Pectoralis Major Research Articles

Effect of the dietary inclusion of Camelina sativa cake into quail diet on live performance, carcass traits, and meat quality

The present research studied the effect of the dietary inclusion of 3 different camelina (Camelina sativa (L.) Crantz) cakes on the live performance, slaughter traits, and breast meat quality of broiler quails (Coturnix japonica). With this purpose, a total of 480 fifteen-day-old broiler quails of both sexes were allocated to 48 cages (12 replicates/treatment, 10 quails/replicate) and received 4 dietary treatments: a control diet (Control), and 3 diets containing 15% of 1 commercial cultivar (Calena), and 2 improved lines (Pearl: low linoleic acid; Alan: low glucosinolates). During the experiment, individual live weight (LW) and cage feed intake were recorded to calculate body weight gain (BWG) and feed conversion ratio (FCR). At 35 d of age, quails were slaughtered, and carcasses were weighed and dissected to compute yields. On breast (pectoralis major muscle) the measurements and analyses considered ultimate pH, L*a*b* color values, proximate composition, oxidative status, cooking loss and WBSF toughness. Broiler quails receiving diets with camelina cakes exhibited mortality and health status similar to the control. However, growth performance was impaired in camelina-fed groups, especially for Calena (P < 0.05). Overall LW and BWG were slightly lower, whereas feed intake was slightly higher in camelina-fed groups compared to Control (P > 0.05). Therefore, higher FCR was recorded for camelina-fed groups compared to Control (P=0.0004). Moreover, breast meat from Calena treatment displayed higher water (P=0.0170), and lower lipid (P=0.0051) contents compared to those of the Control group, while protein and ash content remained unaffected. Heme-iron content and oxidative status of breast meat were not influenced by the dietary incorporation of camelina (P > 0.05). The research outcomes indicated that camelina cakes can be used as an alternative feed ingredient for broiler quails' diets, without compromising carcass yields and meat quality. However, as 15% dietary incorporation worsened live performance, the ideal camelina cake inclusion level should be thoroughly investigated as well as a parallel research effort into further reducing glucosinolates content of camelina.

Management of Locally Advanced Laryngeal Cancer—From Risk Factors to Treatment, the Experience of a Tertiary Hospital from Eastern Europe

Laryngeal cancer is an important oncological entity in which prognosis depends on the establishment of appropriate preventive and diagnostic measures, especially in high-risk populations. We present a retrospective two-year study (January 2021 to December 2022) with 152 patients diagnosed with laryngeal cancer from a tertiary hospital in Romania. The average age of the patients was 62 years old for both sexes, with a range from 44 to 83 years. The most frequent symptom was dysphonia with or without dyspnea in 142 cases (93.42%), followed by dyspnea alone in nine patients (5.92%) and dysphagia in one case (0.66%). Surgical treatment in this study consisted of partial laryngectomy (CO2 laser transoral tumor ablation, supraglottic horizontal laryngectomy or hemilaryngectomy), or total laryngectomy. The main treatment was total laryngectomy (63%). For the eight patients with initial organ preservation treatment, the average time of recurrence was about two-and-a-half years. For the four patients who underwent a total circular pharyngo-laryngectomy, the upper digestive tract needed to be rebuilt with a salivary bypass tube or with a tubed myocutaneous flap from the major pectoralis muscle. One strong point is characteristic of the study group in gathering patients with advanced stages of laryngeal carcinoma candidates for salvage surgery and extended reconstruction methods. The development of new prevention protocols is mandatory in Eastern European countries.

Comparison of Combined Aerobic-Resistance and Aerobic Training on Heart Systolic Function in Heart Failure Patients After Coronary Artery Bypass Graft Surgery (CABG)

Background: Heart disease is the most common cause of mortality worldwide, and heart surgery frequently occurs. The results are strongly dependent on lifestyle modification and especially sports exercises. Objectives: In this study, aimed to compare the effect of eight weeks of aerobic and combined training on systolic cardiac function in heart failure patients after coronary artery bypass surgery. Methods: In this randomized clinical trial, 30 cardiac patients under CABG surgery at Kermanshah Heart Center were randomly divided into three groups, control, combined, and aerobic training. The protocols of the combined group included two movements of the upper limbs (pectoralis major and deltoid muscles) and two movements of the lower limbs (quadriceps and hamstring muscles) by three sets/10Rep and aerobic group with 60 - 85-minute exercises at 70 - 85% peak HR in three sessions per week for eight weeks. The collected data were analyzed using the SPSS software version 22, One-way ANOVA, and Tukey tests; P &lt; 0.05 was considered significant. Results: After eight weeks, Systolic heart function wasn’t increased in the control group (P &gt; 0.05) but was raised in the aerobic and combined training groups (P = 0.0001). There was no significant difference between in two intervention groups (P &gt; 0.05). Conclusions: Aerobic and combined exercises positively affect systolic cardiac function after coronary artery bypass surgery. Therefore, doing both exercises in these patients is recommended.

Insertion sites of the muscles attached to the clavicle: a cadaveric study of the clavicle

BackgroundClavicle fractures are common injuries, especially in young, active individuals. Operative treatment is recommended for completely displaced clavicle shaft fractures, and plate fixation is stronger than the use of intramedullary nails. Few studies have reported on iatrogenic injuries to the muscle attached to the clavicle during fracture surgery. The aim of this study was to clarify the area of the insertion sites of muscles attached to the clavicle in Japanese cadavers using gross anatomy and three-dimensional (3D) analysis. We also aimed to compare the effects of anterior plate templating and superior plate templating on clavicle shaft fractures using 3D images.MethodsThirty-eight clavicles from Japanese cadavers were analyzed. We removed all clavicles to identify the insertion sites and measured the size of the insertion area of each muscle. Three-dimensional templating was performed on both the superior and anterior plates of the clavicle using data obtained from computed tomography. The areas covered by these plates on the muscles attached to the clavicle were compared. Histological examination was performed on four randomly selected specimens.ResultsThe sternocleidomastoid muscle was attached proximally and superiorly; the trapezius muscle was attached posteriorly and partly superiorly; and the pectoralis major muscle and deltoid muscles were attached anteriorly and partially superiorly. The non-attachment area was located mainly in the posterosuperior part of the clavicle. It was difficult to distinguish the borders of the periosteum and pectoralis major muscles. The anterior plate covered a significantly broader area (mean 6.94 ± 1.36 cm2) of the muscles attached to the clavicle than did the superior plate (mean 4.11 ± 1.52 cm2) (p < 0.0001). On microscopy, these muscles were inserted directly into the periosteum.ConclusionMost of the pectoralis major and deltoid muscles were attached anteriorly. The non-attachment area was located mainly from the superior to posterior part of the clavicle midshaft. Both macroscopically and microscopically, the boundaries between the periosteum and these muscles were difficult to demarcate. The anterior plate covered a significantly broader area of the muscles attached to the clavicle than that by the superior plate.

Use of Acellular Biologic Matrix Envelope for Cardiac Implantable Electronic Device Placement to Correct Migration into Submuscular Breast Implant Pocket.

Breast implants whether used for cosmetic or reconstructive purposes can be placed in pockets either above or below the pectoralis major muscle, depending on clinical circumstances such as subcutaneous tissue volume, history of radiation, and patient preference. Likewise, cardiac implantable electronic devices (CIEDs) can be placed above or below the pectoralis major muscle. When a patient has both devices, knowledge of the pocket location is important for procedural planning and for durability of device placement and performance. Here, we report a patient who previously failed subcutaneous CIED placement due to incision manipulation with prior threatened device exposure requiring plane change to subpectoral pocket. Her course was complicated by submuscular migration of the CIED into her breast implant periprosthetic pocket. With subcutaneous plane change being inadvisable due to patient noncompliance, soft tissue support of subpectoral CIED placement with an acellular biologic matrix (ABM) was performed. Similar to soft tissue support used for breast implants, submuscular CIED neo-pocket creation with ABM was performed with durable CIED device positioning confirmed at 9 months postprocedure.

Prevalence of Flexibility Among Health Care Professional Students

Flexibility is a physiological characteristic that allows an individual to execute voluntary movements of maximum joint angular amplitude within morphological limits, free of pain and restrictions. The prevention of musculoskeletal injuries and improvement in muscle movement and performance depend on body flexibility. The purpose of this study was to analyse the prevalence of flexibility among health care professional students. A total of 700 students, in which 68 students were excluded and 632 students were included, Subjects were assessed for joint flexibility by using the measurements of joint range of motion developed by Norkin and White. The inclusion and exclusion criteria were female students aged between 17 and 25 years with recent fractures and sprains, a history of neurological problems, and recent surgeries. The major muscles tested for flexibility are trapezius, pectoralis major, hip flexors, rectus femoris, hamstrings, and calf muscles, as these muscles commonly cause the restriction identified with stretching pain for each muscle. Statistical analyses were conducted according to gender, age, body mass index value[normal-overweight-obese], and the results of the muscle flexibility test. In the overall sample, 9.17% of students had pectoral muscle tightness; 22% of students had upper trapezius muscle tightness; 38% of students had hamstring muscle tightness; 18.2% of students had calf muscle tightness; 3.32% of students had adductor muscle tightness; and 9.33 % of students had rectus femoris muscle tightness. This study confirms that the flexibility of the major muscles is poor because of their daily activities, BMI, and ageing process. Poor flexibility may lead to poor posture and some musculoskeletal problems. These studies help them learn how important it is to do regular physical activities every day.

Association of pectoralis muscle area on computed tomography with airflow limitation severity and respiratory outcomes in COPD: A population-based prospective cohort study

BackgroundPrevious studies have shown that patients with chronic obstructive pulmonary disease (COPD) of severe or very severe airflow limitation have a reduced pectoralis muscle area (PMA), which is associated with mortality. However, whether patients with COPD of mild or moderate airflow limitation also have a reduced PMA remains unclear. Additionally, limited evidence is available regarding the associations between PMA and respiratory symptoms, lung function, computed tomography (CT) imaging, lung function decline, and exacerbations. Therefore, we conducted this study to evaluate the presence of PMA reduction in COPD and to clarify its associations with the referred variables. MethodsThis study was based on the subjects enrolled from July 2019 to December 2020 in the Early Chronic Obstructive Pulmonary Disease (ECOPD) study. Data including questionnaire, lung function, and CT imaging were collected. The PMA was quantified on full-inspiratory CT at the aortic arch level using predefined -50 and 90 Hounsfield unit attenuation ranges. Multivariate linear regression analyses were performed to assess the association between the PMA and airflow limitation severity, respiratory symptoms, lung function, emphysema, air trapping, and the annual decline in lung function. Cox proportional hazards analysis and Poisson regression analysis were used to evaluate the PMA and exacerbations after adjustment. ResultsWe included 1352 subjects at baseline (667 with normal spirometry, 685 with spirometry-defined COPD). The PMA was monotonically lower with progressive airflow limitation severity of COPD after adjusting for confounders (vs. normal spirometry; Global Initiative for Chronic Obstructive Lung Disease [GOLD] 1: β=-1.27, P=0.028; GOLD 2: β=-2.29, P<0.001; GOLD 3: β=-4.88, P<0.001; GOLD 4: β=-6.47, P=0.014). The PMA was negatively associated with the modified British Medical Research Council dyspnea scale (β=-0.005, P=0.026), COPD Assessment Test score (β=-0.06, P=0.001), emphysema (β=-0.07, P<0.001), and air trapping (β=-0.24, P<0.001) after adjustment. The PMA was positively associated with lung function (all P<0.05). Similar associations were discovered for the pectoralis major muscle area and pectoralis minor muscle area. After the 1-year follow-up, the PMA was associated with the annual decline in the post-bronchodilator forced expiratory volume in 1 s percent of predicted value (β=0.022, P=0.002) but not with the annual rate of exacerbations or the time to first exacerbation. ConclusionPatients with mild or moderate airflow limitation exhibit a reduced PMA. The PMA is associated with airflow limitation severity, respiratory symptoms, lung function, emphysema, and air trapping, suggesting that PMA measurement can assist with COPD assessment.

Effects of thermal stress and mechanistic target of rapamycin and wingless-type mouse mammary tumor virus integration site family pathways on the proliferation and differentiation of satellite cells derived from the breast muscle of different chicken lines

Satellite cells (SCs) are muscle stem cells responsible for muscle hypertrophic growth and the regeneration of damaged muscle. Proliferation and differentiation of the pectoralis major (p. major) muscle SCs are responsive to thermal stress in turkeys, which are, in part, regulated by mechanistic target of rapamycin (mTOR) and Frizzled7 (Fzd7)-mediated wingless-type mouse mammary tumor virus integration site family/planar cell polarity (Wnt/PCP) pathways in a growth dependent-manner. It is not known if chicken p. major SCs respond to thermal stress in a manner similar to that of turkey p. major SCs. The objective of the current study was to investigate the effects of thermal stress and mTOR and Wnt/PCP pathways on the proliferation, differentiation, and expression of myogenic transcriptional regulatory factors in SCs isolated from the p. major muscle of a current modern commercial (MC) broiler line as compared to that of a Cornish Rock (BPM8) and Randombred (RBch) chicken line in the 1990s. The MC line SCs had lower proliferation and differentiation rates and decreased expression of myoblast determination factor 1 (MyoD) and myogenin (MyoG) compared to the BPM8 and RBch lines. Heat stress (43°C) increased proliferation and MyoD expression in all the cell lines, while cold stress (33°C) showed a suppressive effect compared to the control temperature (38°C). Satellite cell differentiation was altered with heat and cold stress in a cell line-specific manner. In general, the differentiation of the MC SCs was less responsive to both heat and cold stress compared to the BPM8 and RBch lines. Knockdown of the expression of either mTOR or Fzd7 decreased the proliferation, differentiation, and the expression of MyoD and MyoG in all the cell lines. The MC line during proliferation was more dependent on the expression of mTOR and Fzd7 than during differentiation. Thus, modern commercial meat-type chickens have decreased myogenic activity and temperature sensitivity of SCs in an mTOR- and Fzd7-dependent manner. The decrease in muscle regeneration will make modern commercial broilers more susceptible to the negative effects of myopathies with muscle fiber necrosis requiring satellite cell-mediated repair.

The skin-muscle flap of the pectoralis major muscle in reconstructive surgery of oral cavity

Annotation. The article presents a description of surgical intervention to replace a postoperative defect with a skin-muscle flap of the pectoralis major muscle in a patient with a tumor of the oral cavity. The pectoralis major skin-muscle flap in oral reconstruction is important as a transfer of a vascularized massive block of tissue from a non-irradiated area. The vascular pedicle of the skin-muscle flap of the pectoralis major muscle is of sufficient diameter and length to reconstruct the floor of the oral cavity. The arterialized flap, which includes the pectoralis major muscle, is indicated for the one-moment closure of large postoperative defects of the oral cavity.

From Sub-Pectoral to Pre-Pectoral Implant Reconstruction: A Decisional Algorithm to Optimise Outcomes of Breast Replacement Surgery

Innovations and advancements with implant-based breast reconstruction, such as the use of ADMs, fat grafting, NSMs, and better implants, have enabled surgeons to now place breast implants in the pre-pectoral space rather than under the pectoralis major muscle. Breast implant replacement surgery in post-mastectomy patients, with pocket conversion from retro-pectoral to pre-pectoral, is becoming increasingly common, in order to solve the drawbacks of retro-pectoral implant positioning (animation deformity, chronic pain, and poor implant positioning). A multicentric retrospective study was conducted, considering all patients previously submitted to implant-based post-mastectomy breast reconstruction who underwent a breast implant replacement with pocket conversion procedure at the University Hospital of Udine-Plastic and Reconstructive Surgery Department-and "Centro di Riferimento Oncologico" (C.R.O.) of Aviano, from January 2020 to September 2021. Patients were candidates for a breast implant replacement with pocket conversion procedure if they met the following inclusion criteria: they underwent a previous implant-based post-mastectomy breast reconstruction and developed animation deformity, chronic pain, severe capsular contracture, or implant malposition. Patient data included age, body mass index (BMI), comorbidities, smoking status, pre- or post-mastectomy radiotherapy (RT), tumour classification, type of mastectomy, previous or ancillary procedures (lipofilling), type and volume of implant used, type of ADM, and post-operative complications (breast infection, implant exposure and malposition, haematoma, or seroma). A total of 31 breasts (30 patients) were included in this analysis. Just three months after surgery, we recorded 100% resolution of the problems for which pocket conversion was indicated, which was confirmed at 6, 9, and 12 months post-operative. We also developed an algorithm describing the correct steps for successful breast-implant pocket conversion. Our results, although only early experience, are very encouraging. We realized that, besides gentle surgical handling, one of the most important factors in proper pocket conversion selection is an accurate pre-operative and intra-operative clinical evaluation of the tissue thickness in all breast quadrants.

Intracellular Calcium Overload and Activation of CaMKK/AMPK Signaling Are Related to the Acceleration of Muscle Glycolysis of Broiler Chickens Subjected to Acute Stress.

The current study investigated the effect of preslaughter transport on stress response and meat quality of broilers and explored the underlying mechanisms involved in the regulation of muscle glycolysis through calcium/calmodulin-dependent protein kinase kinase (CaMKK)/AMP-activated protein kinase (AMPK) signaling. Results suggested that transport induced stress responses of broilers and caused PSE-like syndrome of pectoralis major muscle. Preslaughter transport enhanced the mRNA expressions of glycogen phosphorylase and glucose transporters, as well as the activities of glycolytic enzymes, which accelerated the breakdown of glycolytic substrates and the accumulation of lactic acid. In addition, acute stress induced abnormal intracellular calcium homeostasis by disrupting calcium channels on the cell membrane and sarcoplasmic reticulum, which led to the activation of CaMKK and promoted AMPK phosphorylation. This study provides evidence that the intracellular calcium overload and the enhancement of CaMKK/AMPK signaling are related to the accelerated muscle glycolysis of broiler chickens subjected to acute stress.

The Preventive Effect of Specific Collagen Peptides against Dexamethasone-Induced Muscle Atrophy in Mice.

Muscle atrophy, also known as muscle wasting, is the thinning of muscle mass due to muscle disuse, aging, or diseases such as cancer or neurological problems. Muscle atrophy is closely related to the quality of life and has high morbidity and mortality. However, therapeutic options for muscle atrophy are limited, so studies to develop therapeutic agents for muscle loss are always required. For this study, we investigated how orally administered specific collagen peptides (CP) affect muscle atrophy and elucidated its molecular mechanism using an in vivo model. We treated mice with dexamethasone (DEX) to induce a muscular atrophy phenotype and then administered CP (0.25 and 0.5 g/kg) for four weeks. In a microcomputed tomography analysis, CP (0.5 g/kg) intake significantly increased the volume of calf muscles in mice with DEX-induced muscle atrophy. In addition, the administration of CP (0.25 and 0.5 g/kg) restored the weight of the gluteus maximus and the fiber cross-sectional area (CSA) of the pectoralis major and calf muscles, which were reduced by DEX. CP significantly inhibited the mRNA expression of myostatin and the phosphorylation of Smad2, but it did not affect TGF-β, BDNF, or FNDC5 gene expression. In addition, AKT/mTOR, a central pathway for muscle protein synthesis and related to myostatin signaling, was enhanced in the groups that were administered CP. Finally, CP decreased serum albumin levels and increased TNF-α gene expression. Collectively, our in vivo results demonstrate that CP can alleviate muscle wasting through a multitude of mechanisms. Therefore, we propose CP as a supplement or treatment to prevent muscle atrophy.

Goloba kusi (Hornstedtia scottiana [F. Muell.] K. Schum.) fruit as a feed additive to improve the histological structures and growth performance of broiler.

The broiler farming industry in Indonesia has enormous potential, with chicken meat that can be optimized by providing adequate and high-quality feed. However, the main raw material for the feed still relies on imported products, which makes it necessary to produce alternative materials from native plants. Therefore, this study aimed to investigate the effect of giving Goloba kusi fruit (GF) (Hornstedtia scottiana [F. Muell.] K. Schum.) on the growth of the small intestine, pectoralis major, and gastrocnemius muscle, as well as the development of broiler chickens. This study used a completely randomized design, in which 300 day-old Chicks were divided into five groups, consisting of 12 chickens in each group with five replications. The GF treatments, namely, 0% (control [CON]), 0.625% (GF1), 1.25% (GF2), 2.5% (GF3), and 5% (GF4) were administered through per kg basal feed. Subsequently, three chickens from each replication were taken, decapitated on the neck, subjected to surgery for histological preparations, and stained with Hematoxylin-Eosin and Periodic acid-Schiff-alcian blue. The variables observed included small intestine morphology, muscle morphology, and chicken growth performance. The results showed that the small intestine morphology, muscle morphology, and chicken growth performance of the GF4 (5%) group increased significantly compared to the CON group. The administration of GF with an optimum concentration of 5% through basal feed improves small intestine morphology, muscle morphology, and chicken growth performance.

In vivo determination of domestic quail (Coturnix japonica) muscle development by ultrasonography as a function of energy levels

The aim was to evaluate the growth and meat production and some meat quality characteristics of domestic quail (Coturnix japonica) as a function of metabolizable energy (ME) levels in the diet and to adjust predicting equations in ratio to area pectoralis major muscle of the carcass through the ultrasound. Two hundred and seventy mixed sex quail from 7 to 49 days old were distributed in three treatments (7 to 21 days old, diets with 2700; 2900 and 3100 kcal ME/kg; from 21 to 49 days, diets with 2900, 3050 and 3200 kcal of ME/kg), with five replications per treatment. Ultrasonography was performed at 21; 35 and 49 days of age in the pectoralis major muscle to determine prediction equations through multiple linear regression. Feed intake (FI) and feed efficiency (FE) were linearly influenced (P < 0.05) by energy levels in both phases evaluated. Regarding sensory analysis, there was no interference of ME levels on sensory attributes. The equation for predicting breast area was Y = 0.00271*ME + 0.25411*Age-9.58002, R2 = 74.25%. It is concluded that increasing the energy level of the feed from 2700 to 3100 kcal ME/kg reduces FI and improves the FE of quail. The increase in carcass fat from 35 days of age does not harm the physical and sensory characteristics of the meat. The ultrasonography in vivo of the M. pectoralis major, considering the age and energy level of the diet, made it possible to predict the pectoral muscle are a with higher reliability.

Modification of Rotation-Advancement Split Pectoralis Major (RASP) Turnover Flap Technique for Median Sternotomy Wound Dehiscence.

Pectoralis major muscle flap was used alone or mostly combined with rectus muscle or omentum to cover the whole sternal defect.[1] [2] [3] Disadvantages are additional abdominal incisions, herniation of bowel, introducing infection to abdominal cavity. D. A. Staffenberg introduced “Rotation-Advancement Split Pectoralis (RASP) major muscle turnover flap” technique for median sternotomy wound dehiscence.[4] In his technique, one-side split pectoralis major muscle flap was turned over based on internal mammary artery perforators and the other side pectoralis muscle flap advanced to the defect based on thoracoacromial pedicle. In our technique, we modified the split pectoralis muscle upper flap that was islanded based on the thoracoacromial pedicle to achieve more mobilization, less bulging contour deformity, and use the dominant blood supply.

Differential effects of temperature and mTOR and Wnt-planar cell polarity pathways on syndecan-4 and CD44 expression in growth-selected turkey satellite cell populations.

Satellite cells (SCs) comprise a heterogeneous population of muscle stem cells. Thermal stress during the first week after hatch alters proliferation, myogenesis, and adipogenesis of SCs of turkey pectoralis major (p. major) muscle via mechanistic target of rapamycin (mTOR) and wingless-type mouse mammary tumor virus integration site family/planar cell polarity (Wnt/PCP) pathways. Pivotal genes in mTOR and Wnt/PCP pathways are mTOR and frizzled-7 (Fzd7), respectively. The objective of this study was to determine the differential effects of thermal stress on SDC4 and CD44 expression in turkey p. major muscle SCs and how the expression of SDC4 and CD44 is modulated by the mTOR and Wnt/PCP pathways. Satellite cells were isolated from the p. major muscle of 1-week-old faster-growing modern-commercial (NC) turkeys and slower-growing historic Randombred Control Line 2 (RBC2) turkeys, and were challenged with hot (43°C) and cold (33°C) thermal stress for 72 h of proliferation followed by 48 h of differentiation. The NC line SCs were found to contain a lower proportion of SDC4 positive and CD44 negative (SDC4+CD44-) cells and a greater proportion of SDC4 negative and CD44 positive (SDC4-CD44+) cells compared to the RBC2 line at the control temperature (38°C) at both 72 h of proliferation and 48 h of differentiation. In general, at 72 h of proliferation, the proportion of SDC4+CD44- cells decreased with heat stress (43°C) and increased with cold stress (33°C) relative to the control temperature (38°C) in both lines, whereas the proportion of SDC4-CD44+ cells increased with heat stress and decreased with cold stress. In general, the expression of SDC4 and CD44 in the NC SCs showed greater response to both hot and cold thermal stress compared to the RBC2 cells. Knockdown of mTOR or Fzd7 expression increased the proportion of SDC4+CD44- cells while the proportion of SDC4-CD44+ cells decreased during differentiation with line differences being specific to treatment temperatures. Thus, differential composition of p. major muscle SCs in growth-selected commercial turkey may be resulted, in part, from the alteration in SDC4 and CD44 expression. Results indicate differential temperature sensitivity and mTOR and Wnt/PCP pathway responses of growth-selected SC populations and this may have long-lasting effect on muscle development and growth.

The technology of installation of breast implants in the subpectoral space while preservation attachment of the abdominal part of the pectoralis major muscle

The paper describes the technology of installing breast implants in the subpectoral cellular space while maintaining the attachment of the abdominal part of the pectoralis major muscle and evaluate the results of its application. A retrospective analysis of the results of primary breast augmentation in 762 patients operated by the authors in 2010–2020 was carried out.The space for the breast implant was formed following a certain sequence of actions. The boundaries of the receptacle were: inside – the place of attachment of the pectoralis major muscle to the sternum, outside – the abdominal part of the pectoralis major muscle and the pectoral fascia, passing to the bundles of the anterior serratus muscle, at the top – thoracoacromial vascular bundle, below – VI rib and fascial node, formed by the transition of the thoracic fascia and the aponeurosis of the abdominal part of the pectoralis major muscle to the anterior wall of the sheath of the rectus abdominis muscle. Conclusions. 1. The technology of installing implants in the subpectoral cellular space, while maintaining the distal attachment of its abdominal part, allows achieving the stability of the position of the implants and avoiding rotation and malposition of the implants. 2. In terms of up to 3–4 months after surgery, a higher location of implants on the chest is often observed. 3. The decision on the need and degree of mobilization of the abdominal part of the pectoralis major muscle should be made individually. 4. The technique cannot be used when the width of the implant base exceeds the width of the pectoralis major muscle at the level of the IV rib, and, therefore, limits the choice of larger implants.

Sternum Defektlerinin Rekonstrüksiyonunda Güvenilir Bir Yöntem: Pektoralis Major Kas Flebi ile Negatif Basınçlı Yara Bakım Kombinasyonu

Objective: Sternotomy defects may present mildly as isolated skin separation or severely as mediastinitis. A combination of treatment options can support treatment. Methods: Patients who were treated with pectoralis major flap with the combination of negative pressure wound therapy (NPWT) between 2016-2020, were retrospectively reviewed. Demographic features, microorganisms causing wound infection, flap reconstruction preference, time of hospitalization, remission, recurrence and associated morbidity and mortality data were evaluated. Results: Thirteen patients were included with a mean age of 65.4 years. All patients previously underwent coronary artery bypass graft surgery. Wound cultures from patients were positive in nine (69%). Isolated microorganisms were Staphylococcus spp. (n=4), Klebsiella pneumoniae (n=3) and Acinetobacter baumannii complex (n=2). The most common comorbidities were hypertension (76%) and diabetes mellitus(46%). The average hospital stay was 23.4 days. One patient died on the seventh postoperative day, two had seromas at the flap donor site, and one had hematoma. Conclusion: Pectoralis major muscle flap and NPWT after complete removal of dead tissues is an effective method to repair and treat sternum defects.

OUR EXPERIENCE WITH PEC MAJOR FLAP FOR STERNOCLAVICULAR JOINT INFECTIONS

Sternoclavicular joint infections are uncommon but severe and complex condition usually in medically complex and compromised hosts. These infections are challenging to treat with risks of infection extending into the mediastinal structures and surgical drainage is often faced with problems of multiple unplanned returns to theatre, chronic non-healing wounds that turn into sinus and the risk of significant clinical escalation and death. Percutaneous aspirations or small incision drainage often provide inadequate drainage and failed control of infection, while open drainage and washout require multidisciplinary support, due to the close proximity of the mediastinal structures and the great vessels as well as failure to heal the wounds and creation of chronic wound or sinus.We present our series of 8 cases over 6 years where we used the plan of open debridement of the Sternoclavicular joint with medial end of clavicle excision to allow adequate drainage. The surgical incision was not closed primarily, and a suction vacuum dressing was applied until the infection was contained on clinical and laboratory parameters. After the infection was deemed contained, the surgical incision was closed by local muscle flap by transferring the medial upper sternal head of the Pectoralis Major muscle to fill in the sternoclavicular joint defect. This technique provided a consistent and reliable way to overcome the infection and have the wound definitively closed that required no secondary procedures after the flap surgery and no recurrence of infections so far.We suggest that open and adequate drainage of Sternoclavicular joint staged with vacuum dressing followed by pectoralis major local flap is a reliable technique for achieving control of infection and wound closure for these challenging infections.

Nipple-areola complex necrosis following skin-reducing subcutaneous mastectomy and immediate implant-based reconstruction using dual-plane envelope (Bostwick-Nava technique)

Background: During skin-reducing subcutaneous mastectomy (SRSM) the nipple-areola complex (NAC) is harvested and then repositioned as a free graft. In the dual-plane technique of breast reconstruction an inferior post-mastectomy dermal pedicle flap is de-epithelialised and sutured to the inferior edge of the major pectoral muscle to create a musculodermal pouch for an implant. The aim of this study was to investigate the incidence and risk factors of NAC necrosis following SRSM with immediate implant-based dual-plane reconstruction.