in pork samples using HSI techniques for the first time. PMID:26617026

  20. Transcriptome profiling of Musculus longissimus dorsi in two cattle breeds with different intramuscular fat deposition.

    PubMed

    Albrecht, Elke; Komolka, Katrin; Ponsuksili, Siriluck; Gotoh, Takafumi; Wimmers, Klaus; Maak, Steffen

    2016-03-01

    Intramuscular fat (IMF) deposition is a physiological process in cattle and is highly variable among breeds suggesting a large influence of genetic factors besides environmental factors. In order to elucidate molecular pathways underlying the genetic variation in this trait we compared transcriptomes of Musculus longissimus dorsi (MLD) in steers of Japanese Black and Holstein Friesian cattle breeds fed a high energy diet typically applied in Japan to achieve maximum IMF content. We identified a total of 569 differentially expressed genes (DEGs) with the majority (433) up-regulated in Japanese Black cattle. This breed is characterized by an extreme capacity for IMF deposition. Subsequent Ingenuity Pathway Analysis (IPA) revealed a gene network linking parameters of cell morphology and maintenance with lipid metabolism. The data from this study were deposited in NCBI's Gene Expression Omnibus and are accessible through GEO Series accession number GSE75348. We provide here a dataset which is of potential value to dissect molecular pathways influencing differences in fat deposition under high-energy nutrition. PMID:26981380

  1. Fatty Acid and Transcriptome Profiling of Longissimus Dorsi Muscles between Pig Breeds Differing in Meat Quality

    PubMed Central

    Yu, Kaifan; Shu, Gang; yuan, Fangfang; Zhu, Xiaotong; Gao, Ping; Wang, Songbo; Wang, Lina; Xi, Qianyun; Zhang, Shouquan; Zhang, Yongliang; Li, Yan; Wu, Tongshan; Yuan, Li; Jiang, Qingyan

    2013-01-01

    Fat and lean pig breeds show obvious differences in meat quality characteristics including the fatty acid composition of muscle. However, the molecular mechanism underlying these phenotypes differences remains unknown. This study compared meat quality traits between Lantang (a Chinese indigenous breed) and Landrace (a typical lean breed). The Lantang pigs showed higher L* values and intramuscular fat content, lower pH45min, pH24h and shear force in longissimus dorsi (LD) muscle than Landrace (P < 0.05). Fatty acid analysis demonstrated the lower monounsaturated fatty acids (MUFA) and higher polyunsaturated fatty acids (PUFA) percentage in Lantang LD than that in Landrace LD (P < 0.05). To further identify candidate genes for fatty acid composition, the transcriptome of LD muscle from the two breeds were measured by microarrays. There were 586 transcripts differentially expressed, of which 267 transcripts were highly expressed in Lantang pigs. After the validation by real-time quantitative PCR, 13 genes were determined as candidate genes for fatty acid composition of muscle, including Stearoyl-CoA desaturase (SCD). Then, a SCD over-expression plasmid was transfected into C2C12 cells to reveal the effect of SCD on the fatty acid composition in vitro. The results showed that SCD over-expression significantly increased PUFA proportion, while reduced that of saturated fatty acids (SFA) in C2C12 cells (P < 0.05). In summary, this study compared the differences of fatty acid composition and transcriptome in two breeds differing in meat quality, and further identified the novel role of SCD in the regulation of PUFA deposition. PMID:23355796

  2. Comparison of longissimus dorsi Fatty Acids Profiles in Gansu Black Yak and Chinese Yellow Cattle Steers and Heifers

    PubMed Central

    Zhang, S. G.; Liu, T.; Brown, M. A.; Wu, J. P.

    2015-01-01

    Fatty acid (FA) composition of longissimus dorsi intramuscular fat in Black Yak and Chinese Yellow Cattle were evaluated in 44 Black Yak and 41 Chinese Yellow Cattle of both genders. Interactions of species with gender were observed for total saturated fatty acid (SFA), unsaturated fatty acid (UFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), palmitic acid, stearic acid, oleic acid, linolenic acid, arachidonic acid, EPA, and DHA concentrations, as well as PUFA/SFA ratio in the longissimus dorsi (p<0.05). The SFA percentage was greater in yellow cattle than yak in both genders but the species difference in heifers was greater than in steers (p<0.05). Yak had greater UFA, MUFA and PUFA percentages than yellow cattle in both steers and heifers (p<0.05) but the difference between yak and yellow cattle heifers was greater than yak and yellow cattle steers. The percentages of inolenic acid, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid; and PUFA/SFA were greater in yak than yellow cattle in both steers and heifers (p<0.05). In addition, the ratio of n-6/n-3 PUFA in yak was lesser than in yellow cattle (p<0.05). These results indicated that FA composition generally differed between yak and yellow cattle but the differences were not the same in heifers as compared to steers. Results also suggested that species differences in FA composition tended to favor Black Yak over Chinese Yellow Cattle, indicating that the longissimus dorsi of Black Yak may have a higher nutritive value than that of Chinese Yellow Cattle and potential for development as a desirable natural product. PMID:26761841

  3. Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.

    PubMed

    Cederna, P S; Yates, W R; Chang, P; Cram, A E; Ricciardelli, E J

    1995-11-01

    Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction. PMID:8579262

  4. Extra and Intramuscular Distribution of the Thoracodorsal Nerve with Regard to Nerve Reconstruction Surgeries.

    PubMed

    Malalasekera, Ajith; Beneragama, Thushan; Kanesu, Sivasuganthan; Sahathevan, Vithoosan; Jayasekara, Rohan

    2016-06-01

    Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate length and thickness for nerve coaptation. Aim Our objective was to evaluate the length of the LBTN that could be obtained as a donor nerve, externally and within the muscle. Method Eight (8) cadavers with intact upper limbs and thorax which could be positioned in the anatomical position were selected for the study. Cadavers with dissected axillae, brachial plexus or upper limbs were excluded. The thoracodorsal neurovascular bundle was dissected and the number of branches of the thoracodorsal nerve was identified along with its lateral branch. The lateral branch was dissected up to the latissimus dorsi muscle and further intramuscularly. All lengths were measured using a vernier caliper. Results The mean length of the LBTN, up to its first intramuscular branch, is 8.14 cm (range 5.99-12.29 cm). Beyond this, the intramuscular nerve branched further and was of very minute diameter. The mean unbranched intramuscular length of the nerve is 3.36 cm (range 1.3-7.71 cm) which is 41.28% of the total length of the LBTN. Conclusion A significant proportion of the LBTN is found within the latissimus dorsi muscle. This length could potentially be used for direct nerve coaptation by intrafascicular dissection. PMID:26890860

  5. The Expression of Carnosine and Its Effect on the Antioxidant Capacity of Longissimus dorsi Muscle in Finishing Pigs Exposed to Constant Heat Stress

    PubMed Central

    Yang, Peige; Hao, Yue; Feng, Jinghai; Lin, Hai; Feng, Yuejin; Wu, Xin; Yang, Xin; Gu, Xianhong

    2014-01-01

    The objective of this study was to assess the effects of constant high ambient temperatures on meat quality, antioxidant capacity, and carnosine expression in longissimus dorsi muscle of finishing pigs. Castrated 24 male DLY (crossbreeds between Landrace×Yorkshire sows and Duroc boars) pigs were allocated to one of three treatments: constant ambient temperature at 22°C and ad libitum feeding (CON, n = 8); constant high ambient temperature at 30°C and ad libitum feeding (H30, n = 8); and constant ambient temperature at 22°C and pair-fed with H30 (PF, n = 8). Meat quality, malondialdehyde (MDA) content, antioxidant capacity, carnosine content, and carnosine synthetase (CARNS1) mRNA expression in longissimus dorsi muscle were measured after three weeks. The results revealed that H30 had lower pH24 h, redness at 45 min, and yellowness at 24 h post-mortem (p<0.05), and higher drip loss at 48 h and lightness at 24 h post-mortem (p<0.01). Constant heat stress disrupted the pro-oxidant/antioxidant balance in longissimus dorsi muscle with higher MDA content (p<0.01) and lower antioxidant capacity (p<0.01). Carnosine content and CARNS1 mRNA expression in longissimus dorsi muscle of H30 pigs were significantly decreased (p<0.01) after three weeks at 30°C. In conclusion, constant high ambient temperatures affect meat quality and antioxidant capacity negatively, and the reduction of muscle carnosine content is one of the probable reasons. PMID:25358371

  6. High-affinity glutamate transporter and glutamine synthetase content in longissimus dorsi and adipose tissues of growing Angus steers differs among suckling, weanling, backgrounding, and finishing production stages.

    PubMed

    Matthews, J C; Huang, J; Rentfrow, G

    2016-03-01

    Skeletal muscle and adipose tissues play important roles in maintaining whole-body Glu and N homeostasis by the uptake of Glu and release of Gln. To test the hypothesis that expression of high-affinity Glu transporters (GLAST1, EAAT4, EAAC1, GLT-1) and glutamine synthetase (GS) would increase in longissimus dorsi and adipose tissue of newborn Angus steers randomly assigned ( = 6) to develop through suckling (S; 32 d) and/or weanling (W; 184 d), backgrounding (B; 248 d), and finishing (F; 423 d) production stages. Carcass quality was determined at slaughter to verify shifts in adipose and lean deposition with development. Expression of mRNA (RT-PCR/Southern) and relative protein abundance (Western analysis) were determined in tissue homogenates isolated from longissimus dorsi, and kidney and subcutaneous adipose. The effect of production stage or tissue type on carcass and protein abundance was assessed by 1-way ANOVA using the GLM procedure of SAS, and Fisher's protected LSD procedure was used to separate data means. Neither GLAST1 nor EAAT4 mRNA or protein was detected. EAAC1, GLT-1, and GS mRNA were identified in all tissues, but GLT-1 and GS protein were not detected in kidney or subcutaneous adipose, and GS protein was not detected in longissimus dorsi. The EAAC1 content of subcutaneous ( = 0.06) and kidney ( = 0.02) adipose was 2 times greater in B and F than W steers, whereas GS was 5 times greater ( < 0.07) in B than F steers (B = W > F). For longissimus dorsi, EAAC1 ( < 0.01) and GLT-1 ( < 0.04) content decreased with development (S > W > B = F, S = W > B = F, respectively). Within F steers, EAAC1 and GLT-1 mRNA was expressed by subcutaneous, kidney, omental, mesenchymal, and intramuscular adipose tissues, whereas GS mRNA was expressed by all except for intramuscular. Only EAAC1 protein was detected in any adipose tissue, with EAAC1 content being 104% and 112% greater ( < 0.01) in intramuscular than in kidney or subcutaneous adipose, respectively, and not

  7. Effect of Dietary Supplementation with Processed Sulfur on Meat Quality and Oxidative Stability in Longissimus dorsi of Pigs

    PubMed Central

    Noh, Ha-Young; Kim, Gyeom-Heon; Kim, Soo-Ki

    2015-01-01

    The effects of dietary supplementation of processed sulfur in pigs according to the level provided during the fattening phase were examined. The pigs were divided into three groups: control (CON), non-sulfur fed pigs; T1, 0.1% processed sulfur fed pigs; T2, 0.3% processed sulfur fed pigs. Physicochemical and sensory properties, as well as meat quality and oxidative stability of the Longissimus dorsi muscle were investigated. The feeding of processed sulfur did not affect moisture and protein contents (p>0.05). However, the crude fat content of T2 was significantly decreased compared to CON (p<0.05), while the pH value of T2 was significantly higher than those of both CON and T1 (p<0.05). Cooking loss and expressible drip of T2 were also significantly lower than that of CON (p<0.05). The redness of meat from T1 was significantly higher than both CON and T2 (p<0.01). During storage, lipid oxidation of the meat from sulfur fed pigs (T1 and T2) was inhibited compared to CON. Examination of omega-3 polyunsaturated fatty acids revealed T2 to have significantly higher content than CON (p<0.05). In the sensory test, the juiciness and overall acceptability of T2 recorded higher scores than CON. This study demonstrated that meat from 0.3% processed sulfur fed pigs had improved nutrition and quality, with extended shelf-life. PMID:26761847

  8. Influence of Restricted Grazing Time Systems on Productive Performance and Fatty Acid Composition of Longissimus dorsi in Growing Lambs

    PubMed Central

    Wang, Zhenzhen; Chen, Yong; Luo, Hailing; Liu, Xueliang; Liu, Kun

    2015-01-01

    Fifty 3-month-old male Tan lambs (similar in body weight) were divided into 5 groups to investigate the effects of different restricted pasture grazing times and indoor supplementation on the productive performances and fatty acid composition of the intramuscular fat in growing lambs. The lambs grazed for different periods of time (12 h/d, 8 h/d, 4 h/d, 2 h/d, and 0 h) and received various amounts of supplementary feedings during the 120-day trial. Pasture dry matter intake (DMI), total DMI, average daily gains and the live body weights of the lambs were measured during the experiment. The animals were slaughtered at the end of the study, their carcass traits were measured, and their longissimus dorsi muscles were sampled to analyze the intramuscular fat (IMF) content and fatty acid profiles. The results indicated that the different durations of grazing and supplementary feedings affected the animal performances and the composition of fatty acids. Grazing for 8 h/d or 2 h/d with the corresponding supplementary concentrate resulted in lambs with higher body weights, carcass weights and IMF contents. Lambs with longer grazing times and less concentrate accumulated more healthy fatty acids such as conjugated linoleic acid and n-3 polyunsaturated fatty acid and had higher n-3/n-6 ratios. Overall, a grazing allowance of 8 h/d and the corresponding concentrate was recommended to maintain a high quantity and quality of lamb meat. PMID:26104518

  9. Integrative transcriptomics and proteomics analysis of longissimus dorsi muscles of Canadian double-muscled Large White pigs.

    PubMed

    Liu, Shuqin; Han, Wenpeng; Jiang, Shunyan; Zhao, Chunjiang; Wu, Changxin

    2016-02-10

    Canadian double-muscled Large White pigs are characterized by notable muscle mass, showing high daily gain and lean rate and good meat quality. In order to identify the major genes or proteins involved in muscle hyperplasia and hypertrophy, three pairs of full-sib pigs with extreme muscle mass difference from Canadian Large White were selected as experimental animals at 3 months age. The phenotypic differences of longissimus dorsi muscles (LD) were investigated with microarray and proteomics (2-DE, MALDI-TOF-MS), and results were verified by real-time PCR and western bolting respectively. The gene expressing profiling identified 57 and 260 and 147 differently expressed genes (DEGs) from the three pairs respectively with Bayesian statistics and significant analysis of microarrays (SAM) (p<0.05, q<0.05, fold>2). From the network of these DEGs, some major genes were displayed, such as EGF, PPARG, FN1, SERPINE1, MYC, JUN, involved in Wnt, MAPK and TGF-β signal pathway respectively, which mainly participated in cell differentiation and proliferation. In parallel, proteomics analyses revealed 50 differently expressed protein (DEP) spots with mass spectrum, and 33 spots of them were found annotated, which took part in energy metabolism and the structure and contraction of muscle fiber. In brief, our integrated study provides a good foundation for the further study on the genetic mechanism of the double muscle traits in pigs. PMID:26602029

  10. Dietary influence on the m. longissimus dorsi fatty acid composition of lambs in relation to protein source.

    PubMed

    Turner, T D; Karlsson, L; Mapiye, C; Rolland, D C; Martinsson, K; Dugan, M E R

    2012-08-01

    Dietary lipid effect, as a consequence of protein supplement, on lamb m. longissimus dorsi fatty acid composition was investigated, with emphasis on biohydrogenation intermediates. Crossbred lambs (White Swedish Landrace × Texel) were fed a barley-based diet without (CON) or with protein supplements including peas (PEA), rapeseed cake (RC) or hempseed cake (HC). The HC diet resulted in the highest muscle 22:6n-3 proportion, with the RC diet being similar (P<0.05). Protein supplement did not affect the c9,t11 conjugated linoleic acid (CLA) proportion, however the HC diet increased some minor CLA isomers, including t10,c12 CLA (P<0.05). The t10-18:1 and total trans-18:1 were lowest for the RC diet (P<0.05), likely relating to rumen conditions and precursor availability. The saturated, monounsaturated and branched-chain fatty acids were largely unaffected by protein supplement. In conclusion, feeding the RC diet lowered the t10-18:1 and total trans-18:1 in meat, and modestly increased 22:6n-3 content. The direction of these changes would be beneficial, making the RC diet the preferred protein supplement; however the magnitude of the changes in the present experiment may not be sufficient to have an impact on human health. PMID:22459498

  11. Identification of genes in longissimus dorsi muscle differentially expressed between Wannanhua and Yorkshire pigs using RNA-sequencing.

    PubMed

    Li, X-J; Zhou, J; Liu, L-Q; Qian, K; Wang, C-L

    2016-06-01

    Western commercial pig breeds have been intensively selected, resulting in a sizeable, rapid and efficient accretion of muscle but a reduction in meat quality. When compared with Western commercial pig breeds, Chinese indigenous pig breeds exhibited slower growth rates and reduced lean meat content but superior perceived meat quality. To study the factors that determine meat quality, we examined piglets of one Western commercial breed (Yorkshire) and one Chinese indigenous breed (Wannanhua) and sequenced the longissimus dorsi muscle using RNA-sequencing (RNA-seq). We analyzed their transcriptomes, focusing on identifying candidate genes that may influence porcine muscle growth, meat quality and adipose deposition. Gene Ontology functional enrichment and pathway enrichment analyses identified differentially expressed genes (DEGs) primarily associated with glycolytic metabolism, biological processes of muscle development and signaling pathways related to fatty acid metabolism, growth and carcass traits. This finding suggests that the DEGs may play important roles in determining meat quality traits. Quantitative real-time reverse transcription polymerase chain reaction confirmed the differential expression of 12 selected DEG. This study identified a number of novel candidate genes for porcine meat quality and carcass traits that merit further investigation to elucidate the molecular mechanisms responsible for muscle growth and fat deposition. PMID:27038141

  12. Study on Growth Curves of Longissimus dorsi Muscle Area, Backfat Thickness and Body Conformation for Hanwoo (Korean Native) Cows

    PubMed Central

    Lee, J. H.; Oh, S.-H.; Lee, Y. M.; Kim, Y. S.; Son, H. J.; Jeong, D. J.; Whitley, N. C.; Kim, J. J.

    2014-01-01

    The objective of this study was to estimate the parameters of Gompertz growth curves with the measurements of body conformation, real-time ultrasound longissimus dorsi muscle area (LMA) and backfat thickness (BFT) in Hanwoo cows. The Hanwoo cows (n = 3,373) were born in 97 Hanwoo commercial farms in the 17 cities or counties of Gyeongbuk province, Korea, between 2000 and 2007. A total of 5,504 ultrasound measurements were collected for the cows at the age of 13 to 165 months in 2007 and 2008. Wither height (HW), rump height (HR), the horizontal distance between the top of the hips (WH), and girth of chest (GC) were also measured. Analysis of variance was conducted to investigate variables affecting LMA and BFT. The effect of farm nested in location was included in the statistical model, as well as the effects of HW, HR, WH, and GC as covariates. All of the effects were significant in the analysis of variance for LMA and BFT (p<0.01), except for the HR effect for LMA. The two ultrasound measures and the four body conformation traits were fitted to a Gompertz growth curve function to estimate parameters. Upper asymptotic weights were estimated as 54.0 cm2, 7.67 mm, 125.6 cm, 126.4 cm, 29.3 cm, and 184.1 cm, for LMA, BFT, HW, HR, WH, and GC, respectively. Results of ultrasound measurements showed that Hanwoo cows had smaller LMA and greater BFT than other western cattle breeds, suggesting that care must be taken to select for thick BFT rather than an increase of only beef yield. More ultrasound records per cow are needed to get accurate estimates of growth curve, which, thus, helps producers select animals with high accuracy. PMID:25178367

  13. Gene Expression Patterns Associated with Peroxisome Proliferator-activated Receptor (PPAR) Signaling in the Longissimus dorsi of Hanwoo (Korean Cattle)

    PubMed Central

    Lim, Dajeong; Chai, Han-Ha; Lee, Seung-Hwan; Cho, Yong-Min; Choi, Jung-Woo; Kim, Nam-Kuk

    2015-01-01

    Adipose tissue deposited within muscle fibers, known as intramuscular fat (IMF or marbling), is a major determinant of meat quality and thereby affects its economic value. The biological mechanisms that determine IMF content are therefore of interest. In this study, 48 genes involved in the bovine peroxisome proliferator-activated receptor signaling pathway, which is involved in lipid metabolism, were investigated to identify candidate genes associated with IMF in the longissimus dorsi of Hanwoo (Korean cattle). Ten genes, retinoid X receptor alpha, peroxisome proliferator-activated receptor gamma (PPARG), phospholipid transfer protein, stearoyl-CoA desaturase, nuclear receptor subfamily 1 group H member 3, fatty acid binding protein 3 (FABP3), carnitine palmitoyltransferase II, acyl-Coenzyme A dehydrogenase long chain (ACADL), acyl-Coenzyme A oxidase 2 branched chain, and fatty acid binding protein 4, showed significant effects with regard to IMF and were differentially expressed between the low- and high-marbled groups (p<0.05). Analysis of the gene co-expression network based on Pearson’s correlation coefficients identified 10 up-regulated genes in the high-marbled group that formed a major cluster. Among these genes, the PPARG-FABP4 gene pair exhibited the strongest correlation in the network. Glycerol kinase was found to play a role in mediating activation of the differentially expressed genes. We categorized the 10 significantly differentially expressed genes into the corresponding downstream pathways and investigated the direct interactive relationships among these genes. We suggest that fatty acid oxidation is the major downstream pathway affecting IMF content. The PPARG/RXRA complex triggers activation of target genes involved in fatty acid oxidation resulting in increased triglyceride formation by ATP production. Our findings highlight candidate genes associated with the IMF content of the loin muscle of Korean cattle and provide insight into the

  14. Reconstruction of full thickness chest wall defects.

    PubMed

    Morgan, R F; Edgerton, M T; Wanebo, H J; Daniel, T M; Spotnitz, W D; Kron, I L

    1988-06-01

    Over the last 5 years, 14 patients were treated by wide en bloc resection of chest wall tumors with primary reconstruction. There were nine females and five male patients with an age range of 31-77 years. All patients had a skeletal resection of the chest wall. An average of 3.9 ribs were resected in the patients treated. In three patients a partial sternectomy was carried out in conjunction with the rib resections. Chest wall skeletal defects were reconstructed with Prolene mesh, which was placed under tension. Soft tissue reconstruction utilized selected portions of the latissimus dorsi musculocutaneous territory with fasciocutaneous extensions beyond the muscle itself. Primary healing was obtained in all patients and secondary procedures were not required. The average hospitalization was 23 days. All patients survived the resection and reconstruction and were alive 30 days after operation. In selected patients the preservation of a portion of the innervated muscle in situ or the transfer of the muscle with the preservation of its resting length has maintained the majority of the muscle function. PMID:3389939

  15. The Type of Breast Reconstruction May Not Influence Patient Satisfaction in the Chinese Population: A Single Institutional Experience

    PubMed Central

    Chen, Jiaying; Chen, Ying; Hu, Zhen; Liu, Guangyu; Shen, Zhenzhou; Shao, Zhimin; Wu, Jiong

    2015-01-01

    Background The goal of this study was to evaluate patient satisfaction with four common types of breast reconstruction performed at our institution: latissimus dorsi myocutaneous (LDM) flap reconstruction with or without implants, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, and free deep inferior epigastric perforator (DIEP) flap reconstruction. Methods A custom survey consisting of questions that assessed general and aesthetic satisfaction was sent to patients who had undergone breast reconstruction in the last 5 years. The clinical data and details of the surgery were also collected from the patients who returned the surveys. We compared satisfaction rates across the four breast reconstruction types and analyzed the effects of various factors on overall general and aesthetic satisfaction rates using a binary logistic regression model. Result A total of 207 (72%) patients completed the questionnaires. Overall, significant differences in general and aesthetic satisfaction among the four procedures were not observed. A multivariate analysis revealed that the factor “complications” (p = 0.001) played a significant role in general satisfaction and that the factors “> 2 years since reconstruction” (p = 0.043) and “age > 35 years” (p = 0.05) played significant roles in overall aesthetic satisfaction. Conclusion The present study demonstrated that the type of breast reconstruction might not influence satisfaction in Chinese patients. PMID:26562294

  16. Reconstruction of full thickness chest wall defects.

    PubMed Central

    Morgan, R F; Edgerton, M T; Wanebo, H J; Daniel, T M; Spotnitz, W D; Kron, I L

    1988-01-01

    Over the last 5 years, 14 patients were treated by wide en bloc resection of chest wall tumors with primary reconstruction. There were nine females and five male patients with an age range of 31-77 years. All patients had a skeletal resection of the chest wall. An average of 3.9 ribs were resected in the patients treated. In three patients a partial sternectomy was carried out in conjunction with the rib resections. Chest wall skeletal defects were reconstructed with Prolene mesh, which was placed under tension. Soft tissue reconstruction utilized selected portions of the latissimus dorsi musculocutaneous territory with fasciocutaneous extensions beyond the muscle itself. Primary healing was obtained in all patients and secondary procedures were not required. The average hospitalization was 23 days. All patients survived the resection and reconstruction and were alive 30 days after operation. In selected patients the preservation of a portion of the innervated muscle in situ or the transfer of the muscle with the preservation of its resting length has maintained the majority of the muscle function. Images Fig. 3A. Fig. 3C. Fig. 3D. Fig. 4A. Fig. 4C. Fig. 4D. Fig. 4E. Fig. 5A. Fig. 5B. Fig. 5D. Fig. 6A. Fig. 6C. Fig. 6D. Fig. 6E. Fig. 6F. Fig. 6G. Fig. 6H. PMID:3389939

  17. Extended thoracodorsal artery perforator flap for breast reconstruction.

    PubMed

    Angrigiani, Claudio; Rancati, Alberto; Escudero, Ezequiel; Artero, Guillermo

    2015-12-01

    A total of 45 patients underwent partial or total autologous breast reconstruction after skin-sparing mastectomy, skin-reducing mastectomy, and quadrantectomy using a thoracodorsal artery perforator (TDAP) flap. The detailed surgical technique with its variations is explained in this report. The propeller, flip-over, conventional perforator, and muscle-sparing flaps have been described and evaluated. The flaps were partially or completely de-epithelialized. The conventional TDAP can be enlarged or "extended" as the traditional latissimus dorsi musculocutaneous (LD-MC) flap by incorporating the superior and inferior fat compartments. It can be referred to as the "extended TDAP flap". This technique augments the flap volume. In addition, this flap can serve as a scaffold for lipofilling to obtain autologous breast reconstruction in medium to large cases. There were two complete failures due to technical errors during flap elevation. Distal partial tissue suffering was observed in four flaps. These flaps were longer than usual; they reached the midline of the back. It is advisable to discard the distal medial quarter of the flap when it is designed up to the midline to avoid steatonecrosis or fibrosis. A retrospective analysis of the 39 flaps that survived completely revealed a satisfactory result in 82% of the cases. The main disadvantage of this procedure is the final scar. The TDAP flap is a reliable and safe method for partial or total breast autologous reconstruction. PMID:26645006

  18. The inferior mesenteric vessels as recipients when performing free tissue transfer for pelvic defects following abdomino-perineal resection. A novel technique and review of intra-peritoneal recipient vessel options for microvascular transfer.

    PubMed

    Petrie, Nicola C; Chan, James K K; Chave, Helen; McGuiness, Caroline N

    2010-12-01

    Successful microvascular transfer of tissue is dependent upon suitable vessels not only of the donor tissue but also at the recipient site. Congenital deformities, previous surgery, infection or irradiation at the recipient site may render vessels less suitable for this purpose. Under such circumstances it becomes desirable to identify suitable recipient vessels remote to the compromised area. In cases where external beam radiotherapy has been delivered, the superficial surface area damaged can be rather extensive precluding the use of even the longest of flap pedicles--a problem potentially addressed by searching for recipient vessels deep to the tissue planes affected. We report one such case where the inferior mesenteric vessels were used as recipient vessels for the microvascular transfer of a free Latissimus Dorsi musculocutaneous flap to reconstruct an extensive perineal defect following abdomino-perineal resection where the vessels would otherwise serve no purpose. Whilst a limited number of intra-peritoneal vessels have previously been reported as recipient vessels for free flap surgery there has not been, to our knowledge, any report of utilising the inferior mesenteric artery (Inf Mes A). Whilst based on a single case report, this article examines the literature describing microvascular transfer of tissue to compromised recipient sites and it reviews previously reported recipient vessel options available when reconstructing the perineum, abdominal wall or trunk with particular emphasis on intra-peritoneal options. PMID:20378437

  19. Gene expression profile of Musculus longissimus dorsi in bulls of a Charolais × Holstein F2-cross with divergent intramuscular fat content

    PubMed Central

    Komolka, Katrin; Ponsuksili, Siriluck; Albrecht, Elke; Kühn, Christa; Wimmers, Klaus; Maak, Steffen

    2015-01-01

    Transcriptomes of Musculus longissimus dorsi (MLD) were compared between bulls from a F2-cross derived from Charolais and Holstein Friesian. Two groups of 10 bulls were selected which differed significantly in intramuscular fat (IMF) deposition despite standardized husbandry and feeding conditions and identical sires in both groups. Consequently, genetic factors underlying the different capability of IMF deposition should be identified. A total of 32 differentially expressed genes (DEGs) were found of which 11 were up-regulated and 21 were down-regulated in the high IMF group. Ingenuity Pathway Analysis (IPA) identified a gene network comprising DEGs with functions in carbohydrate metabolism, lipid metabolism and molecular transport. The data from this study were deposited in NCBI's Gene Expression Omnibus and are accessible through GEO Series accession number GSE75347. We provide here a dataset which is of potential value to dissect molecular pathways influencing differences in IMF deposition in crossbred cattle with standardized genetic background. PMID:26981388

  20. Colour, composition and quality of M. longissimus dorsi and M. extensor carpi radialis of steers housed on straw or concrete slats or accommodated outdoors on wood-chips.

    PubMed

    Dunne, P G; Rogalski, J; Moreno, T; Monahan, F J; French, P; Moloney, A P

    2008-08-01

    Forty-five Charolais crossbred steers were offered a common diet and accommodated either outside on wood-chips (OWP, 18m(2)/head) or in a naturally-ventilated building in slatted-floor pens (SLA, 2.5m(2)/500kg bodyweight) or in straw-bedded pens (STR, 4m(2)/head) for 132 days. Carcass weight averaged 351, 362, and 372 (sed 6.63)kg (P<0.05), for SLA, STR and OWP, respectively. Accommodation system did not affect the colour, drip loss, shear force or composition of Musculus longissimus dorsi (LD) or Musculus extensor carpi radialis (ECR) muscles or the sensory characteristics of LD. The ultimate pH of ECR was highest (P<0.05) for OWP steers, while their LD was darker at 2 days post-mortem than LD from STR steers. It is concluded that accommodating cattle on OWP had a minor transient effect on beef colour and no impact on beef composition or eating quality. PMID:22063032

  1. Evaluation of the Activities of Antioxidant Enzyme and Lysosomal Enzymes of the Longissimus dorsi Muscle from Hanwoo (Korean Cattle) in Various Freezing Conditions

    PubMed Central

    2014-01-01

    This study was conducted to evaluate the activities of antioxidant enzyme (glutathione peroxidase (GSH-Px)) and lysosomal enzymes (alpha-glucopyranosidase (AGP) and beta-N-acetyl-glucosaminidase (BNAG)) of the longissimus dorsi (LD) muscle from Hanwoo (Korean cattle) in three freezing conditions. Following freezing at -20, -60, and -196℃ (liquid nitrogen), LD samples (48 h post-slaughter) were treated as follows: 1) freezing for 14 d, 2) 1 to 4 freeze-thaw cycles (2 d of freezing in each cycle), and 3) refrigeration (4℃) for 7 d after 7 d of freezing. The control was the fresh (non-frozen) LD. Freezing treatment at all temperatures significantly (p<0.05) increased the activities of GSH-Px, AGP, and BNAG. The -196 ℃ freezing had similar effects to the -20℃ and -60℃ freezing. Higher (p<0.05) enzymes activities were sustained in frozen LD even after 4 freeze-thaw cycles and even for 7 d of refrigeration after freezing. These findings suggest that freezing has remarkable effects on the activities of antioxidant enzyme and lysosomal enzymes of Hanwoo beef in any condition. PMID:26761669

  2. Evaluation of the Activities of Antioxidant Enzyme and Lysosomal Enzymes of the Longissimus dorsi Muscle from Hanwoo (Korean Cattle) in Various Freezing Conditions.

    PubMed

    Kang, Sun Moon; Kang, Geunho; Seong, Pil-Nam; Park, Beomyoung; Kim, Donghun; Cho, Soohyun

    2014-01-01

    This study was conducted to evaluate the activities of antioxidant enzyme (glutathione peroxidase (GSH-Px)) and lysosomal enzymes (alpha-glucopyranosidase (AGP) and beta-N-acetyl-glucosaminidase (BNAG)) of the longissimus dorsi (LD) muscle from Hanwoo (Korean cattle) in three freezing conditions. Following freezing at -20, -60, and -196℃ (liquid nitrogen), LD samples (48 h post-slaughter) were treated as follows: 1) freezing for 14 d, 2) 1 to 4 freeze-thaw cycles (2 d of freezing in each cycle), and 3) refrigeration (4℃) for 7 d after 7 d of freezing. The control was the fresh (non-frozen) LD. Freezing treatment at all temperatures significantly (p<0.05) increased the activities of GSH-Px, AGP, and BNAG. The -196 ℃ freezing had similar effects to the -20℃ and -60℃ freezing. Higher (p<0.05) enzymes activities were sustained in frozen LD even after 4 freeze-thaw cycles and even for 7 d of refrigeration after freezing. These findings suggest that freezing has remarkable effects on the activities of antioxidant enzyme and lysosomal enzymes of Hanwoo beef in any condition. PMID:26761669

  3. An Optimized Trichloroacetic Acid/Acetone Precipitation Method for Two-Dimensional Gel Electrophoresis Analysis of Qinchuan Cattle Longissimus Dorsi Muscle Containing High Proportion of Marbling

    PubMed Central

    Hao, Ruijie; Adoligbe, Camus; Jiang, Bijie; Zhao, Xianlin; Gui, Linsheng; Qu, Kaixing; Wu, Sen; Zan, Linsen

    2015-01-01

    Longissimus dorsi muscle (LD) proteomics provides a novel opportunity to reveal the molecular mechanism behind intramuscular fat deposition. Unfortunately, the vast amounts of lipids and nucleic acids in this tissue hampered LD proteomics analysis. Trichloroacetic acid (TCA)/acetone precipitation is a widely used method to remove contaminants from protein samples. However, the high speed centrifugation employed in this method produces hard precipitates, which restrict contaminant elimination and protein re-dissolution. To address the problem, the centrifugation precipitates were first grinded with a glass tissue grinder and then washed with 90% acetone (TCA/acetone-G-W) in the present study. According to our result, the treatment for solid precipitate facilitated non-protein contaminant removal and protein re-dissolution, ultimately improving two-dimensional gel electrophoresis (2-DE) analysis. Additionally, we also evaluated the effect of sample drying on 2-DE profile as well as protein yield. It was found that 30 min air-drying did not result in significant protein loss, but reduced horizontal streaking and smearing on 2-DE gel compared to 10 min. In summary, we developed an optimized TCA/acetone precipitation method for protein extraction of LD, in which the modifications improved the effectiveness of TCA/acetone method. PMID:25893432

  4. Fatty Acid Profiles and Stearoyl-CoA Desaturase Gene Expression in Longissimus dorsi Muscle of Growing Lambs Influenced by Addition of Tea Saponins and Soybean Oil

    PubMed Central

    Mao, H. L.; Wang, J. K.; Lin, J.; Liu, J. X.

    2012-01-01

    This study was conducted to determine the effects of dietary addition of tea saponins (TS) and soybean oil (SO) on fatty acid profile and gene expression of stearoyl-CoA desaturase (SCD) in longissimus dorsi (LD) muscle of growing lambs. Thirty-two Huzhou lambs were assigned to four dietary treatments in a 2×2 factorial arrangement with main effects of TS (0 or 3 g/d) and SO (0 or 30 g/kg of diet DM). The diet without additives was considered as NTNS (no TS or SO). After a feeding trial for 60 d, four lambs of each treatment were slaughtered to collect the samples of LD muscle. Percentage of trans-11 vaccenic acid was enhanced (p<0.05) in muscle of lambs fed TS and SO. The proportion of total conjugated linoleic acid (CLA) was increased (p<0.05) by SO, but decreased (p<0.05) by TS in LD muscle. The percentage of total saturated fatty acids in muscle was decreased (p<0.05) by addition of TS and SO, while addition of SO increased (p<0.05) the percentage of total polyunsaturated fatty acids. The ratio of cis-9, trans-11 CLA to tran-11 vaccenic acid was decreased (p<0.05) by TS, but increased (p<0.05) by SO. The same effects were observed in SCD mRNA expression. From these results it is indicated that including TS and SO in the diet of growing lambs affect the fatty acid profiles of LD muscle and that the proportion of cis-9, trans-11 CLA in the muscle influenced by TS and SO may be related to the SCD gene expression. PMID:25049609

  5. Effects of live weight at slaughter on fatty acid composition of Longissimus dorsi and Biceps femoris muscles of indigenous Lori goat.

    PubMed

    Kiani, Ali; Fallah, Rozbeh

    2016-01-01

    This study aimed to determine fatty acid (FA) composition of Longissimus dorsi (LD) and Biceps femoris (BF) muscles of an Iranian indigenous goat (Lori goat) at two live weights at slaughter (LWS). Twenty male Lori goats (5 to 8 months) raised in nomadic system were slaughtered either at LWS less than 20 kg (light) or LWS more than 30 kg (heavy). Carcass dressing and FA composition of intramuscular fat of LD and BF muscles as well as cholesterol content of LD muscle were determined. Heavy goats had higher dressing percentage than light ones (42.7vs.39.3%, P < 0.01). The predominant n-6 FA were C18:2, and C20:4 while C22:5, C20:5, C18:3, C20:3, and C22:6 were the n-3 FA detected. Polyunsaturated and saturated FA contributed 22% and 36% of the total FA in both muscles, respectively. Palmitic acid (C16:0) of LD was higher in heavy compared to the light goats (P < 0.05). BF muscle had higher α-linolenic acid (18:3 n-3) as percentage than LD muscle (P < 0.05). The ratio of n-6/n-3 FA and polyunsaturated/saturated FA were 3.8 and 0.6, respectively. Cholesterol content of LD muscle of light and heavy goats were 71.2 ± 16 and 59.5 ± 14 mg per 100 g fresh meat respectively. In conclusion, desirable PUFA/SFA (0.6) and n-3/n-6 ratio (3.8) found in indigenous Lori goat propose healthy source of lean meat for the consumers. PMID:26431711

  6. Comparisons of different myosin heavy chain types, AMPK, and PGC-1α gene expression in the longissimus dorsi muscles in Bama Xiang and Landrace pigs.

    PubMed

    Huang, Y N; Ao, Q W; Jiang, Q Y; Guo, Y F; Lan, G Q; Jiang, H S

    2016-01-01

    Bama Xiang and Landrace pigs are the local fatty and lean breeds, respectively, in China. We compared differences in carcass traits, meat quality traits, and myosin heavy chain (MyHC) types in the longissimus dorsi muscles between Bama Xiang and Landrace pigs. This was done in pigs of the same age, using real-time PCR, to investigate the relationship between MyHC fiber types and carcass characteristics, meat quality traits, and the key factors regulating muscle fiber type. Bama Xiang pigs exhibited smaller size and slower growth than Landrace pigs (P < 0.01). We found that the superior meat quality, especially the high intramuscular fat (IMF) content in Bama Xiang pig, was related to elevated type I oxidative muscle fiber content (P < 0.01). In contrast, Landrace pig muscle had a higher glycolytic type IIb muscle fiber content (P < 0.01). MyHC I gene expression was significantly positively correlated with backfat thickness and IMF content (P < 0.01). MyHC IIb was significantly negatively correlated with IMF content (P < 0.05), and positively correlated with carcass yield (P < 0.05). AMP-activated protein kinase and peroxisome proliferator-activated receptor-g coactivator-1a are suggested to be the two key factors regulating muscle fiber type in pigs. Our results indicate that muscle fiber composition is one of the key differences leading to the differences of meat quality between Bama Xiang and Landrace pigs. These results may provide a theoretical basis for further studies of the molecular mechanism underlying the excellent meat quality of the Bama Xiang pig. PMID:27421023

  7. Association of DNA Methylation Levels with Tissue-specific Expression of Adipogenic and Lipogenic Genes in Longissimus dorsi Muscle of Korean Cattle

    PubMed Central

    Baik, M.; Vu, T. T. T.; Piao, M. Y.; Kang, H. J.

    2014-01-01

    Epigenetic factors, such as DNA methylation status, may regulate adipogenesis and lipogenesis, thus affecting intramuscular fat (IMF) deposition in longissimus dorsi muscle (LM) of beef cattle. In Korean cattle steers, the LM consists mainly of muscle tissue. However, the LM tissue also contains IMF. We compared the gene expression levels between the IMF and muscle portions of the LM after tissue separation. Real-time polymerase chain reaction analysis showed that the mRNA levels of both adipogenic peroxisome proliferator-activated receptor gamma isoform 1 (PPARG1) and lipogenic fatty acid binding protein 4 (FABP4) were higher (p<0.01) in the IMF than in the muscle portion of the LM. We determined DNA methylation levels of regulatory regions of the PPARG1 and FABP4 genes by pyrosequencing of genomic DNA. DNA methylation levels of two of three CpG sites in the PPARG1 gene promoter region were lower (p<0.05) in the IMF than in the muscle portion of the LM. DNA methylation levels of all five CpG sites from the FABP4 gene promoter region were also lower (p<0.001) in the IMF than in the muscle portion. Thus, mRNA levels of both PPARG1 and FABP4 genes were inversely correlated with DNA methylation levels in regulatory regions of CpG sites of the corresponding gene. Our findings suggest that DNA methylation status regulates tissue-specific expression of adipogenic and lipogenic genes in the IMF and muscle portions of LM tissue in Korean cattle. PMID:25178302

  8. Differential Expression of PPARγ, FASN, and ACADM Genes in Various Adipose Tissues and Longissimus dorsi Muscle from Yanbian Yellow Cattle and Yan Yellow Cattle

    PubMed Central

    Ji, Shuang; Yang, Runjun; Lu, Chunyan; Qiu, Zhengyan; Yan, Changguo; Zhao, Zhihui

    2014-01-01

    The objective of this study was to investigate the correlation between cattle breeds and deposit of adipose tissues in different positions and the gene expressions of peroxisome proliferator-activated receptor gamma (PPARγ), fatty acid synthase (FASN), and Acyl-CoA dehydrogenase (ACADM), which are associated with lipid metabolism and are valuable for understanding the physiology in fat depot and meat quality. Yanbian yellow cattle and Yan yellow cattle reared under the same conditions display different fat proportions in the carcass. To understand this difference, the expression of PPARγ, FASN, and ACADM in different adipose tissues and longissimus dorsi muscle (LD) in these two breeds were analyzed using the Real-time quantitative polymerase chain reaction method (qRT-PCR). The result showed that PPARγ gene expression was significantly higher in adipose tissue than in LD in both breeds. PPARγ expression was also higher in abdominal fat, in perirenal fat than in the subcutaneous fat (p<0.05) in Yanbian yellow cattle, and was significantly higher in subcutaneous fat in Yan yellow cattle than that in Yanbian yellow cattle. On the other hand, FASN mRNA expression levels in subcutaneous fat and abdominal fat in Yan yellow cattle were significantly higher than that in Yanbian yellow cattle. Interestingly, ACADM gene shows greater fold changes in LD than in adipose tissues in Yan yellow cattle. Furthermore, the expressions of these three genes in lung, colon, kidney, liver and heart of Yanbian yellow cattle and Yan yellow cattle were also investigated. The results showed that the highest expression levels of PPARγ and FASN genes were detected in the lung in both breeds. The expression of ACADM gene in kidney and liver were higher than that in other organs in Yanbian yellow cattle, the comparison was not statistically significant in Yan yellow cattle. PMID:25049920

  9. Effects of supplementation of rumen-protected choline on growth performance, meat quality and gene expression in longissimus dorsi muscle of lambs.

    PubMed

    Li, Huawei; Wang, Hongrong; Yu, Lihuai; Wang, Mengzhi; Liu, Shimin; Sun, Lisha; Chen, Qing

    2015-01-01

    This study determined the effects of rumen-protected choline (RPC) on growth performance, blood lipids, meat quality and expression of genes involved in fatty-acid metabolism in young lambs. A total of 24 Dorper × Hu lambs (about 20 kg body weight) were kept in individual pens and fed diets with 0%, 0.25%, 0.50% and 0.75% RPC for 60 d. Supplementation of 0.25% RPC increased average daily gain of lambs, whereas treatments had no significant effect on feed intake. The pH values of meat were increased at 0.25% RPC and both, dripping loss and shear force of meat, were significantly decreased in RPC-supplemented lambs. No significant changes were observed for dressing percentage and intramuscular fat. RPC supplementations had no significant effect on the concentrations of triglycerides and cholesterols in serum, but the concentration of high-density lipoprotein was decreased at 0.50% RPC and that of low-density lipoprotein was increased at 0.75% RPC. In m. longissimus dorsi, the expressions of cluster of differentiation 36 (CD36), acetyl-CoA carboxylase (ACC) and fatty-acid synthase (FASN) genes were increased at 0.25% RPC. Supplementation of 0.75% RPC increased the expressions of lipoprotein lipase (LPL) and FASN genes, decreased the expression of ACC gene and had no effect on CD36 gene. The results of this study showed that supplementation of 0.25% RPC could promote growth performance of lambs and improve meat quality. This may be mediated by effects on blood lipid profiles and the metabolism of fatty acids in skeleton muscles. However, the beneficial effects of 0.25% RPC supplementation need to be validated with a larger number of animals. Higher doses, particularly 0.75% RPC, showed adverse effects on live weight gain and ACC expression. PMID:26305383

  10. Δ(9) desaturase protein expression and fatty acid composition of longissimus dorsi muscle in lambs fed green herbage or concentrate with or without added tannins.

    PubMed

    Vasta, Valentina; Priolo, Alessandro; Scerra, Manuel; Hallett, Katharine G; Wood, Jeffrey D; Doran, Olena

    2009-07-01

    The aims of this study were to investigate the effect of feeding system and of supplementation of tannins (8.93% DM) on the relationship between intramuscular fat content, fatty acid composition and Δ(9)desaturase (Δ(9)d) protein expression in longissimus dorsi muscle of lamb. Twenty-eight Comisana lambs (age 45days) were fed either vetch (Vicia sativa) or concentrate. The herbage diet was (i) lower in saturated fatty acids (especially in C16:0), C18:1 n-9 and in C18:2 n-6; (ii) higher in C16:1 and C18:3 n-3 when compared to concentrate. Within each feeding system the lambs were divided into two sub-groups, one of which received the diet without tannins supplementation, and the other was fed the diets supplemented with the tannins from Quebracho (Schinopsis lorentzii). The animals were slaughtered at age 105days. The concentrate feeding system increased (p<0.01) the total intramuscular fat content and the amount of SFA, MUFA and n-6 PUFA and decreased the level of n-3 PUFA (p=0.05) when compared to the vetch-fed animals but did not affect Δ(9) desaturase protein expression. There was no correlation between Δ(9)d protein expression and total intramuscular fatty acids, CLA and MUFA level. It was suggested that in ruminants, in contrast to monogastric animals, Δ(9)d expression does not play the key role in intramuscular fatty acids formation. Tannins supplementation resulted in higher (p<0.05) muscle levels of transC18:1 and C18:2 n-6. It has also increased Δ(9)d expression in the case of herbage-based diet but not in the case of concentrate-based diet. The mechanism of tannins action on the enzyme expression needs to be elucidated. PMID:20416712

  11. Neurovascular free-muscle transfer for the treatment of established facial paralysis following ablative surgery in the parotid region.

    PubMed

    Takushima, Akihiko; Harii, Kiyonori; Asato, Hirotaka; Ueda, Kazuki; Yamada, Atsushi

    2004-05-01

    Neurovascular free-muscle transfer for facial reanimation was performed as a secondary reconstructive procedure for 45 patients with facial paralysis resulting from ablative surgery in the parotid region. This intervention differs from neurovascular free-muscle transfer for treatment of established facial paralysis resulting from conditions such as congenital dysfunction, unresolved Bell palsy, Hunt syndrome, or intracranial morbidity, with difficulties including selection of recipient vessels and nerves, and requirements for soft-tissue augmentation. This article describes the authors' operative procedure for neurovascular free-muscle transfer after ablative surgery in the parotid region. Gracilis muscle (n = 24) or latissimus dorsi muscle (n = 21) was used for transfer. With gracilis transfer, recipient vessels comprised the superficial temporal vessels in 12 patients and the facial vessels in 12. For latissimus dorsi transfer, recipient vessels comprised the facial vessels in 16 patients and the superior thyroid artery and superior thyroid or internal jugular vein in four. Facial vessels on the contralateral side were used with interpositional graft of radial vessels in the remaining patient with latissimus dorsi transfer. Cross-face nerve grafting was performed before muscle transfer in 22 patients undergoing gracilis transfer. In the remaining two gracilis patients, the ipsilateral facial nerve stump was used as the primary recipient nerve. Dermal fat flap overlying the gracilis muscle was used for cheek augmentation in one patient. In the other 23 patients, only the gracilis muscle was used. With latissimus dorsi transfer, the ipsilateral facial nerve stump was used as the recipient nerve in three patients, and a cross-face nerve graft was selected as the recipient nerve in six. The contralateral facial nerve was selected as the recipient nerve in 12 patients, and a thoracodorsal nerve from the latissimus dorsi muscle segment was crossed through the upper lip

  12. [Synovial cyst of chest wall; report of a case].

    PubMed

    Chujo, Masao; Anami, Kentaro; Miura, Takashi

    2014-12-01

    A 55-year-old male taxi driver visited our hospital because of a left dorsal tumor. The tumor was palpated at the inferior angle of the left scapula with tenderness. Computed tomography (CT) revealed a homogeneous 5-cm mass with capsule between the latissimus dorsi muscle and rib. T2-weighted magnetic resonance imaging( MRI) demonstrated the tumor with high intensity. The latissimus dorsi muscle was divided and separated off from the tumor and the lower layer;then, an applied wound retractor (Alexis) was placed under the lower layer of the latissimus dorsi muscle and the operative field was developed. Next, the anterior serratus and greater rhomboid muscles were separated off from the tumor and the lower layer, the Alexis was placed under the lower layer of those muscles. All muscles were preserved and the tumor was removed. The tumor was 56×32 mm in size. The histological diagnosis was synovial cyst. PMID:25434552

  13. Effects of Gas Composition in the Modified Atmosphere Packaging on the Shelf-life of Longissimus dorsi of Korean Native Black Pigs-Duroc Crossbred during Refrigerated Storage

    PubMed Central

    Muhlisin; Panjono; Kim, Dong Soo; Song, Yeong Rae; Lee, Sung-Jin; Lee, Jeong Koo; Lee, Sung Ki

    2014-01-01

    This study was conducted to observe the effects of gas composition in modified atmosphere packaging (MAP) on the shelf-life of Longissimus dorsi of Korean Native Black Pigs-Duroc Crossbred (KNP×D) during refrigerated storage. Muscle sample was obtained from the left side of carcass of seven months old of KNP×D barrow. The sample was sliced into 1 cm in thickness, placed on trays (two slices/tray) and filled with different gas composition, i.e. 0:20:80/O2:CO2:N2 (MAP1), 30:20:50/O2:CO2:N2 (MAP2) and 70:20:10/O2:CO2:N2 (MAP3). Other slices of sample were vacuum packed (VP) as a control. All packs were stored at 5±1°C. At 12 d of storage, pH value of MAP2 and MAP3 were higher (p<0.05) than that of MAP1 and pH value of MAP1 was higher (p<0.05) than that of VP. At 6 d of storage, redness (a*) value of MAP2 and MAP3 were higher (p<0.05) than that of VP and MAP1 and, at 9 and 12 d of storage, redness value of MAP3 was higher (p<0.05) than that of VP, MAP1, and MAP2. At 3, 6, 9, and 12 d of storage, the 2-thiobarbituric acid reactive substances (TBARS) value of MAP3 was higher than that of MAP2 and TBARS value of MAP2 was higher than that of VP and MAP1. At 3, 6, 9, and 12 d of storage, volatile basic nitrogen values of MAP2 and MAP3 were higher (p<0.05) than those of VP and MAP1. At 3 d of storage, total aerobic plate counts of MAP2 and MAP3 were higher (p<0.05) than those of VP and MAP1 and, at 6 d of storage, total aerobic plate counts of MAP3 was higher (p<0.05) than that of MAP1 and MAP2. However, there was no significant different total aerobic plate count among MAP1, MAP2, and MAP3 at 9 and 12 d of storage. There was no significant different total anaerobic plate count among MAP1, MAP2, and MAP3 during storage. It is concluded that the MAP containing 30:20:50/O2:CO2:N2 gas composition (MAP2) might be ideal for better meat quality for KNP×D meat. PMID:25083110

  14. [Large abdominal wall reconstruction by free flap after recurrence of a dermatofibrosarcoma protuberans].

    PubMed

    Le Fourn, B; Lejeune, F; Sartre, J Y; Loirat, Y; Pannier, M

    1996-12-01

    Based on a case of recurrence of a dermatofibrosarcoma protuberans of the abdominal wall, the authors discuss the need for initial wide resection of this type of skin tumour and the possibilities of repair of extensive full thickness defects of the abdominal wall by means of a latissimus dorsi myocutaneous free flap. PMID:9768175

  15. The effect of chilled conditioning at 4°C on selected water and lipid-soluble flavor precursors in Bison bison longissimus dorsi muscle and their impact on sensory characteristics.

    PubMed

    Williamson, Jennifer; Ryland, Donna; Suh, Miyoung; Aliani, Michel

    2014-01-01

    Water and lipid-soluble flavor precursors were monitored using chromatography methods in the longissimus dorsi (LD) muscle of six grain-fed Bison bison, stored at 4°C for 2, 4, 8, 15 and 21 days in order to investigate their potential impact on sensory attributes of cooked bison meat. While pH and lipid-soluble compounds remained mostly unchanged, several changes in water-soluble compounds were observed. The breakdown of inosine-5'-monophosphate (IMP) led to increases in inosine, hypoxanthine and ribose (7-fold). Non-polar amino acids including valine, leucine and phenylalanine showed the most significant increases over 21 days. Trained panelists (n=8) found a significant increase at day 15 in vinegary/sour aroma, tenderness and juiciness, while chewiness and connective tissue significantly decreased. Although, most flavor attributes were undetectable, partial least squares (PLS) analysis revealed most water-soluble precursors were positively correlated with extended conditioning as well as beef and oily/fatty flavors. Quantitative changes observed in flavor precursors may be responsible for some sensory attributes developed during the heating process. PMID:23896147

  16. Pharmacologic manipulation of the microcirculation in cutaneous and myocutaneous flaps in pigs

    SciTech Connect

    Pang, C.Y.; Neligan, P.C.; Nakatsuka, T.; Sasaki, G.H.

    1985-04-01

    The vascular effects of isoxsuprine, diazoxide, and isoproterenol were studied in arterial buttock flaps and latissimus dorsi myocutaneous flaps in pigs. Capillary blood flow to the skin and muscles of these flaps was measured by the radioactive microsphere (15-mu diameter) technique 6 hours postoperatively under pentobarbital anesthesia. It was observed that isoproterenol, a beta-adrenergic receptor agonist, was not effective in augmentation of skin blood flow in the arterial buttock flaps. However, isoproterenol significantly increased capillary blood flow to the arterialized portion of latissimus dorsi myocutaneous flaps compared with controls. Isoxsuprine and diazoxide (vascular smooth muscle relaxants) significantly (p less than 0.05) increased total capillary blood flow to the skin of arterial buttock flaps and to the skin and muscles of the latissimus dorsi myocutaneous flaps. However, the increase in capillary blood flow occurred mainly in the arterialized portion of these flaps. The capillary blood flow, which was supplied by the small arteries in the distal portion of the arterial buttock and latissimus dorsi flaps, was not increased by treatment with isoxsuprine or diazoxide. Therefore, there was also no increase in the maximum distance of capillary blood flow from the pedicle to the distal end of the flaps. These observations led the authors to hypothesize that different sizes (diameters) of arteries in the skin and muscle have different reactivity (or sensitivity) to vasodilatory drugs. In the present experiment, the large dominant artery of the arterial buttock and latissimus dorsi flaps responded to isoxsuprine or diazoxide (vascular smooth-muscle relaxants), resulting in an increase in blood supply to the capillaries in the proximal portion of the flaps.

  17. [The gracilis muscle as musculocutaneous flap. Evaluation of 20 cases].

    PubMed

    Gholam, D; Trevidic, P; Kleimann, P; Hautefeuille, P; Nicoletis, C

    1991-01-01

    The use of gracilis as muscular or myocutaneous flap is very well-known. The authors report 20 cases of gracilis flap including 13 reconstructions of the vaginal cavity following extended abdomino-perineal resection. Some technical points concerning the localization of the cutaneous part of the flap and the pedicle dissection are discussed. The use of gracilis flap is still limited in surgical teams following extended abdomino-perineal resection, nevertheless it is a very useful flap because of its low morbidity, the shortening of patient hospitalization and the very satisfying aesthetic result of the neo-vaginal cavity. PMID:1726389

  18. A triceps musculocutaneous flap for chest-wall defects

    SciTech Connect

    Hartrampf, C.R. Jr.; Elliott, L.F.; Feldman, S. )

    1990-09-01

    A posterior upper arm flap based on the profunda brachii vessels has been described to cover soft-tissue defects in the upper anterolateral chest. In our series, the posterior upper arm skin is elevated with the long head of the triceps muscle to cover seven chest-wall defects resulting from indolent postradiation open wounds following partial TRAM flap failure (n = 2), soft-tissue deficiencies following partial TRAM flap loss (n = 3), and primarily as an ancillary flap in TRAM flap breast reconstruction (n = 2). This flap also may be used to supply well-vascularized tissue in the regions of the shoulder, axilla, and posterolateral back. A prerequisite for this operation is redundant tissue of the upper arm often present in middle-aged women and in patients with lymphedema following mastectomy. In our series of seven patients, all donor sites were closed primarily, and there was no subjective functional deficit following transfer of the long head of the triceps muscle.

  19. Free tissue transfer in patients with severe peripheral arterial disease: functional outcome in reconstruction of chronic lower extremity defects.

    PubMed

    Kolbenschlag, Jonas; Hellmich, Susanne; Germann, Günter; Megerle, Kai

    2013-11-01

    Chronic wounds of the lower extremity are difficult to treat, especially in patients with peripheral arterial disease (PAD). This patient population frequently suffers from multiple comorbidities, which further impairs wound healing. Local flaps are often not available, or are insufficient to cover these defects, and limbs are frequently amputated, although they could possibly be salvaged by free tissue transplantation. Although there is a growing evidence that free tissue transfer may be feasible in these patients with otherwise doomed extremities, previous studies have mostly focused on short-term flap survival, but not long-term ambulatory status and independence. Therefore, we investigated the long-term results of limb salvage, ambulatory status, and social independence in patients with PAD who underwent free tissue transfer for chronic wounds of the lower extremities.In this study we retrospectively reviewed 38 patients who underwent free tissue transfer because of nontraumatic, chronic wounds of the lower extremities at our institution. All patients suffered from a nontraumatic occlusion of at least one major lower leg artery verified by angiography. After a mean time period of 34 months we assessed flap survival and limb preservation as well as pre- and postoperative ambulatory status and social independence. A subgroup of 14 patients with a "single-vessel-leg" was evaluated separately.It was observed that anterolateral thigh and latissimus dorsi musculocutaneous flaps were most often used to cover the defects. Overall 29 out of the 38 flaps healed completely (9 flap failures) and 34 extremities were salvaged, including 12 out of 14 single-vessel-legs. One patient had to be amputated despite a vital free flap because of persistent calcaneal osteomyelitis. After failure of free tissue transfer, six extremities could still be salvaged by secondary procedures (two secondary free flaps, two local flaps, and two skin grafts). Total 22 out of 34 patients with

  20. Treatment options for irreparable postero-superior cuff tears in young patients

    PubMed Central

    Galasso, Olimpio; Familiari, Filippo; Gasparini, Giorgio

    2015-01-01

    Rotator cuff tears (RCTs) occur more commonly with advanced age, with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs. Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population, and the incidence of irreparable RCTs in young patients is still unknown. Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs, such as rotator cuff debridement, partial rotator cuff repair, biceps tenotomy/tenodesis, rotator cuff grafting, latissimus dorsi tendon transfer, and reverse shoulder arthroplasty. After being thoroughly investigated in open surgery, arthroscopic techniques for latissimus dorsi tendon transfer have been recently described. They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management. PMID:26601058

  1. Treatment options for irreparable postero-superior cuff tears in young patients.

    PubMed

    Galasso, Olimpio; Familiari, Filippo; Gasparini, Giorgio

    2015-11-18

    Rotator cuff tears (RCTs) occur more commonly with advanced age, with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs. Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population, and the incidence of irreparable RCTs in young patients is still unknown. Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs, such as rotator cuff debridement, partial rotator cuff repair, biceps tenotomy/tenodesis, rotator cuff grafting, latissimus dorsi tendon transfer, and reverse shoulder arthroplasty. After being thoroughly investigated in open surgery, arthroscopic techniques for latissimus dorsi tendon transfer have been recently described. They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management. PMID:26601058

  2. Free Flap Reconstruction for Complex Scalp and Forehead Defects with Associated Full-Thickness Calvarial Bone Resections

    PubMed Central

    Larrañaga, Juan; Rios, Alfredo; Franciosi, Edgardo; Mazzaro, Eduardo; Figari, Marcelo

    2012-01-01

    Extensive defects of the scalp and forehead associated with calvarial bone resections demand complex reconstructions. Free flaps offer vascularized tissue of excellent quality and quantity. We report six patients with extensive scalp and forehead defects associated with calvarial bone resections reconstructed with free flaps. Five patients also required a cranioplasty. The flaps used were two anterolateral thigh flaps, one vastus lateralis flap, one myocutaneous latissimus dorsi flap, one latissimus dorsi flap, and one radial forearm flap. All flaps survived with no partial necrosis. There were no donor site complications. One patient presented an exposure of the alloplastic material used for cranioplasty. We strongly recommend the use of free flaps for this kind of reconstruction. PMID:24294403

  3. Myogenic Growth Factor Present in Skeletal Muscle is Purified by Heparin-Affinity Chromatography

    NASA Astrophysics Data System (ADS)

    Kardami, Elissavet; Spector, Dennis; Strohman, Richard C.

    1985-12-01

    A myogenic growth factor has been purified from a skeletal muscle, the anterior latissimus dorsi, of adult chickens. In the range of 1-10 ng, this factor stimulates DNA synthesis as well as protein and muscle-specific myosin accumulation in myogenic cell cultures. Purification is achieved through binding of the factor to heparin. The factor is distinct from transferrin and works synergistically with transferrin in stimulating myogenesis in vitro.

  4. A reliable approach to the closure of large acquired midline defects of the back

    SciTech Connect

    Casas, L.A.; Lewis, V.L. Jr. )

    1989-10-01

    A systematic regionalized approach for the reconstruction of acquired thoracic and lumbar midline defects of the back is described. Twenty-three patients with wounds resulting from pressure necrosis, radiation injury, and postoperative wound infection and dehiscence were successfully reconstructed. The latissimus dorsi, trapezius, gluteus maximus, and paraspinous muscles are utilized individually or in combination as advancement, rotation, island, unipedicle, turnover, or bipedicle flaps. All flaps are designed so that their vascular pedicles are out of the field of injury. After thorough debridement, large, deep wounds are closed with two layers of muscle, while smaller, more superficial wounds are reconstructed with one layer. The trapezius muscle is utilized in the high thoracic area for the deep wound layer, while the paraspinous muscle is used for this layer in the thoracic and lumbar regions. Superficial layer and small wounds in the high thoracic area are reconstructed with either latissimus dorsi or trapezius muscle. Corresponding wounds in the thoracic and lumbar areas are closed with latissimus dorsi muscle alone or in combination with gluteus maximus muscle. The rationale for systematic regionalized reconstruction of acquired midline back wounds is described.

  5. Scalp reconstruction by microvascular free tissue transfer

    SciTech Connect

    Furnas, H.; Lineaweaver, W.C.; Alpert, B.S. )

    1990-05-01

    We report on a series of patients with scalp defects who have been treated with a variety of free flaps, spanning the era of microvascular free tissue transfer from its incipient stages to the present. Between 1971 and 1987, 18 patients underwent scalp reconstruction with 21 free flaps: 11 latissimus dorsi, 3 scalp transfers between identical twins, 3 groin, one combined latissimus dorsi and serratus anterior, two serratus anterior, and one omentum. These flaps were used to cover scalp defects resulting from burns, trauma, radiation, and tumors in patients ranging from 7 to 79 years of age. Follow-up has ranged from 3 weeks to 7 years. All of our flaps survived and covered complex defects, many of which had failed more conservative attempts at cover. One patient received radiation therapy to his flap without unfavorable sequelae. This experience began with a pioneering omental flap and includes cutaneous and muscle flaps. The latissimus dorsi is our first choice for free flap reconstruction of extensive, complicated scalp wounds because of its large size, predictable blood supply, ease of harvesting, and provision of excellent vascularity to compromised beds.

  6. Cardiomyoplasty - improvement of muscle fibre type transformation by an anabolic steroid (metenolone).

    PubMed

    Czesla, M; Mehlhorn, G; Fritzsche, D; Asmussen, G

    1997-11-01

    Dynamic cardiomyoplasty, a method to support ventricular function by the chronically stimulated latissimus dorsi muscle wrapped around the heart is accompanied by a loss of mass and force of the transplanted muscle. These effects and the fast-to-slow transformation of the muscle could be possibly influenced by the additional administration of anabolic steroids. In this study, the left latissimus dorsi muscles of 12 sheep were electrically conditioned (group A). In 12 other animals (group B), stimulation was combined with the administration of metenolone (100 mg/week). Biopsies were taken from the right and left muscles at the beginning and after 6 and 12 weeks of treatment, frozen and cross-sectioned. The muscle fibre type composition was studied enzymhistochemically (SDH-staining and Myosin-ATPase-reaction) and immunocytochemically (using antibodies against different myosin heavy chains, MHC). Furthermore, the expression of different MHC isoforms was investigated electrophoretically. The untreated latissimus dorsi muscle contains 20% type I fibres expressing slow MHC and 80% type II fibres expressing fast MHC. After 6 weeks, the respective fibre type composition was 42 and 58% (group A) and 80 and 20% (group B). After 12 weeks, the percentage of the type I fibres rose in group A to 59% and in group B to 98%. In accordance with these morphological results, the MHC pattern determined electrophoretically showed a corresponding shift from the fast to the slow isoform. Therefore, the administration of metenolone avoids severe muscle atrophy, and improves and accelerates fast to slow fibre type conversion necessary for successful cardiomyoplasty. PMID:9405174

  7. Extended V-Y Advancement Flap Reconstruction of a Large Posterior Upper Midline Trunk Defect

    PubMed Central

    Fukudome, Eugene Y.; Bharadia, Deepak R.; Helm, Douglas L.

    2016-01-01

    Summary: Large posterior upper trunk defects can be challenging to reconstruct. Trapezius or latissimus dorsi myocutaneous flaps are principally utilized for reconstruction; however, some defects may not be amenable to this standard approach. Here, we describe a patient with a full-thickness skin and subcutaneous tissue loss of the upper back and inferior cervical region after dermatofibrosarcoma protuberans resection. A large, extended V-Y flap was used for closure of this wound secondary to its location, size, and orientation. This approach preserves shoulder function, allows for readvancement of the flap as needed, and is a reconstructive option for patients with large upper back defects.

  8. Reconstructive Options for Oncologic Posterior Trunk Defects: A Review

    PubMed Central

    Behr, Björn; Wagner, Johannes M.; Wallner, Christoph; Harati, Kamran; Lehnhardt, Marcus; Daigeler, Adrien

    2016-01-01

    After oncological tumor resections at the back, large defects can remain that depending on the size and location may represent reconstructive challenges to plastic surgeons. Flap selection includes the entire armamentarium of coverage, including transposition flaps, perforator flaps, pedicled muscle flaps, and free flaps. Most defects can be closed and reconstructed with local or pedicled muscle flaps. In our hands, sufficient closure could be obtained with all techniques, except the latissimus dorsi turn-over flap. Thereupon, an algorithm for closure of posterior trunk defects related to the anatomical region is proposed. PMID:27014626

  9. Underwater Near-Infrared Spectroscopy: Muscle Oxygen Changes in the Upper and Lower Extremities in Club Level Swimmers and Triathletes.

    PubMed

    Jones, B; Cooper, C E

    2016-01-01

    To date, measurements of oxygen status during swim exercise have focused upon systemic aerobic capacity. The development of a portable, waterproof NIRS device makes possible a local measurement of muscle hemodynamics and oxygenation that could provide a novel insight into the physiological changes that occur during swim exercise. The purpose of this study was to observe changes in muscle oxygenation in the vastus lateralis (VL) and latissimus dorsi (LD) of club level swimmers and triathletes. Ten subjects, five club level swimmers and five club level triathletes (three men and seven women) were used for assessment. Swim group; mean±SD=age 21.2±1.6 years; height 170.6±7.5 cm; weight 62.8±6.9 kg; vastus lateralis skin fold 13.8±5.6 mm; latissimus dorsi skin fold 12.6±3.7. Triathlete group; mean±SD=age 44.0±10.5 years; height 171.6±7.0 cm; weight 68.6±12.7 kg; vastus lateralis skin fold 11.8±3.5 mm; latissimus dorsi skin fold 11.2±3.1. All subjects completed a maximal 200 m freestyle swim, with the PortaMon, a portable NIR device, attached to the subject's dominant side musculature. ΔTSI% between the vastus lateralis and latissimus dorsi were analysed using either paired (2-tailed) t-tests or Wilcoxon signed rank test. The level of significance for analysis was set at p<0.05. No significant difference (p=0.686) was found in ΔTSI (%) between the VL and LD in club level swimmers. A significant difference (p=0.043) was found in ΔTSI (%) between the VL and LD in club level triathletes. Club level swimmers completed the 200 m freestyle swim significantly faster (p=0.04) than club level triathletes. Club level swimmers use both the upper and lower muscles to a similar extent during a maximal 200 m swim. Club level triathletes predominately use the upper body for propulsion during the same exercise. The data produced by NIRS in this study are the first of their kind and provide insight into muscle oxygenation changes during swim exercise which can indicate the

  10. Extended V-Y Advancement Flap Reconstruction of a Large Posterior Upper Midline Trunk Defect.

    PubMed

    Fukudome, Eugene Y; Bharadia, Deepak R; Helm, Douglas L; Sinha, Indranil

    2016-05-01

    Large posterior upper trunk defects can be challenging to reconstruct. Trapezius or latissimus dorsi myocutaneous flaps are principally utilized for reconstruction; however, some defects may not be amenable to this standard approach. Here, we describe a patient with a full-thickness skin and subcutaneous tissue loss of the upper back and inferior cervical region after dermatofibrosarcoma protuberans resection. A large, extended V-Y flap was used for closure of this wound secondary to its location, size, and orientation. This approach preserves shoulder function, allows for readvancement of the flap as needed, and is a reconstructive option for patients with large upper back defects. PMID:27579237

  11. Ultrasound-Guided Serratus Anterior Plane Block in Breast Reconstruction Surgery.

    PubMed

    Khemka, Rakhi; Chakraborty, Arunangshu; Ahmed, Rosina; Datta, Taniya; Agarwal, Sanjit

    2016-05-01

    Pecs block and its variations have been used for various breast surgeries. We describe 2 cases of mastectomy and breast reconstruction by latissimus dorsi (LD) flap where regional analgesia was provided by a combination of ultrasound-guided Pecs-I block and serratus anterior plane block, a recently described technique in which local anesthetic is deposited in the plane between the LD and serratus anterior muscle. This resulted in excellent intraoperative and postoperative analgesia and a minimum of systemic analgesics. The described technique is safe to administer and provides good analgesia for breast reconstruction surgery by LD flap. PMID:26934607

  12. Simultaneous bilateral breast reconstruction with the transverse rectus abdominus musculocutaneous free flap.

    PubMed Central

    Khouri, R K; Ahn, C Y; Salzhauer, M A; Scherff, D; Shaw, W W

    1997-01-01

    OBJECTIVE: The purpose of the study was to assess the results and morbidity associated with simultaneous bilateral TRAM free flap breast reconstruction and describe refinements in its surgical technique. SUMMARY BACKGROUND DATA: Bilateral prophylactic total mastectomies might be an agreeable option for those patients at highest risk for breast cancer if autogenous tissue breast reconstruction could be performed with reasonable technical ease and acceptable morbidity. However, some surgeons harbor reservations regarding the extensiveness of the surgery, the associated morbidity, and the aesthetic quality of the resulting outcome. METHODS: A multicenter retrospective review of clinical experience with 120 consecutive patients who underwent 240 simultaneous bilateral TRAM free flap breast reconstructions was developed. RESULTS: The average operating time, including the time required for the breast ablative portion of the procedures, was 8.6 hours. The average length of hospitalization was 7.6 days. However, for the last 40 patients, these figures were reduced to 7.1 hours and 6.1 days, respectively. Nonautologous blood transfusions were needed in 33 cases (28%), but only 1 was required in the last 40 patients. Thromboses developed in six of 240 flaps (2.5%): 4 were arterial and 2 were venous. Re-exploration allowed us to restore circulation in five flaps, whereas one flap was unsalvageable and was replaced successfully with an alternate flap. An uncomplicated deep vein thromboses developed in one patient with a history of recurrent deep vein thromboses that had no adverse effect on her outcome. Minor complications developed in 18 patients (15%) (e.g., hematoma, partial wound necrosis, wound infection, or prolonged postoperative ileus) that did not affect the long-term outcome. Fourteen patients (11.6%) had abdominal wall weakness or hernias. Follow-up time averaged 37.2 months (range, 14-62 months). On last follow-up, patients' self-reported overall satisfaction with the procedure was 56% excellent, 40% good, and 4% fair.CONCLUSIONS: Simultaneous bilateral free flap reconstruction is technically feasible with a high rate of success and an acceptable morbidity. When performed by experienced surgeons, bilateral prophylactic total mastectomies combined with simultaneous bilateral TRAM free flap reconstruction may provide an adequate surgical option with aesthetically acceptable results for patients at high risk for breast cancer. Images Figure 1. Figure 4. Figure 5. Figure 6. PMID:9242334

  13. Salvage Free Anterolateral Thigh Composite Flap Transfer Based on the Musculocutaneous Perforator Retrograde Blood Flow Principle.

    PubMed

    Zhao, Jingyi; Chan, Fuan Chiang; Yang, Xiaonan; Zong, Xianlei; Sun, Hengyun; Qi, Zuoliang; Jin, Xiaolei

    2016-03-01

    An anterolateral thigh myo-adipofascial flap was used in the definitive management of a patient presented with chronic infective process associated with a large fronto-nasal defect. Unfortunately, the risk of free flap transfer failure emerged when intraoperative dissection showed absence of a reliable ipsilateral superficial temporal artery as the recipient artery. This rare incident happened at the stage whereby the anterolateral thigh flap was nearly completely raised with a distal perforator in situ. In this article, the authors presented an innovative strategy to salvage the flap by transforming the flap into a modified composite flap based on the retrograde blood flow principle. To the best of our knowledge, this is the first report of using such a technique in reconstructive microsurgery. This successful salvage strategy has clinical application and could potentially minimize free flap transfer failure. PMID:26854778

  14. Relationship between spinal range of motion and trunk muscle activity during trunk rotation

    PubMed Central

    Sugaya, Tomoaki; Sakamoto, Masaaki; Nakazawa, Rie; Wada, Naoki

    2016-01-01

    [Purpose] The aim of this study was to clarify the relationship between spinal range of motion and trunk muscle activity during trunk rotation using a three-dimensional motion analysis system and surface electromyography. [Subjects and Methods] The subjects comprised 11 healthy men. A three-dimensional motion analysis system measured the trunk rotational angle of 4 segments of the thoracic vertebrae and 2 segments of the lumbar vertebrae. Surface electromyography measured the activities of the unilateral latissimus dorsi, lumbar multifidus, rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. [Results] During ipsilateral rotation at thoracic vertebral levels, the muscle activity of the latissimus dorsi and external oblique was significantly increased compared with the activity in the 0–10% range of trunk rotation. During early ipsilateral rotation at lumbar vertebral levels, the muscle activity of the internal oblique and transversus abdominis was significantly increased compared with that in the 0–10% range of trunk rotation. During contralateral rotation at both thoracic and lumbar vertebral levels, the muscle activity of the external oblique was significantly increased compared with that in the 0–10% range of trunk rotation. [Conclusion] This study indicates that it is important to consider vertebral segments and spinal range of motion during trunk rotation. PMID:27065549

  15. Mechanical implications of chimpanzee positional behavior.

    PubMed

    Hunt, K D

    1991-12-01

    Mechanical hypotheses concerning the function of chimpanzee anatomical specializations are examined in light of recent positional behavior data. Arm-hanging was the only common chimpanzee positional behavior that required full abduction of the humerus, and vertical climbing was the only distinctive chimpanzee positional behavior that required forceful retraction of the humerus and flexion of the elbow. Some elements of the chimpanzee anatomy, including an abductible humerus, a broad thorax, a cone-shaped torso, and a long, narrow scapula, are hypothesized to be a coadapted functional complex that reduces muscle action and structural fatigue during arm-hanging. Large muscles that retract the humerus (latissimus dorsi and probably sternocostal pectoralis major and posterior deltoid) and flex the elbow (biceps brachii, probably brachialis and brachioradialis) are argued to be adaptations to vertical climbing alone. A large ulnar excursion of the manus and long, curved metacarpals and phalanges are interpreted as adaptations to gripping vertical weight-bearing structures during vertical climbing and arm-hanging. A short torso, an iliac origin of the latissimus dorsi, and large muscles for arm-raising (caudal serratus, teres minor, cranial trapezius, and probably anterior deltoid and clavicular pectoralis major) are interpreted as adaptations to both climbing and unimanual suspension. PMID:1776659

  16. Biomechanical and Electromyographic Comparisons of Isometric Trunk Flexor Endurance Test Postures: Prone Plank Versus V-Sit.

    PubMed

    Musalem, Lindsay L; Stankovic, Tatjana; Glisic, Drazen; Cook, Gillian E; Beach, Tyson A

    2015-12-01

    The objective of this study was to investigate why holding times on 2 different tests of isometric trunk flexor endurance capacity (prone plank and v-sit) are weakly correlated. Body position and ground reaction force data from 10 men and 10 women were used to conduct static biomechanical analyses of both test postures, and bilateral activations of the rectus abdominis, internal and external obliques, latissimus dorsi, and lumbar and thoracic erector spinae were measured in a second sample of 15 men and 15 women while holding the test postures. No between-posture differences in net low back flexor moments were found (P = .111), but the lumbar spine was 28° more flexed in the v-sit than in the plank (P < .001). No between-posture differences were detected in the rectus abdominis (P = .397), external obliques (P = .204), internal obliques (P = .226), or lumbar erector spinae (P = .116) activation levels, but those of the thoracic erector spinae (P = .0253) and latissimus dorsi (P < .001) were greater in the plank than in the v-sit. Altogether, the findings suggest that differences between plank and v-sit holding times are most likely related to between-test differences in lumbar spine postures and shoulder demands. PMID:26252077

  17. Biomechanical evaluation of the Eco-Pick lift assist: A device designed to facilitate product selection tasks in distribution centers.

    PubMed

    Lavender, Steven A; Ko, Pei-Ling; Sommerich, Carolyn M

    2013-03-01

    Developing lift assist devices to aid workers performing case tasks in distribution centers has been challenging given the movement of workers through a distribution facility. The objective of this work was to biomechanically evaluate a lift assist that can be integrated with pallet jacks and thereby move through the facility with the workers. Twelve participants transferred 16.4 kg boxes from one pallet to another manually and using the Eco-Pick lift assist. Electromyographic (EMG) activities were measured bilaterally in the Bicep, Deltoid, Latissimus Dorsi, and Erector Spinae muscles. The analysis showed that the 90th percentile normalized EMG values were significantly reduced in 4 of the 8 muscles sampled when using the Eco-Pick. Likewise, the 50th percentile normalized EMG data were significantly reduced for the Erector Spinae, Latissimus Dorsi, and the Bicep muscles when using the assist. For some of the muscles the advantage of the Eco-Pick was dependent upon the initial lift height or the placement height. Overall, it appears that this evaluation of the Eco-Pick's efficacy indicates that the device has the potential to be an effective means of reducing worker exposure to risk factors associated with back and shoulder injuries experienced during manual palletizing tasks found in distribution centers. PMID:22884290

  18. An electromyographic evaluation of dual role breathing and upper body muscles in response to front crawl swimming.

    PubMed

    Lomax, M; Tasker, L; Bostanci, O

    2015-10-01

    The upper body trunk musculature is key in supporting breathing, propulsion, and stabilization during front crawl swimming. The aim of this study was to determine if the latissimus dorsi, pectoralis major, and serratus anterior contributed to the development of inspiratory muscle fatigue observed following front crawl swimming. Fourteen trained swimmers completed a 200-m front crawl swim at 90% of race pace. Maximal inspiratory and expiratory mouth pressures (PImax and PEmax) were assessed before (baseline) and after each swim, and electromyography was recorded from the three muscles. Post-swim PImax fell by 11% (P < 0.001, d = 0.57) and the median frequency (MDF: a measure of fatigue) of the latissimus dorsi, pectoralis major, and serratus anterior fell to 90% (P = 0.001, d = 1.57), 87% (P = 0.001, r = -0.60) and 89% (P = 0.018, d = 1.04) of baseline, respectively. The fall in serratus anterior MDF was correlated with breathing frequency (r = 0.675, P = 0.008) and stroke rate (r = 0.639, P = 0.014). The results suggest that the occurrence of inspiratory muscle fatigue was partly caused by fatigue of these muscles, and that breathing frequency and stroke rate particularly affect the serratus anterior. PMID:25640018

  19. Evaluation of muscle fatigue during 100-m front crawl.

    PubMed

    Stirn, Igor; Jarm, Tomaz; Kapus, Venceslav; Strojnik, Vojko

    2011-01-01

    The aim of this study was to evaluate muscle fatigue in upper body muscles during 100-m all-out front crawl. Surface electromyogram (EMG) was collected from the pectoralis major, latissimus dorsi and triceps brachii muscles of 11 experienced swimmers. Blood lactate concentration level increased to 14.1 ± 2.9 mmol l(-1) 5 min after the swim. The velocity, stroke length and stroke rate calculated based on video analysis decreased by 15.0, 5.8 and 7.4%, respectively, during the swim. EMG amplitude of the triceps and the lower part of the latissimus muscles increased, whilst the mean power frequency (MNF) of all muscles significantly decreased by 20-25%. No significant differences in the relative MNF decrease were observed amongst the muscles; however, the differences in the rate of the MNF decrease between the lower part of the latissimus and the triceps brachii muscles were found (P < 0.05). The time of rest between the muscle activation of the two consecutive arm strokes at the end of swimming was extended (P < 0.05). It was concluded that 100-m all-out crawl induced significant fatigue with no evident differences amongst the analysed muscles. PMID:20824283

  20. The influence of experimentally induced pain on shoulder muscle activity.

    PubMed

    Diederichsen, Louise Pyndt; Winther, Annika; Dyhre-Poulsen, Poul; Krogsgaard, Michael R; Nørregaard, Jesper

    2009-04-01

    Muscle function is altered in painful shoulder conditions. However, the influence of shoulder pain on muscle coordination of the shoulder has not been fully clarified. The aim of the present study was to examine the effect of experimentally induced shoulder pain on shoulder muscle function. Eleven healthy men (range 22-27 years), with no history of shoulder or cervical problems, were included in the study. Pain was induced by 5% hypertonic saline injections into the supraspinatus muscle or subacromially. Seated in a shoulder machine, subjects performed standardized concentric abduction (0 degrees -105 degrees) at a speed of approximately 120 degrees/s, controlled by a metronome. During abduction, electromyographic (EMG) activity was recorded by intramuscular wire electrodes inserted in two deeply located shoulder muscles and by surface-electrodes over six superficially located shoulder muscles. EMG was recorded before pain, during pain and after pain had subsided and pain intensity was continuously scored on a visual analog scale (VAS). During abduction, experimentally induced pain in the supraspinatus muscle caused a significant decrease in activity of the anterior deltoid, upper trapezius and the infraspinatus and an increase in activity of lower trapezius and latissimus dorsi muscles. Following subacromial injection a significantly increased muscle activity was seen in the lower trapezius, the serratus anterior and the latissimus dorsi muscles. In conclusion, this study shows that acute pain both subacromially and in the supraspinatus muscle modulates coordination of the shoulder muscles during voluntary movements. During painful conditions, an increased activity was detected in the antagonist (latissimus), which support the idea that localized pain affects muscle activation in a way that protects the painful structure. Further, the changes in muscle activity following subacromial pain induction tend to expand the subacromial space and thereby decrease the load

  1. [Immediate vaginal reconstruction with a musculocutaneous flap from the gracilis muscle after extended abdomino-perineal resection].

    PubMed

    Sezeur, A; Hautefeuille, P; Trevidic, P

    1995-01-01

    Reconstruction of a functional vagina after radical abdomino-perineal resection is a difficult surgical problem. The use of the gracilis myocutaneous flap provides a satisfactory solution. This article describes the surgical procedure of immediate vaginal reconstruction using the gracilis myocutaneous flap. Unfortunately, this technique is still not widely used by surgical teams. Nevertheless, it is a useful flap because of its low morbidity and the satisfying result of the functional neovaginal cavity. PMID:8526447

  2. Male breast cancer originating in an accessory mammary gland in the axilla: a case report.

    PubMed

    Yamamura, Jun; Masuda, Norikazu; Kodama, Yoshinori; Yasojima, Hiroyuki; Mizutani, Makiko; Kuriyama, Keiko; Mano, Masayuki; Nakamori, Shoji; Sekimoto, Mitsugu

    2012-01-01

    Carcinoma of an accessory mammary gland is an extremely rare tumor. A 61-year-old male patient presented with a hard mass measuring 85 mm × 51 mm in the left axilla. Incisional biopsy histopathologically showed an adenocarcinoma compatible with breast carcinoma originating in an accessory mammary gland. Systemic examinations revealed no evidence of malignant or occult primary lesion in the bilateral mammary glands or in other organs. Neoadjuvant chemotherapy was performed for the locally advanced axillary tumor and reduced the tumor to 55 mm in size, and, then, he could undergo complete resection with a negative surgical margin in combination with reconstructive surgery to fill the resulting skin defect with a local flap of the latissimus dorsi muscle. The patient has presented with no metastatic lesion in four years since the operation. This unusual case shows that neoadjuvant chemotherapy is an effective and tolerated therapy for advanced accessory breast cancer in the axilla. PMID:23251170

  3. Perioperative Management of Multiple Noncardiac Implantable Electronic Devices.

    PubMed

    Ramos, Juan A; Brull, Sorin J

    2015-12-01

    The number of patients with noncardiac implantable electronic devices is increasing, and the absence of perioperative management standards, guidelines, practice parameters, or expert consensus statements presents clinical challenges. A 69-year-old woman presented for latissimus dorsi breast reconstruction. The patient had previously undergone implantation of a spinal cord stimulator, a gastric pacemaker, a sacral nerve stimulator, and an intrathecal morphine pump. After consultation with device manufacturers, the devices with patient programmability were switched off. Bipolar cautery was used intraoperatively. Postoperatively, all devices were interrogated to ensure appropriate functioning before home discharge. Perioperative goals include complete preoperative radiologic documentation of device component location, minimizing electromagnetic interference, and avoiding mechanical damage to implanted device components. PMID:26588030

  4. The Efficacy of Continuous Negative Pressure and Irrigation Treatment Inside the Wound by a Closed System in Reconstruction of All Layers of the Cranium Accompanying Infection and Cerebrospinal Fluid Leakage.

    PubMed

    Oyama, Mai; Rikimaru, Hideaki; Migita, Hisashi; Sakata, Kensuke; Kiyokawa, Kensuke

    2016-01-01

    There have been many reports to date with respect to treatments on reconstruction of the cranium without accompanying infections following trauma and tumor resection. The morality is, however, high in patients observed with generation of cranial bone defect of all layers accompanying infection and cerebrospinal fluid leakage, and moreover, there are barely any reports on such cases because of the reconstruction thereof being very difficult. In this study, the authors were able to cure such 2 cases by carrying out continuous negative pressure and irrigation treatment inside the wound by a closed system following transplant of free latissimus dorsi muscle flap. This method is believed to be very effective for cranial bone defect of all layers accompanying infection and cerebrospinal fluid leakage, in which treatment was determined to be very difficult. PMID:26674903

  5. Soft tissue coverage at the resource-challenged facility.

    PubMed

    Nguyen, Tuan Anh

    2008-10-01

    Covering soft tissue defects remains challenging for orthopaedic surgeons, especially those in resource-challenged facilities. Covering tissue defects follow a plan from simple to complex: primary closure, local flap, area flap, pedicle flap, and free flap. I will limit my discussion to the role of latter two. At the district-level hospital in Vietnam, pedicle flaps are generally more useful, so I will discuss free flaps only briefly. The choices of pedicle flaps include: kite flap, posterior interosseous flap, radial flap (Chinese flap), neurocutaneous flap, anterolateral thigh fasciocutaneous flap, gastrocnemius flap, sural flap, posterior leg flaps; we typically use a free flap with the latissimus dorsi. Soft tissue coverage with pedicle flaps has many advantages: reliability, relatively easy harvest, and good blood supply. Free flaps with microanastomosis have an important place in covering difficult medium- or large-sized soft tissue defects but also require more instruments and more highly trained surgeons. PMID:18665433

  6. Noninvasive Free Flap Monitoring Using Eulerian Video Magnification

    PubMed Central

    Liu, Yuan Fang; Vuong, Christopher; Walker, Paul Charles; Peterson, Nathaniel Ray; Inman, Jared Christian; Filho, Pedro Alcantara Andrade; Lee, Steve Choon-Sung

    2016-01-01

    Eulerian Video Magnification (EVM) can enhance subtle changes in videos to reveal what was once invisible to the naked eye. In this proof of concept study, we investigated using EVM as a novel form of free flap monitoring. Free flaps with skin paddles were filmed in the operating room with manipulation of their pedicles. In a representative 77-year-old female who received a latissimus dorsi-serratus-rib composite free flap, EVM was able to detect blockage of arterial or venous supply instantaneously, providing a visible representation through degree of color change in videos. EVM has the potential to serve as a powerful free flap monitoring tool with the benefit of being noninvasive, sensitive, easy-to-use, and nearly cost-free. PMID:27092284

  7. Mediastinal infusion with tracheal necrosis: an unusual complication of Port-a-cath devices.

    PubMed

    Renaud, Stéphane; Santelmo, Nicola; Falcoz, Pierre Emmanuel; Massard, Gilbert

    2011-06-01

    The Port-a-cath (PAC) is a catheter totally implanted under the skin. It is commonly used in oncology for permanent venous access. It provides a more simple way to infuse chemotherapies, antibiotics or parenteral nutrition, while offering improved comfort to patients. The usual complications of these devices (infections and catheter obstructions) are well documented. More exceptional events are catheter fractures with systemic migration, and endopleural perfusions due to a wrong positioning of the catheter. Since 1998, 10 cases of mediastinal infusion of cytotoxics have been reported. Surgical management was necessary in only two cases. We are reporting the case of a 57-year-old female suffering from a multimetastatic sigmoid adenocarcinoma. A mediastinal infusion of Folfiri and bevacizumab with a tracheal necrosis complicated the PAC use and required a latissimus dorsi myoplasty to fill up the tracheo-bronchial defect. PMID:21362735

  8. Successful treatment of a bronchopleural fistula after en masse lobectomy

    PubMed Central

    Ibe, Takashi; Kawatani, Natsuko; Ohsawa, Fumi; Yoshikawa, Ryohei

    2016-01-01

    A 72-year-old man underwent en masse lobectomy of the lower left lobe because of continued hemoptysis. We chose en masse lobectomy as a last resort because the patient had cardiopulmonary problems including chronic obstructive pulmonary disease (COPD), pulmonary hypertension, and continued hemoptysis. The patient developed a bronchopleural fistula 2 weeks later, so the Clagett window procedure was performed. After gauze exchange and cleaning of the pleural space, the Clagett window was closed using a latissimus dorsi muscle flap. He was discharged about 3 months after the initial operation. One of the most critical complications after en masse lobectomy is a bronchopleural fistula because the bronchial stump and vessel are too close to each other. The space between the bronchus and vessel can fill with tissue, such as pulmonary parenchyma or lymph nodes, which cover the fistula. PMID:27621901

  9. The synthesis, characterisation and in vivo study of a bioceramic for potential tissue regeneration applications

    PubMed Central

    Poinern, Gérrard Eddy Jai; Brundavanam, Ravi Krishna; Thi Le, Xuan; Nicholls, Philip K.; Cake, Martin A.; Fawcett, Derek

    2014-01-01

    Hydroxyapatite (HAP) is a biocompatible ceramic that is currently used in a number of current biomedical applications. Recently, nanometre scale forms of HAP have attracted considerable interest due to their close similarity to the inorganic mineral component of the bone matrix found in humans. In this study ultrafine nanometre scale HAP powders were prepared via a wet precipitation method under the influence of ultrasonic irradiation. The resulting powders were compacted and sintered to form a series of ceramic pellets with a sponge-like structure with varying density and porosity. The crystalline structure, size and morphology of the powders and the porous ceramic pellets were investigated using advanced characterization techniques. The pellets demonstrated good biocompatibility, including mixed cell colonisation and matrix deposition, in vivo following surgical implantation into sheep M. latissimus dorsi. PMID:25168046

  10. Reconstruction of complex defects of the parotid region using a lateral thoracic wall donor site.

    PubMed

    Biglioli, Federico; Pedrazzoli, Marco; Rabbiosi, Dimitri; Colletti, Giacomo; Colombo, Valeria; Frigerio, Alice; Autelitano, Luca

    2013-04-01

    Radical treatment of parotid neoplasms may lead to complex parotid defects that present functional and aesthetic reconstructive challenges. We report our experience using the lateral thoracic wall as a single donor site. Between 2003 and 2009, four patients with malignant tumours in the parotid gland underwent radical parotidectomy and simultaneous reconstruction using a perforator latissimus dorsi cutaneous free flap (de-epithelialized and entire skin paddle in two cases each). A thoracodorsal nerve graft was used in all cases to replace the intraglandular branches of the facial nerve. Costal grafts were used for mandibular reconstruction in two patients. All patients underwent postoperative physiotherapy. No donor-site complication occurred and all treatments achieved good aesthetic results. All patients recovered nearly complete symmetry at rest and partial facial mimetic function. The lateral thoracic wall is a good donor site for the reconstruction of complex parotid defects. PMID:23245945

  11. Successful treatment of a bronchopleural fistula after en masse lobectomy.

    PubMed

    Kamiyoshihara, Mitsuhiro; Ibe, Takashi; Kawatani, Natsuko; Ohsawa, Fumi; Yoshikawa, Ryohei

    2016-08-01

    A 72-year-old man underwent en masse lobectomy of the lower left lobe because of continued hemoptysis. We chose en masse lobectomy as a last resort because the patient had cardiopulmonary problems including chronic obstructive pulmonary disease (COPD), pulmonary hypertension, and continued hemoptysis. The patient developed a bronchopleural fistula 2 weeks later, so the Clagett window procedure was performed. After gauze exchange and cleaning of the pleural space, the Clagett window was closed using a latissimus dorsi muscle flap. He was discharged about 3 months after the initial operation. One of the most critical complications after en masse lobectomy is a bronchopleural fistula because the bronchial stump and vessel are too close to each other. The space between the bronchus and vessel can fill with tissue, such as pulmonary parenchyma or lymph nodes, which cover the fistula. PMID:27621901

  12. The reverse zygomatic implant: a new implant for maxillofacial reconstruction.

    PubMed

    Dawood, Andrew; Collier, Jonathan; Darwood, Alastair; Tanner, Susan

    2015-01-01

    This case report describes the rehabilitation of a patient who had been treated with a hemimaxillectomy, reconstruction with a latissimus dorsi vascularized free flap, and radiotherapy for carcinoma of the sinus some years previously. Limited jaw opening, difficult access through the flap to the bony site, and the very small amount of bone available in which to anchor the implant inspired the development and use of a new "reverse zygomatic" implant. For this treatment, site preparation and implant insertion were accomplished using an extraoral approach. The implant was used along with two other conventional zygomatic implants to provide support for a milled titanium bar and overdenture to rehabilitate the maxilla. Two years later, the patient continues to enjoy a healthy reconstruction. The reverse zygomatic implant appears to show promise as a useful addition to the implant armamentarium for the treatment of the patient undergoing maxillectomy. PMID:26574864

  13. Biomechanical bases of rehabilitation of children with cerebral palsy

    NASA Astrophysics Data System (ADS)

    Davlet'yarova, K. V.; Korshunov, S. D.; Kapilevich, L. V.

    2015-11-01

    Biomechanical analysis and the study results of children's with cerebral palsy (CP) muscles bioelectrical activity while walking on a flat surface are represented. Increased flexion in the hip and shoulder joints and extension in the elbow joint in children with cerebral palsy were observed, with the movement of the lower limbs had less smooth character in comparison with the control group. Herewith, the oscillation amplitude was significantly increased, and the frequency in the m. gastrocnemius and m. lateralis was decreased. It was shown, that the dynamic stereotype of walking in children with cerebral palsy was characterized by excessive involvement of m. gastrocnemius and m.latissimus dorsi in locomotion. Thus, resulting biomechanical and bioelectrical parameters of walking should be considered in the rehabilitation programs development.

  14. Autologous reconstruction of a complex form of Poland syndrome using 2 abdominal perforator free flaps.

    PubMed

    Masia, Jaume; Pons, Gemma; Loschi, Pietro; Sanchez Porro-Gil, Lidia; Nardulli, Maria Luisa; Olivares, Leyre

    2015-05-01

    Poland syndrome is the most frequent cause of congenital breast aplasia and hypoplasia. Breast and possible chest wall deformities can be treated with several surgical techniques, including implants, and pedicled or free flaps.We describe the case of a young patient with severe Poland syndrome with amastia, athelia, and deformity of the chest wall, and aplasia of 2 ribs. Marked hypoplasia of the ipsilateral latissimus dorsi muscle ruled out a reliable reconstructive option.Two perforator flaps were performed in a single-stage operation. A hemi-deep inferior epigastric perforator flap was harvested to correct the chest deformity, whereas the contralateral superficial inferior epigastric artery flap allowed breast reconstruction.No complications occurred and a subjectively and objectively pleasing cosmetic result was maintained at 3-year follow-up. PMID:24322640

  15. Stabilization of the Chest Wall: Autologous and Alloplastic Reconstructions

    PubMed Central

    Mahabir, Raman Chaos; Butler, Charles E.

    2011-01-01

    The goals of chest wall stabilization include maintenance of a rigid airtight cavity, protection of the thoracic and abdominal contents, optimization of respiration, and, whenever possible, an aesthetic reconstruction. Evidence suggests that bony fixation results in reduced ventilator dependence, a shorter overall hospital stay, and improved upper extremity function. We prefer to accomplish this with autologous tissue alone (such as the pectoralis major, latissimus dorsi, or rectus abdominus muscle flaps) for small to moderate defects. En bloc resection of defects larger than 5 cm or containing four or more ribs will likely benefit from chest wall stabilization. For patients previously treated with radiation, even larger defects may be tolerated owing to fibrosis. For these larger defects, methyl methacrylate composite meshes are used and covered with vascularized tissue. Contaminated wounds are generally reconstructed with bioprosthetic mesh rather than synthetic mesh. Using these principles, the reconstructive plastic surgeon can devise a comprehensive and safe plan to repair tremendous defects of the chest wall. PMID:22294941

  16. Management of Large Sternal Wound Infections With the Superior Epigastric Artery Perforator Flap.

    PubMed

    Eburdery, H; Grolleau, J L; Berthier, C; Bertheuil, N; Chaput, B

    2016-01-01

    The management of sternal wound infections often requires pedicled flaps. In recent years, the emergence of perforator flaps has changed our management of wounds involving tissue loss. For sternal wounds, the superior epigastric artery perforator (SEAP) flap can be used with the propeller procedure with minimal donor site morbidity. In our practice, this flap has replaced the traditional latissimus dorsi and pectoralis major flaps in the treatment of many sternal wounds. We report our experience with 4 patients with large sternal wound infection after cardiothoracic operations. The SEAP flap appears a safe alternative for low-morbidity coverage of sternal infections. Moreover, muscle flaps remain available in case the SEAP flap fails. PMID:26694288

  17. Surgical Treatment of Pediatric Upper Limb Spasticity: The Shoulder.

    PubMed

    Seruya, Mitchel; Johnson, Joshua D

    2016-02-01

    The shoulder joint is essential for placing the hand in a functional position for reach and overhead activities. This depends on the delicate balance between abductor/adductor and internal/external rotator muscles. Spasticity alters this equilibrium, limiting the interaction of the upper limb with the environment. Classically, pediatric patients with upper limb spasticity present with an adduction and internal rotation contracture of the shoulder. These contractures are typically secondary to spasticity of the pectoralis major and subscapularis muscles and sometimes attributed to the latissimus dorsi muscle. Fractional lengthening, Z-step lengthening, or tendon release of the contributing muscle groups may help correct the adduction and internal rotation contractures. With proper diagnosis, a well-executed surgical plan, and a consistent hand rehabilitation regimen, successful surgical outcomes can be achieved. PMID:26869863

  18. The effectiveness of stretch-shortening cycling in upper-limb extensor muscles during elite cross-country skiing with the double-poling technique.

    PubMed

    Zoppirolli, Chiara; Holmberg, Hans-Christer; Pellegrini, Barbara; Quaglia, Diego; Bortolan, Lorenzo; Schena, Federico

    2013-12-01

    This investigation was designed to evaluate the effectiveness of stretch-shortening cycling (SSC(EFF)) in upper-limb extensor muscles while cross-country skiing using the double-poling technique (DP). To this end, SSC(EFF) was analyzed in relation to DP velocity and performance. Eleven elite cross-country skiers performed an incremental test to determine maximal DP velocity (V(max)). Thereafter, cycle characteristics, elbow joint kinematics and poling forces were monitored on a treadmill while skiing at two sub-maximal and racing velocity (85% of V(max)). The average EMG activities of the triceps brachii and latissimus dorsi muscles were determined during the flexion and extension sub-phases of the poling cycle (EMG(FLEX), EMG(EXT)), as well as prior to pole plant (EMG(PRE)). SSC(EFF) was defined as the ratio of aEMG(FLEX) to aEMG(EXT). EMG(PRE) and EMG(FLEX) increased with velocity for both muscles (P < 0.01), as did SSC(EFF) (from 0.9 ± 0.3 to 1.3 ± 0.5 for the triceps brachii and from 0.9 ± 0.4 to 1.5 ± 0.5 for the latissimus dorsi) and poling force (from 253 ± 33 to 290 ± 36N; P < 0.05). Furthermore, SSC(EFF) was positively correlated to Vmax, to EMG(PRE) and EMG(FLEX) (P < 0.05). The neuromuscular adaptations made at higher velocities, when more poling force must be applied to the ground, exert a major influence on the DP performance of elite cross-country skiers. PMID:24064180

  19. [Covering of a thoraco-lumbar defect by omentoplasty].

    PubMed

    Le Fourn, B; Loirat, Y; Sartre, J Y; Lejeune, F; Pannier, M

    1997-02-01

    With a case of thoraco-lumbar defect, the authors discuss about different procedures to cover it. In this place, the better procedure is certainly the latissimus dorsi flap, in all combinations. The indication for omentoplasty at this spinal site should not be performed by first intention but by exclusion of other procedures, as in the case considered by the authors. It was a 37-year-old man, paraplegic from the age of 16, with a deep chronic spinal wound, secondary to sepsis of a posterior segmental fixations. A staphylococcus aureus infection which developed as a surgical complication was initially treated with antibiotics and surgical cleaning procedures without removing instrumentation. However, the infection remained active and the material was finally removed. Spinal immobilisation was strengthened by external fixation. The area was cleared of all suspect material, including bone graft, leaving a wide back-wound open to the spine. Spontaneous healing was first attempted, but the size and the chronicity of the wound led us to use pedicled greater omentum to close the defect. The omentum was pedicled on the right gastroepiploic vessels and transferred to the back wound through the posterior abdominal wall muscles, next to the right kidney. This procedure allows rapid healing. In association with suitable antibiotics, it has prevented any recurrent infection after 18 months of follow-up. It was no feasible to cover the wound with a latissimus dorsi flap, considering the importance of this muscle in the movements of a paraplegic and considering the initial impossibility of removing the external fixation. PMID:9768139

  20. Trunk Muscle Activation and Estimating Spinal Compressive Force in Rope and Harness Vertical Dance.

    PubMed

    Wilson, Margaret; Dai, Boyi; Zhu, Qin; Humphrey, Neil

    2015-12-01

    Rope and harness vertical dance takes place off the floor with the dancer suspended from his or her center of mass in a harness attached to a rope from a point overhead. Vertical dance represents a novel environment for training and performing in which expected stresses on the dancer's body are different from those that take place during dance on the floor. Two male and eleven female dancers with training in vertical dance performed six typical vertical dance movements with electromyography (EMG) electrodes placed bilaterally on rectus abdominus, external oblique, erector spinae, and latissimus dorsi. EMG data were expressed as a percentage of maximum voluntary isometric contraction (MVIC). A simplified musculoskeletal model based on muscle activation for these four muscle groups was used to estimate the compressive force on the spine. The greatest muscle activation for erector spinae and latissimus dorsi and the greatest trunk compressive forces were seen in vertical axis positions where the dancer was moving the trunk into a hyper-extended position. The greatest muscle activation for rectus abdominus and external oblique and the second highest compressive force were seen in a supine position with the arms and legs extended away from the center of mass (COM). The least muscle activation occurred in positions where the limbs were hanging below the torso. These movements also showed relatively low muscle activation compression forces. Post-test survey results revealed that dancers felt comfortable in these positions; however, observation of some positions indicated insufficient muscular control. Computing the relative contribution of muscles, expressed as muscle activation and estimated spinal compression, provided a measure of how much the muscle groups were working to support the spine and the rest of the dancer's body in the different movements tested. Additionally, identifying typical muscle recruitment patterns in each movement will help identify key exercises

  1. Does breathing type influence electromyographic activity of obligatory and accessory respiratory muscles?

    PubMed

    Gutiérrez, M F; Valenzuela, S; Miralles, R; Portus, C; Santander, H; Fuentes, A D; Celhay, I

    2014-11-01

    Craniomandibular electromyographic (EMG) studies frequently include several parameters, e.g. resting, chewing and tooth-clenching. EMG activity during these parameters has been recorded in the elevator muscles, but little is known about the respiratory muscles. The aim of this study was to compare EMG activity in obligatory and accessory respiratory muscles between subjects with different breathing types. Forty male subjects were classified according to their breathing type into two groups of 20 each: costo-diaphragmatic breathing type and upper costal breathing type. Bipolar surface electrodes were placed on the sternocleidomastoid, diaphragm, external intercostal and latissimus dorsi muscles. EMG activity was recorded during the following tasks: (i) normal quiet breathing, (ii) maximal voluntary clenching in intercuspal position, (iii) natural rate chewing until swallowing threshold, (iv) short-time chewing. Diaphragm EMG activity was significantly higher in the upper costal breathing type than in the costo-diaphragmatic breathing type in all tasks (P < 0·05). External intercostal EMG activity was significantly higher in the upper costal breathing type than in the costo-diaphragmatic breathing type in tasks 3 and 4 (P < 0·05). Sternocleidomastoid and latissimus dorsi EMG activity did not show significant differences between breathing types in the tasks studied (P > 0·05). The significantly higher EMG activity observed in subjects with upper costal breathing than in the costo-diaphragmatic breathing type suggests that there could be differences in motor unit recruitment strategies depending on the breathing type. This may be an expression of the adaptive capability of muscle chains in subjects who clinically have a different thoraco-abdominal expansion during inspiration at rest. PMID:25040551

  2. Trends in Immediate Postmastectomy Breast Reconstruction in the United Kingdom

    PubMed Central

    Bottle, Alex; Mayer, Erik; Patten, Darren K.; Rao, Christopher; Aylin, Paul; Hadjiminas, Dimitri J.; Athanasiou, Thanos; Darzi, Ara; Gui, Gerald

    2015-01-01

    Background: The study aimed to evaluate local and national trends in immediate breast reconstruction (IBR) using the national English administrative records, Hospital Episode Statistics. Our prediction was an increase in implant-only and free flap procedures and a decline in latissimus flap reconstructions. Methods: Data from an oncoplastic center were interrogated to derive numbers of implant-only, autologous latissimus dorsi (LD), LD-assisted, and autologous pedicled or free flap IBR procedures performed between 2004 and 2013. Similarly, Hospital Episode Statistics data were used to quantify national trends in these procedures from 1996 to 2012 using a curve fitting analysis. Results: National data suggest an increase in LD procedures between 1996 (n = 250) and 2002 (n = 958), a gradual rise until 2008 (n = 1398) followed by a decline until 2012 (n = 1090). As a percentage of total IBR, trends in LD flap reconstruction better fit a quadratic (R2 = 0.97) than a linear function (R2 = 0.63), confirming a proportional recent decline in LD flap procedures. Conversely, autologous (non-LD) flap reconstructions have increased (1996 = 0.44%; 2012 = 2.76%), whereas implant-only reconstructions have declined (1996 = 95.42%; 2012 = 84.92%). Locally, 70 implant-assisted LD procedures were performed in 2003 -2004, but only 2 were performed in 2012 to 2013. Conclusions: Implants are the most common IBR technique; autologous free flap procedures have increased, and pedicled LD flap procedures are in decline. PMID:26495220

  3. Sarcomere length dynamics of postmortem ovine Psoas major and Longissimus dorsi muscles.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Understanding relationships between biological mechanisms of postmortem events in muscle and meat quality is of enormous importance for the meat industry. Because sarcomere length has been previously related to tenderness issues in lambs, we decided to study two contrasting types of muscle with know...

  4. Proteome Analysis of Bovine Longissimus dorsi Muscle Associated with the Marbling Score

    PubMed Central

    Shen, Y. N.; Kim, S. H.; Yoon, D. H.; Lee, H. G.; Kang, H. S.; Seo, K. S.

    2012-01-01

    The breeding value of marbling score in skeletal muscle is an important factor for evaluating beef quality. In the present study, we investigated proteins associated with the breeding value of the marbling score for bovine sirloin to select potential biomarkers to improve meat quality through comparative proteomic analysis. Proteins isolated from muscle were separated by two-dimensional gel electrophoresis. After analyzing images of the stained gel, seven protein spots for the high marbling score group were identified corresponding to changes in expression that were at least two-fold compared to the low marbling score group. Four spots with increased intensities in the high marbling score group were identified as phosphoglycerate kinase 1, triosephophate isomerase, acidic ribosomal phosphoprotein PO, and capping protein (actin filament) Z-line alpha 2. Spots with decreased intensities in the high marbling score group compared to the low score group were identified as 14-3-3 epsilon, carbonic anhydrase II, and myosin light chain 1. Expression of myosin light chain 1 and carbonic anhydrase 2 was confirmed by Western blotting. Taken together, these data could help improve the economic performance of cattle and provide useful information about the underlying the function of bovine skeletal muscle. PMID:25049666

  5. Molecular cloning, sequence identification, and gene expression analysis of bovine ADCY2 gene.

    PubMed

    Li, Y X; Jin, H G; Yan, C G; Ren, C Y; Jiang, C J; Jin, C D; Seo, K S; Jin, X

    2014-06-01

    Adenylyl cyclase 2 (ADCY2), a class B member of adenylyl cyclases, is important in accelerating phosphor-acidification as well as glycogen synthesis and breakdown. Given its distinct role in flesh tenderization after butchering, we cloned and sequenced the ADCY2 gene from Yanbian cattle and assessed its expression in bovine tissues. A 2947 bp nucleotide sequence representing the full-length cDNA of bovine ADCY2 gene was obtained by 5' and 3' remote analysis computations for gene expression. Analyses of the putative protein sequence showed that ADCY2 had high homology among species, except with the non-mammal Oreochromis niloticus. Gene structural domain analyses in humans and rats indicated that the ADCY2 protein had no flaw; only the transmembrane domain was reduced and the CYCc structure domain was shortened. Assessment of ADCY2 expression in bovine tissues by real-time PCR showed that the highest expression was in the testes, followed by the longissimus dorsi, tensor fasciae latae, and latissimus dorsi. These data will serve as a foundation for further insight into the cattle ADCY2 gene. PMID:24797538

  6. [A case of palatal polymorphous low grade adenocarcinoma].

    PubMed

    Ishimoto, S; Tanaka, T; Nibu, K; Ishibashi, T; Ichimura, K; Yamada, A

    1995-07-01

    We present a 58-year-old male patient with bilateral cheek swelling and an extraorally protruding tumor who has had deaf mutism since birth. He underwent surgery of the right hard palate 11 years ago. Five years later biopsy was performed for a recurrent lesion diagnosed as pleomorphic adenoma. He refused additional treatment and the size of the tumor subsequently increased slowly. As rapid tumor-growth had been observed since autumn of 1992, he was referred to Tokyo University Hospital. We took meticulous care of this deaf-mute patient, especially from the psychological aspect, which caused him to place great reliance upon us. We performed bilateral maxillectomy with partial resection of the right cheek skin and reconstructed his face and palate successfully using both latissmus dorsi and serratus anterior musculocutaneous free flaps with a rib. Histopathological diagnosis of the tumor was polymorphous low grade adenocarcinoma, which was registered as a definite entity in the WHO Classification in 1991. There was no evidence of local recurrence or metastasis one year postoperatively. PMID:7562229

  7. Electromyographic Analysis of the Shoulder Girdle Musculature During External Rotation Exercises

    PubMed Central

    Alizadehkhaiyat, Omid; Hawkes, David H.; Kemp, Graham J.; Frostick, Simon P.

    2015-01-01

    Background: Implementation of overhead activity, a key component of many professional sports, requires an effective and balanced activation of the shoulder girdle muscles, particularly during forceful external rotation (ER) motions. Purpose: To identify activation strategies of 16 shoulder girdle muscles/muscle segments during common shoulder ER exercises. Study Design: Descriptive laboratory study. Method: Thirty healthy subjects were included in this study, and 16 shoulder girdle muscles/muscle segments were investigated (surface electrode: anterior, middle, and posterior deltoid; upper, middle, and lower trapezius; serratus anterior; teres major; upper and lower latissimus dorsi; and upper and lower pectoralis major; fine wire electrodes: supraspinatus, infraspinatus, subscapularis, and rhomboid major) using a telemetric electromyography (EMG) system. Five ER exercises (standing ER at 0° and 90° of abduction, with underarm towel roll, prone ER at 90° of abduction, side-lying ER with underarm towel) were studied. Exercise EMG amplitudes were normalized to EMG at maximum ER force in a standard position. Univariate analysis of variance and post hoc analysis applied on EMG activity of each muscle were used to assess the main effect of the exercise condition. Results: Muscular activity differed significantly among the ER exercises (P < .05 to P < .001). The greatest activation for anterior and middle deltoid, supraspinatus, upper trapezius, and serratus anterior occurred during standing ER at 90° of abduction; for posterior deltoid, middle trapezius, and rhomboid during side-lying ER with underarm towel; for lower trapezius, upper and lower latissimus dorsi, subscapularis, and teres major during prone ER at 90° of abduction; and for the clavicular and sternal part of the pectoralis major during standing ER with underarm towel. Conclusion: Key glenohumeral and scapular muscles can be optimally activated during specific ER exercises, particularly in positions that

  8. New model for cardiomyocyte sheet transplantation using a virus-cell fusion technique

    PubMed Central

    Takahashi, Yuto; Tomotsune, Daihachiro; Takizawa, Sakiko; Yue, Fengming; Nagai, Mika; Yokoyama, Tadayuki; Hirashima, Kanji; Sasaki, Katsunori

    2015-01-01

    AIM: To facilitate close contacts between transplanted cardiomyocytes and host skeletal muscle using cell fusion mediated by hemagglutinating virus of Japan envelope (HVJ-E) and tissue maceration. METHODS: Cardiomyocytes (1.5 × 106) from fetal rats were first cultured. After proliferation, some cells were used for fusion with adult muscle fibers using HVJ-E. Other cells were used to create cardiomyocyte sheets (area: about 3.5 cm2 including 2.1 × 106 cells), which were then treated with Nile blue, separated, and transplanted between the latissimus dorsi and intercostal muscles of adult rats with four combinations of HVJ-E and/or NaOH maceration: G1: HVJ-E(+), NaOH(+), Cardiomyocytes(+); G2: HVJ-E(-), NaOH(+), Cardiomyocytes(+); G3: HVJ-E(+), NaOH(-), Cardiomyocytes(+); G4: HVJ-E(-), NaOH(-), Cardiomyocytes(-). At 1 and 2 wk after transplantation, the four groups were compared by detection of beating domains, motion images using moving target analysis software, action potentials, gene expression of MLC-2v and Mesp1 by reverse transcription-polymerase chain reaction, hematoxylin-eosin staining, and immunostaining for cardiac troponin and skeletal myosin. RESULTS: In vitro cardiomyocytes were fused with skeletal muscle fibers using HVJ-E. Cardiomyocyte sheets remained in the primary transplanted sites for 2 wk. Although beating domains were detected in G1, G2, and G3 rats, G1 rats prevailed in the number, size, motion image amplitudes, and action potential compared with G2 and G3 rats. Close contacts were only found in G1 rats. At 1 wk after transplantation, the cardiomyocyte sheets showed adhesion at various points to the myoblast layer in the latissimus dorsi muscle. At 2 wk after transplantation, close contacts were seen over a broad area. Part of the skeletal muscle sarcoplasma seemed to project into the myocardiocyte plasma and some nuclei appeared to share both sarcoplasmas. CONCLUSION: The present results show that close contacts were acquired and facilitated

  9. A Biomechanical Assessment of Ergometer Task Specificity in Elite Flatwater Kayakers

    PubMed Central

    Fleming, Neil; Donne, Bernard; Fletcher, David; Mahony, Nick

    2012-01-01

    The current study compared EMG, stroke force and 2D kinematics during on-ergometer and on-water kayaking. Male elite flatwater kayakers (n = 10) performed matched exercise protocols consisting of 3 min bouts at heart and stroke rates equivalent to 85% of VO2peak (assessed by prior graded incremental test). EMG data were recorded from Anterior Deltoid (AD), Triceps Brachii (TB), Latissimus Dorsi (LD) and Vastus Lateralis (VL) via wireless telemetry. Video data recorded at 50 Hz with audio triggers pre- and post-exercise facilitated synchronisation of EMG and kinematic variables. Force data were recorded via strain gauge arrays on paddle and ergometer shafts. EMG data were root mean squared (20ms window), temporally and amplitude normalised, and averaged over 10 consecutive cycles. In addition, overall muscle activity was quantified via iEMG and discrete stroke force and kinematic variables computed. Significantly greater TB and LD mean iEMG activity were recorded on-water (239 ± 15 vs. 179 ± 10 μV. s, p < 0.01 and 158 ± 12 vs. 137 ± 14 μV.s, p < 0.05, respectively), while significantly greater AD activity was recorded on-ergometer (494 ± 66 vs. 340 ± 35 μV.s, p < 0.01). Time to vertical shaft position occurred significantly earlier on-ergometer (p < 0.05). Analysis of stroke force data and EMG revealed that increased AD activity was concurrent with increased external forces applied to the paddle shaft at discrete phases of the on-ergometer stroke cycle. These external forces were associated with the ergometer loading mechanism and were not observed on- water. The current results contradict a previous published hypothesis on shoulder muscle recruitment during on-water kayaking. Key pointsWhen exercising at fixed heart and stroke rates, biomechanical differences exist between onergometer and on-water kayaking.Ergometer kayaking results in significantly greater Anterior Deltoid activity but significantly lower Triceps Brachii and Latissimus Dorsi activity

  10. Associations between portion size acceptability of beef cuts and ribeye area of beef carcasses.

    PubMed

    Bass, P D; Scanga, J A; Chapman, P L; Smith, G C; Belk, K E

    2009-09-01

    Carcasses that do not conform to mainstream specifications (i.e., those with nonconforming ribeye area) may not achieve their full potential value. Research was conducted to evaluate the relationship between beef carcass LM area at the 12th and 13th rib interface (LMA) and portion size acceptability of other muscles in the carcass. Sixty beef carcass sides of varying LMA sizes (between 67.74 and 116.13 cm(2)) were fabricated to generate 14 individual muscle cuts (triceps brachii long head, infraspinatus, chuckeye complexus, pectoralis profundus, longissimus thoracis, latissimus dorsi, gluteus medius, longissimus lumborum, tensor fasciae latae, psoas major, semimembranosus, biceps femoris, semitendinosus, and vastus lateralis). Retail portion size (g/1.27-cm-thick steak) as well as face surface area and dimensions were recorded for each steak cut perpendicular at the midpoint of the longitudinal axis of each muscle. Subsequently, a nationwide survey was conducted with foodservice chefs and retail meat merchandisers to evaluate acceptability of portion sizes and dimensions of individual muscle cuts. Simple linear regression and nonparametric regression analyses were used to evaluate results of the carcass muscle evaluation and survey, respectively. Results demonstrated that LMA did not affect (P < 0.05) retail portion size of 7 of the 14 muscles (chuckeye complexus, pectoralis profundus, psoas major, semimembranosus, tensor fasciae latae, triceps brachii, and vastus lateralis). Similarly, LMA did not affect (P < 0.05) surface area of steak cross-sectional face areas from 7 of the 14 muscles (chuckeye complexus, psoas major, semimembranosus, tensor fasciae latae, infraspinatus, vastus lateralis, and latissimus dorsi). Muscles for which carcass LMA (P < 0.05) was related to portion size or surface area of portion steaks, or both, were included in the survey. Results of the survey demonstrated that portion size for many muscles were still acceptable to retail

  11. Low frequency chronic electrical stimulation of normal and dystrophic chicken muscle.

    PubMed Central

    Barnard, E A; Barnard, P J; Jarvis, J C; Lai, J

    1986-01-01

    The fast-twitch posterior latissimus dorsi muscle of normal and genetically dystrophic chickens was subjected to continuous indirect electrical stimulation at 10 Hz for periods of 4-8 weeks. To sustain this in vivo nerve stimulation an internally implantable miniature stimulator device was designed. This regime of stimulation caused complete fatigue of the normal muscle within 5 min of its initiation. The dystrophic muscles maintained a very small degree of contractile activity during this initial phase. Tangible twitching of the muscle returned in 5 week birds between 3 and 5 days and in 10 week birds between 11 and 16 days after implantation. After 4 weeks of stimulation, no significant change was measured in the time-to-peak of the isometric twitch response, nor in the half-relaxation time. The resistance to fatigue was significantly increased in the stimulated muscles when tested with a series of tetani at 40 Hz. The mean fibre area was decreased, in all muscles stimulated for longer than 3 weeks, in comparison to their contralateral controls, except where fibre splitting in dystrophic birds abnormally reduced the control value. The majority fibre type of the muscle was changed from type IIB to IIA. The histochemical reactions for both NADH-linked oxidation and phosphorylase were distinctly increased in the stimulated muscles. In normal muscle, stimulation increased somewhat the number of nuclei per unit area and changed their intracellular distribution, so that a greater proportion was found adjacent to the sarcolemma. The normal posterior latissimus dorsi muscle responded to chronic stimulation with increases of 3-6-fold in its acetylcholinesterase (AChE) activity. The maximum change in AChE occurred after 2 weeks stimulation; a steady level, 3 times that of the control unstimulated muscle, persisted at later times. Chronic stimulation suppressed the over-production of AChE that is characteristic of dystrophic chicken fast-twitch muscle, to attain a level

  12. Eating Quality Traits of Hanwoo longissimus dorsi Muscle as a Function of End-Point Cooking Temperature.

    PubMed

    Yang, Jieun; Jeong, Dawoon; Na, Chong-Sam; Hwang, Inho

    2016-01-01

    Interaction between carcass quality grade and end-point cooking temperature on eating quality of Hanwoo m. longissimus was investigated. Ten (10) of steers were sampled from a commercial population; carcasses with QG 1(++) (n=5) and QG 1 (n=5) were chosen. Samples were cooked by electric oven at 60 or 82℃ and compared with uncooked control samples. The pH was not affected by cooking temperature but decreased the redness after cooking and steaks cooked at 60℃ were more reddish than steaks cooked at 82℃ in both QG groups. Higher cooking temperature greatly (p<0.05) increased the cooking loss, but there was no significant interaction between cooking temperature and QG on the cooking loss. Moisture is negatively correlated with temperature in both QG while the proportionate relationship between crude fat and end-point temperature found in QG 1(++). WBSF values were significantly (p<0.05) high for QG 1, while that was significantly (p<0.05) increased when the temperature continues to increase. The increasing quality grade of beef resulted in significant higher (p<0.01) level of TBARS and cooking temperature increased TBARS content. Fatty acid composition was not altered by cooking at both temperatures and also the amount of fat intake was not changed. The current study indicates that eating quality of beef m. longissimus was greatly influenced by end-point temperature being interacted with QG. However, the amount and composition of fat were stable regardless of end-point temperatures. These results will provide a consumer reference to determine cooking conditions and intramuscular fat content. PMID:27433099

  13. Eating Quality Traits of Hanwoo longissimus dorsi Muscle as a Function of End-Point Cooking Temperature

    PubMed Central

    2016-01-01

    Interaction between carcass quality grade and end-point cooking temperature on eating quality of Hanwoo m. longissimus was investigated. Ten (10) of steers were sampled from a commercial population; carcasses with QG 1++ (n=5) and QG 1 (n=5) were chosen. Samples were cooked by electric oven at 60 or 82℃ and compared with uncooked control samples. The pH was not affected by cooking temperature but decreased the redness after cooking and steaks cooked at 60℃ were more reddish than steaks cooked at 82℃ in both QG groups. Higher cooking temperature greatly (p<0.05) increased the cooking loss, but there was no significant interaction between cooking temperature and QG on the cooking loss. Moisture is negatively correlated with temperature in both QG while the proportionate relationship between crude fat and end-point temperature found in QG 1++. WBSF values were significantly (p<0.05) high for QG 1, while that was significantly (p<0.05) increased when the temperature continues to increase. The increasing quality grade of beef resulted in significant higher (p<0.01) level of TBARS and cooking temperature increased TBARS content. Fatty acid composition was not altered by cooking at both temperatures and also the amount of fat intake was not changed. The current study indicates that eating quality of beef m. longissimus was greatly influenced by end-point temperature being interacted with QG. However, the amount and composition of fat were stable regardless of end-point temperatures. These results will provide a consumer reference to determine cooking conditions and intramuscular fat content. PMID:27433099

  14. Comparison of thawing assisted by low-intensity ultrasound on technological properties of pork Longissimus dorsi muscle.

    PubMed

    Gambuteanu, Corina; Alexe, Petru

    2015-04-01

    The objective of the present study was to analyses technological and textural properties of pork thawed by low intensity ultrasound compared to meat thawed conventionally in air (control) or by immersion in water. The pork thawing was done by means of a generator of constant frequency, with adjusting ultrasound intensity, coupled with a transducer plate and a water bath. The frequency of 25 kHz and the intensity of 0.6 W/cm(2) allowed reducing by 87 % the time required for thawing from -5 °C to -1 °C as well as the overall thawing time as compared to thawing in air. Using intensity of 0.2, 0.4, and 0.6 W/cm(2) thawing rates were 0.62, 0.73, 1 °C/min, versus 0.16 °C/min in the control. The textural and technological properties of meat thawed by ultrasound are not impaired by the significant lowering of thawing time; there were no large mass loss or modification of meat ultrastructure as compared to control. PMID:25829593

  15. Use of 25-hydroxyvitamin D3 and vitamin E to improve tenderness of beef from the longissimus dorsi of heifers.

    PubMed

    Carnagey, K M; Huff-Lonergan, E J; Trenkle, A; Wertz-Lutz, A E; Horst, R L; Beitz, D C

    2008-07-01

    The objective of this trial was to determine whether a single bolus of 25-hydroxyvitamin D(3) (25-OH D(3)), vitamin E, or a combination of the 2 would improve the tenderness of steaks from the LM of beef heifers. Forty-eight Angus crossbred heifers were allotted randomly to 8 pens. Six heifers were in each pen, and there were 2 pens per treatment. The 4 treatments included control (no 25-OH D(3) or vitamin E); 25-OH D(3) (500 mg of 25-OH D(3) administered as a one-time oral bolus 7 d before slaughter); vitamin E (1,000 IU of vitamin E administered daily as a top-dress for 104 d before slaughter); or combination (500 mg of 25-OH D(3) administered as a one-time oral bolus 7 d before slaughter and 1,000 IU of vitamin E administered daily as a top-dress for 104 d before slaughter). Blood samples were obtained on the day that heifers were allotted to treatments, on the day 25-OH D(3) was administered, and on the day before slaughter. Plasma calcium concentration was increased when 25-OH D(3) was administered with or without vitamin E (P < 0.007). In LM, calcium concentration tended to increase (P = 0.10) when 25-OH D(3) was administered alone but not when 25-OH D(3) was administered with vitamin E. Concentrations of 25-OH D(3) and 1,25-dihydroxyvitamin D(3) in plasma were increased when 25-OH D(3) was administered with or without vitamin E (P < 0.001). Steaks from heifers treated with 25-OH D(3) or vitamin E, but not both, tended to have lower Warner-Bratzler shear force than steaks in the control group at 14 d postmortem (P = 0.08). Postmortem protein degradation as measured by Western blot of the 30-kDa degradation product of troponin-T was increased with all treatments after 3 d postmortem (P

  16. Optimizing the Combination of Smoking and Boiling on Quality of Korean Traditional Boiled Loin (M. longissimus dorsi)

    PubMed Central

    Choi, Yun-Sang; Kim, Hyun-Wook; Kim, Young-Boong; Kim, Cheon-Jei

    2015-01-01

    The combined effects of smoking and boiling on the proximate composition, technological quality traits, shear force, and sensory characteristics of the Korean traditional boiled loin were studied. Cooking loss, processing loss, and shear force were lower in the smoked/boiled samples than those in the control (without smoking treatment) (p<0.05). The results showed that the boiled loin samples between the control and treatment did not differ significantly in protein, fat, or ash contents, or pH values (p>0.05). The treated samples had higher score for overall acceptability than the control (p<0.05). Thus, these results show that the Korean traditional boiled loin treated with smoking for 60 min before boiling had improved physicochemical properties and sensory characteristics. PMID:26761822

  17. Normal shoulder muscular activation and co-ordination during a shoulder elevation task based on activities of daily living: an electromyographic study.

    PubMed

    Hawkes, David H; Alizadehkhaiyat, Omid; Fisher, Anthony C; Kemp, Graham J; Roebuck, Margaret M; Frostick, Simon P

    2012-01-01

    Studies of normal shoulder function have often failed to consider the inter-relationship between different muscle groups in activities relevant to daily life. Upper limb functional status was assessed in 12 healthy male volunteers using the Functional Impairment Test-Hand, Neck, Shoulder and Arm test (FIT-HaNSA). Electromyography was then used to study the activity and coordination of 13 muscles (10 by surface electrodes, 3 by fine-wire intramuscular electrodes) around the shoulder during a dynamic movement task based on the shelf-lifting task in FIT-HaNSA. Muscles were grouped for analysis into deltoid (anterior, middle, and posterior divisions), adductors (latissimus dorsi and teres major), rotator cuff (supraspinatus, infraspinatus, and subscapularis), and elbow flexor (brachioradialis, biceps brachii) groups. There were no significant inter-session effects. Using cross-correlation analysis to investigate the whole time-course of activation, there were highly significant positive correlations (p < 0.001) between the deltoid and rotator cuff, the deltoid and adductor and the adductor and rotator cuff groups, and a significant negative correlation between the deltoid and elbow flexor groups (p = 0.031). We conclude that the deltoid, adductor, and rotator cuff muscles all contribute to the muscular component of glenohumeral joint stability. Muscular stability can be adapted as required to meet task-specific demands. PMID:21674607

  18. Elastofibroma of scapula: a case report and literature review

    PubMed Central

    Hergli, Ilhem; Boudaya, Mohamed Sadok; Ismail, Olfa; Ayadi-Kaddour, Aida; Kilani, Tarek; El Mezni, Faouzi

    2013-01-01

    Elastofibromas are benign soft tissue tumors. They occur mostly in the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle, with a prevalence of up to 24% in the elderly. The etiology of this lesion remains uncertain and is a source of ongoing debate. We herein report a 54-year-old female patient, manual worker who presented with bilateral subscapular slow growing tumors for 7 months. Physical examination showed two masses of 4 cm in diameter on the right, and 8 cm on the left, both located inferior to the inferior margin of the scapula. They were more or less firm and mobile on palpation. Computed tomography scan showed large fusiform subscapular soft tissue heterogeneous solid masses with linear areas of low density secondary to fat. The lesions measured 5 cm × 4 cm on the right side and 8 cm × 8 cm on the left. Resection of the largest left tumor was achieved. Macroscopic and histological findings were consistent with elastofibroma. PMID:25332975

  19. Adaptations to isolated shoulder fatigue during simulated repetitive work. Part I: Fatigue.

    PubMed

    Tse, Calvin T F; McDonald, Alison C; Keir, Peter J

    2016-08-01

    Upper extremity muscle fatigue is challenging to identify during industrial tasks and places changing demands on the shoulder complex that are not fully understood. The purpose of this investigation was to examine adaptation strategies in response to isolated anterior deltoid muscle fatigue while performing simulated repetitive work. Participants completed two blocks of simulated repetitive work separated by an anterior deltoid fatigue protocol; the first block had 20 work cycles and the post-fatigue block had 60 cycles. Each work cycle was 60s in duration and included 4 tasks: handle pull, cap rotation, drill press and handle push. Surface EMG of 14 muscles and upper body kinematics were recorded. Immediately following fatigue, glenohumeral flexion strength was reduced, rating of perceived exertion scores increased and signs of muscle fatigue (increased EMG amplitude, decreased EMG frequency) were present in anterior and posterior deltoids, latissimus dorsi and serratus anterior. Along with other kinematic and muscle activity changes, scapular reorientation occurred in all of the simulated tasks and generally served to increase the width of the subacromial space. These findings suggest that immediately following fatigue people adapt by repositioning joints to maintain task performance and may also prioritize maintaining subacromial space width. PMID:26208429

  20. Whole-body vibration effects on the muscle activity of upper and lower body muscles during the baseball swing in recreational baseball hitters.

    PubMed

    Reyes, Gabriel F; Dickin, D Clark; Crusat, Nolan J K; Dolny, Dennis G

    2011-11-01

    The purpose of this study was to evaluate the effects of whole-body vibration (WBV) on the muscle recruitment of selected upper and lower body muscles during the baseball swing. Participants were recreationally trained males (n = 16, 22 +/- 2 years, 181.4 +/- 7.4 cm, 84.7 +/- 9.0 kg), with previous baseball experience. Subjects participated in three randomized sessions on separate days, consisting of three sets of five swings offa hitting tee. Exercises (upper and lower body dynamic and static movements) with or without WBVexposure were performed between swing sets. During each swing, the gastrocnemius, biceps femoris, gluteus maximus, pectoralis major, latissimus dorsi, and triceps brachii were evaluated for electromyographic (EMG) activity. EMG values were normalized to EMG measured during maximal voluntary isometric contraction. Statistical analysis revealed no significant differences in EMG activity across the three treatments. In addition, the results displayed a specific muscle recruitment order during the swing, starting with the lower body followed by the upper body muscles. This study was the first to report the recruitment order during the baseball swing. Although acute exposure to WBV did not significantly alter the muscle recruitment, these results may prove useful for practitioners looking to enhance baseball swing performance. PMID:22303781

  1. [Strategies for the treatment of postoperative sternal infections].

    PubMed

    Akil, A; Schnorr, P; Wiebe, K

    2016-02-01

    Postoperative sternal infections are associated with significant morbidity and mortality. An incidence of up to 8 % has to be expected. Typically, a highly inflammatory acute infection with a marked soft tissue component is observed. However, the infection may also be present as a less symptomatic reaction and localised chronic osteomyelitis with fistula formation. The treatment strategy for a deep sternal wound infection consists of several steps. A radical debridement of the wound requires the opening of all abscesses, the resection of non-vital bone and the removal of all infected allomaterial. This is followed by a period of VAC therapy (Vacuum-Assisted Closure Therapy) for infection treatment and conditioning of the wound. Secondary closure of the wound may be planned only after the infection is completely controlled. The sternum is stabilised by osteosynthesis. Sternal defects are covered. In most cases adequate soft tissue coverage is achieved by mobilisation of both pectoral muscles together with the precostal soft tissues. Following resection of the sternum, the reconstruction of the thoracic wall requires the implantation of material for stabilisation as well as soft tissue coverage. For complicated or large defects various muscle flaps and the omentum majus have been advocated. The latissimus dorsi muscle with skin is the muscle flap most frequently used. PMID:26492536

  2. Trends in head and neck microvascular reconstructive surgery in Liverpool (1992-2001).

    PubMed

    Brown, J S; Magennis, P; Rogers, S N; Cawood, J I; Howell, R; Vaughan, E D

    2006-10-01

    Microvascular reconstructive techniques in head and neck surgery are well established, but we are now entering an era of modification exemplified by perforator and free style free flaps. We present a review of the database introduced into the unit in 1992 over a 10-year period, during which time 977 patients with malignant disease were operated on and 620 defects were reconstructed with free flaps. There were 358 radial forearm flaps, 78 composite radial forearm flaps, 84 iliac crest flaps, 43 fibular flaps, 24 from the scapula, 26 from the latissimus dorsi, 4 from the rectus abdominis, and 3 from the lateral arm. The main changes over this time have been the use of more bulky flaps for larger resections of the tongue and the preference for iliac crest flaps over those from the fibula and forearm for composite reconstructions. Improving reliability of tissue transfer remains an important aim, and further development of reliable objective methods of monitoring of flaps is required. PMID:16169640

  3. Skeletal muscle grafts applied to the heart. A word of caution.

    PubMed

    Anderson, W A; Andersen, J S; Acker, M A; Hammond, R L; Chin, A J; Douglas, P S; Khalafalla, A S; Salmons, S; Stephenson, L W

    1988-11-01

    Latissimus dorsi pedicle grafts (LDPGs) were wrapped around the heart in eight dogs. In four dogs, the LDPGs were stimulated chronically; the remaining four dogs served as unstimulated controls. Right-sided cardiac filling pressures were normal in all dogs when measured 4 months after graft application. Mean tension generated by the viable LDPGs was 153 +/- 49.9 g. LDPGs contracting in synchrony with the heart did not increase cardiac output. In one dog, the aortic pressure changed from 140/100 to 155/85 mm Hg during synchronous contraction of the LDPG. Three dogs were placed on cardiopulmonary bypass, and their hearts were placed in fibrillation. The LDPGs were then stimulated at a burst frequency of 85 Hz and contracted vigorously. Under these conditions, the left ventricular pressure increased by an average of 15 mm Hg with each LDPG contraction; however, the mean aortic pressure was virtually unchanged. Left ventricular and aortic pressures of 125/20 and 125/65 mm Hg, respectively, could be obtained with manual compression of the fibrillating heart. This study indicates that although LDPGs can be made to contract chronically and in synchrony with the heart, they do not necessarily augment left ventricular performance. PMID:3180397

  4. In vivo 31P-NMR spectroscopy of chronically stimulated canine skeletal muscle.

    PubMed

    Clark, B J; Acker, M A; McCully, K; Subramanian, H V; Hammond, R L; Salmons, S; Chance, B; Stephenson, L W

    1988-02-01

    Chronic stimulation converts skeletal muscle of mixed fiber type to a uniform muscle made up of type I, fatigue-resistant fibers. Here, the bioenergetic correlates of fatigue resistance in conditioned canine latissimus dorsi are assessed with in vivo phosphorus-31 nuclear magnetic resonance (31P-NMR) spectroscopy. After chronic electrical stimulation, five dogs underwent 31P-NMR spectroscopic and isometric tension measurements on conditioned and contralateral control muscle during stimulation for 200, 300, 500, and 800 ms of an 1,100-ms duty cycle. With stimulation, phosphocreatine (PCr) fell proportional to the degree of stimulation in both conditioned and control muscle but fell significantly less in conditioned muscle at all but the least intense stimulation period (200 ms). Isometric tension, expressed as a tension time index per gram muscle, was significantly greater in the conditioned muscle at the two longest stimulation periods. The overall small change in PCr and the lack of a plateau in tension observed in the conditioned muscle are similar to that seen in cardiac muscle during increased energy demand. This study indicates that the conditioned muscle's markedly enhanced resistance to fatigue is in part the result of its increased capacity for oxidative phosphorylation. PMID:3348365

  5. The effect of ephedra and caffeine on maximal strength and power in resistance-trained athletes.

    PubMed

    Williams, Andrew D; Cribb, Paul J; Cooke, Matthew B; Hayes, Alan

    2008-03-01

    Caffeine and ephedrine-related alkaloids recently have been removed from International Olympic Committee banned substances lists, whereas ephedrine itself is now permissible at urinary concentrations less than 10 mug.mL. The changes to the list may contribute to an increased use of caffeine and ephedra as ergogenic aids by athletes. Consequently, we sought to investigate the effects of ingesting caffeine (C) or a combination of ephedra and caffeine (C + E) on muscular strength and anaerobic power using a double-blind, crossover design. Forty-five minutes after ingesting a glucose placebo (P: 300 mg), C (300 mg) or C + E (300 mg + 60 mg), 9 resistance-trained male participants were tested for maximal strength by bench press [BP; 1 repetition maximum (1RM)] and latissimus dorsi pull down (LP; 1RM). Subjects also performed repeated repetitions at 80% of 1RM on both BP and LP until exhaustion. After this test, subjects underwent a 30-second Wingate test to determine peak anaerobic cycling power, mean power, and fatigue index. Although subjects reported increased alertness and enhanced mood after supplementation with caffeine and ephedra, there were no significant differences between any of the treatments in muscle strength, muscle endurance, or peak anaerobic power. Our results do not support the contention that supplementation with ephedra or caffeine will enhance either muscle strength or anaerobic exercise performance. PMID:18550961

  6. Evaluation of adipose-derived stem cells for tissue-engineered muscle repair construct-mediated repair of a murine model of volumetric muscle loss injury.

    PubMed

    Kesireddy, Venu

    2016-01-01

    Volumetric muscle loss (VML) can occur from congenital defects, muscle wasting diseases, civilian or military injuries, and as a result of surgical removal of muscle tissue (eg, cancer), all of which can lead to irrevocable functional and cosmetic defects. Current tissue engineering strategies to repair VML often employ muscle-derived progenitor cells (MDCs) as one component. However, there are some inherent limitations in their in vitro culture expansion. Thus, this study explores the potential of adipose-derived stem cells (ADSCs) as an alternative cell source to MDCs for tissue engineering of skeletal muscle. A reproducible VML injury model in murine latissimus dorsi muscle was used to evaluate tissue-engineered muscle repair (TEMR) constructs incorporating MDCs or ADSCs. Importantly, histological analysis revealed that ADSC-seeded constructs displayed regeneration potential that was comparable to those seeded with MDCs 2 months postrepair. Furthermore, morphological analysis of retrieved constructs demonstrated signs of neotissue formation, including cell fusion, fiber formation, and scaffold remodeling. Immunohistochemistry demonstrated positive staining for both structural and functional proteins. Positive staining for vascular structures indicated the potential for long-term neotissue survival and integration with existing musculature. Qualitative observation of lentivirus-Cherry-labeled donor cells by immunohistochemistry indicates that participation of ADSCs in new hybrid myofiber formation incorporating donor cells was relatively low, compared to donor MDCs. However, ADSCs appear to participate in vascularization. In summary, I have demonstrated that TEMR constructs generated with ADSCs displayed skeletal muscle regeneration potential comparable to TEMR-MDC constructs as previously reported. PMID:27114706

  7. Upper Girdle Imaging in Facioscapulohumeral Muscular Dystrophy

    PubMed Central

    Tasca, Giorgio; Monforte, Mauro; Iannaccone, Elisabetta; Laschena, Francesco; Ottaviani, Pierfrancesco; Leoncini, Emanuele; Boccia, Stefania; Galluzzi, Giuliana; Pelliccioni, Marco; Masciullo, Marcella; Frusciante, Roberto; Mercuri, Eugenio; Ricci, Enzo

    2014-01-01

    Background In Facioscapulohumeral muscular dystrophy (FSHD), the upper girdle is early involved and often difficult to assess only relying on physical examination. Our aim was to evaluate the pattern and degree of involvement of upper girdle muscles in FSHD compared with other muscle diseases with scapular girdle impairment. Methods We propose an MRI protocol evaluating neck and upper girdle muscles. One hundred-eight consecutive symptomatic FSHD patients and 45 patients affected by muscular dystrophies and myopathies with prominent upper girdle involvement underwent this protocol. Acquired scans were retrospectively analyzed. Results The trapezius (100% of the patients) and serratus anterior (85% of the patients) were the most and earliest affected muscles in FSHD, followed by the latissimus dorsi and pectoralis major, whilst spinati and subscapularis (involved in less than 4% of the patients) were consistently spared even in late disease stages. Asymmetry and hyperintensities on short-tau inversion recovery (STIR) sequences were common features, and STIR hyperintensities could also be found in muscles not showing signs of fatty replacement. The overall involvement appears to be disease-specific in FSHD as it significantly differed from that encountered in the other myopathies. Conclusions The detailed knowledge of single muscle involvement provides useful information for correctly evaluating patients' motor function and to set a baseline for natural history studies. Upper girdle imaging can also be used as an additional tool helpful in supporting the diagnosis of FSHD in unclear situations, and may contribute with hints on the currently largely unknown molecular pathogenesis of this disease. PMID:24932477

  8. Cranial-base surgery: a reconstructive algorithm.

    PubMed

    Georgantopoulou, A; Hodgkinson, P D; Gerber, C J

    2003-01-01

    Skull-base surgery is associated with a high risk of cerebrospinal fluid (CSF) leak, infection, and functional and aesthetic deformity. Appropriate reconstruction of cranial-base defects following surgery helps to prevent these complications. Between March 1998 and May 2000, 28 patients (age: 1-68 years) underwent reconstruction of the anterior and middle cranial fossae. The indications for surgery were tumours, trauma involving the anterior cranial fossa, midline dermoid cysts with intracranial extension, late post-traumatic CSF leak, craniofacial deformity and recurrent frontal mucocoele. We used local anteriorly based pericranial flaps (23 flaps, alone or in combination with other flaps), bipedicled galeal flaps (seven patients) and free flaps (nine patients; radial forearm fascial/fasciocutaneous flaps, rectus abdominis muscle flap and latissimus dorsi muscle flap). Follow-up has been 4-24 months. We had no deaths, no flap failure and no incidence of infection. Complications included two CSF leaks, three intracranial haematomas and one pulsatile enophthalmos. All patients had a very good aesthetic result. We present an algorithm for skull-base reconstruction and comment on the design and vascularity of the bipedicled galeal flap. The monitoring of intracranial flaps and the difficulties of perioperative management of free flaps in neurosurgical patients are also discussed. PMID:12706142

  9. Integrated metabolomic and transcriptome analyses reveal finishing forage affects metabolic pathways related to beef quality and animal welfare

    PubMed Central

    Carrillo, José A.; He, Yanghua; Li, Yaokun; Liu, Jianan; Erdman, Richard A.; Sonstegard, Tad S.; Song, Jiuzhou

    2016-01-01

    Beef represents a major dietary component and source of protein in many countries. With an increasing demand for beef, the industry is currently undergoing changes towards naturally produced beef. However, the true differences between the feeding systems, especially the biochemical and nutritional aspects, are still unclear. Using transcriptome and metabolome profiles, we identified biological pathways related to the differences between grass- and grain-fed Angus steers. In the latissimus dorsi muscle, we have recognized 241 differentially expressed genes (FDR < 0.1). The metabolome examinations of muscle and blood revealed 163 and 179 altered compounds in each tissue (P < 0.05), respectively. Accordingly, alterations in glucose metabolism, divergences in free fatty acids and carnitine conjugated lipid levels, and altered β-oxidation have been observed. The anti-inflammatory n3 polyunsaturated fatty acids are enriched in grass finished beef, while higher levels of n6 PUFAs in grain finished animals may promote inflammation and oxidative stress. Furthermore, grass-fed animals produce tender beef with lower total fat and a higher omega3/omega6 ratio than grain-fed ones, which could potentially benefit consumer health. Most importantly, blood cortisol levels strongly indicate that grass-fed animals may experience less stress than the grain-fed individuals. These results will provide deeper insights into the merits and mechanisms of muscle development. PMID:27185157

  10. The use of fabricated chimeric flap for reconstruction of extensive foot defects.

    PubMed

    Song, Baoqiang; Chen, Jianwu; Han, Yan; Hu, Yalan; Su, Yingjun; Li, Yang; Zhang, Juan; Guo, Shuzhong

    2016-05-01

    Repair of extensive foot defects requires both adequate tissues for wound coverage and special tissues for functional reconstruction. To maximize its function reconstruction, fabricated chimeric flaps consisting of multiple separate flaps were designed to reconstruct such defects. Five patients suffered extensive foot defects with sizes ranging from 23 × 12 cm to 38 × 14 cm(2) in multiple regions including heel, forefoot, dorsum, ankle, anterior leg, and even toes. Causes included crushing injuries, avulsion injuries, and scar excision. Most areas of the defects except heel were first covered by latissimus dorsi muscle flap or anterolateral thigh flap and their pedicles were anastomosed with recipient vessels. Then free medial plantar flaps were transferred for heel reconstruction and their pedicles were further attached to either side branches of the main source vessel or to its distal continuation. All chimeric flaps survived uneventfully and all patients were able to walk in normal footwear during the 1.5- to 4-years follow-up. None of the flaps developed ulcer and flap breakdown. The assessment by Maryland Foot Score showed that four of the five patients gained a "good" recovery and one patient showed moderate improvement of foot functions. Appearances of reconstructed heels were near-normal. The results indicate that fabricated chimeric flap has good design flexibility and may provide an option for functional reconstruction of extensive foot defects. © 2015 Wiley Periodicals, Inc. Microsurgery 36:303-309, 2016. PMID:25752811

  11. Functional anatomy and muscle moment arms of the thoracic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris).

    PubMed

    Williams, S B; Wilson, A M; Daynes, J; Peckham, K; Payne, R C

    2008-10-01

    We provide quantitative muscle-tendon architecture and geometry data for the racing greyhound thoracic limb. Muscle mass, belly length, fascicle lengths, pennation angles and moment arms were measured, as were tendon masses and lengths. Maximum isometric force and maximum power were estimated for muscles, and maximum stress and strain were estimated for tendons. Results are compared with other fast quadrupedal runners, and to previously published data in mixed-breed dogs. The implications of the functional adaptations of the greyhound thoracic limb for sprinting performance are discussed. The thoracic limb was found to benefit from a similar proportion of locomotor muscle mass to the pelvic limb, suggesting that it may be used to some extent in propulsion, or alternatively that stabilisation is very important in this animal. Extrinsic muscles, especially latissimus dorsi and pectoralis profundus, were predicted to be powerful and important for generating net positive work during accelerations. Proximal biarticular muscles show specialisation toward preventing collapse of the shoulder and elbow joints to enable strut-like limb function, or some form of dynamic control. Distal muscles did not appear specialised for elastic energy storage, a functional difference to pelvic limb muscles, and the equivalents in horse thoracic limbs. The greyhound thoracic limb appears to possess substantial differences from both that of more 'sub-maximal specialist' quadrupeds, and from the greyhound pelvic limb. PMID:19034998

  12. Chest wall reconstruction. Experience with 100 consecutive patients.

    PubMed Central

    Arnold, P G; Pairolero, P C

    1984-01-01

    Experience with 100 consecutive chest wall reconstructions during the past 7 years was reviewed. There were 52 female and 48 male patients with ages ranging from 13 to 78 years (average 53). Of the 100 patients, 42 had tumors of the chest wall, 19 had radiation necrosis, 24 had infected median sternotomies , and 15 had combinations of the three. Seventy-six patients underwent skeletal resection of the chest wall. An average of 5.7 ribs were resected in 63 patients. Total or partial sternectomies were performed in 29. Ninety-two patients underwent 142 muscle flaps: 77 pectoralis major, 29 latissimus dorsi, and 36 other muscles, including serratus anterior, rectus abdominis, and external oblique muscles. The omentum was transposed in ten patients. Chest wall skeletal defects were closed with Prolene mesh in 29 patients and with autogenous ribs in 11. Eighty-nine patients underwent primary closure of the skin. The 100 patients underwent an average of 2.1 operations. Hospitalization averaged 17.5 days. There was one perioperative death (29 days). Two patients required tracheostomy. Follow-up averaged 21.6 months. There were 24 late deaths. All 99 patients who were alive 30 days after operation had excellent results at the time of death or last follow-up. Images Figs. 2A-D. Figs. 3A-F. Figs. 4A-D. Figs. 4A-D. Fig. 5. Fig. 5. PMID:6732314

  13. Anatomy and histochemistry of flight muscles in a wing-propelled diving bird, the Atlantic puffin, Fratercula arctica.

    PubMed

    Kovacs, C E; Meyers, R A

    2000-05-01

    Twenty-three species within the avian family Alcidae are capable of wing-propelled flight in the air and underwater. Alcids have been viewed as Northern Hemisphere parallels to penguins, and have often been studied to see if their underwater flight comes at a cost, compromising their aerial flying ability. We examined the anatomy and histochemistry of select wing muscles (Mm. pectoralis, supracoracoideus, latissimus dorsi caudalis, coracobrachialis caudalis, triceps scapularis, and scapulohumeralis caudalis) from Atlantic puffins (Fratercula arctica) to assess if the muscle fiber types reveal the existence of a compromise associated with "dual-medium" flight. Pectoralis was found to be proportional in size with that of nondiving species, although the supracoracoideus was proportionally larger in puffins. Muscle fiber types were largely aerobic in both muscles, with two distinct fast-twitch types demonstrable: a smaller, aerobic, moderately glycolytic population (FOg), and a larger, moderately aerobic, glycolytic population (FoG). The presence of these two fiber types in the primary flight muscles of puffins suggests that aerial and underwater flight necessitate a largely aerobic fiber complement. We suggest that alcids do not represent an adaptive compromise, but a stable adaptation for wing-propelled locomotion both in the air and underwater. PMID:10761049

  14. An Application of Keystone Perforator Island Flap for Closure of Lumbosacral Myelomeningocele Defects.

    PubMed

    Park, Hye-Sung; Morrison, Edwin; Lo, Cheng; Leong, James

    2016-09-01

    Myelomeningocele, also known as spina bifida, is the commonest form of neural tube defect in which both meninges and spinal cord herniate through a large vertebral defect. It may be located at any spinal level; however; lumbosacral involvement is most common. After birth, the closure of spinal lesion is preferably undertaken in the first 48 hours to minimize the risk of injury and central nervous system infection. Relatively small skin defects overlying the dural repair may be directly closed. However, larger defects require reconstructive closure. Numerous methods of reconstruction have been described, such as split skin graft, local flaps or lumbosacral fasciocutaneous flaps, muscle flaps using latissimus dorsi, gluteal or paraspinous muscles, and perforator flaps namely superior gluteal artery perforators, and dorsal intercostal artery perforator flaps. At Monash Health, Victoria, we have used the keystone perforator island flaps to reconstruct lumbosacral myelomeningocele defects on 5 newborns between January 2008 and January 2014. This article evaluates the short-term and long-term outcomes of these patients who were followed up for 10 to 66 months. PMID:26418773

  15. Regulation of skeletal alpha-actin promoter in young chickens during hypertrophy caused by stretch overload.

    PubMed

    Carson, J A; Yan, Z; Booth, F W; Coleman, M E; Schwartz, R J; Stump, C S

    1995-04-01

    Anterior latissimus dorsi (ALD) muscles of 3-wk-old male chickens were injected with plasmids containing various lengths of the chicken skeletal alpha-actin promoter (ranging from -2,090 to -77 relative to the transcription start site) driving luciferase. Hypertrophy of the left ALD muscle was induced by attaching a weight (11% of body wt) to the left wing of each chicken, with the unweighted contralateral wing serving the control. Six days of stretch overload significantly increased muscle mass 110%. Luciferase activity from the -2,090 actin-luciferase chimeric gene increased 127% compared with the contralateral control ALD muscle. Luciferase activities driven by the -424, -202, and -99 actin promoters were 179, 134, and 378% higher, respectively, in the stretched ALD muscle than in the contralateral control ALD muscle. Luciferase activity from the -77 deletion construct was not different between stretched and control muscles. These data indicate that the gene region responding to stretch is downstream of -99 and imply, but do not conclusively prove, that the region between -99 and -77, which contains serum response element 1, contributes to the stretch-induced increase in skeletal alpha-actin promoter activity in the ALD muscle. PMID:7537453

  16. [The Current Role of Salvage-Surgery of Recurrent Tumors in the Larynx and Pharynx].

    PubMed

    Stuck, B A; Rothmeier, N; Mattheis, S; Dominas, N; Lang, S

    2016-05-01

    Over the past 20 years, the therapeutic concepts for the treatment of head and neck cancer have evolved and non-surgical treatment strategies have gained in importance. However, despite improved organ preservation protocols and primary chemoradiation, tumor recurrence is still frequent. Under these conditions, salvage surgery if often the only remaining curative treatment option. Over the past 30 years, advancements in plastic-reconstructive surgery have broadened the surgical spectrum in the head and neck area, offering new treatment options for salvage surgery in recurrent cancer of the pharynx and larynx. Survival after salvage surgery mainly depends on the primary treatment modality as well as the localization and tumor stage at the time of initial diagnosis and local recurrence. For the reconstruction of defects after salvage surgery, pedicled flaps and microvascular free flaps may be utilized. The most frequently used flaps in these situations are the pectoralis major island- or the myocutaneous latissimus dorsi island flap. The radial forearm and the ALT-flap are potentially applicable free flaps. With the use of these flaps, vital tissue is transferred into the previously irradiated area, hereby allowing for reconstruction and functional preservation of the resected area and preventing complications such as fistulas. The expected morbidity and the likelihood of surgical success must be assessed thoroughly in every individual case prior to performing salvage surgery. This review aims to support decision making in these situations. PMID:27135424

  17. A comparison of muscle activations during traditional and abbreviated tennis serves.

    PubMed

    Seeley, Matthew K; Uhl, Tim L; McCrory, Jean; McGinn, Patricia; Kibler, W Ben; Shapiro, Robert

    2008-05-01

    The abbreviated tennis serve is a relatively novel modification of the traditional serve that has been reported to provide performance advantages over the traditional technique. However, there are limited objective data regarding the benefits and biomechanics of the abbreviated serve; no data exist that describe shoulder muscle activations during the abbreviated serve. The purpose of this study was to compare muscle activations between the traditional and abbreviated serves. Electromyographic data were collected for the anterior and posterior deltoid, infraspinatus, middle trapezius, latissimus dorsi, serratus anterior, and pectoralis major. When muscle activations were compared during each serve phase, no significant differences were observed between the traditional and abbreviated tennis serve techniques, indicating that the traditional and abbreviated serves are similar regarding shoulder muscle activations. These results could have implications for performance of and injury related to the abbreviated versus traditional serve technique. Although the abbreviated serve has anecdotally been described as advantageous, the present data do not indicate any significant advantages or disadvantages in performing the abbreviated serve technique versus the traditional serve. PMID:18610776

  18. Maximizing Outcomes While Minimizing Morbidity: An Illustrated Case Review of Elbow Soft Tissue Reconstruction

    PubMed Central

    Ooi, Adrian; Ng, Jonathan; Chui, Christopher; Goh, Terence; Tan, Bien Keem

    2016-01-01

    Background. Injuries to the elbow have led to consequences varying from significant limitation in function to loss of the entire upper limb. Soft tissue reconstruction with durable and pliable coverage balanced with the ability to mobilize the joint early to optimize rehabilitation outcomes is paramount. Methods. Methods of flap reconstruction have evolved from local and pedicled flaps to perforator-based flaps and free tissue transfer. Here we performed a review of 20 patients who have undergone flap reconstruction of the elbow at our institution. Discussion. 20 consecutive patients were identified and included in this study. Flap types include local (n = 5), regional pedicled (n = 7), and free (n = 8) flaps. The average size of defect was 138 cm2 (range 36–420 cm2). There were no flap failures in our series, and, at follow-up, the average range of movement of elbow flexion was 100°. Results. While the pedicled latissimus dorsi flap is the workhorse for elbow soft tissue coverage, advancements in microvascular knowledge and surgery have brought about great benefit, with the use of perforator flaps and free tissue transfer for wound coverage. Conclusion. We present here our case series on elbow reconstruction and an abbreviated algorithm on flap choice, highlighting our decision making process in the selection of safe flap choice for soft tissue elbow reconstruction. PMID:27313886

  19. Thoracic wall defects: surgical management of 205 consecutive patients

    SciTech Connect

    Pairolero, P.C.; Arnold, P.G.

    1986-07-01

    In this article, we review our experience during the past 9 years with 205 consecutive thoracic wall reconstructions. The 100 female and 105 male patients ranged in age from 12 to 85 years (mean, 53.4 years). One hundred fourteen patients had thoracic wall tumors, 56 had radiation necrosis, 56 had infected median sternotomy wounds, and 8 had costochondritis. Twenty-nine of these patients had combinations of the aforementioned conditions. One hundred seventy-eight patients underwent skeletal resection. A mean of 5.4 ribs were resected in 142 patients. Total or partial sternectomies were performed in 60. Skeletal defects were closed with prosthetic material in 66 patients and with autogenous ribs in 12. One hundred sixty-eight patients underwent 244 muscle flap procedures: 149 pectoralis major, 56 latissimus dorsi, 14 rectus abdominis, 13 serratus anterior, 8 external oblique, 2 trapezius, and 2 advancement of diaphragm. The omentum was transposed in 20 patients. The mean number of operations per patient was 1.9 (range, 1 to 8). The mean duration of hospitalization was 16.5 days. One perioperative death occurred (at 29 days). Four patients required tracheostomy. During a mean follow-up of 32.4 months, there were 49 late deaths, predominantly due to malignant disease. All 204 patients who were alive 30 days after operation had excellent surgical results at last follow-up examination or at the time of death due to causes unrelated to the reconstructive procedure.

  20. Keyhole Flap Nipple Reconstruction

    PubMed Central

    Cash, Camille G.; Iman, Al-Haj; Spiegel, Aldona J.; Cronin, Ernest D.

    2016-01-01

    Summary: Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76). The average patient follow-up was 17 months. The design of the flap is based on a keyhole configuration. The base of the flap determines the width of the future nipple, whereas the length of the flap determines the projection. We try to match the projection of the contralateral nipple if present. The keyhole flap is simple to construct yet reliable. It provides good symmetry and projection and avoids the creation of new scars. The areola is then tattooed approximately 3 months after the nipple reconstruction.

  1. Electromyography variables during the golf swing: a literature review.

    PubMed

    Marta, Sérgio; Silva, Luís; Castro, Maria António; Pezarat-Correia, Pedro; Cabri, Jan

    2012-12-01

    The aim of the study was to review systematically the literature available on electromyographic (EMG) variables of the golf swing. From the 19 studies found, a high variety of EMG methodologies were reported. With respect to EMG intensity, the right erector spinae seems to be highly activated, especially during the acceleration phase, whereas the oblique abdominal muscles showed moderate to low levels of activation. The pectoralis major, subscapularis and latissimus dorsi muscles of both sides showed their peak activity during the acceleration phase. High muscle activity was found in the forearm muscles, especially in the wrist flexor muscles demonstrating activity levels above the maximal voluntary contraction. In the lower limb higher muscle activity of the trail side was found. There is no consensus on the influence of the golf club used on the neuromuscular patterns described. Furthermore, there is a lack of studies on average golf players, since most studies were executed on professional or low handicap golfers. Further EMG studies are needed, especially on lower limb muscles, to describe golf swing muscle activation patterns and to evaluate timing parameters to characterize neuromuscular patterns responsible for an efficient movement with lowest risk for injury. PMID:22542769

  2. Lumbar spinal loads and muscle activity during a golf swing.

    PubMed

    Lim, Young-Tae; Chow, John W; Chae, Woen-Sik

    2012-06-01

    This study estimated the lumbar spinal loads at the L4-L5 level and evaluated electromyographic (EMG) activity of right and left rectus abdominis, external and internal obliques, erector spinae, and latissimus dorsi muscles during a golf swing. Four super VHS camcorders and two force plates were used to obtain three-dimensional (3D) kinematics and kinetics of golf swings performed by five male collegiate golfers. Average EMG levels for different phases of golf swing were determined. An EMG-assisted optimization model was applied to compute the contact forces acting on the L4-L5. The results revealed a mean peak compressive load of over six times the body weight (BW) during the downswing and mean peak anterior and medial shear loads approaching 1.6 and 0.6 BW during the follow-through phases. The peak compressive load estimated in this study was high, but less than the corresponding value (over 8 BW) reported by a previous study. Average EMG levels of different muscles were the highest in the acceleration and follow-through phases, suggesting a likely link between co-contractions of paraspinal muscles and lumbar spinal loads. PMID:22900401

  3. Integrated metabolomic and transcriptome analyses reveal finishing forage affects metabolic pathways related to beef quality and animal welfare.

    PubMed

    Carrillo, José A; He, Yanghua; Li, Yaokun; Liu, Jianan; Erdman, Richard A; Sonstegard, Tad S; Song, Jiuzhou

    2016-01-01

    Beef represents a major dietary component and source of protein in many countries. With an increasing demand for beef, the industry is currently undergoing changes towards naturally produced beef. However, the true differences between the feeding systems, especially the biochemical and nutritional aspects, are still unclear. Using transcriptome and metabolome profiles, we identified biological pathways related to the differences between grass- and grain-fed Angus steers. In the latissimus dorsi muscle, we have recognized 241 differentially expressed genes (FDR < 0.1). The metabolome examinations of muscle and blood revealed 163 and 179 altered compounds in each tissue (P < 0.05), respectively. Accordingly, alterations in glucose metabolism, divergences in free fatty acids and carnitine conjugated lipid levels, and altered β-oxidation have been observed. The anti-inflammatory n3 polyunsaturated fatty acids are enriched in grass finished beef, while higher levels of n6 PUFAs in grain finished animals may promote inflammation and oxidative stress. Furthermore, grass-fed animals produce tender beef with lower total fat and a higher omega3/omega6 ratio than grain-fed ones, which could potentially benefit consumer health. Most importantly, blood cortisol levels strongly indicate that grass-fed animals may experience less stress than the grain-fed individuals. These results will provide deeper insights into the merits and mechanisms of muscle development. PMID:27185157

  4. Chronic expanding hematoma with bronchopleural fistula and empyema space.

    PubMed

    Tsubochi, Hiroyoshi; Sato, Nobuyuki; Imai, Tadashi

    2009-06-01

    Chronic expanding hematoma of the thorax is not typically accompanied by a bronchopleural fistula or purulent lesion. We report an extremely rare case of chronic expanding hematoma with a bronchopleural fistula and empyema space in a 66-year-old man with a history of tuberculous pleurisy admitted because of fever and bloody sputa. Computed tomography and a magnetic resonance imaging revealed a huge mass and an air space in the right thorax. A fiber-optic bronchoscope examination showed hemorrhagic effusion from the apical bronchus of the right lower lobe. First, open-window thoracostomy was undertaken to control the septic state and to prevent aspiration of infected pleural fluid. At operation, air leakage was found at the most superior portion in the rear of the thoracic empyema space; this was thought to be from the bronchopleural fistula. Enterococcus casseliflavus was detected in cultures for bacteria of the effusion from the empyema space. After an improvement of his general condition, a radical operation, including the complete extirpation of the hematoma and intrathoracic muscle transposition using the latissimus dorsi muscle, was successfully performed. PMID:19597392

  5. Evaluation of Myoelectric Activity of Paraspinal Muscles in Adolescents with Idiopathic Scoliosis during Habitual Standing and Sitting

    PubMed Central

    Kwok, Garcia; Yip, Joanne; Cheung, Mei-Chun; Yick, Kit-Lun

    2015-01-01

    There is a number of research work in the literature that have applied sEMG biofeedback as an instrument for muscle rehabilitation. Therefore, sEMG is a good tool for this research work and is used to record the myoelectric activity in the paraspinal muscles of those with AIS during habitual standing and sitting. After the sEMG evaluation, the root-mean-square (RMS) sEMG values of the paraspinal muscles in the habitual postures reflect the spinal curvature situation of the PUMC Type Ia and IIc subjects. Both groups have a stronger average RMS sEMG value on the convex side of the affected muscle regions. Correction to posture as instructed by the physiotherapist has helped the subjects to achieve a more balanced RMS sEMG ratio in the trapezius and latissimus dorsi regions; the erector spinae in the thoracic region and/or erector spinae in the lumbar region. It is, therefore, considered that with regular practice of the suggested positions, those with AIS can use motor learning to achieve a more balanced posture. Consequently, the findings can be used in less intrusive early orthotic intervention and provision of care to those with AIS. PMID:26583151

  6. The influence of biocomposites containing genetically modified flax fibers on gene expression in rat skeletal muscle.

    PubMed

    Gredes, Tomasz; Kunert-Keil, Christiane; Dominiak, Marzena; Gedrange, Tomasz; Wróbel-Kwiatkowska, Magdalena; Szopa, Jan

    2010-12-01

    In many studies, natural flax fibers have been proven to be resistant and surgically suitable. Genetically modified flax fibers, derived from transgenic flax expressing three bacterial genes for the synthesis of poly-3-hydroxybutyric acid (PHB), have better mechanical properties than unmodified flax fibers. The aim of this study was to examine the biocompatibility of composites containing flax fibers from transgenic polyhydroxybutyrate producing (M50) and control (wt-NIKE) plants in a polylactide (PLA) matrix in rat Musculus latissimus dorsi. For this purpose, effects of biocomposites on the expression of growth factors and osteogenic differentiation, in particular the mRNA expression of vascular endothelial growth factor, insulin like growth factor 1, insulin like growth factor 2, collagen-1, collagen-2 and myostatin, were analyzed using quantitative RT-PCR. The biocomposites did not show any inflammation response after subcutaneous insertion. The results following subcutaneous insertion of PLA alone and PLA-M50 showed no significant changes on the gene expression of all tested genes, whereas PLA-wt-NIKE reduced the mRNA amount of myostatin, VEGFA and IGF2, respectively. It can be asserted that modified flax membranes with PHB and other organic substances have a good biocompatibility to the muscle and they do not disrupt the muscle function. Furthermore, composites from transgenic flax plants producing PHB did not differ from composites of non-transgenic flax plants. PMID:20973615

  7. A new surgical strategy for breast conservation in locally advanced breast cancer that achieves a good locoregional control rate: preliminary report.

    PubMed

    Moneer, M; Ismael, S; Khaled, H; El-Gantery, M; Zaghloul, M S; El-Didi, M

    2001-06-01

    The scope of breast conserving surgery has recently expanded to include locally advanced breast cancer (LABC) patients who are downstaged following neoadjuvant chemotherapy (NACT). However, the efficacy of this approach in achieving adequate locoregional control of disease is in doubt. Some reports have attributed the failure to the association of NACT-induced tumour downstaging which can leave multifocal in situ and invasive lesions around the main tumour mass. In the present study, in order to eradicate all possible tumour satellites, a very wide local excision that included the whole original tumour-bearing area was performed regardless of the expected wide defect. This defect was then immediately reconstructed by an ipsilateral pedicled latissimus dorsi myocutaneous (LDM) flap. The study included 26 patients with LABC without evidence of primary tumour-multicentricity. Tumours were downstaged following NACT. The early cosmetic outcome was good in the majority of cases. Early complications were minimal. Twenty-two patients had a mean follow up period of 30.2 (range 7-50) months. In those evaluable cases, locoregional control of the disease was excellent (100%) but distant metastases occurred in seven cases (31.8%). PMID:14965588

  8. Influences of the position of the head on posture while lifting.

    PubMed

    Ishida, H; Watanabe, S; Eguchi, A; Kobara, K

    2008-01-01

    In clinical training of some lower back pain patients, teaching them to control their lumbar lordosis during lifting may be difficult. Therefore, another effective method for lifting technique is required. In standing, head cannot move without some compensating postural adjustment. The purpose of this study was to examine the influence of head position on lifting posture. Fourteen healthy male volunteers (22.6 +/- 4.4 years old) lifted a case while maintaining two different head positions; a downward position and an upright position. In the upright position, activities of the latissimus dorsi and vastus lateralis significantly increased, and these of the biceps femoris significantly decreased during the initial 100 msec phase of lifting. There were no differences in the activities of the upper trapezius, lumbar extensor muscles (L3, L5), and obliquus abdominis under the two conditions. There were also no differences in the lumbar angle when the case was lifted. The flexion angles of the hip, knee, and ankle significantly increased, and the lumbar spine moved closer to the case. Lifting posture was influenced by the head position. Advantages included being able to shift loads on the body from the lower back to the legs, to move the lumbar spine closer to the case, and to relatively increase the moment of lumbar extension. The weight of the head as it moved upward and back, and the weight of the rear part of the body as it moved downward and forward helped to maintain balance. PMID:18551836

  9. Bench Press Upper-Body Muscle Activation Between Stable and Unstable Loads.

    PubMed

    Dunnick, Dustin D; Brown, Lee E; Coburn, Jared W; Lynn, Scott K; Barillas, Saldiam R

    2015-12-01

    The bench press is one of the most commonly used upper-body exercises in training and is performed with many different variations, including unstable loads (ULs). Although there is much research on use of an unstable surface, there is little to none on the use of an UL. The purpose of this study was to investigate muscle activation during the bench press while using a stable load (SL) vs. UL. Twenty resistance-trained men (age = 24.1 ± 2 years; ht = 177.5 ± 5.8 cm; mass = 88.7 ± 13.7 kg) completed 2 experimental conditions (SL and UL) at 2 different intensities (60 and 80% one repetition maximum). Unstable load was achieved by hanging 16 kg kettlebells by elastic bands from the end of the bar. All trial lifts were set to a 2-second cadence with a slight pause at the bottom. Subjects had electrodes attached to 5 muscles (pectoralis major, anterior deltoid, medial deltoid, triceps brachii, and latissimus dorsi) and performed 3 isometric bench press trials to normalize electromyographic data. All 5 muscles demonstrated significantly greater activation at 80% compared with 60% load and during concentric compared with eccentric actions. These results suggest that upper body muscle activation is not different in the bench press between UL and SL. Therefore, coaches should use their preference when designing training programs. PMID:26540024

  10. En bloc prefabrication of vascularized bioartificial bone grafts in sheep and complete workflow for custom-made transplants.

    PubMed

    Kokemüller, H; Jehn, P; Spalthoff, S; Essig, H; Tavassol, F; Schumann, P; Andreae, A; Nolte, I; Jagodzinski, M; Gellrich, N-C

    2014-02-01

    The aim of this pilot study was to determine, in a new experimental model, whether complex bioartificial monoblocs of relevant size and stability can be prefabricated in a defined three-dimensional design, in which the latissimus dorsi muscle serves as a natural bioreactor and the thoracodorsal vessel tree is prepared for axial construct perfusion. Eighteen sheep were included in the study, with six animals in each of three experimental groups. Vitalization of the β-tricalcium phosphate-based constructs was performed by direct application of unmodified osteogenic material from the iliac crest (group A), in vivo application of nucleated cell concentrate (NCC) from bone marrow aspirate (group B), and in vitro cultivation of bone marrow stromal cells (BMSC) in a perfusion bioreactor system (group C). The contours of the constructs were designed digitally and transferred onto the bioartificial bone grafts using a titanium cage, which was bent over a stereolithographic model of the defined subvolume intraoperatively. At the end of the prefabrication process, only the axial vascularized constructs of group A demonstrated vital bone formation with considerable stability. In groups B and C, the applied techniques were not able to induce ectopic bone formation. The presented computer-assisted workflow allows the prefabrication of custom-made bioartificial transplants. PMID:24238866

  11. Increasing the vascular pedicle length in a free flap using a two-stage preliminary ectopic transfer.

    PubMed

    Schmidt, A; Herndl, E; Mühlbauer, W

    1991-08-01

    The length of the vascular pedicle is critically important in the use and safety of a free flap. A lengthening of the artery and vein, until now, has been achieved through the use of either an autologous vein interposition graft or an arteriovenous loop. In such patients, the risk is nevertheless increased and does so proportionally to the increasing length of the venous interposition. We present a 30-year-old male electrician who had lost his left forearm and most of his right ulna after high-voltage electrical trauma. Lengthening of the vascular pedicle of a free fibula flap was achieved by anastomosis to the thoracodorsal vessels for 4 weeks. After this time, the flap was raised again together with the pedicle of the latissimus dorsi and used safely for reconstruction of the ulnar defect. Postoperative recovery after both operations was uneventful and the aim of reconstruction fully realized. In our opinion, this procedure provides an interesting alternative in patients in whom the length of the vascular pedicle is crucial but the designated flap has only a short pedicle. PMID:1952745

  12. Surface EMG during the Push-up plus Exercise on a Stable Support or Swiss Ball: Scapular Stabilizer Muscle Exercise

    PubMed Central

    Seo, Sung-Hwa; Jeon, In-Ho; Cho, Yong-Ho; Lee, Hyun-Gi; Hwang, Yoon-Tae; Jang, Jee-Hun

    2013-01-01

    [Purpose] Scapular stabilizer strengthening exercise is crucial for shoulder rehabilitation. The purpose of this study was to compare two types of push-up plus exercises, on a stable and unstable bases of support, using surface electromyography (EMG), to suggest an effective shoulder rehabilitation program. [Subjects and Methods] Ten healthy men volunteered for this study. All volunteers performed two sets of push-up plus exercise (standard push up and knee push up) on stable and unstable bases of support. The muscle activities of five important scapular stabilizer muscles (upper trapezius, middle trapezius, lower trapezius, serratus anterior, latissimus dorsi) were recorded during the exercise. [Results] The upper trapezius showed greater mean electric activation amplitude in the scapular retraction posture than in the scapular protraction posture, and the serratus anterior showed greater mean electric activation amplitude in the scapular protraction posture than in the scapular retraction posture. The root-mean-square normalized EMG values of the muscles were greater during the exercise performed on the unstable support than those on the stable support. [Conclusion] The standard push-up plus exercise on an unstable base of support helps to increase muscle activity, especially those of the upper/middle trapezius and serratus anterior. PMID:24259864

  13. Effect of various hand position widths on scapular stabilizing muscles during the push-up plus exercise in healthy people

    PubMed Central

    Batbayar, Yanjinsuren; Uga, Daisuke; Nakazawa, Rie; Sakamoto, Masaaki

    2015-01-01

    [Purpose] The purpose of this study was to determine the effect of various hand position widths during the push-up plus (PUP) exercise on the activity of the scapular stabilizing muscles and other upper-extremity muscles involved in the exercise. [Subjects and Methods] Nine healthy men participated in our study. The PUP exercise was performed on a stable surface in seven different hand positions, namely shoulder width (SW), and narrower SW (NSW) and wider SW (WSW) at 10%, 20%, and 30%. Surface electromyography was used to measure the muscle activities and muscle ratio of the upper trapezius (UT), middle trapezius, lower trapezius (LT), serratus anterior (SA), pectoralis major, deltoid anterior, latissimus dorsi (LD), and triceps muscles. [Results] The SA and LD muscle activities significantly decreased in the 30% NSW and 20% WSW hand positions, respectively. The UT/LT muscle ratio significantly increased in the 30% WSW hand position. [Conclusion] The results of this study suggest that during the PUP exercise, the SW hand position should be used. In the 30% NSW hand position, the SA muscle activity decreased, and the UT/ LT ratio increased in the 30% WSW hand position. PMID:26357442

  14. Myoelectric activity and sequencing of selected trunk muscles during isokinetic lifting.

    PubMed

    Noe, D A; Mostardi, R A; Jackson, M E; Porterfield, J A; Askew, M J

    1992-02-01

    Trained weight lifters lift heavy loads without a concomitant degree of acute low-back injuries. To study the process by which large loads are lifted with minimal injury, integrated electromyographic signals were recorded from four large muscle groups: gluteus maximus, quadriceps, latissimus dorsi, and erector spinae in 4 weight lifters and 11 asymptomatic control subjects. These signals were recorded during a floor-to-knuckle-height isokinetic lift (dead lift) at 30.5 and 45.7 cm/sec. The signals were normalized for the height of the lift and the maximal isokinetic integrated electromyographic activity. The weight lifters achieved maximal force at 50% of maximal lift height, whereas the control subjects achieved it at 67%. Although not statistically significant, the weight lifters used the gluteus maximus more during the early stages of the lift, perhaps contributing to earlier development of force. This process would stabilize the pelvis and permit the erector spinae to extend the trunk more efficiently. The weight lifter then completed the lift with prolonged and increasing activity in the quadriceps. This technique may minimize the required force in the erector spinae and the forces on the low-back structures. Clinical implications include more effective strength training of lifting muscle groups other than spinal extensors and the teaching of lifting strategies employed by weight lifters in low-back rehabilitation and work-hardening programs. PMID:1532462

  15. Long-term results of pectoralis major muscle transposition for infected sternotomy wounds.

    PubMed Central

    Pairolero, P C; Arnold, P G; Harris, J B

    1991-01-01

    During an 11.5-year period, 100 consecutive patients (79 male, 21 female) underwent repair of an infected sternotomy wound. Sixty-five patients had failed attempts at wound closure by other physicians. Median age was 61.5 years (range, 5 to 85 years). Reconstruction included muscle in 79 patients, omentum in 4, and both in 15. A total of 175 muscles were transposed, including 169 pectoralis major, 3 rectus abdominis, 2 external oblique, and 1 latissimus dorsi. Median number of operations was four (range, 1 to 11). Mechanical ventilation was required in 30 patients. Two perioperative deaths occurred, one related to sepsis. Median follow-up was 4.2 years (range, 1.3 to 13.5 years). Twenty-six patients had recurrent infection. Median time from our closure to recurrence was 5.5 months (range, 0.3 to 27.6 months). Cause of recurrence was inadequate removal of cartilage in 16 patients, bone in 6, and retained foreign body in 4. Eighteen patients had the wound reopened with further resection; 10 had another muscle or omentum transposition. There were 30 late deaths, only one related to recurrent infection. At the time of death or last follow-up, 92 patients had a healed chest wall. Transposition of the pectoralis major muscle remains an excellent method of management for infected sternotomy wounds. Failure is directly related to persistent infection of cartilage, bone, or retained foreign bodies. PMID:2039289

  16. Treatment of a giant congenital melanocytic nevus in the adult: review of the current management of giant congenital melanocytic nevus.

    PubMed

    Su, Jeannie J; Chang, Daniel K; Mailey, Brian; Gosman, Amanda

    2015-05-01

    Giant congenital melanocytic nevi (GCMNs) create cosmetic disfigurements and pose risk for malignant transformation. Adult GCMN cases are uncommon because most families opt for surgical treatment during childhood. We review the current literature on GCMN and present an interesting case of an adult with a GCMN encompassing the entire back with painful nodules exhibiting gross involvement of his back musculature, without pathologic evidence of malignancy. Surgical management was deferred in childhood because of parental desires to allow the patient to make his own decision, and treatment in adulthood was pursued on the basis of the significant impairment of the patient's quality of life and self-esteem due to the massive size and deforming nature of the nevus. The treatment strategy used for this young adult male patient involved a massive en bloc excision of the GCMN with partial resection of the latissimus dorsi, followed by a 5-week staged reconstructive process using dermal regenerative matrices and split-thickness skin grafting. Because of the shift in GCMN management from early surgical management to more conservative management, we may see an increase in adult cases of GCMN. Thus, it is critical to better understand the controversy surrounding early versus delayed management of GCMN. PMID:25664413

  17. Evaluation of Myoelectric Activity of Paraspinal Muscles in Adolescents with Idiopathic Scoliosis during Habitual Standing and Sitting.

    PubMed

    Kwok, Garcia; Yip, Joanne; Cheung, Mei-Chun; Yick, Kit-Lun

    2015-01-01

    There is a number of research work in the literature that have applied sEMG biofeedback as an instrument for muscle rehabilitation. Therefore, sEMG is a good tool for this research work and is used to record the myoelectric activity in the paraspinal muscles of those with AIS during habitual standing and sitting. After the sEMG evaluation, the root-mean-square (RMS) sEMG values of the paraspinal muscles in the habitual postures reflect the spinal curvature situation of the PUMC Type Ia and IIc subjects. Both groups have a stronger average RMS sEMG value on the convex side of the affected muscle regions. Correction to posture as instructed by the physiotherapist has helped the subjects to achieve a more balanced RMS sEMG ratio in the trapezius and latissimus dorsi regions; the erector spinae in the thoracic region and/or erector spinae in the lumbar region. It is, therefore, considered that with regular practice of the suggested positions, those with AIS can use motor learning to achieve a more balanced posture. Consequently, the findings can be used in less intrusive early orthotic intervention and provision of care to those with AIS. PMID:26583151

  18. Improved Mechanism for Capturing Muscle Power for Circulatory Support

    PubMed Central

    Trumble, Dennis R.; Melvin, David B.; Byrne, Mark T.; Magovern, James A.

    2016-01-01

    Although it is now understood that trained skeletal muscle can generate enough steady-state power to provide significant circulatory support, there are currently no means by which to tap this endogenous energy source to aid the failing heart. To that end, an implantable muscle energy converter (MEC) has been constructed and its function has been improved to optimize durability, anatomic fit, and mechanical efficiency. Bench tests show that MEC transmission losses average less than 10% of total work input and that about 85% of this muscle power is successfully transferred to the working fluid of the pump. Results from canine implant trials confirm excellent biocompatibility and demonstrate that contractile work of the latissimus dorsi muscle—measured to 290 mJ/stroke in one dog—can be transmitted within the body at levels consistent with cardiac assist requirements. These findings suggest that muscle-powered cardiac assist devices are feasible and that efforts to further develop this technology are warranted. PMID:16143010

  19. Angular Velocity Affects Trunk Muscle Strength and EMG Activation during Isokinetic Axial Rotation

    PubMed Central

    Fan, Jian-Zhong; Liu, Xia; Ni, Guo-Xin

    2014-01-01

    Objective. To evaluate trunk muscle strength and EMG activation during isokinetic axial rotation at different angular velocities. Method. Twenty-four healthy young men performed isokinetic axial rotation in right and left directions at 30, 60, and 120 degrees per second angular velocity. Simultaneously, surface EMG was recorded on external oblique (EO), internal oblique (IO), and latissimus dorsi (LD) bilaterally. Results. In each direction, with the increase of angular velocity, peak torque decreased, whereas peak power increased. During isokinetic axial rotation, contralateral EO as well as ipsilateral IO and LD acted as primary agonists, whereas, ipsilateral EO as well as contralateral IO and LD acted as primary antagonistic muscles. For each primary agonist, the root mean square values decreased with the increase of angular velocity. Antagonist coactiviation was observed at each velocity; however, it appears to be higher with the increase of angular velocity. Conclusion. Our results suggest that velocity of rotation has great impact on the axial rotation torque and EMG activity. An inverse relationship of angular velocity was suggested with the axial rotation torque as well as root mean square value of individual trunk muscle. In addition, higher velocity is associated with higher coactivation of antagonist, leading to a decrease in torque with the increase of velocity. PMID:24804227

  20. Multi-view stereophotogrammetry for post-mastectomy breast reconstruction.

    PubMed

    Ju, Xiangyang; Henseler, Helga; Peng, Matthew Jian-Qiao; Khambay, Balvinder S; Ray, Arup K; Ayoub, Ashraf F

    2016-03-01

    A multi-view three-dimensional stereophotogrammetry system was developed to capture 3D shape of breasts for breast cancer patients. The patients had received immediate unilateral breast reconstruction after mastectomy by the extended latissimus dorsi flap and without contralateral surgery. In order to capture the whole breast shape including the inframammary fold, the patients were introduced to the imaging room and leaned over the imaging rig to open up the inframammary fold and to expose the entire area of each breast. The imaging system consisted of eight high-resolution ([Formula: see text] pixels) digital cameras and four flash units. The cameras were arranged in four stereo pairs from four different view angles to cover the whole surface of the breasts. The system calibration was carried out ahead of every capture session, and the stereo images were matched to generate four range images to be integrated using an elastic model proposed. A watertight breast mesh model was reconstructed to measure the volume of the breast captured. The accuracy of using the developed multi-view stereophotogrammetry system for breast volume measurement was 11.12cc with SEM 7.74cc, comparing to the measurements of the water displacement method. It was concluded that the 3D stereophotogrammetry image system developed was more reliable than the method of water displacement. PMID:26133282

  1. The use of free flaps in skull base reconstruction.

    PubMed

    Macía, G; Picón, M; Nuñez, J; Almeida, F; Alvarez, I; Acero, J

    2016-02-01

    Skull base tumours are rare, comprising less than 1% of all tumours of the head and neck. Surgical treatment of these tumours involves the approach, the resection, and the reconstruction of the defect, which present a challenge due to the technical difficulty and anatomical complexity. A retrospective study of 17 patients with tumours involving the skull base, treated by resection and immediate reconstruction using microsurgical free flaps, is presented; 11 were men and six were women. The following types of flap were used: osteocutaneous fibula flaps, fasciocutaneous anterolateral thigh flaps, and myocutaneous latissimus dorsi flaps. The most common histology of the tumours was squamous cell carcinoma. The most frequent point of origin was the paranasal sinuses (58.8%). All of the free flaps used for reconstruction were viable. A cerebrospinal fluid fistula occurred in two patients, and in one of these cases, meningoencephalitis led to death. In conclusion, the reconstruction of large defects of the skull base after ablation requires a viable tissue that in many cases can be obtained only through the use of microvascular free flaps. The type of flap to be selected depends on the anatomical structures and size of the defect to be restored. PMID:26421478

  2. Evaluation of adipose-derived stem cells for tissue-engineered muscle repair construct-mediated repair of a murine model of volumetric muscle loss injury

    PubMed Central

    Kesireddy, Venu

    2016-01-01

    Volumetric muscle loss (VML) can occur from congenital defects, muscle wasting diseases, civilian or military injuries, and as a result of surgical removal of muscle tissue (eg, cancer), all of which can lead to irrevocable functional and cosmetic defects. Current tissue engineering strategies to repair VML often employ muscle-derived progenitor cells (MDCs) as one component. However, there are some inherent limitations in their in vitro culture expansion. Thus, this study explores the potential of adipose-derived stem cells (ADSCs) as an alternative cell source to MDCs for tissue engineering of skeletal muscle. A reproducible VML injury model in murine latissimus dorsi muscle was used to evaluate tissue-engineered muscle repair (TEMR) constructs incorporating MDCs or ADSCs. Importantly, histological analysis revealed that ADSC-seeded constructs displayed regeneration potential that was comparable to those seeded with MDCs 2 months postrepair. Furthermore, morphological analysis of retrieved constructs demonstrated signs of neotissue formation, including cell fusion, fiber formation, and scaffold remodeling. Immunohistochemistry demonstrated positive staining for both structural and functional proteins. Positive staining for vascular structures indicated the potential for long-term neotissue survival and integration with existing musculature. Qualitative observation of lentivirus-Cherry-labeled donor cells by immunohistochemistry indicates that participation of ADSCs in new hybrid myofiber formation incorporating donor cells was relatively low, compared to donor MDCs. However, ADSCs appear to participate in vascularization. In summary, I have demonstrated that TEMR constructs generated with ADSCs displayed skeletal muscle regeneration potential comparable to TEMR–MDC constructs as previously reported. PMID:27114706

  3. Keyhole Flap Nipple Reconstruction.

    PubMed

    Chen, Joseph I; Cash, Camille G; Iman, Al-Haj; Spiegel, Aldona J; Cronin, Ernest D

    2016-05-01

    Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76). The average patient follow-up was 17 months. The design of the flap is based on a keyhole configuration. The base of the flap determines the width of the future nipple, whereas the length of the flap determines the projection. We try to match the projection of the contralateral nipple if present. The keyhole flap is simple to construct yet reliable. It provides good symmetry and projection and avoids the creation of new scars. The areola is then tattooed approximately 3 months after the nipple reconstruction. PMID:27579228

  4. Reconstruction with a patient-specific titanium implant after a wide anterior chest wall resection

    PubMed Central

    Turna, Akif; Kavakli, Kuthan; Sapmaz, Ersin; Arslan, Hakan; Caylak, Hasan; Gokce, Hasan Suat; Demirkaya, Ahmet

    2014-01-01

    The reconstruction of full-thickness chest wall defects is a challenging problem for thoracic surgeons, particularly after a wide resection of the chest wall that includes the sternum. The location and the size of the defect play a major role when selecting the method of reconstruction, while acceptable cosmetic and functional results remain the primary goal. Improvements in preoperative imaging techniques and reconstruction materials have an important role when planning and performing a wide chest wall resection with a low morbidity rate. In this report, we describe the reconstruction of a wide anterior chest wall defect with a patient-specific custom-made titanium implant. An infected mammary tumour recurrence in a 62-year old female, located at the anterior chest wall including the sternum, was resected, followed by a large custom-made titanium implant. Latissimus dorsi flap and split-thickness graft were also used for covering the implant successfully. A titanium custom-made chest wall implant could be a viable alternative for patients who had large chest wall tumours. PMID:24227881

  5. In vivo sup 31 P-NMR spectroscopy of chronically stimulated canine skeletal muscle

    SciTech Connect

    Clark, B.J. III; McCully, A.K.; Subramanian, H.V.; Hammond, R.L.; Salmons, S.; Chance, B.; Stephenson, L.W. Univ. of Pennsylvania School of Medicine, Philadelphia Univ. of Birmingham )

    1988-02-01

    Chronic stimulation converts skeletal muscle of mixed fiber type to a uniform muscle made up of type I, fatigue-resistant fibers. Here, the bioenergetic correlates of fatigue resistance in conditioned canine latissimus dorsi are assessed with in vivo phosphorus-31 nuclear magnetic resonance ({sup 31}P-NMR) spectroscopy. After chronic electrical stimulation, five dogs underwent {sup 31}P-NMR spectroscopic and isometric tension measurements on conditioned and contralateral control muscle during stimulation for 200, 300, 500, and 800 ms of an 1,100-ms duty cycle. With stimulation, phosphocreatine (PCr) fell proportional to the degree of stimulation in both conditioned and control muscle but fell significantly less in conditioned muscle at all the least intense stimulation period (200 ms). Isometric tension, expressed as a tension time index per gram muscle, was significantly greater in the conditioned muscle at the two longest stimulation periods. The overall small change in PCr and the lack of a plateau in tension observed in the conditioned muscle are similar to that seen in cardiac muscle during increased energy demand. This study indicates that the conditioned muscle's markedly enhanced resistance to fatigue is in part the result of its increased capacity for oxidative phosphorylation.

  6. Effects of short-term fatigue on biomechanical and physiological aspects of double poling in high-level cross-country skiers.

    PubMed

    Zoppirolli, Chiara; Pellegrini, Barbara; Bortolan, Lorenzo; Schena, Federico

    2016-06-01

    The study aim was to evaluate biomechanical and physiological alterations in double poling technique (DP) after a short-term fatiguing exercise. Eight high-level skiers performed a sub-maximal DP trial (20kmh(-1), 1°) before (PRE) and after (POST) a DP test to exhaustion while roller skiing on a treadmill. An integrated analysis of DP technique during PRE and POST included measurement of pole, joint, and centre of mass (COM) kinematics, poling forces, cycle timing, and metabolic parameters. Muscle fatigue in three upper-body muscles was assessed by calculating the Dimitrov' fatigue index (FInms5) of specific electromyographic segments. FInms5 tended to increase in the latissimus dorsi and teres major muscles (P=0.023 and P=0.030, respectively) across consecutive DP cycles, as did blood lactate concentration (P=0.001) and rating of perceived exertion (P=0.005). The changes indicated a state of fatigue during POST and coincided with the reduction in poling force exertion capacity (P=0.020). Pole, joint and COM kinematics did not differ between PRE and POST (P>0.050), whereas recovery phase and cycle times were shorter at POST (P<0.001 and P=0.001, respectively). Short-term fatigue led to a reduction in poling force exertion capacity and cycle time in high-level skiers, without altering body and pole kinematics. PMID:26904974

  7. Extraordinary Lymph Drainage in Cutaneous Malignant Melanoma and the Value of Hybrid Imaging: A Case Report.

    PubMed

    Brammen, Lindsay; Nedomansky, Jakob; Haslik, Werner; Staudenherz, Anton

    2014-12-01

    In melanoma patients, preoperative lymphoscintigraphy has become a gold standard. The role of single-photon emission computed tomography (SPECT) or its combination with computed tomography (SPECT-CT) as part of the standard sentinel scintigraphy protocol has yet to be determined. A 46-year-old female patient with melanoma of the trunk received preoperative lymphoscintigraphy and subsequent surgical excision. Planar imaging displayed two hot spots in the region of the primary lesion. No other lymphatic flow pathways could be appreciated. Two focal hot spots, one dorsal to the primary lesion near the left latissimus dorsi muscle and one just lateral to the primary lesion in the subcutaneous tissue, were appreciated with SPECT-CT imaging. The primary melanoma lesion, as well as the two additional lesions, which were detected by SPECT-CT, were excised and sent for histopathological examination. While the primary lesion was a superficial spreading melanoma, the lesions appreciated in SPECT-CT revealed four sentinel lymph nodes, each of which was negative for tumor cells. Melanomas, especially of the trunk, can demonstrate multiple lymphatic drain basins in a large percentage of patients. Given that without the detailed anatomical information provided by SPECT-CT it would be very difficult to locate the diverse lymphatic drain basins and their lymph nodes, we would suggest routinely implementing SPECT-CT in the standard planar sentinel imaging protocol. PMID:26396636

  8. Microsurgical reconstruction of oncological scalp defects in the elderly.

    PubMed

    Simunovic, Filip; Eisenhardt, Steffen U; Penna, Vincenzo; Thiele, Jan R; Stark, G Björn; Bannasch, Holger

    2016-07-01

    The incidence of scalp tumors requiring radical excision increases with age. Free flap surgery is the standard reconstructive option for large defects; however, there is an ongoing uncertainty about its safety in the elderly. We conducted a review of data and report on 19 patients aged ≥75 years and 13 < 75 years. Data regarding patient demographics, types of tumors, surgery, size of defect, flaps used, and prevalence of complications were analyzed. The patients in the elderly group had more accompanying medical conditions and a higher ASA score. Squamous cell carcinoma was the predominant tumor in the elderly and sarcoma in the younger patients. The defect size was similar in both groups. The latissimus dorsi (LD) and the anterolateral thigh (ALT) flaps were flaps of first choice, with temporal vessels most commonly used for anastomosis. Surgery lasted longer in the younger patients. There was no difference in the duration of hospital stay. No significant correlation was found between age and the flap-related or medical complications. Revision surgery was more often required in the younger patients. We conclude that free flap surgery is safe and reliable in the elderly population. The LD and the ALT are the most commonly used flaps. Advanced age should not be considered a risk factor for free flap surgery in these patients. PMID:27133193

  9. Evaluation of Meat Color and Physiochemical Characteristics in Forequarter Muscles of Holstein Steers.

    PubMed

    Moon, Sung Sil; Seong, Pil-Nam; Jeong, Jin Young

    2015-01-01

    The beef forequarter muscle comprises approximately 52% of carcass weight. The objective of this study was to evaluate the physiochemical characteristics and meat color from forequarter muscle of Holstein steers. Fifteen forequarter muscles were trimmed of external connective tissue and fat. An experimental group of eight Holstein steers was assessed using meat color, water-holding capacity, drip loss, and Warner-Bratzler shear force value at the same quality grade. The M. omotransversarius (0.45 kg) had the highest (p<0.05) lightness (L*) value, whereas the M. teres major (0.4 kg) and M. triceps brachii (caput laterale) (0.52 kg) had the lowest (p<0.05) values. The M. semispanitus capitus (1.48 kg), which is a neck muscle, had the highest values for both redness (a*) and yellowness (b*), whereas the lowest (p<0.05) values were for the M. teres major. The M. omotransversarius, M. latissimus dorsi (1.68 kg), and M. rhomboideus (1.2 kg) were ranked high (p<0.05) in water-holding capacity. The drip loss value was the highest for the M. longissimus dorsi thoracis (p<0.05; 1.86 kg), while the M. infraspinatus (2.28 kg), M. supraspinatus (1.38 kg), M. brachiocephalicus (1.01 kg), and M. pectoralis superficialis (1.18 kg) had the lowest (p<0.05). The Warner-Bratzler shear force value indicated that the M. pectoralis profundus (3.39 kg), M. omotransversarius, and M. brachiocephalicus were the toughest (p<0.05), whereas the M. subscapularis (0.86 kg), M. longissimus dorsi thoracis, M. teres major, and M. infraspinatus were the most tender cuts (p<0.05). Here, muscle type explained most of the variability in the forequarter physiochemical characteristics. Thus, our findings suggest that these muscle profile data will allow for more informed decisions when selecting individual muscles to produce value-added products from Holstein steers. PMID:26761893

  10. Evaluation of Meat Color and Physiochemical Characteristics in Forequarter Muscles of Holstein Steers

    PubMed Central

    Moon, Sung Sil

    2015-01-01

    The beef forequarter muscle comprises approximately 52% of carcass weight. The objective of this study was to evaluate the physiochemical characteristics and meat color from forequarter muscle of Holstein steers. Fifteen forequarter muscles were trimmed of external connective tissue and fat. An experimental group of eight Holstein steers was assessed using meat color, water-holding capacity, drip loss, and Warner–Bratzler shear force value at the same quality grade. The M. omotransversarius (0.45 kg) had the highest (p<0.05) lightness (L*) value, whereas the M. teres major (0.4 kg) and M. triceps brachii (caput laterale) (0.52 kg) had the lowest (p<0.05) values. The M. semispanitus capitus (1.48 kg), which is a neck muscle, had the highest values for both redness (a*) and yellowness (b*), whereas the lowest (p<0.05) values were for the M. teres major. The M. omotransversarius, M. latissimus dorsi (1.68 kg), and M. rhomboideus (1.2 kg) were ranked high (p<0.05) in water-holding capacity. The drip loss value was the highest for the M. longissimus dorsi thoracis (p<0.05; 1.86 kg), while the M. infraspinatus (2.28 kg), M. supraspinatus (1.38 kg), M. brachiocephalicus (1.01 kg), and M. pectoralis superficialis (1.18 kg) had the lowest (p<0.05). The Warner–Bratzler shear force value indicated that the M. pectoralis profundus (3.39 kg), M. omotransversarius, and M. brachiocephalicus were the toughest (p<0.05), whereas the M. subscapularis (0.86 kg), M. longissimus dorsi thoracis, M. teres major, and M. infraspinatus were the most tender cuts (p<0.05). Here, muscle type explained most of the variability in the forequarter physiochemical characteristics. Thus, our findings suggest that these muscle profile data will allow for more informed decisions when selecting individual muscles to produce value-added products from Holstein steers. PMID:26761893