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Use of free-tissue transfer in the treatment of median sternotomy wound infections: retrospective review.

The incidence of sternal wound infection following median sternotomy is 0.4 to 5 percent. Debridement and closure of the wounds with local and regional muscles, such as a pectoralis or a pedicled rectus abdominis, have been the mainstay of surgical treatment. Often, both pectoralis major muscles and the superior portion of a rectus abdominis muscle must be used to close large sternal wounds. Loss of these major muscles can be both debilitating and cosmetically disfiguring. Free-tissue transfer can be employed to limit the amount of tissue needed to fill the sternal defect. The authors present a series of 12 free-tissue transfers used in 11 patients to close large sternal defects in this subset of patients. Total flap loss occurred in one patient. Partial loss of the skin island was noted in three patients. Two patients developed abdominal hernias after rectus abdominis free flaps. Free-tissue transfer offers the ability to close these large wounds, using one muscle, in those patients where pedicled rectus abdominis flaps are not available.

Female↗

Changes in upper body power following heavy-resistance strength training in college men.

The purpose of this study was to determine the effects of heavy-resistance strength training on measures of bench press power (BPP) using absolute loads and seated shot put (SSP) performance. Twenty-four college men were measured for 1-RM bench press, BPP, and SSP before and after weight training twice weekly for 12 weeks. BPP was measured with free weights using a digital timing system and randomly assigned loads equivalent to 30%, 40%, 50%, 60%, 70% and 80% of the 1-RM. Post-training tests used the same absolute loads as during the pre-training test to assess BPP. Following training BPP increased significantly at each load, shifting the power curve upward by an average of 13.6%. The 1-RM bench press increased significantly by 9.1%, but the SSP increased nonsignificantly by only 1.8%. Peak power was produced at approximately 40-50% of the 1-RM before and after training. Changes in SSP distance were nonsignificantly correlated (r=0.27-0.20) with the increases in BPP. Resistance training shifts the power curve in a positive direction when the measurements are determined with absolute loads, but the increased power may not be transferred to an absolute performance task like the SSP.

Adult↗

The effect of light intensity on growth and development of turkey toms.

1. The effect of light intensities from 10 to 700 lux on the performance of 5 to 18 week-old turkey males was studied in 2 trials. 2. Body weight of 18 week-old turkeys, in both experiments, was highest under the lowest light intensity This coincided with higher weight gain and lower food intake, which resulted in significantly better food conversion efficiency 3. Light intensity affected heart muscle weight but not weight of breast muscle, abdominal fat or testis as proportions of body weight. 4. The decline in plasma T3 concentration with age differed from other treatments at the low light intensity, which resulted in a significantly higher T3 concentration in turkeys exposed to 10 lux at the age of 10 to 15 weeks. 5. It is concluded that light intensity significantly affects food conversion efficiency in turkey males. This is likely to be related to differential investment of energy expenditure for maintenance.

Animals↗

Growth curve analyses in selected duck lines.

1. Growth patterns of male ducks from 4 lines (lines A, B, C and D) selected for market weight were analysed and compared to growth patterns of ducks in the respective line 7 generations earlier. Growth curves were analysed using procedures derived from the Weibull sigmoidal function and the linear-linear relative growth rate model and simple allometry. 2. The ducks were fed ad libitum under 24-h lighting throughout the experiment. At weekly intervals from the time of hatch through 70 d of age, 16 ducks from each line were killed to determine body, carcase, breast-muscle, leg and thigh-muscle, and abdominal fat weights. 3. Line A was the heaviest line, followed by line B, line C and line D. However, body weight, carcase weight and breast-muscle weight at 49 d of age were not significantly different between lines A and B. After 7 generations of selection, the breast-muscle yield was increased to >19% and the abdominal fat percent was reduced to <1.4% in all lines. 4. The Weibull growth curve analysis of body weight showed an increase in the asymptotes during selection, while the age of the inflection point remained constant in all lines (21.3 to 26.0 d). For breast-muscle growth, ducks reached the inflection point 12.8 to 14.3 d later than for body weight. Between line A and line B, asymptotes for body weight, asymptotes for breast-muscle weight and allometric growth coefficients of breast muscle and leg and thigh muscles from 14 to 49 d were not significantly different. 5. The relative growth rate model discriminated body and breast-muscle growth patterns of line A and line B. The initial decline in the relative body growth rate was less and the time to reach the transition was longer in line A than line B. On the other hand, the initial decline in the relative breast-muscle growth rate was greater in line A than line B.

Abdomen↗

Torque and EMG in isometric graded flexion-rotation and extension-rotation.

The main objective of the study was to measure the magnitude and pattern of electromyographic (EMG) activity of the trunk muscles in combined motions of flexion-rotation and extension-rotation. Another objective of the study was to determine the torque-EMG Root Mean Square (RMS) relationship in these activities for predictive purposes. Nineteen normal young adult subjects who met the inclusion criteria were fitted with 12 pairs of surface electrodes on their external and internal oblique, rectus abdominis, latissimus dorsi, and erector spinae muscles at T10 and L3 levels bilaterally. Using a Posture Stabilizing Platform (PSP) they were fixed in 40 degrees flexed and 40 degrees right rotated trunk postures. From this posture subjects attempted an isometric extension-rotation and flexion-rotation in the plane defined by the asymmetrical postural axis in the plane of rotation of the assumed posture. Contractions of 25, 50 and 75% of the previously measured maximal voluntary contraction (MVC) were attempted using a Static Dynamic Strength Tester (SDST) and force monitor attached by a steel cable to a rigid thoracic harness worn by the subjects. The data were acquired at 1 kHz. Descriptive statistics were calculated and ANOVA, correlation and regression analyses were carried out. With linear increase in flexion-rotation and extension-rotation torque, the magnitude of total EMG output increased exponentially. In flexion-rotation the EMG magnitude of all muscles increased with increasing grades of contraction (% of MVC). However, in proportional terms, the magnitude of erector spinae EMG declined. In extension-rotation there was a reversal of roles between the ventral and dorsal muscles compared to the flexion-rotation. For the two genders, all muscles and grades of contractions were significantly different from each other (p<0.01). There was a significant but modest correlation between EMG and torque (r = 0.25 to 0.54; p<0.01). The regressions were significant (p<0.01) and explained up to 74% of the variance in torque. The flexion-rotation and extension-rotation torques can be predicted with only a moderate accuracy.

Abdominal Muscles↗

Can betaine partially replace or enhance the effect of methionine by improving broiler growth and carcase characteristics?

1. Growth rates and carcase characteristics were measured in male broiler chickens fed on a control diet deficient in methionine (c. 2.8 g/kg methionine) or a series of diets containing graded levels of betaine or DL-methionine or both additives. 2. We aimed to answer 2 main questions. First, can betaine replace part of the methionine in a broiler ration? Secondly is there a synergism between methionine and betaine? 3. Birds given the control diet or that supplemented only with betaine ate less, grew more slowly, had higher food convension ratio (FCR) and varied more in mass at 42 d than birds fed diets with DL-methionine. Adding 1.2 g/kg DL-methionine to the control ration produced the heaviest birds at 42 d (2500 g) with the 2nd heaviest breast muscle (366 g). 4. After correcting for treatment differences in body mass (analysis of convariance), birds fed on the control diet and the diet supplemented with betaine only, had relatively lighter breast muscles but relatively heavier abdominal fat pads than those of birds given diets supplemented with DL-methionine. However, adding betaine to diets containing added methionine further improved the relative breast muscle yield. 5. After correcting for differences in body mass between treatments, birds fed on diets containing most methionine had lighter viscera than birds fed diets deficient in methionine. This demonstrated gut plasticity, suggesting that the viscera enlarged to sequester methionine from low-methionine diets. 6. Our data refute the hypothesis that betaine can substitute for methionine in broilers fed diets that are marginally deficient in methionine plus cystine. However, betaine may improve carcase composition, especially breast meat yield.

Adipose Tissue↗

Dynamics of capping protein and actin assembly in vitro: uncapping barbed ends by polyphosphoinositides.

Bursts of actin polymerization in vivo involve the transient appearance of free barbed ends. To determine how rapidly barbed ends might appear and how long they might remain free in vivo, we studied the kinetics of capping protein, the major barbed end capper, binding to barbed ends in vitro. First, the off-rate constant for capping protein leaving a barbed end is slow, predicting a half-life for a capped barbed end of approximately 30 min. This half-life implies that cells cannot wait for capping protein to spontaneously dissociate from capped barbed ends in order to create free barbed ends. However, we find that phosphatidylinositol 4,5-bisphosphate (PIP2) and phosphatidylinositol 4-mono-phosphate (PIP) cause rapid and efficient dissociation of capping protein from capped filaments. PIP2 is a strong candidate for a second messenger regulating actin polymerization; therefore, the ability of PIP2 to remove capping protein from barbed ends is a potential mechanism for stimulating actin polymerization in vivo. Second, the on-rate constant for capping protein binding to free barbed ends predicts that actin filaments could grow to the length of filaments observed in vivo during one lifetime. Third, capping protein beta-subunit isoforms did not differ in their actin binding properties, even in tests with different actin isoforms. A major hypothesis for why capping protein beta-subunit isoforms exist is thereby excluded. Fourth, the proposed capping protein regulators, Hsc70 and S100, had no effect on capping protein binding to actin in vitro.

Actin Depolymerizing Factors↗

Growth rate and maturation of skeletal muscles over a size range of galliform birds.

The relationship between growth rate and development of function in leg and pectoral muscles was studied in four species of galliform birds ranging from 125 g to 18 kg and, for comparison, in an altricial species, the European starling (80 g). An index to neonatal maturity (muscle dry content proportion as a fraction of adult value) was higher in leg than in pectoral muscles and lower in larger than in smaller galliforms. The maturity index was substantially lower in starling neonates. After the first week posthatch, however, the maturity index was highest in larger species. Exponential growth rates decreased linearly with increasing maturity in both pectoral and leg muscles, following similar regressions in all species including the starling. At a particular value of the maturity index, the exponential growth rate was higher in pectoral than in leg muscles. The exponential growth rates of muscles of neonatal large galliforms were lower than expected from their low maturity. This may represent the down-regulation shortly after hatching of the high exponential growth rate needed to reach a large hatching mass in a short incubation period. A slower growth rate immediately posthatch may be necessary if the relatively immature neonatal digestive system cannot deliver nutrients or metabolized energy required for more rapid growth. Smaller species may not be faced with the constraint of rapid growth toward the end of the embryonic period.

Aging↗

The use of halothane gas to identify turkeys prone to developing pale, exudative meat when transported before slaughter.

Halothane screening has been used in the swine industry to identify animals susceptible to stress and prone to developing pale, soft, exudative (PSE) meat. This study evaluated the ability of halothane to identify stress-susceptible turkeys prone to developing PSE meat when reared to market age and transported before slaughter. Male Nicholas turkeys (n = 1,286) were exposed to 3% halothane for 5 min at 4 wk of age in two trials. Birds were classified as halothane sensitive (HAL+) or halothane nonresponder (HAL-), in which HAL+ birds showed signs of muscle rigidity in the legs upon removal from halothane gas, and HAL- birds showed no stiffness response. Approximately 3.5% (45) of the turkeys were HAL+. All HAL+ birds and an equal number of HAL- birds were grown until 20 wk of age. Immediately prior to slaughter, all birds were transported in coops on a flatbed trailer for 2 h and then immediately slaughtered upon arrival at the processing plant. Breast muscle pH (0, 1.5, and 24 h postmortem) and L* value (1.5 h and 24 h postmortem) were measured on the fillets. Drip loss and cook loss were also determined on marinated and nonmarinated breast fillets from each carcass. There were no significant mean differences in any parameter measured between the HAL+ and HAL- turkeys. However, the HAL+ turkeys had a greater percentage of fillets with L* values >51 compared with the HAL- turkeys. These results suggest that either halothane response is only a limited predictor of PSE meat in turkeys or that transportation is not an appropriate stressor to induce the PSE condition.

Anesthetics, Inhalation↗

Fatty acid content in chicken thigh and breast as affected by dietary polyunsaturation level.

One hundred ninety-two female broiler chickens were randomly distributed into 16 experimental treatments as a result of the combination of 4 levels of dietary polyunsaturated fatty acids (PUFA) (15, 34, 45, and 61 g/kg) and 4 levels of supplementation with alphatocopheryl acetate (alpha-TA) (0, 100, 200, and 400 mg/kg), to determine the modification of the amount and type of fatty acids (FA) deposited in raw and cooked chicken tissues. At 44 d, quantified FA of thighs and breasts were not affected by dietary supplementation with alpha-TA. Total FA content of breast was less than 15% of the total FA content of thigh. However, increasing the PUFA content of the diet by 46 g, from 15 to 61 g/kg, decreased total FA of thigh 17%, but did not affect FA content in breast meat. Monounsaturated fatty acid (MUFA) and saturated fatty acid (SFA) content of thigh (y) decreased linearly as the inclusion of dietary PUFA (x) increased (MUFA: y = 89.34 - 0.92x, R2 = 0.70; SFA: y = 53.81 - 0.43x, R2 = 0.57), whereas the relationship between PUFA content of feed (x) and thighs (y) was exponential (y = 92.03 92.03e(-00155x), R2 = 0.75). A similar response was observed in breast, with less variation and more incorporation of PUFA than thigh. Cooking of thigh meat led to a reduction in total FA content that affected SFA, MUFA, and PUFA in a similar proportion.

Animals↗

Effects of intramuscular fat levels on sensory characteristics of duck breast meat.

We conducted a study to evaluate the effects of intramuscular fat levels on the sensory characteristics of duck breast meat. Combining duck genotypes (Muscovy, Pekin, and their crossbreed hinny and mule ducks) and feeding levels (overfeeding between 12 and 14 wk of age vs. ad libitum feeding) enabled us to obtain a wide range of lipid levels in breast muscle. The average values were between 2.55 and 6.40 g per 100 g of muscle. Breast muscle from overfed ducks showed higher lipid and lower water levels than breast muscle from ducks fed ad libitum. Muscle from the overfed ducks was also paler in color and exhibited greater yellowness and cooking loss values. Juiciness was judged lower and flavor more pronounced in overfed ducks. Muscovy ducks exhibited higher breast weight and lower lipid levels than the other genotypes. At the other extreme, Pekin ducks exhibited the highest lipid levels and the lowest breast weights; values for these criteria were intermediate in hinny and mule ducks. Breast muscle of Muscovy ducks was paler, less red, and more yellow than that of other genotypes. Breast muscle of Pekin ducks exhibited the lowest values for lightness, yellowness, and energy necessary to shear meat, as well as the highest cooking loss values, and was judged more tender, juicy and less stringy than that of other genotypes. In contrast, scores for breast muscle of Muscovy ducks were the lowest for tenderness, juiciness, and flavor, and the highest for stringiness. Breast muscle of hinny and mule ducks scored the highest values for redness. Hinny ducks also scored the highest values for flavor. Genotype exerted a higher effect on the sensory quality of breast muscle than did feeding levels. Finally, increasing lipid levels in breast muscle increased lightness, yellowness, cooking loss, tenderness, and flavor, with correlation coefficients of 0.49, 0.47, 0.54, 0.43, and 0.28, respectively. However, breast meat color and tenderness were mainly influenced by genotype.

Adipose Tissue↗

Inspiratory muscle function following abdominal weight exercises in healthy subjects.

Three indexes of inspiratory muscle function were evaluated in 20 healthy young adults before and after a six-week program of diaphragmatic breathing exercises. Thrice weekly, each subject performed 30 maximal voluntary diaphragmatic contractions in the supine position with a moderately heavy weight (range: 7-23 kg, or 15.4-50.7 lb) placed on the anterior abdominal wall to resist diaphragmatic descent. This protocol failed to improve 1) inspiratory capacity, 2) peak inspiratory flow rate, and 3) maximal pressures generated by the inspiratory muscles under static conditions. These finding indicated that this commonly used isotonic exercise regimen does not increase the maximal shortening, velocity of shortening, or strength of the diaphragm in healthy subjects. On the other hand, most subjects increased the maximal weight they found tolerable, performed the exercise more rapidly, and reported that their initial discomfort either waned or disappeared by the end of the program. These latter observations suggest that the exercise program might have improved inspiratory muscle endurance.

Adult↗

Reliability of isokinetic trunk muscle strength measurement.

OBJECTIVE: To determine the intrarater and interrater reliability of reciprocal concentric trunk flexion and extension peak torque values at different angular velocities using the Cybex NORM isokinetic dynamometer. DESIGN: Trunk flexor and extensor muscles of 15 healthy subjects were assessed at 60 degrees/sec and 90 degrees/sec angular velocities. Each subject was tested by two physicians three times, with at least 48 hr between test sessions. Intraclass correlation coefficients were used to determine the intrarater and interrater reliability of the reciprocal concentric trunk flexion and extension peak torques at 60 degrees/sec and 90 degrees/sec angular velocities. RESULTS: For intrarater reliability intraclass correlation coefficients for trunk flexion, peak torque values ranged from 0.89 to 0.95; for the extensors, values ranged from 0.80 to 0.92. The intraclass correlation coefficient values for interrater reliability were also found to be highly reliable, and peak torque values demonstrated intraclass correlation coefficients values that ranged from 0.95 to 0.98. CONCLUSIONS: Reciprocal concentric trunk flexion and extension peak torque measurements at 60 degrees/sec and 90 degrees/sec angular velocities had a high intrarater and interrater reliability with the Cybex NORM isokinetic dynamometer in healthy subjects.

Adult↗

Restoration of elbow flexion by a new operative technique.

In order to treat some of the awkward and unusual problems and to avoid some of the complications associated with paralytic elbows, the distal part of the flexor carpi ulnaris is detached and the muscle is freed up to its neurovascular bundle. The tendon is turned upon itself, its distal end is passed through a subcutaneous tunnel to the upper arm, and fixed to the humerus by staples. A posterior splint is applied for a period of 6 weeks followed by supervised graduated active elbow flexion exercises.

Elbow Joint↗

Model-based detection of partially obstructed endotracheal tube.

OBJECTIVES: A five-element lumped pulmonary model was developed to estimate respiratory mechanics automatically and noninvasively. The model was applied to diagnose obstructed endotracheal tube. Events like bronchospasm and stiff chest wall were also tested to determine the specificity of the diagnosis. Cases with positive end-expiratory pressure were also included in the analysis to see the effects of positive end-expiratory pressure on the model. DESIGN: Randomized controlled animal study. SETTING: University department of anesthesiology. SUBJECTS: Ten anesthetized, paralyzed, and mechanically ventilated mongrel dogs (19-45 kg) of either gender. INTERVENTIONS: Two levels of upper airway obstruction were induced in ten dogs by partially constricting the endotracheal tube. Acute bronchial constriction was produced in five dogs by injecting methacholine through a central venous catheter. In the same five dogs, the chest wall was stiffened by wrapping a pressure cuff around the chest. Positive end-expiratory pressure was also applied as a separate event in these five animals. MEASUREMENTS AND MAIN RESULTS: Airway pressure and flow were continuously recorded at the mouth. Model parameters were iteratively identified until the root mean square error between respiratory impedance (obtained from airway pressure and flow) and model-predicted impedance (calculated using Ohm's law) was minimum. The peak inspiratory pressure increased and the peak expiratory flow rate decreased with increasing levels of partial obstruction. The value of the model parameters R(1) and C(2) increased and C(1) decreased with partial obstructed endotracheal tube, whereas R(1) increased and L and C(2) decreased with bronchospasm. With stiff chest wall, R(2) increased and C(2) decreased. With positive end-expiratory pressure, the L parameter decreased and no significant change in other model parameters was observed. Obstructed endotracheal tube is indicated if R(1) increased > or =30%, C(1) decreased > or =10%, and C(2) increased > or =10% from baseline. The test results using 45 events, including control, three complications, and positive end-expiratory pressure, show that when the model is used to diagnose obstructed endotracheal tube, the method has a sensitivity of 90% and specificity of 97%. CONCLUSIONS: During an obstructed endotracheal tube, model parameters change such that the event can be diagnosed noninvasively, automatically, and accurately. The model differentiates between upper airway obstruction and complications like bronchospasm and stiff chest wall.

Airway Resistance↗