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PubMed2004

[Reconstruction of shoulder abduction and external rotation in obstetric brachial plexus palsy].

OBJECTIVES: We evaluated the results of the subscapularis and pectoralis major muscle releases and the transfer of the latissimus dorsi/teres major muscles to the rotator cuff in patients with internal rotation contractures due to obstetric brachial plexus palsy. METHODS: Seventy patients (44 boys, 26 girls; mean age 7.6 years; range 2 to 16 years) underwent transfer of the latissimus dorsi/teres major muscles to the rotator cuff. Spinal root involvement was at C5-C6 in 19 patients, at C5-C7 in 16 patients, and at C5-T1 in 35 patients. In 46 patients, the subscapularis muscle was released from the anterior surface of the scapula, and in 55 patients, the pectoralis major muscle was released by fractional tenotomy. The glenohumeral joint was evaluated by anteroposterior direct graphies and axial magnetic resonance scans. According to the Waters-Peljovich grading system, all the patients had type I or type II deformities. Pre- and postoperative range of motion values and Mallet scores were compared. The mean follow-up period was 37.9 months (range 24 to 64 months). RESULTS: The mean shoulder abduction increased to 132.6 degrees (range 90 degrees to 170 degrees; mean gain 60.3 degrees) and external rotation increased to 81.1 degrees (range 30 degrees to 100 degrees; mean gain 58.7 degrees). The mean postoperative Mallet scores for global abduction and external rotation were 3.9; hand-to-head, to-mouth, and to-back scores were 3.7, 3.4, and 2.5, respectively. No serious complications were seen during the follow-up period. CONCLUSION: The results of reconstruction techniques employed in our study show satisfactory increases in shoulder abduction and external rotation in patients with a minimal glenohumeral deformity.

Adolescent↗
PubMed1980

Electromyographic activity of shoulder muscles during unilateral upper extremity proprioceptive neuromuscular facilitation patterns.

Twenty-nine normal adults were tested to measure the electrical activity of the anterior, middle, and posterior portions of the deltoid muscle and sternal portion of the pectoralis major muscle during the performance of four upper extremity diagonal patterns with the elbow straight, flexing, and extending. The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. With the elbow straight, the middle portion of the deltoid muscle was primarily active with shoulder flexion, abduction, and external rotation; the anterior portion of the deltoid muscle with shoulder flexion, adduction, and external rotation; the posterior portion of the deltoid muscle with shoulder extension, abduction, and internal rotation; and the sternal portion of the pectoralis major muscle with shoulder extension, adduction, and internal rotation. The middle and anterior portions of the deltoid muscle exhibited significantly greater activity in their optimal patterns with the elbow strainght, followed by patterns with the elbow flexing and significantly less activity with the elbow extending. The posterior portion of the deltoid muscle in its optimal pattern produced greatest activity with the elbow straight or extending. Findings confirm the patterns considered optimal for monitored portions of these two muscles in normal subjects. Suggestions are made for study of patients who exhibit imbalances of muscle strength.

Adult↗
PubMed1984

Enhanced T1 differentiation between normal and dystrophic muscles.

Proton spin-lattice relaxation times (T1) of pectoralis major muscles from normal (Line 412) and homozygous dystrophic (Line 413) chicks was measured by FONAR QED 80 at 1.69 MHz. The T1 values of dystrophic muscles (216.8 +/- 17.3 ms) was two-fold higher than those of normal muscles (110.2 +/- 8.1 msec). When these values were compared with the T1 values obtained at high frequencies (20 MHz and 32 MHz), the T1 differentiation between normal and dystrophic muscles was considerably enhanced at 1.69 MHz. Based on these results, we suggest that the high resolution of T1 obtained at low frequency (1.69 MHz) could be effectively used to detect the degenerative processes in muscles by the NMR techniques.

Animals↗
PubMed1986

Activities of antioxidant enzymes in muscle, liver and lung of chickens with inherited muscular dystrophy.

An inherited form of muscular dystrophy in chickens has been used as a model of Duchenne muscular dystrophy. The pectoralis major muscle of chickens with this disease showed a significantly elevated activity of catalase (CAT) one day after hatching, and by 7 days showed elevated superoxide dismutase (SOD), glutathione peroxidase (GPX) and glutathione-S-transferase (GST) activities. Increases were also found in tissues of the dystrophic birds that, unlike the pectoralis muscle, are considered to be unaffected by the pathology of muscular dystrophy. The soleus muscle contained significantly increased levels of SOD and GPX in 1 and 7 day old chickens, and increased GST in 1, 14, and 28 day old birds. CAT was significantly increased in liver from 1 and 7 day old chickens, while GPX was increased in lung from 1, 7 and 14 day old birds. These results support the possibility that excess oxygen free-radicals or altered cellular antioxidant defenses play some role in the pathogenesis of muscular dystrophy.

Animals↗
PubMed1991

[The muscular arch of the axilla and its nerve supply in Japanese adults].

We examined 94 axillary regions of 47 Japanese adults and found the muscular arch of the axilla (Maa) in five sides of three cadavers as well as the tendinous arch of the axilla (Taa) in two sides of two cadavers. The results are summarized as follows: 1) The frequency of Maa was 6.4% of the total bodies and 5.3% of the sides in this series. 2) In the left side of a 57-year-old male (No. 427), Maa was attached to the surface of the coracobrachialis muscle after fusing with the dorsal surface of the inserting tendon of the pectoralis quartus muscle. Both muscles were supplied by the caudal pectoral nerve (Npc) from the medial pectoral nerve. Moreover, in this same specimen, the sternalis muscle was recognized on the ventral surface of the pectoralis major muscle. In the left side of a 93-year-old female (No. 386), the cranial part of the muscular arch of the axilla (Cpa) was extended to the coracoid process by a tendon and attached to the abdominal part of the pectoralis major by two muscle bundles supplied by independent branches from Npc. One muscle bundle was attached to the lower margin of the abdominal part of the pectoralis major on the same plane, and the other bundle was located on the dorsal surface of the abdominal part. In a 74-year-old female (No. 411), the well-developed lateral part of the muscular arch of the axilla (Lpa) was attached to the inferior side of the tendinous arch. According to Ruge (1914) and Kasai et al. (1977), this arch was in the transition of the muscle bundle of Cpa to the arch. In the right side of the same specimen, only the thoracodorsal nerve (Ntd) was distributed into Lpa, whereas in the left side, only Npc supplied branches to Lpa. 3) The axillary arch was classified into 8 types based on the form and the supplying nerve of Cpa and Lpa. Cpa consisting of the muscle bundle is Type I, and Cpa consisting of the tendinous arch is Type II. We proposed that only Type II-A, with Cpa as tendinous arch and no Lpa, be designated as Taa (found in two cases), and the others as Maa. The following types were found in this study: Type I-A, consisting of only Cpa supplied by Npc (two cases); Type I-D, consisting of Cpa supplied by Npc and Lpa supplied by Ntd (one case); Type II-B, consisting of the tendinous arch and Lpa supplied by Npc (one case); Type II-D, consisting of the tendinous arch and Lpa supplied by Ntd (one case). 4) From the above findings, it can be suggested that Maa of varying shapes have been formed by a portion of the latissimus dorsi muscle supplied by Ntd, together with the pectoralis subcutaneous muscle, consisting of the pectoralis abdominalis, humeroabdominalis, humerodorsalis and ventrolateralis muscles supplied by Npc. The latter three muscles were proposed by Ura (1937) as the panniculus carnosus muscle, which was well developed in some lower mammalian orders. However, early investigators suggested that Maa was derived from the panniculus. Maa might have occurred as a rudimentary phylogenetic remainder in an early human embryonic stage.

Aged↗
PubMed1988

Complexity of myosin species in the avian posterior latissimus dorsi muscle.

The myosin content of the avian posterior latissimus dorsi muscle, a small fast-twitch muscle similar in fibre type to the much-studied pectoralis major muscle (type IIB), has been explored using high resolution chromatography of the proteolytic fragment known as subfragment-1 and of the products of its limited tryptic digestion, followed by N-terminal sequencing of selected peptides. The complexity of species found greatly exceeds that anticipated from the fibre-type homogeneity of the muscle and from previous studies (Bandman et al., Cell 29 (1982) 645-50; Lowey et al., J. Musc. Res. Cell Motility 4 (1983) 695-716; Crow & Stockdale Dev. Biol. 118 (1986) 333-42). A minimum of four heavy chain species were identified. One form, approximately 40% of the heavy chain complement, appears to be identical to the well-characterized type IIB isoform of the pectoralis major muscle. The remaining species differ from the pectoralis major form in primary sequence. None is identical to the post-hatch isoform of the pectoralis major muscle.

Amino Acid Sequence↗
PubMed2004

Inheritance of breast muscle morphology in turkeys at sixteen weeks of age.

The inheritance of morphology of the pectoralis major muscle in turkeys at 16 wk of age was studied in a randombred control line (RBC2), a subline (F) of RBC2 selected long term for increased 16 wk BW only, and F1 and F2 crosses of the F and RBC2 lines. Samples of pectoralis major muscle were obtained from 10 males and 10 females of each genetic group in a manner to avoid muscle contraction. After being fixed and cross sectioned, the muscle samples were stained with hematoxylin and eosin to view muscle morphology. The stained sections were analyzed for muscle fiber width, number of fibers in a 136-microm2 area, and extracellular matrix perimysial (PW) and endomysial (EW) width in areas of sections in which accurate measurements could be made. Because muscle damage was evident in some sections and, therefore, morphological measurements might not have provided a complete overview of muscle morphology, sections of the F2 crosses were subjectively rated by 4 people. The ratings ranged from 1 (little extracellular matrix and indistinct muscle fibers) to 5 (large extracellular space and distinct muscle fibers). Ratings of 2 to 4 were intermediate to these extremes. Creatine kinase concentrations of blood samples taken immediately prior to collecting muscle tissue were obtained and correlated with muscle section ratings within genetic group and sex. The F and RBC2 lines differed in PW and EW but not in individual fiber measurements. In the F1 generation, heterosis was -10.4% (P < or = 0.01), 19.7% (P < or = 0.05), -25.2% (P < or = 0.01), and -34.3% (P < or = 0.01), respectively, for fiber width, number of muscle fibers, PW, and EW. The F2 crosses differed only in EW based on measurements of sections in which accurate measurements could be made. However, based on subjective ratings of the muscle sections, possible maternal inheritance was suggested, as the orthogonal contrast was significant (P < or = 0.01) for crosses with F dams as F1 parents vs. those with RBC2 dams as F1 parents, confirming a previous study. The correlation coefficient between creatine kinase concentration and muscle section ratings was -0.282 (P < or = 0.01) after adjustment for line and sex effects.

Aging↗
PubMedDate not supplied

Electromyographical study of the pectoralis major (sternocostal part) and deltoid muscles (middle fibers) in volleyball sequential actions.

UNLABELLED: The Pectoralis Major muscles (Sternocostal part) and Deltoid (middle fibers) had been studied using electromyography in 8 male individuals, who practice volleyball, youth category, (age between 15 and 17 average +/- 16,25 years old), right-handed, those involved in volleyball for about one year. The objective was to analyze the potential of action of these muscles engaged in the volleyball movements: service, spike, pass, set and blocking with and without ball. The work was developed in the Electromyography and Biomechanics of Posture Laboratory(Physical Education Faculty--State University of Campinas--UNICAMP). To caption the muscle action potential, surface electrodes were set with conductive gel and fixed on the skin, in the center of the muscles. It was used an electromyography Lynx with 6 channels. The apparatus calibration was 2.500 microV, 1199.760 Hz. The low and high pass filter was set at 600-10 Hz. The sequential experiments without ball were performed for 10 seconds, and the sequential experiments with ball in 12 seconds. RESULTS: The Pectoralis Major muscle (Sternocostal part) revealed active during the basic movements of volleyball, (service and spike) in all movements of the extension of the arm, as well as the arm abduction during the pass movement. The Deltoid muscle (middle fibers), in spite of being primary in the abduction, showed the potential of action in all movements practiced in volleyball, however, they were more intense, in the spike and block actions. It is interesting to observe, that the general average and the standard deviation of the Deltoid muscle (middle fibers), were higher in the sequential movements executed without ball.

Action Potentials↗
PubMed1998

Bilateral Poland anomaly.

Bilateral absence of the pectoralis major muscle with accompanying abnormalities of shoulder muscles has been reported in patients without Poland anomaly (PA). However, symmetric absence of pectoralis major muscles, hypoplasia of breasts and nipples with symmetric chest wall deformity and bilateral hand anomaly has not previously been reported. A 6-year-old girl with bilateral absence of pectoralis major muscles and hand involvement and symmetric chest wall deformity is, to our knowledge, the first known case of bilateral Poland anomaly.

Breast↗
PubMed1984

The true pectoralis major myocutaneous island flap: an anatomical study.

The pattern of blood supply to the clavicular and sternocostal portions of the pectoralis major muscle was studied in the cadaver with X-rays of injected specimens. The major blood supply to the sternocostal part was derived from the pectoral branch, although in about 50% of cases the clavicular branch provided minor contributions. This finding supports the clinical experience that it is safe to isolate the full length of the vascular pedicle, deep to the clavicular portion of the muscle, in the preparation of a pectoralis major myocutaneous flap.

Humans↗
PubMed1999

Painful pectoralis major myospasm as a result of sternal wound reconstruction: complete resolution with bilateral pectoral neurectomies.

We report a patient with a highly unusual and previously unreported complication with the use of the pectoralis major muscle to treat the infected median sternotomy. The diagnosis of painful myospasm was made by a combination of physical findings and exclusion of other conditions such as recurrent infection. Treatment by pectoral denervation was relatively simple and highly successful. Patients with chest-wall pain after sternal wound reconstruction should have myospasm entertained as a possible cause.

Aged↗
PubMed2001

Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types.

In breast augmentation, surgeons usually choose a pocket location for the implant behind breast parenchyma (retromammary), partially behind the pectoralis major muscle (partial retropectoral), or totally behind pectoralis major and serratus (total submuscular). Each of these implant pocket locations has specific indications, but each also has a unique set of tradeoffs. When applied to a wide range of breast types, each pocket location has limitations. Glandular ptotic and constricted lower pole breasts offer unique challenges that often are not solved without tradeoffs when using a strictly retromammary, partial retropectoral, or total submuscular pocket. This article describes specific indications and techniques for a dual plane approach to breast augmentation in several different breast types, introducing techniques that combine retromammary and partial retropectoral pocket locations in a single patient to optimize the benefits of each pocket location while limiting the tradeoffs and risks of a single pocket location. A total of 468 patients had dual plane augmentation between January of 1992 and March of 1998 using the specific techniques of dual plane augmentation described in this article. All patients were treated as outpatients and received general anesthesia. Indications, operative techniques, results, and complications for this series of patients are presented. Dual plane augmentation mammaplasty adjusts implant and tissue relationships to ensure adequate soft-tissue coverage while optimizing implant-soft-tissue dynamics to offer increased benefits and fewer tradeoffs compared with a single pocket location in a wide range of breast types.

Adult↗
PubMedDate not supplied

Effects of the sex-linked dwarf gene (dw) on the expression of the muscular dystrophy gene (am) in chicken.

The sex-linked dwarf gene (dw) was introduced into companion muscular dystrophic (am) and nondystrophic (Am+) New Hampshire chicken lines to investigate influences of the dwarf gene on breast muscle weights, muscle fiber area, and the histological expression of muscular dystrophy. Dystrophic and nondystrophic chickens within dwarf or nondwarf genotypes were similar in body and carcass weights. Pectoralis and supracoracoideus muscle weights (as a percentage of adjusted carcass weight) were similar in nondystrophic dwarf and nondwarf males and females. In addition, pectoralis weight was similar in dystrophic dwarf males and dystrophic nondwarf males and females. However, pectoralis weight was significantly smaller in dystrophic dwarf females than in dystrophic nondwarf females, whereas supracoracoideus weight was significantly larger in dystrophic dwarf males than in dystrophic nondwarf males. Supracoracoideus weight was similar in dystrophic dwarf males and females and dystrophic nondwarf females. Pectoralis muscle fiber area was influenced by sex and by dwarf and dystrophy genotype. Muscle fiber area was larger in females than in males, smaller in dwarfs than in nondwarfs, and smaller in dystrophic than in nondystrophic muscles. Muscle fiber degeneration and adipose infiltration was more extensive in dystrophic than in nondystrophic females and males, and it was more advanced in dwarfs than in nondwarfs. Excessive acetylcholinesterase staining patterns were characteristic of dystrophic muscle in both dwarf and nondwarf genotypes. Nondystrophic and dystrophic dwarf male and female chickens are comparable substitutes for nondwarfs as biomedical models with respect to pectoralis histology, acetylcholinesterase staining pattern, and pectoralis muscle hypertrophy.

Acetylcholinesterase↗
PubMed1994

[The indications for reconstruction of the oral cavity using a pedicled flap of the musculus pectoralis major].

The reconstruction of postoperative or post-radiotherapeutic losses of substance in the oral cavity must respond to a number of basic requirements, such as lingual motility, the conservation of the labiogingival groove and adequate drainage of saliva towards the pharynx. This study reports the authors' experience of the reconstruction of the oral cavity using a pectoralis major myocutaneous flap. The identification of anatomic structures, such as the interpectoral compartment which separates the deep folium of the pectoralis major muscle from the clavi-coraco-axillary fascia covering the smaller pectoral muscle. Is indispensable for the correct preparation of the flap. Using an oblique incision along the lateral margin of the pectoralis major muscle the edge of the muscle is revealed and the muscle is separated from the pectoralis minor and from the costosternal structure. The cutaneous island is formed using the deep level of the muscle, and after tunnelling into the subcutaneous plane of the superficial fascia in the deltopectoral region, the flap is overturned to reach the part of the surgical reconstruction. The transposed tissue is sutured at various levels so as to reduce traction on a single component of the flap and to preserve the integrity of the perforating vessels. A total of 16 reconstructions of the oral cavity were performed by the authors using a pedunculated flap from the pectoralis major muscle. Fourteen of these cases were advanced stages of cancer and two were the outcome of radiotherapy. A myofascial flap was used in one case due to the excessive thickness of the subcutaneous panniculus of fat, whereas in the other cases it was not necessary to involve the cutaneous component which guarantees better functional adaptation. The following results were obtained: the metaplasia of the cutaneous surfaces of the flap into a multi-stratified non-keratinized epithelium and the contemporary reduction of cutaneous adnexa. The best functional recovery was observed using myocutaneous flaps compared to the case with the myofascial flap. Other results included: flap versatility in the reconstruction of the region of the retromolar trigonum and antero-lateral oral floor, and lastly the difficulty of performing a correct plastic surgery of the soft palate in those cases with damage in the tonsillar region and consequent rhinolalia. Complications observed, attributable to lesions of the perforating vessels, included two cases of total necrosis of the cutaneous component of the flap and four cases of partial necrosis which were resolved using local reclamation and medication.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed2003

[A new technique for post-mastectomy breast reconstruction: the Muscular Flag Flap (MFF)].

The possibility of breast reconstruction after a mastectomy resulting from breast cancer is still not widely exploited, and perhaps because it is relatively uncommon and unknown, is not widely practised. The plastic surgeons who were pioneers in this field know just how hard it has been to reach the stage we are at today. This leads to longer operating times, in the context of over-worked operating theaters in which time was already at a premium, and this is expecially the case in peripheral hospitals lacking in-house resources for surgical reconstruction and dependent on outisde specialist consultants. In order to address this problem, a new single-operation surgical technique, MFF (Muscular Flag Flap) has been developed. The surgical techniques adopted at present are based on immediate reconstruction or successive reconstruction. The MFF technique was developed as a response to demand for intraoperative reconstruction even when "demolition" is extensive and the breast large. This will reduce the need to operate the contralateral breast. Upper and lower pectoralis major muscle flaps are created in order to produce a large enough pocket for the final prothesis. The elasticity of this muscle is such that a large pocket is possible. The pectoralis major muscle will then envelop at least two thirds of the prosthesis. Projection of the reconstructed cone and a more anatomically normal profile are obtained. This method gives excellent esthetic results in a single operation. Thanks to the collaboration of the hospitals of Ivrea, Pinerolo and Alba over a period of approximately one year, about 80 patients have been very successfully treated using this techhnique. Rapid functional and social recovery have been observed, with no particular problems. In view of the above, we confirm that this new surgical technique will be of considerable benefit to patients.

Breast Implantation↗