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PubMedDate not supplied

Expiratory function in complete tetraplegics: study of spirometry, maximal expiratory pressure, and muscle activity of pectoralis major and latissimus dorsi muscles.

Respiratory complications, such as pneumonia and atelectasis, are major causes of mortality and inhibit rehabilitation programs in spinal cord injury. Tetraplegic patients cannot cough enough to clear their sputum because of expiratory muscle weakness, mainly of the abdominal muscles. However, tetraplegics are still able to activate some muscles during coughing. Some tetraplegics, even though they cannot contract the abdominal muscles, can cough effectively. It was supposed that some accessory expiratory muscles were activated during coughing in tetraplegics. We, therefore, studied the peak expiratory flow rate, expiratory muscle strength, and the activities of the pectoralis major and latissimus dorsi muscles in 11 complete tetraplegics. Peak expiratory flow rate was measured by spirometry. Expiratory muscles strength was assessed by maximal expiratory mouth pressure; muscle activity was assessed by means of the root mean square voltage obtained by surface electromyography. The results showed that peak expiratory flow rate, maximal expiratory mouth pressure, and root mean square of these two muscles were correlated with neurological level. Peak expiratory flow rate was correlated with peak expiratory flow rate. Peak expiratory flow rate was correlated with the root mean square voltage of the pectoralis major and latissimus dorsi muscles. It was supposed that these two muscles were activated as accessory expiratory muscles and play an important role in expiratory function in tetraplegic patients.

Adult↗
PubMed1988

The pectoralis major muscle flap without skin in intra-oral reconstruction.

There are many methods of reconstructing intra-oral defects following surgical treatment of cancer. A very reliable flap is the pectoralis major myocutaneous flap which has the added advantage of carotid artery protection when a radical neck dissection has also been necessary. However this flap is very bulky, may cause distortion of the female breast and there is also the problem of continued hair growth in male patients. A description of the use of the pectoralis major muscle-only flap without any overlying skin, fascia or breast tissue is given. The advantages of rapid epithelialisation within the mouth of the muscle flap together with the minimal changes to the breasts are emphasised.

Adult↗
PubMed2000

[Transfer of the clavicular portion of the pectoralis major muscle in the treatment of irreparable tears of the subscapularis muscle].

PURPOSE OF THE STUDY: Old tears of the subscapular muscle situated in the glenoid area are not accessible to direct repair and require locoregional muscle plasty. The clavicular portion of the pectoralis major can be used for reconstruction. The purpose of this study was to describe the operative technique and examine short-term outcome. MATERIAL AND METHODS: Five patients, mean age 54 years (45-71 years) with an irreparable tear of the subscapularis in the glenoid area with fatty degeneration greater than grade two in the Goutallier classification were treated. Four had had previous surgery for acromioplasty associated with rotator cuff repair in two or implantation of a humeral prosthesis in one. The preoperative Constant score was 27.5 (mean, range=8.5-54) due to invalidating pain, limited active mobility and reduced muscle force. Gerber's lift-off test was positive for those patients for whom it could be performed. Plain x-rays evidenced anterior subdislocation of the humeral head in one case. Subscapular reconstruction was achieved using the entire clavicular portion of the pectoralis major which was dissected and sectioned at its distal insertion on the humerus then reinserted by transosseous suture onto the lesser tuberosity. The rehabilitation program started with active and passive mobility against gravity within a few days of surgery using biofeedback contraction of the muscle flap then active contractions two months postoperatively. Patients were reviewed at a mean 19 months (6-42 months) for clinical and radiological assessment. RESULTS: Four patients had a painless shoulder with a negative lift-off test. The gain in active mobility was predominantly achieved with anterior elevation and abduction. Muscle force was weak leading to a low overall Constant score at revision (mean=50, range=30-63). Radiographically, the humeral head was centered exactly as on the preoperative films. There were no cases with a new anterior subdislocation nor an aggravation of a former subdislocation. Functional outcome was better in cases with a unique tear of the subscapularis. DISCUSSION AND CONCLUSION: Open surgery is used for primary repair of recent tears of the subscapularis. This technique gives 80 p. 100 good and very good results. In case of symptomatic acromioclavicular osteoarthtisis, better long-term results can be obtained by using a tendodesis of the long biceps and resecting the lateral centimeter of the clavicle. In case of irreparable tears in the glenoid area, reconstruction by transfer of the clavicular portion of the pectoralis major can produce a stable painless shoulder with improved active moblity and normal clinical tests. This method provides anterior stability of the glenohumeral articulation and prevents any anterior subdislocation of the humeral head, thus protecting the joint from secondary degeneration.

Activities of Daily Living↗
PubMed2001

Increased responsiveness to dietary lysine deficiency of pectoralis major muscle protein turnover in broilers selected on breast development.

It has been previously established that growth and carcass qualities of chicks are modified by genotype and dietary amino acid supply. In this study, we evaluated the effects of lysine deficiency and genetic selection on muscle protein metabolism. Chicks originating from an experimental line selected for breast development (QL) and its control line (CL) were provided ad libitum access to isoenergetic diets containing 20% crude protein but differing in their lysine content (0.75 or 1.01%). Protein fractional synthesis rates (FSR) were measured in vivo in the pectoralis major and sartorius muscles of 3-wk-old chickens (flooding dose of [3H]phenylalanine). Fractional breakdown rates (FBR) were estimated as the difference between synthesis and deposition. Lysine deficiency reduced (P < 0.001) growth performance and muscle weights and increased (P < 0.05) muscle FSR, capacity for protein synthesis (muscle RNA:Protein, Cs) and FBR. Although QL birds grew faster and had heavier pectoralis major muscles than CL birds (P < 0.05), there was no line difference in sartorius weight (P = 0.15). No difference between the lines was observed in sartorius protein metabolism (P > 0.14). In the pectoralis major muscle, chicks of both lines receiving an adequate lysine intake also exhibited similar protein turnover rates. However, in chicks fed the lysine-deficient (0.75% lysine) diet, FSR and Cs were higher in QL than in CL chicks (P < 0.05), and FBR tended (P = 0.07) to be higher in QL chicks. This increased protein turnover in the QL birds on the lysine-deficient diet suggests that the responsiveness of muscle protein metabolism to amino acid supply is modified by genetic selection for breast development.

Animals↗
PubMed2000

Pectoralis major muscle flap for deep sternal wound infection in neonates.

BACKGROUND: Deep sternotomy wound infections during the neonatal period, their management utilizing the pectoralis major muscle flap (PMF), and their follow-up are reported. METHODS: Seven hundred-twenty consecutive pediatric cardiac operations performed from 1995 to mid 1998 in 108 neonates and 612 infants are reviewed. Nine children (1.25%), 6 neonates and 3 infants, developed deep sternotomy wound infections and underwent PMF reconstruction. The 6 neonates are reviewed. Their follow-up includes growth and development reports, physical examination, and computerized tomographic scans of the chest. RESULTS: The incidence of sternal wound complications in our neonatal patients (5.5%, 6 of 108) was significantly higher than in the infantile group (0.5%, 3 of 612), (p = 0.0001, odds ratio = 11.94). Five neonates were treated with a unilateral, turnover PMF reconstruction. One patient was treated by a bilateral rotational PMF. All sternal wounds healed successfully, and all patients survived. In a follow-up period, ranging from 6 to 31 months (mean 16.5 months), the growth and development of all operated neonates was as expected for their age. There were no signs of chronic sternal infection in any of them. CONCLUSIONS: Early recognition of sternal wound complications should facilitate surgical treatment. Utilizing the PMF promotes rapid wound healing and preservation of life in these severely ill neonates, with minimal developmental problems.

Adolescent↗
PubMed1995

Development of metabolic enzyme activity in locomotor and cardiac muscles of the migratory barnacle goose.

Preflight development of the goslings was typified by rapid increases in the mitochondrial enzymes of the semimembranosus and heart ventricular muscles resulting in near-adult values by 3 wk of age. In contrast, aerobic capacity of the pectoralis muscle initially developed slowly but showed a rapid increase between 5 and 7 wk of age, in preparation for becoming airborne. Activities of glycolytic enzymes in the pectoralis muscle showed similar patterns of development as those found for the aerobic enzymes, except for hexokinase, which was low at all ages, indicating an adaptation for catabolism of both intracellular glycogen and plasma fatty acids in preference to plasma glucose. Muscle mass specific activity of citrate synthase in the pectoralis increased by only 33% from goslings during the first few days of flight, compared with premigratory geese. Activities of anaerobic glycolytic enzymes in the ventricles were low, but values for hexokinase, which is involved in the phosphorylation of plasma glucose, developed rapidly. Values for lactate dehydrogenase were also high, reflecting the capacity of the heart to catabolize plasma lactate. Substrate flux supplied by carnitine palmitoyltransferase and oxoglutarate dehydrogenase (OGD), in the pectoralis muscles of the premigratory geese, appears to have the smallest excess capacities to meet the requirements of sustained aerobic flight. The average maximum oxygen uptake for premigratory geese during flight, as indicated by values for OGD, is calculated to be 484 ml O2/min (or 208 ml O2.min-1.kg-1).

Aging↗
PubMed2004

Developmental regulated expression of syndecan-1 and glypican in pectoralis major muscle in turkeys with different growth rates.

Heparan sulfate proteoglycans, syndecan-1 and glypican, are low-affinity receptors for fibroblast growth factor 2 (FGF2). Since FGF2 stimulates skeletal muscle cell proliferation but inhibits differentiation, differences in syndecan-1 and glypican expression might affect muscle development and growth by changing the intensity of FGF2 signaling. In the present study, the pectoralis major muscle from 14 to 24-day-old-embryos, and from 1 to 16-week-old birds from a turkey line (F) selected for increased 16-week bodyweight and its genetic control line (RBC2), were used to address how syndecan-1 and glypican are expressed during skeletal muscle formation. The expression of syndecan-1 and glypican was measured by semiquantitative reverse transcription polymerase chain reaction. For males, the F-line embryos expressed more syndecan-1 (days 14 and 16) and glypican (days 14 and 18) than the RBC2 line. Similar line differences for males were observed during posthatch development. The male embryos from both lines expressed more syndecan-1 at days 18 through 22 and more glypican at days 20 and 22 than the corresponding females. The temporal and spatial distribution of syndecan-1 and glypican was detected by in situ hybridization. Syndecan-1 was identified in all muscle fibers at all embryonic stages studied, whereas the glypican was detected from embryonic day 18. The data from the current study provided new information about the expression of syndecan-1 and glypican as it relates to skeletal muscle growth properties.

Animals↗
PubMed1993

[Pectoralis major muscle island flaps. Personal experiences].

Fifty-six pectoralis major island flap procedures were carried out in 52 patients for the immediate reconstruction of defects after resection of head, neck or thoracic tumors. In 28 we used only a part of the muscle covered with meshgraft, in another 28 as a myocutaneous island flap. The complication rate was low: One partial flap necrosis, two bleedings postoperatively on the donor site, four fistulas (one required a second operation). One necrosis of ribs required the resection and covering with a latissimus dorsi flap. One patient died with mediastinitis. The functional aspects of the muscle donor site is stressed out.

Adult↗