Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications. Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction. Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria. Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx (P = 0.013) as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (P = 0.002). The former condition is also associated with major reconstruction failure (P = 0.018). An even lower incidence of major complications was noted in patients under the age of 53 (P = 0.044). Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

Isotopic traceability in body tissues and in different breeding periods of broilers

Rastrearam-se a inclusão de farinha de vísceras de aves (FV) em dietas de frangos por ocasião de eventual substituição de dieta contendo FV por dieta estritamente vegetal, e vice-versa, por isótopos estáveis de carbono e de nitrogênio. Foram distribuídos aleatoriamente 192 pintos de um dia de idade, em 12 tratamentos com quatro repetições de quatro aves. Os tratamentos constituíam-se de dieta de vegetais (VG) passando para dietas contendo FV, após certa idade, ou o inverso, em que as aves começaram se alimentando de dieta FV e depois passaram para dieta VG. Aos 42 dias de idade, foram coletadas amostras de músculo peitoral (Pectoralis major), quilha e tíbia, para determinação das razões isotópicas (13C/12C e 15N/14N). A técnica dos isótopos estáveis somente não foi capaz de rastrear a utilização de FV na alimentação de frangos de corte, quando esse ingrediente fez parte da dieta das aves apenas nos primeiros sete, 14 ou 21 dias de idade. Entretanto, há a possibilidade da aplicação dessa técnica em aves mais jovens, amostradas antes de eventual mudança de dieta, pois elas podem ter a assinatura isotópica da alimentação estabilizada em torno de duas semanas de idade.

Traceability of bovine meat and bone meal in poultry by stable isotope analysis

Bovine meat and bone meal (MBM) was widely used in animal diets until outbreaks of Bovine Spongiform Encefalopathy (BSE) occurred in some countries. It has not been confirmed yet whether or not BSE may be transmitted to man through chicken meat originated from poultry that had been fed diets containing MBM. Therefore, consumers nowadays express preference for meat originated from birds fed exclusively vegetable diets. This study analyzed samples of major breast muscle (Pectoralis major) using mass spectrometry of stable isotopes (carbon and nitrogen) as a means to assess the presence of MBM in broiler diets, a technique that might be used in the certification of poultry quality. A total of 150 day-old chicks were reared in five randomized treatments with increasing MBM dietary inclusion levels (0, 1, 2, 4 and 8%). on day 42, breast muscle samples were collected from three birds per treatment and used in the determination of 13C/12C and 15N/14N isotope ratios. The breast muscle isotope values were expressed as delta in parts per thousand (delta ). The following carbon isotope values (13C) were found: 18.74 ±0.11, 18.51 ±0.19, 18.24 ±0.10, -17.79 ±0.12, and -17.15 ±0.15 for 0, 1, 2, 4 and 8% MBM dietary levels, respectively. Nitrogen isotope values (15N) were 1.65 ±0.14, 1.65 ±0.28, 1.72 ±0.08, 1.95 ±0.16, and 2.52 ± 0.09 for 0, 1, 2, 4 and 8% MBM dietary levels, respectively. This study showed important differences in delta13C and delta15N values in breast meat, evidencing a simultaneous enrichment of this isotopic pair, which allowed tracing MBM in bird diets. Analysis of carbon and nitrogen stable isotopes may be used to ensure feeding with exclusively vegetable diets, and might also be used as a reliable evaluation tool in broiler meat certification. The diet with 1% inclusion level of MBM and the exclusively vegetable diet showed similar results.

Influência da composição das rações na rastreabilidade de farinhas de origem animal pela técnica dos isótopos estáveis em frangos de corte

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Rastreabilidade de farinhas de origem animal em tecidos de codornas de corte pela técnica dos isótopos estáveis de carbono ('intpot.13C'/'intpot.12C') e nitrogênio ('intpot.15N'/'intpot.14N')

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Traceability of poultry offal meal in broiler feeding using isotopic analysis (delta C-13 and delta N-15) of different tissues

Our goal was to trace the inclusion of poultry offal meal (OM) in diets by using carbon (13C/12C) and nitrogen (15N/14N) isotopic ratios of different tissues in order to contribute for the development of an independent technology for the certification of the feeding of broilers reared on diets with no addition of animal ingredients. Eighty one-day-old chicks were randomly distributed into five experimental treatments, that is, diets containing increasing levels of OM inclusion (0, 2, 4, 8 and 16% OM), with four replicates of four birds each. At 42 days of age, four birds per treatment (n=4) were randomly selected, weighed, and sacrificed to collect breast muscle (Pectoralis major), keel and tibia samples to determine their isotopic ratios (13C/12C e 15N/14N). It was observed that 13C and 15N enrichment increased as a function of increasing OM inclusion in all diets. The analyses of the Pectoralis major showed that that only treatments with 8 and 16% OM dietary inclusion were different form those in the control group (0% OM). on the other hand, when the keel and tibia were analyzed, in addition to 8 and 16% OM), the treatment with 4% OM inclusion was also different from the control group. The use of isotopic ratios of stable carbon and nitrogen isotopes is an alternative to trace OM inclusion in broiler diets as it is capable of tracing OM levels below those usually practiced by the poultry industry in Brazil.

Poultry offal meal traceability in meat quail tissues using the technique of stable carbon (13C/12C) and nitrogen (15N/14N) isotopes

Studies on the detection of animal by-products in poultry meat are rare, and non-existent on quail meat. This study aimed at detectiong increasing levels of poultry offal meal (POM) in quail meat, using carbon (13C/12C) and nitrogen (15N/14N) stable isotopes technique. Sixty four on-day-old male quails derived from a commercial farm were randomly distributed into seven different groups, which were fed experimental diets containing 0, 1.5, 3.0, 4.5, 6.0, 7.5, and 15% of POM. Diets were formulated to contain equal energy, protein, and amino acid levels. Four individuals per treatment were sacrificed at 42 days of age for breast muscle (Pectoralis major), keel, and tibia collection, which were subsequently submitted to analyses. Isotopic δ13C and δ15N enrichment was observed in all analyzed tissues, with the lowest detection level of 3% dietary inclusion of poultry offal meal.

Familial aplasia of the trapezius muscle: clinical and MRI findings.

A 5-year-old boy was referred to our neurology clinic for suspected myopathy. His parents reported normal upper extremity strength and no limitation in daily activities; however, he was unable to raise his arms above his head. On examination, both shoulders were down-slanting and anteriorly displaced, leading to a webbed neck appearance. Muscle MRI demonstrated isolated bilateral aplasia of the trapezius muscles. His father was found to have a unilateral partial trapezius hypoplasia with no functional consequences. Conclusion:  Congenital aplasia of the trapezius muscle is a rare condition; bilateral aplasia of the muscle, having been reported in only five cases, is most often associated with aplasia of the pectoralis major. This is the first report to our knowledge to demonstrate bilateral isolated trapezius aplasia by MRI.

Tracheo-carinal reconstructions using extrathoracic muscle flaps.

OBJECTIVES: Prospective evaluation of tracheo-carinal airway reconstructions using pedicled extrathoracic muscle flaps for closing airway defects after non-circumferential resections and after carinal resections as part of the reconstruction for alleviation of anastomotic tension. METHODS: From January 1996 to June 2006, 41 patients underwent tracheo-carinal airway reconstructions using 45 extrathoracic muscle flaps (latissimus dorsi, n=25; serratus anterior, n=18; pectoralis major, n=2) for closing airway defects resulting from (a) bronchopleural fistulas (BPF) with short desmoplastic bronchial stumps after right upper lobectomy (n=1) and right-sided (pleuro) pneumonectomy (n=13); (b) right (n=9) and left (n=3) associated with partial carinal resections for pre-treated centrally localised tumours; (c) partial non-circumferential tracheal resections for pre-treated tracheal tumours, tracheo-oesophageal fistulas (TEF) and chronic tracheal injury with tracheomalacia (n=11); (d) carinal resections with the integration of a muscle patch in specific parts of the anastomotic reconstruction for alleviation of anastomotic tension (n=4). The airway defects ranged from 2 x 1 cm to 8 x 4 cm and involved up to 50% of the airway circumference. The patients were followed by clinical examination, repeated bronchoscopy, pulmonary function testing and CT scans. The minimum follow-up time was 6 months. RESULTS: Ninety-day mortality was 7.3% (3/41 patients). Four patients (9.7%) sustained muscle flap necrosis requiring re-operation and flap replacement without subsequent mortality, airway dehiscence or stenosis. Airway dehiscence was observed in 1/41 patients (2.4%) and airway stenosis in 1/38 surviving patients (2.6%) responding well to topical mitomycin application. Follow-up on clinical grounds, by CT scans and repeated bronchoscopy, revealed airtight, stable and epithelialised airways and no recurrence of BPF or TEF in all surviving patients. CONCLUSIONS: Tracheo-carinal airway defects can be closed by use of pedicled extrathoracic muscle flaps after non-circumferential resections and after carinal resections with the muscle patch as part of the reconstruction for alleviation of anastomotic tension.

Influence of enclosure size on growth of breast and leg muscle fibers in domestic fowl

This experiment evaluated the growth of breast and leg muscle fibers of domestic fowl raised in two enclosure sizes (SE: Small Enclosure, 1.125 m2/10 birds; LE: Large Enclosure, 5.25 m2/10 birds). In breast muscles, the number of fibers per area decreased over time and higher values were observed in broilers housed in SE compared to LE. The fiber size increased with age and was greater in LE than SE at 56 days of age, suggesting greater hypertrophic growth of fibers in breast muscle for broilers maintained in LE. In leg muscles, the muscle cross-sectional area was greater for broilers raised in LE than SE at 56 days of age and decreased from 42 to 56 days of age in broilers raised in SE, suggesting leg muscle atrophy in these birds. The Fast Glycolytic (FG), Fast Oxidative-Glycolytic (FOG) and Slow Oxidative (SO) fibers grew until 42 days of age in both enclosure sizes. The area of FOG fibers was greater in broilers raised in LE than those in SE at 28 and 56 days of age; in LE-raised broilers, the SO area was greater at 28, 42 and 56 days of age, suggesting that the muscles of broilers housed in LE are more oxidative. The BW gain was greater for broilers raised in LE than SE, whereas BW, feed intake and feed conversion were not influenced by enclosure size. Thus, the enclosure space affected hypertrophic growth and metabolic characteristics of breast and leg muscle fibers. © Asian Network for Scientific Information, 2012.

Sensitivity to halothane and its relationship to the development of PSE (Pale, Soft, Exudative) meat in female lineage broilers

This work aimed to evaluate female lineage broilers for halothane sensitivity and for their susceptibility to the subsequent development of PSE meat. The halothane test was carried out in an anesthetic chamber with 3.0% halothane. The unconscious birds were examined for leg muscle rigidity. If one or both legs became extended and rigid, the birds were classified as halothane sensitive (HAL+), while unresponsive birds were classified as halothane negative (HAL-). The results showed that of 298 birds aged 42 days old, 95.6% were HAL- and 4.4% were HAL+. A sample of pectoralis major muscle was collected from HAL- (n=105) and HAL+ (n=13) birds. The pH and breast fillet color were determined at 4ºC, 24 hours post-mortem. Interestingly, only 2.5% of HAL+ birds displayed PSE meat characteristics compared to 12.7% of HAL- individuals. The halothane test demonstrated that female lineage broilers displayed very little sensitivity towards halothane, indicating that the development of PSE meat is related to other environmental factors.

Shoulder Muscular Activity During Isometric Three-Point Kneeling Exercise on Stable and Unstable Surfaces

The purpose of this study was to determine if performing isometric 3-point kneeling exercises on a Swiss ball influenced the isometric force output and EMG activities of the shoulder muscles when compared with performing the same exercises on a stable base of support. Twenty healthy adults performed the isometric 3-point kneeling exercises with the hand placed either on a stable surface or on a Swiss ball. Surface EMG was recorded from the posterior deltoid, pectoralis major, biceps brachii, triceps brachii, upper trapezius, and serratus anterior muscles using surface differential electrodes. All EMG data were reported as percentages of the average root mean square (RMS) values obtained in maximum voluntary contractions for each muscle studied. The highest load value was obtained during exercise on a stable surface. A significant increase was observed in the activation of glenohumeral muscles during exercises on a Swiss ball. However, there were no differences in EMG activities of the scapulothoracic muscles. These results suggest that exercises performed on unstable surfaces may provide muscular activity levels similar to those performed on stable surfaces, without the need to apply greater external loads to the musculoskeletal system. Therefore, exercises on unstable surfaces may be useful during the process of tissue regeneration.

Coactivation of the shoulder and arm muscles during closed kinetic chain exercises on an unstable surface

Introduction: The purpose of this study was to compare the electromyography index of muscle coactivation of the following muscle pairs: posterior deltoid and pectoralis major (PD/PM); triceps brachii and biceps brachii (TB/BB); and serratus anterior and upper trapezius (SA/UT) during three different closed kinetic chain exercises (wall-press, bench-press and push-up) on an unstable surface at the maximal load. Methods: A total of 20 healthy sedentary men participated in the study. Integral linear values were obtained from three sustained contractions of six seconds each for the three proposed exercises. Mean coactivation index values were compared using the mixed-effects linear model, with a five percent significance level. Results: Electromyography indexes of muscle coactivation showed significant differences for the PD/PM and TB/BB muscle pairs. No differences were found between exercises for the SA/UT muscle pair. Conclusion: Our results seem to differ from those of previous studies, which reported that the similarity in exercises performed is responsible for the comparable muscle activation levels.

Neuromuscular activity during bench press exercise performed with and without the preexhaustion method

Brennecke, A, Guimaraees, TM, Leone, R, Cadarci, M, Mochizuki, L, Simao, R, Amadio, AC, and Serrao, J. Neuromuscular activity during bench press exercise performed with and without the preexhaustion method. J Strength Cond Res 23(7): 1933-1940, 2009-The purpose of the present study was to investigate the effects of exercise order on the tonic and phasic characteristics of upper-body muscle activity during bench press exercise in trained subjects. The preexhaustion method involves working a muscle or a muscle group combining a single-joint exercise immediately followed by a multi-joint exercise (e. g., flying exercise followed by bench press exercise). Twelve subjects performed 1 set of bench press exercises with and without the preexhaustion method following 2 protocols (P1-flying before bench press; P2-bench press). Both exercises were performed at a load of 10 repetition maximum (10RM). Electromyography (EMG) sampled at 1 kHz was recorded from the pectoralis major (PM), anterior deltoid (DA), and triceps brachii (TB). Kinematic data (60 Hz) were synchronized to define upward and downward phases of exercise. No significant (p > 0.05) changes were seen in tonic control of PM and DA muscles between P1 and P2. However, TB tonic aspect of neurophysiologic behavior of motor units was significantly higher (p < 0.05) during P1. Moreover, phasic control of PM, DA, and TB muscles were not affected (p > 0.05). The kinematic pattern of movement changed as a result of muscular weakness in P1. Angular velocity of the right shoulder performed during the upward phase of the bench press exercise was significantly slower (p < 0.05) during P1. Our results suggest that the strategies set by the central nervous system to provide the performance required by the exercise are held constant throughout the exercise, but the tonic aspects of the central drive are increased so as to adapt to the progressive occurrence of the neuromuscular fatigue. Changes in tonic control as a result of the muscular weakness and fatigue can cause changes in movement techniques. These changes may be related to limited ability to control mechanical loads and mechanical energy transmission to joints and passive structures.

Activation of the shoulder and arm muscles during axial load exercises on a stable base of support and on a medicine ball

The purpose of this study was to compare SEMG activities during axial load exercises on a stable base of support and on a medicine ball (relatively unstable). Twelve healthy male volunteers were tested (x = 23 +/- 7y). Surface EMG was recorded from the biceps brachii, anterior deltoid, clavicular portion of pectoralis major, upper trapezius and serratus anterior using surface differential electrodes. All SEMG data are reported as percentage of RMS mean values obtained in maximal voluntary contractions for each muscle studied. A 3-way within factor repeated measures analysis of variance was performed to compare RMS normalized values. The RMS normalized values of the deltoid were always greater during the exercises performed on a medicine ball in relation to those performed on a stable base of support. The trapezius showed greater mean electric activation amplitude values on the wall-press exercise on a medicine ball, and the pectoralis major on the push-up. The serratus and biceps did not show significant differences of electric activation amplitude in relation to both tested bases of support. Independent of the base of support, none of the studied muscles showed significant differences of electric activation amplitude during the bench-press exercise. The results contribute to the identification of the levels of muscular activation amplitude during exercises that are common in clinical practice of rehabilitation of the shoulder and the differences in terms of type of base of support used. (C) 2006 Elsevier Ltd. All rights reserved.