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At least 1,279 records · Page 71Linked to original sources
PubMed2004

Developmental states of the collagen content, distribution and architecture in the pectoralis, iliotibialis lateralis and puboischiofemoralis muscles of male Red Cornish x New Hampshire and normal broilers.

1. Developmental states of the collagen content, distribution and architecture in the pectoralis (PT), iliotibialis lateralis (ITL) and puboischiofemoralis (PIF) muscles of male Red Cornish x New Hampshire (RN, 80 d, body weight 2.9 kg) and normal (3.1 kg) broilers were evaluated. 2. In PT muscle the total amount of collagen was significantly greater in RN broilers (3.33 mg/g) than in normal ones (1.71 mg/g). This higher collagen content in RN broilers was based mainly on the closer mesh sizes of endomysial honeycomb. The collagen structures in the perimysia also differed between broiler types, when more collagen fibres were observed in RN broilers. 3. ITL muscle contained total collagen of 4.10 to 5.00 mg/g. Types I and III collagens were distributed on the perimysia at higher percentages in RN broilers (31.6%, 37.2%) than normal (15.6%, 30.8%), respectively. The thick bands of tough collagen fibres characteristic of ITL muscle perimysium in cockerels had not yet developed in these broilers. 4. Total collagen was 4.63 to 6.29 mg/g in PIF material with fascia. In PIF muscle the perimysial collagen fibres had not yet attained their full growth but consisted of densely packed fibrils. PIF muscle was characterised by the earlier maturing collagen structure. 5. These results show that a perimysial collagen structure in broilers is still in an undeveloped state. It is supposed that tenderness of broiler meat is attributed mainly to characteristics of the collagen distribution, in which the majority of types I and III collagens is distributed on the closer mesh of endomysial honeycomb.

Animals↗
PubMed1997

Video-assisted thoracoscopic closure of postpneumonectomy bronchopleural fistulas.

Despite improved surgical techniques and advances in medical-surgical treatment, postpneumonectomy bronchopleural fistulas remain an important cause of morbidity and a therapeutic challenge. Video-assisted thoracoscopic closure of these fistulas reinforced by transposition of bulky chest wall muscles or omentum to obliterate the residual space may lessen risks and complications of repeated thoracotomy in these often frail, debilitated, and compromised patients. We report our initial experience with video-assisted thoracoscopic debridement of the empyema cavity and closure of the postpneumonectomy bronchopleural fistula by transposing an entire pectoralis major muscle in one patient and by transposing a pedicled omentum in another patient.

Aged↗
PubMed2005

Three-dimensional anatomical vascular distribution in the pectoralis major myocutaneous flap.

BACKGROUND: In head and neck reconstruction, the pectoralis major myocutaneous flap, located adjacent to the area of reconstruction, is a very useful and easy-to-prepare flap. However, it is reported to have an unstable blood circulation that could result in partial necrosis of the skin island. The current study investigated the detailed three-dimensional vascular network in the flap to establish a method of preparation with a stable circulation. METHODS: The pectoralis major muscle and the anterior chest skin on 12 sides of eight fresh cadavers were subjected to angiographic procedures in which contrast medium was injected selectively to the internal thoracic artery and the thoracoacromial artery. On another fresh cadaver, resin was injected in the same manner, and a clear specimen of the pectoralis major myocutaneous flap was prepared. RESULTS: The pectoralis major muscle consists of two anatomical vascular territories that the choke vessels in the muscle at the level of the fourth costal cartilage divide into cranial and caudal sides. The chest skin area on the caudal side where the skin island of the flap is prepared receives its blood supply from a dense anastomotic network formed by the fourth, fifth, and sixth intercostal perforating branches. CONCLUSIONS: The blood flow in the pectoral branch of the thoracoacromial artery runs through the choke vessels that dilate at the elevation of the pectoralis major myocutaneous flap, first into the fourth intercostal perforating branches; then to the anastomotic vascular network of the fourth, fifth, and sixth intercostal perforating branches; and finally to reach the periphery of the skin island.

Blood Circulation↗
PubMed1999

Sentinel Node Biopsy in Breast Cancer Patients with Clinically Negative Lymph-Nodes.

BACKGROUND: The purpose of the present study is to evaluate the usefulness ofdye-guided sentinel node biopsy in breast cancer patients with clinically negative nodes and to clarify the anatomic distribution of sentinel nodes in the axilla. METHODS: Sentinel node biopsy was performed in patients with T1 or T2 breast cancer who had clinically negative nodes, using an indocyanin green dye-guided method. Thereafter, complete axillary dissection was performed. Sentinel node andcomplete axillary lymph-node dissection specimens were examined separately, andthe incidence of metastases was compared. RESULTS: We identified sentinel nodes in 115 (76.7%) of 150 patients with clinically negative nodes. The mean number of sentinel nodes was 1.7 (range, one toeight nodes). The mean size of sentinel nodes was 9.0 mm (range, 2.0 to 28.0 mm). Of the 31 patients who had a tumor-positive sentinel node, 14 (45.2%) patients had only the sentinel node involved. There was concordance on histological examination between sentinel node and axillary node status in 111 (96.5%) of 115 cases. Of the sentinel nodes 89.1% were located cranially to the intercostobrachial nerve and within 2 cm of the lateral edge of the pectoralis minor muscle. CONCLUSIONS: Sentinel node biopsy guided by indocyanin green dye is an easy technique with an acceptable detection rate of sentinel nodes for breast cancer patients with clinically negative nodes. Most of the sentinel nodes were locatednear the lateral edge of the pectoralis minor muscle and cranial to the intercostobrachial nerve.

Journal Article↗
PubMed2006

Delayed hypopharyngeal and esophageal perforation after anterior spinal fusion: primary repair reinforced by pedicled pectoralis major flap.

STUDY DESIGN: This report documents a case of delayed hypopharyngeal and esophageal perforation after anterior spinal fusion and reviews relevant literature. OBJECTIVES: Presentation of an alternative solution of primary repair and reinforcement of a delayed esophageal and hypopharyngeal perforation after anterior spinal fusion. SUMMARY OF BACKGROUND DATA: Anterior plating is generally used for stabilization after cervical spine trauma. Esophageal and hypopharyngeal perforation is a rare but potentially life-threatening complication due to mediastinitis with consecutive septic shock and multiorgan failure. METHODS: Our patient was operated on after cervical trauma caused by car accident. The neurologic condition did not improve in the postoperative period. About 4 months later, the patient had increasing dysphagia as well as episodes of odynophagia. Flexible esophagoscopy showed a perforation of a part of the plate from the hypopharynx down to the proximal esophagus. Primary repair reinforced by a pedicled pectoralis major flap was done without complications. RESULTS: Postoperative fluoroscopy as well as endoscopy showed no signs of perforation. Swallowing was possible without any further episodes of dysphagia or odynophagia. Neck movement was unconfined. CONCLUSIONS: Primary repair reinforced by pedicled pectoralis major flap has been shown to be an alternative in case of combined hypopharyngeal and esophageal perforation due to orthopedic spine stabilization. Advantage of the pectoralis major muscle flap is no functional loss of neck movement.

Accidents, Traffic↗
PubMed1996

Complete congenital sternal cleft in an adult: repair by autogenous tissues.

We are reporting here a rare case of congenital complete sternal cleft in an adult of 25 years of age, with absent anterior pericardium and "diastasis recti." Successful surgical repair was achieved along with the preservation of the already existing anatomic and mechanical sanctity of thoracic cage, sternal reconstruction, and protection of the underlying heart and great vessels with a good cosmetic result using autogenous tissue i.e., iliac bone and "V-Y" myoplasty of pectoralis major muscles with their functional preservation and correction of associated anomalies.

Adult↗
PubMed1980

Infected median sternotomy wound. Successful treatment by muscle flaps.

The purpose of this paper is to present the experience at Emory University Hospital with the infected median sternotomy wound and to offer a treatment plan for those patients recalcitrant to the usual therapy of debridement and closed catheter irrigation with antimicrobial agents. When standard treatment fails, we proceed not only with the necessary thorough debridement to convert the wound to a relatively clean one but also concomitant closure by pectoralis major muscle flaps to completely obliterate dead space. Transposition flaps of rectus abdominus muscle or omentum are used when necessary to complete the closure. In the initial phase of this study, there were 3,239 patients who underwent open heart procedures through a median sternotomy approach in the years 1975 through 1978. In the 50 patients who had wound infections (1.54%), there were nine deaths. Three were thought to be unrelated to the sternal wound infection, four patients ruptured the ventricle or aorta, two patients died of generalized sepsis. Of these 50 patients, 22 responded to simple drainage; 28 had involvement of the mediastinum (0.86%). Of the 28 patients, 25 had debridement and closed mediastinal irrigation by catheter. Fourteen of these 25 did not respond. In these failing patients, 12 were treated by further debridement and closure by muscle flaps. Nine of these 12 were rescued. In the past nine months, an additional 1,052 patients had an open heart procedure. Of these, 11 had a median sternotomy infection. There have been no deaths in this latter group of patients, most of whom were treated by the muscle flap procedure. In addition to the improvement in mortality, morbidity has been reduced substantially. This procedure provides for a rational approach that we have found to permit salvage of a high percentage of patients who failed conventional closed irrigation techniques.

Anti-Bacterial Agents↗
PubMed1992

Experience with the modified pectoralis major myocutaneous flap.

Results of 75 reconstructions with a modified pectoralis major myocutaneous flap are described in patients with advanced (stages III and IV) head and neck tumors between 1982 and 1986. The course of the supplying thoracoacromial artery was determined with angiographic studies and was found to follow the middle clavicular line in most cases. The pectoralis major muscle was mobilized up to its acromial attachment, which made the bridging of considerable distances possible between the site of the removed tumor and the donor site. The bulk of the pedicle was reduced at the same time without endangering the safety of the blood supply of the pectoralis major myocutaneous flap. The flaps were viable in the 70 evaluable patients. Partial necroses were observed in three cases. Postoperative fistulas were encountered in 13 patients (surgical closure was necessary in three). Reconstruction with the pectoralis major myocutaneous flap is a safe and versatile procedure, yielding good clinical and functional results in patients with advanced head and neck tumors.

Adult↗
PubMed2006

[Repair of pharynx with acellular dermal matrix].

OBJECTIVE: To evaluate the clinical use of acellular dermal matrix (ADM) in the repair of pharynx. METHOD: From June 2003 to December 2004, 18 cases of laryngopharyngeal carcinoma or oropharyngeal carcinoma accepted treatment of surgery. Four of them had the tumor in the place of posterior wall of laryngopharynx or oropharynx. In the operation, the tumor was resected and the function of larynx was reserved, reconstruction of the posterior wall of laryngopharynx or oropharynx was made with ADM. Three of them had normal function of vocal cords and the tumor was in the place of posterior wall of pharynx and lateral wall of piriform fossa. These patients accepted resection of the tumor and the larynx was reserved. ADM was sutured to the prevertebral fascia to repair the pharynx, reinforcement was made with sternocleidomastoid muscle then. The other 11 patients had the tumor in the pharynx and cervico-esophagus and the vocal cords were fixed. These cases accepted total resection of the larynx and laryngopharynx. ADM was sutured to the prevertebral fascia to repair the posterior wall of laryngopharynx, musculo-cutaneous flap of pectoralis major muscle was made to repair the anterior and lateral walls. All these 18 patients accepted radiotherapy after the operation, the dosage was 60-70 Gy. RESULTS: Among all these 18 cases, no rejection of ADM or formation of pharynx fistula happened after the operation. The allograft became normal mucosa finally. Two patients had subcutaneous infection. After the treatment of dressing change and antibiotics, the wound healing was satisfying. All the 18 patients had resumption of oral diet finally but 3 of them had light mis-swallowing. Seven patients whose larynx were reserved had the trachea cannula pulled out The follow-up periods after the operation lasted 12 months to 30 months. The middle follow-up period was 19. 38 months. Neither rejection nor scar formation of the allograft happened. The follow-up of 11 patients lasted more than 18 months, 3 of them had relapse of tumor. After the second operation 1 patient was still alive and 2 patients died of distant metastasis. CONCLUSION: ADM can be easily obtained. Its histocompatibility were perfect The operative procedure were easy to perform. The complications of donor part can be totally avoided. The combined use of ADM and musculo-cutaneous flap of pectoralis major muscle or other neck tissue was safe and effective in the reconstruction of pharynx.

Aged↗
PubMed1997

Maxillomandibular deformity in association with Poland anomaly.

A case of jaw deformity in association with right-sided Poland anomaly in an 18-year-old male patient is presented. As there have been no cases previously reported of pectoralis major muscle hypoplasia combined with dentofacial deformity, it is hoped that other reports would emerge to describe a new syndrome.

Abnormalities, Multiple↗
PubMedDate not supplied

A one-stage flap reconstruction following resection for stomal recurrence.

The pectoralis major myocutaneous island flap has been used for a one-stage reconstruction following ablative surgery for stomal recurrence. The skin island of this flap is supplied by the perforating musculature vessels of the thoracicoacromial artery. The flap can be elevated primarily and is used in a one-stage reconstruction. The new stoma is created in the center of the skin island, and the great vessels are covered by the pectoralis major muscle pedicle. The surgical technique as performed in seven successful cases is presented.

Humans↗
PubMed1987

Nemaline bodies in spinal progressive muscular atrophy. An autopsy case.

Numerous nemaline bodies were demonstrated in the pectoralis major muscle of an autopsy case of a 52-year-old woman, who died of respiratory failure after having suffered from spinal progressive muscular atrophy for 1 year. Rod-like structures ultrastructurally indistinguishable from classical nemaline bodies were abundant in both normal-appearing and atrophic myofibers of the pectoralis major muscle but not in the appendicular skeletal muscles. Morphometric analysis of spinal anterior horn cells clearly showed severe depopulation of somatic motor neurons in the lower cervical cord segments. The present case may provide further support for the neurogenic nature of nemaline body formation.

Female↗
PubMed1988

Thoraco-cervico-brachial confined spaces an anatomic study.

A description is made on narrow spaces through which the brachial plexus and subclavian-axillary vessels run from the cervical spine up to the inferior border of the pectoralis major muscle. The spaces are: "Pleural suspensory Apparatus", interscalene spaces (vascular and neural), costo-clavicular, clavi-pectoral, retro-pectoralis minor, pre-humeral head, median nerve roots compass, pre-scalene space. Compressions with or without cervical rib, static or dynamic, are also described. Downward migration of shoulder girdle and muscle variations are analyzed. Forced positions which may produce compressions are also considered (downward pull, abduction + retraction, hyperabduction).

Axilla↗
PubMed1991

[Partial agenesis of the musculus pectoralis major].

The authors report a rare case of partial agenesia of the pectoralis major muscle with presence of the "pars clavicularis" only. Full range of movement was possible in this case, in accordance with other reports in the literature.

Adolescent↗
PubMedDate not supplied

Poland syndrome in a neonate: report of one case.

Poland syndrome is an infrequent disease that presents in newborn infants and features an incidence of about one in 7,000 to one in 100,000 live births. The clinical features include an absence of the costosternal portion of the pectoralis major muscle, hypoplasia and/or aplasia of the ipsilateral breast or nipple, hypoplasia of subcutaneous tissue, abnormalities of the rib cage and upper extremity anomalies. We present a male newborn suffering Poland syndrome who featured a depressed left chest wall with respiratory distress. Ultrasonography of the chest revealed the absence of a section of pectoralis major muscle over the left chest wall, although no abnormality was found over the ipsilateral upper extremity. The patient was regularly followed up and showed no limitation to the range of motion of the left upper extremity at the age of four months.

Humans↗
PubMed2006

Poland's syndrome: report of a variant.

Poland's syndrome is a rare congenital anomaly consisting of unilateral partial or total absence of a breast and/or pectoralis major muscle, and ipsilateral symbrachydactyly. Many structural and functional abnormalities have been described in association with the syndrome. However, only a few hemostatic disorders have been reported. The case of a 12-year-old secondary school girl with unilateral hypoplasia of the breast, absence of anterior axillary fold and absence of the pectoralis major muscle is hereby presented. She also had thrombocytopenia and several episodes of spontaneous bleeding from the ipsilateral anterior chest wall. She did well on medical treatment, with no recurrence of bleeding 10 months after treatment. The author is not aware of any previously reported case of Poland's syndrome associated with bleeding disorder in Africa. This case is presented to alert clinicians of its existence and possible association with hematological disorders.

Child↗