Nowadays, lamb meat represents only 7% of all meat produced in the world. In recent years the demand for standardized lamb meat cuts has been considered of great importance and the marketing occurs predominantly in th...Nowadays, lamb meat represents only 7% of all meat produced in the world. In recent years the demand for standardized lamb meat cuts has been considered of great importance and the marketing occurs predominantly in the form of frozen cuts. Herewith, the main of this work was to evaluate the stability and safety of lamb meat during frozen storage. Meats were vacuum packed in high barrier multilayer plastic iflms and stored during 12 mon at （-18±1）℃. The meat stability was assessed by physical and chemical （lipid oxidation, objective color, pH value, cooking losses and instrumental texture）, microbiological （total count of psychrotrophic, coliform count at 45℃, coagulase-positive staphylococci and the presence of Salmonella） and sensory analysis （acceptance test and visual evaluation）. The vacuum packed lamb meat remained stable as to most physical and chemical indexes. Microbiological indexes showed good stability throughout the storage period according to Brazilian legislation standards to pathogenic microorganisms. Although a signiifcant reduction in tenderness （shear force increase from 3 to 8 kg）, it showed a good sensorial acceptance for all attributes tested, including texture, with scores of around 7 （like moderately） during the 12 mon of storage. Therefore, it can be concluded that, under the conditions applied in this study, lamb meat presents a shelf life of at least 12 mon when stored at-18℃.展开更多
The objective of this study was to evaluate supplemental organic chromium（Cr） to finishing lambs on growth performance, carcass characteristics, and meat quality. Eighteen Suffolk lambs（age（4.5±0.2） mon;（25...The objective of this study was to evaluate supplemental organic chromium（Cr） to finishing lambs on growth performance, carcass characteristics, and meat quality. Eighteen Suffolk lambs（age（4.5±0.2） mon;（25.8±3.6） kg body weight（BW）） were randomly assigned to three levels of supplemental organic Cr（0.0, 0.2 and 0.4 mg kg^–1 dry matter（DM）） in a complete random design. Growth performance was evaluated for 70 d, and then lambs were slaughtered to study carcass characteristics and chemical composition of meat. Orthogonal contrasts were performed（contrast one-average level 0.2 ppm Cr vs. average level 0.4 ppm Cr; contrast two-level 0 vs. average levels（0.2＋0.4） ppm Cr）. Orthogonal polynomials were used to estimate the linear and quadratic effects of Cr concentrations. Growth and carcass performance were not affected by supplemental organic Cr. Muscle conformation and leg perimeter linearly increased（P〈0.05） as organic Cr level increased in the diet. Kidney fat decreased linearly（P〈0.05） as supplemental Cr increased. In Longissimus dorsi（LD）, the ash content decreased linearly, and shear force（kg cm^–2） increased（P〈0.05） as organic Cr level increased in the diet. It is concluded that organic Cr did not affect growth performance, but it improved positively the muscle conformation, reduced kidney fat, whereas in LD there was an increment in shear force in finishing carcass lambs.展开更多
AIM: To facilitate close contacts between transplanted cardiomyocytes and host skeletal muscle using cell fusion mediated by hemagglutinating virus of Japan envelope(HVJ-E) and tissue maceration. METHODS: Cardiomyocyt...AIM: To facilitate close contacts between transplanted cardiomyocytes and host skeletal muscle using cell fusion mediated by hemagglutinating virus of Japan envelope(HVJ-E) and tissue maceration. METHODS: Cardiomyocytes(1.5 × 106) from fetal rats were first cultured. After proliferation, some cells were used for fusion with adult muscle fibers using HVJ-E. Other cells were used to create cardiomyocyte sheets(area: about 3.5 cm2 including 2.1 × 106 cells), which were then treated with Nile blue, separated, and transplanted between the latissimus dorsi and intercostal muscles of adult rats with four combinations of HVJ-E and/or Na OH maceration: G1: HVJ-E(+), Na OH(+), Cardiomyocytes(+); G2: HVJ-E(-), NaO H(+), Cardiomyocytes(+); G3: HVJ-E(+),Na OH(-), Cardiomyocytes(+); G4: HVJ-E(-), Na OH(-), Cardiomyocytes(-). At 1 and 2 wk after transplantation, the four groups were compared by detection of beating domains, motion images using moving target analysis software, action potentials, gene expression of MLC-2v and Mesp1 by reverse transcription-polymerase chain reaction, hematoxylin-eosin staining, and immunostaining for cardiac troponin and skeletal myosin.RESULTS: In vitro cardiomyocytes were fused with skeletal muscle fibers using HVJ-E. Cardiomyocyte sheets remained in the primary transplanted sites for 2 wk. Although beating domains were detected in G1, G2, and G3 rats, G1 rats prevailed in the number, size, motion image amplitudes, and action potential compared with G2 and G3 rats. Close contacts were only found in G1 rats. At 1 wk after transplantation, the cardiomyocyte sheets showed adhesion at various points to the myoblast layer in the latissimus dorsi muscle. At 2 wk after transplantation, close contacts were seen over a broad area. Part of the skeletal muscle sarcoplasma seemed to project into the myocardiocyte plasma and some nuclei appeared to share both sarcoplasmas.CONCLUSION: The present results show that close contacts were acquired and facilitated the beating function, thereby providing a new cel展开更多
Background： The latissimus dorsi （LD） flap procedure remains a popular and useful breast reconstrtlction tool in China and Western countries, and donor site seroma formation is the main complication. This study was...Background： The latissimus dorsi （LD） flap procedure remains a popular and useful breast reconstrtlction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment. Methods： A retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time （i.e. the size of the seroma did not increase） were observed without treatment. The measured outcomes included the incidence ofseromas, the volume and duration of postoperative wound drainage, and other demographic characteristics. Results： Twenty-four patients （53.3%） developed a seroma at the donor site. Of these, 21 patients （87.5%） did not require treatment, and the seroma resolved over time. The mean duration of a sustained serol-na was 6.8 ± 1.4 weeks （range： 4-9 weeks）. Conclusions： This study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatnlent.展开更多
Background Since its first description in 1841, numerous variations and treatments of Poland＇s syndrome （congenital deficiency of the pectoralis major muscle associated with brachysyndactyly） have been reported. No...Background Since its first description in 1841, numerous variations and treatments of Poland＇s syndrome （congenital deficiency of the pectoralis major muscle associated with brachysyndactyly） have been reported. None of the reports, however, involved female Chinese patients. Methods A retrospective study of 24 female patients was conducted to guide the selection of methods of surgical reconstruction. The patients were divided into three groups according to the degree of thoracic tissue development. Type I （mild）： Limited tissue loss which can be treated with simple filling with autologous fat and/or an artificial breast implant. Type II （moderate）： Moderate thoracic tissue hypoplasia where the breast parenchyma can still offer adequate implant coverage. Mammoplasty using a latissimus dorsi muscular flap with an implant was performed in this group. The flap was used to fill the infraclavicular hollow, and the implant was placed in the dual-plane pocket. Type Ⅲ （severe）： Severe thoracic tissue hypoplasia, without sufficient parenchyma to offer implant coverage. A latissimus dorsi muscular flap was used to form a total submuscular pocket in which an implant was placed. Results The numbers of Type Ⅰ, Ⅱ, and Ⅲ patients were 15, 3, and 6, respectively. All of the flaps and injected fat demonstrated good survival. Satisfactory cosmetic results were exhibited during the follow-up period of 1 to 9 years. Conclusions Although this group of patients showed varied conditions, they can be roughly divided into three types according to the degree of thoracic tissue development. In our experience, this classification is simple and useful in choosing the breast reconstruction options.展开更多
To investigate the molecular basis of porcine heterosis, suppression subtractive hybridization （SSH） was performed to detect the differences in gene expression between porcine longissimus dorsi of Meishan X Large Wh...To investigate the molecular basis of porcine heterosis, suppression subtractive hybridization （SSH） was performed to detect the differences in gene expression between porcine longissimus dorsi of Meishan X Large White （MS × LW） F1 hybrids and their parents Meishan pigs. An expression sequence tag （EST） differentially expressed was found, designated as ML556, which was homologous to a hypothetical protein HSPC117, from human hematopoietic stem/progenitor cells （HSPCs）, and the full-length cDNA of porcine HSPC117 was cloned using rapid amplification of cDNA ends （RACE） method. Translation of the mRNA transcript revealed an open reading frame （ORF） of 505 amino acid residues encoding a peroxisomal targeting signal （PTS） with theoretical molecular weight of 55 kDa. Alignment analysis revealed that the deduced protein sequence exhibit 98, 98, 98, 97, and 97% identity with that of cattle, human, dog, rat, and mouse, respectively. The tissue expression analysis indicated that the porcine HSPC117 gene is highly expressed in muscle, spleen, lung, kidney, uterus, ovary and testis, moderately expressed in fat, heart, and liver, and not expressed in stomach and small intestine. The possible role of porcine HSPC117 and its relationship with porcine heterosis were discussed.展开更多
We studied the temporal and spacial character of the electromyogram (EMG) evoked by acupuncture in long-issimus dorsi (LD) muscles of rat, and evaluated the effect of needling direction or local blockade on EMG propag...We studied the temporal and spacial character of the electromyogram (EMG) evoked by acupuncture in long-issimus dorsi (LD) muscles of rat, and evaluated the effect of needling direction or local blockade on EMG propagation. When certain sites on LD muscle were acupunctured, asynchronous EMG could be activated not only at the acupunctured point, but also within the muscle region supplied by the adjacent 2-3 vertebral segments. The EMG evoked by stimulation on the borderline of aponeurosis and muscle venter was larger in amplitude than those on the other sites in the same vertebral segment. When the distance from the recorded site to stimulated site increased, the EMG amplitude decreased, and its latency prolonged. Acupuncture in an oblique direction toward rostral or caudal side of the muscle enhanced the EMG amplitude in the same direction. EMG activity was weakened and its propagation was blocked by local injection of procaine. These results indicated that the character of EMG propagation evoked by展开更多
Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented...Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors(both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical(non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; p T3(10 cm), p N0(0/15), M0,R0; Oncotype DX Recurrence Score indicated low risk(RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.展开更多
Rotator cuff tears(RCTs) occur more commonly with advanced age,with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs.Irreparable postero-superior cu...Rotator cuff tears(RCTs) occur more commonly with advanced age,with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs.Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population,and the incidence of irreparable RCTs in young patients is still unknown.Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs,such as rotator cuff debridement,partial rotator cuff repair,biceps tenotomy/tenodesis,rotator cuff grafting,latissimus dorsi tendon transfer,and reverse shoulder arthroplasty.After being thoroughly investigated in open surgery,arthroscopic techniques for latissimus dorsi tendon transfer have been recently described.They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management.展开更多
Objective： To discuss the suitable immediate breast reconstruction modalities for Chinese patients by comparing the pedicled transverse rectus abdominis myocytaneous flap （TRAM） reconstruction with latissimus dorsi...Objective： To discuss the suitable immediate breast reconstruction modalities for Chinese patients by comparing the pedicled transverse rectus abdominis myocytaneous flap （TRAM） reconstruction with latissimus dorsi myocytaneous flap （LTD） reconstruction plus implants or not after mastectomy due to breast cancer. Methods： From Jan. 2000 to Jul. 2005, 74 staged 0-II patients （mean age 39） were performed immediate breast reconstruction with autologous tissue either using LTD flaps or pedicled TRAM flaps with supplemental implants when necessary after mastectomy due to breast cancer and the charts were reviewed. Results： The age, marriage and menses status did not affect the selection of modalities and the need of implants. In 74 patients, 62 cases （83.8%） were performed LTD reconstruction with 13 implants and 12 cases received TRAM with 1 implant. The difference in need of implants or not between the two modalities had no statistical significance （P=0.442, Fisher＇ exact test）. Aesthetic results judged as good or fair were in 88% patients and the cosmetic effects between LTD and TRAM groups or implant and non-implant groups had no differences. All reconstructions were successful, with 4.1% cumulative locoregional recurrence and 100% overall survival by following up to 66 months （median 9 months）. The DFS and RFS between the two modalities had no significant differences by log rank test. Conclusion： Immediate autologous tissue reconstruction makes it possible to regain the natural and symmetric contour of breast without increased local recurrence. The LTD flap reconstruction is a suitable option for most Chinese women as well as the pedicled TRAM flap.展开更多
Amputation is frequently used to treat malignant tumors invading into the shoulder joint. When the vessels and major nerves of the upper arm are preserved, however, the limb may be salvaged with a combined osseous, my...Amputation is frequently used to treat malignant tumors invading into the shoulder joint. When the vessels and major nerves of the upper arm are preserved, however, the limb may be salvaged with a combined osseous, myocutaneous flap. We reconstructed large defects, which included the shoulder joint, using a vascularized rib-latissmus dorsi combined flap. Ribs were connected via the ninth or tenth posterior intercostal artery. Several slits were cut in the ribs, and the rib was glass stick fractured to straighten it. The thoracodorsal nerve was preserved and the latissmus dorsi muscle was transferred to the defect previously occupied by the biceps humerus. The ribs were connected to the residual clavicle via a Leeds-Keio artificial ligament. The flaps completely engrafted. The patient was able to flex her elbow relatively early postoperatively. The function of the hand was preserved intact. In conclusion, the combined vascularized rib-latissmus dorsi flap is useful for patients who require functional or bony reconstruction of large defects involving the shoulder joint.展开更多
Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aestheti...Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm<sup>3</sup> ± 59.57) cm<sup>3</sup>, while the mean flap volume was (218.27 cm<sup>3</sup> ± 53.64 cm<sup>3</sup>). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.展开更多
Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the l...Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery.The entire treatment period was divided into two stages,during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I,the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively;the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch;and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II,the chest scars were excised,and breast tissues were repositioned;the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery.Results From October 2010 to October 2019,21 patients(on 24 sides)underwent reconstructive procedures for extensive scar contractures on the anterior chest.All flaps survived,and their donor sites were sutured directly.During a follow-up of 3 months to 8 years,the flaps became soft and exhibited color similar to that of the adjacent tissues.The limited neck and shoulder movements improved,and postoperatively,all female patients were satisfied with the shape of their breasts.Additionally,neither apparent weakening on the adduction,internal rotation,or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed.Conclusion Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thora展开更多
Surgical resection of soft tissue sarcoma of the trunk can result in large defects requiring complex reconstruction for coverage of vital neurovascular structures and tissue defect. Large defects of the back could be ...Surgical resection of soft tissue sarcoma of the trunk can result in large defects requiring complex reconstruction for coverage of vital neurovascular structures and tissue defect. Large defects of the back could be reconstructed with multiple random pattern or local pedicled flaps. We present the case of a 48-year-old patient with a locally advanced dermatofibrosarcoma protuberans of the back. Wide local excision of the lesion was performed. The soft tissue defect measured 22 cm × 20 cm × 4 cm and was reconstructed with bilateral reverse latissimus dorsi myocutaneous (RLDM) flap. Each RLDM flap measured 24 cm × 10 cm. The donor site on the back was closed directly on both sides. The patient recovered well and the two flaps healed uneventfully. Twelve months after surgery the patient is disease-free. The use of a RLDM flap in mid-back reconstructions provided wide well-vascularized soft tissue, minimized risk of infection, and maximized back coverage. This flap is an excellent choice for reconstruction of large defects of the mid-back.展开更多
Developments of digital technology and three-dimensional(3D)reconstruction allowed a precise description of anatomic structures.With the introduction of Visible Human Project and Virtual Chinese Human(VCH)techniques,m...Developments of digital technology and three-dimensional(3D)reconstruction allowed a precise description of anatomic structures.With the introduction of Visible Human Project and Virtual Chinese Human(VCH)techniques,more detailed anatomic images could be obtained.Digitized visible models of these structures can be applied as a useful tool in clinical training.The aim of this study was to reconstruct the normal structures of thoracodorsal artery in 3D images and to establish the digitized visible models of latissimus dorsi myocutaneous(LDM)flap.The cross-sectional images from the four VCH datasets were reviewed to study LDM and thoraco-dorsal artery structures on a section-by-section basis.Next,two adult fresh cadaver specimens were perfused with lead oxide-gelatine mixture and subject to radio-graphic CT scanning on their torsos.The cross-sectional images from the CT images were reviewed to study thor-acodorsal artery structures.Three-dimensional computer-ized reconstructions of LDM flap structures were conducted from these datasets by using Amira 3.1(TGS)software respectively.The 3D reconstructed visible models established from these datasets perfectly displayed the anatomic characteristics of LDM flap.展开更多
Aim:Permanent expanders allow for breast reconstruction as a single stage.These prostheses are more expensive than conventional tissue expanders,but this excess cost is markedly offset as only one operation is require...Aim:Permanent expanders allow for breast reconstruction as a single stage.These prostheses are more expensive than conventional tissue expanders,but this excess cost is markedly offset as only one operation is required.However,if the revision rate is sufficiently high,then this effect is negated.We aim to compare costs of one-stage vs.two-stage reconstruction at a single center,taking into account explantation and unexpected admissions following complications.Methods:A retrospective review was carried out on all patients who underwent one-stage and two-stage reconstruction over a 5-year period by a single surgeon.A cost analysis was performed taking into account,explantation and additional admissions.Results:One hundred and forty-three one-stage and 45 two-stage procedures were included.The explantation rate for one-stage procedures is 36%,at a mean of 12.9 months postimplantation,the majority of which were exchanged for silicone implants to improve cosmesis.Four(9%)of the two-stage procedures were explanted a mean of 18 months postreconstruction.Overall,one-stage reconstructions were significantly more expensive than the two-stage group(P=0.016).Conclusion:There are many benefits of one-stage breast reconstruction.However,it does not appear to be cost-effective when additional admissions for explantation surgery are taken into account.展开更多
Necrotizing fasciitis (NF) is a severe soft tissue infection which has to be treated with a radical debridement as the key element. In the further course often large tissue defects occur, so that a long-term stable de...Necrotizing fasciitis (NF) is a severe soft tissue infection which has to be treated with a radical debridement as the key element. In the further course often large tissue defects occur, so that a long-term stable defect reconstruction plays a crucial role after any successful debridement. The reconstruction can include split skin grafting or local and free flaps. Here we present a case of a 41-year-old male patient with a NF in the trochanter major region after spondylodesis and spinal cord stimulation (SCS) device implantation. After multiple operations including local and free flaps we performed a defect reconstruction using an arteriovenous (AV) loop and subsequent free latissimus dorsi transplantation leading to no further operations. This complex reconstruction can be considered as the final stage of any reconstruction latter.展开更多
Aim: The aim was to study the effectiveness of the reverse latissimus dorsi muscle flap in reconstruction of complex defects of the back. Methods: This is a retrospective study of patients who underwent reverse latiss...Aim: The aim was to study the effectiveness of the reverse latissimus dorsi muscle flap in reconstruction of complex defects of the back. Methods: This is a retrospective study of patients who underwent reverse latissimus dorsi flap for reconstruction of the back, in a tertiary care hospital. The patient demographics, etiology, surgery indications and complications were studied. Results: The study had five patients between 2012 and 2016 who underwent reverse latissimus dorsi flap for reconstruction. The flaps survived in all the patients. Two patients had complications, unrelated to the latissimus dorsi muscle flap. Conclusion: The vascularity of the flap is reliable can be used to obliterate the dead space, can be used to control the infection, in complex cases of the back.展开更多
Objective: Bronchopleural fistula (BPF) is a life threatening complication after pneumonectomy. Extra thoracic skeletal muscle transposition especially latissimus dorsi muscle flap (LDMF) had been used to prevent this...Objective: Bronchopleural fistula (BPF) is a life threatening complication after pneumonectomy. Extra thoracic skeletal muscle transposition especially latissimus dorsi muscle flap (LDMF) had been used to prevent this complication. The aim of this study was to assess the effectiveness of LDMF in preventing BPF developing after extrapleural pneumonectomy (EPP) and external radiation therapy in malignant pleural mesothelioma (MPM). Methods: Between May 1999 and Dec. 2008, 37 patients with MPM were operated upon by EPP using LDMF prophylactically to reinforce the bronchial stump, and then received external radiation therapy with or without postoperative chemotherapy. Results: The mean age of all patients was 46.7 (range 26-57) years. Twenty five patients were males and 12 patients were females. Twenty three patients had MPM of the right side and 14 patients had MPM of the left side. The peri-operative mortality was 2.7% and only few flap related postoperative morbidity were reported in the form of minor seroma and subcutaneous surgical emphysema. The median follow up was 17 (range 9-43) months. All cases completed their postoperative external radiation therapy with no reported cases of early or late BPF. Conclusion: Intrathoracic pedicled LDMF transposition is proved to be effective in prevention of BPF developing after EPP and external radiation therapy in MPM and it is advised to be a routine step in EPP in these cases and to use more sophisticated technique of postoperative external beam radiotherapy (3D conformal or IMRT) to minimize this complication.展开更多
基金the Foundation for Research Support of the State So Paulo(FAPESP) for financial support(Research Program in Public Policy - Process n.o 06/51695)Cryovac for donating the plastic films and the Brazilian Federal Agency for the Improvement of Higher Education(CAPES) for granting scholarships
文摘Nowadays, lamb meat represents only 7% of all meat produced in the world. In recent years the demand for standardized lamb meat cuts has been considered of great importance and the marketing occurs predominantly in the form of frozen cuts. Herewith, the main of this work was to evaluate the stability and safety of lamb meat during frozen storage. Meats were vacuum packed in high barrier multilayer plastic iflms and stored during 12 mon at （-18±1）℃. The meat stability was assessed by physical and chemical （lipid oxidation, objective color, pH value, cooking losses and instrumental texture）, microbiological （total count of psychrotrophic, coliform count at 45℃, coagulase-positive staphylococci and the presence of Salmonella） and sensory analysis （acceptance test and visual evaluation）. The vacuum packed lamb meat remained stable as to most physical and chemical indexes. Microbiological indexes showed good stability throughout the storage period according to Brazilian legislation standards to pathogenic microorganisms. Although a signiifcant reduction in tenderness （shear force increase from 3 to 8 kg）, it showed a good sensorial acceptance for all attributes tested, including texture, with scores of around 7 （like moderately） during the 12 mon of storage. Therefore, it can be concluded that, under the conditions applied in this study, lamb meat presents a shelf life of at least 12 mon when stored at-18℃.
基金University Autonomous of Mexico State, UAEM and the National Council of Science and Technology, Mexico (CONACy T) for the financial support
文摘The objective of this study was to evaluate supplemental organic chromium（Cr） to finishing lambs on growth performance, carcass characteristics, and meat quality. Eighteen Suffolk lambs（age（4.5±0.2） mon;（25.8±3.6） kg body weight（BW）） were randomly assigned to three levels of supplemental organic Cr（0.0, 0.2 and 0.4 mg kg^–1 dry matter（DM）） in a complete random design. Growth performance was evaluated for 70 d, and then lambs were slaughtered to study carcass characteristics and chemical composition of meat. Orthogonal contrasts were performed（contrast one-average level 0.2 ppm Cr vs. average level 0.4 ppm Cr; contrast two-level 0 vs. average levels（0.2＋0.4） ppm Cr）. Orthogonal polynomials were used to estimate the linear and quadratic effects of Cr concentrations. Growth and carcass performance were not affected by supplemental organic Cr. Muscle conformation and leg perimeter linearly increased（P〈0.05） as organic Cr level increased in the diet. Kidney fat decreased linearly（P〈0.05） as supplemental Cr increased. In Longissimus dorsi（LD）, the ash content decreased linearly, and shear force（kg cm^–2） increased（P〈0.05） as organic Cr level increased in the diet. It is concluded that organic Cr did not affect growth performance, but it improved positively the muscle conformation, reduced kidney fat, whereas in LD there was an increment in shear force in finishing carcass lambs.
基金Supported by A Grant-in-Aid for Scientific Research from the Japanese Ministry of Education,Science and Sports,No.24240076
文摘AIM: To facilitate close contacts between transplanted cardiomyocytes and host skeletal muscle using cell fusion mediated by hemagglutinating virus of Japan envelope(HVJ-E) and tissue maceration. METHODS: Cardiomyocytes(1.5 × 106) from fetal rats were first cultured. After proliferation, some cells were used for fusion with adult muscle fibers using HVJ-E. Other cells were used to create cardiomyocyte sheets(area: about 3.5 cm2 including 2.1 × 106 cells), which were then treated with Nile blue, separated, and transplanted between the latissimus dorsi and intercostal muscles of adult rats with four combinations of HVJ-E and/or Na OH maceration: G1: HVJ-E(+), Na OH(+), Cardiomyocytes(+); G2: HVJ-E(-), NaO H(+), Cardiomyocytes(+); G3: HVJ-E(+),Na OH(-), Cardiomyocytes(+); G4: HVJ-E(-), Na OH(-), Cardiomyocytes(-). At 1 and 2 wk after transplantation, the four groups were compared by detection of beating domains, motion images using moving target analysis software, action potentials, gene expression of MLC-2v and Mesp1 by reverse transcription-polymerase chain reaction, hematoxylin-eosin staining, and immunostaining for cardiac troponin and skeletal myosin.RESULTS: In vitro cardiomyocytes were fused with skeletal muscle fibers using HVJ-E. Cardiomyocyte sheets remained in the primary transplanted sites for 2 wk. Although beating domains were detected in G1, G2, and G3 rats, G1 rats prevailed in the number, size, motion image amplitudes, and action potential compared with G2 and G3 rats. Close contacts were only found in G1 rats. At 1 wk after transplantation, the cardiomyocyte sheets showed adhesion at various points to the myoblast layer in the latissimus dorsi muscle. At 2 wk after transplantation, close contacts were seen over a broad area. Part of the skeletal muscle sarcoplasma seemed to project into the myocardiocyte plasma and some nuclei appeared to share both sarcoplasmas.CONCLUSION: The present results show that close contacts were acquired and facilitated the beating function, thereby providing a new cel
文摘Background： The latissimus dorsi （LD） flap procedure remains a popular and useful breast reconstrtlction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment. Methods： A retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time （i.e. the size of the seroma did not increase） were observed without treatment. The measured outcomes included the incidence ofseromas, the volume and duration of postoperative wound drainage, and other demographic characteristics. Results： Twenty-four patients （53.3%） developed a seroma at the donor site. Of these, 21 patients （87.5%） did not require treatment, and the seroma resolved over time. The mean duration of a sustained serol-na was 6.8 ± 1.4 weeks （range： 4-9 weeks）. Conclusions： This study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatnlent.
文摘Background Since its first description in 1841, numerous variations and treatments of Poland＇s syndrome （congenital deficiency of the pectoralis major muscle associated with brachysyndactyly） have been reported. None of the reports, however, involved female Chinese patients. Methods A retrospective study of 24 female patients was conducted to guide the selection of methods of surgical reconstruction. The patients were divided into three groups according to the degree of thoracic tissue development. Type I （mild）： Limited tissue loss which can be treated with simple filling with autologous fat and/or an artificial breast implant. Type II （moderate）： Moderate thoracic tissue hypoplasia where the breast parenchyma can still offer adequate implant coverage. Mammoplasty using a latissimus dorsi muscular flap with an implant was performed in this group. The flap was used to fill the infraclavicular hollow, and the implant was placed in the dual-plane pocket. Type Ⅲ （severe）： Severe thoracic tissue hypoplasia, without sufficient parenchyma to offer implant coverage. A latissimus dorsi muscular flap was used to form a total submuscular pocket in which an implant was placed. Results The numbers of Type Ⅰ, Ⅱ, and Ⅲ patients were 15, 3, and 6, respectively. All of the flaps and injected fat demonstrated good survival. Satisfactory cosmetic results were exhibited during the follow-up period of 1 to 9 years. Conclusions Although this group of patients showed varied conditions, they can be roughly divided into three types according to the degree of thoracic tissue development. In our experience, this classification is simple and useful in choosing the breast reconstruction options.
基金financially supported by National Basic Research Program of China(973 Program,2006CB102102)National Natural Science Foundation of China(30400313).
文摘To investigate the molecular basis of porcine heterosis, suppression subtractive hybridization （SSH） was performed to detect the differences in gene expression between porcine longissimus dorsi of Meishan X Large White （MS × LW） F1 hybrids and their parents Meishan pigs. An expression sequence tag （EST） differentially expressed was found, designated as ML556, which was homologous to a hypothetical protein HSPC117, from human hematopoietic stem/progenitor cells （HSPCs）, and the full-length cDNA of porcine HSPC117 was cloned using rapid amplification of cDNA ends （RACE） method. Translation of the mRNA transcript revealed an open reading frame （ORF） of 505 amino acid residues encoding a peroxisomal targeting signal （PTS） with theoretical molecular weight of 55 kDa. Alignment analysis revealed that the deduced protein sequence exhibit 98, 98, 98, 97, and 97% identity with that of cattle, human, dog, rat, and mouse, respectively. The tissue expression analysis indicated that the porcine HSPC117 gene is highly expressed in muscle, spleen, lung, kidney, uterus, ovary and testis, moderately expressed in fat, heart, and liver, and not expressed in stomach and small intestine. The possible role of porcine HSPC117 and its relationship with porcine heterosis were discussed.
基金This work was supported by the fund of Climbing Program provided by the State Science and Technology Commission.
文摘We studied the temporal and spacial character of the electromyogram (EMG) evoked by acupuncture in long-issimus dorsi (LD) muscles of rat, and evaluated the effect of needling direction or local blockade on EMG propagation. When certain sites on LD muscle were acupunctured, asynchronous EMG could be activated not only at the acupunctured point, but also within the muscle region supplied by the adjacent 2-3 vertebral segments. The EMG evoked by stimulation on the borderline of aponeurosis and muscle venter was larger in amplitude than those on the other sites in the same vertebral segment. When the distance from the recorded site to stimulated site increased, the EMG amplitude decreased, and its latency prolonged. Acupuncture in an oblique direction toward rostral or caudal side of the muscle enhanced the EMG amplitude in the same direction. EMG activity was weakened and its propagation was blocked by local injection of procaine. These results indicated that the character of EMG propagation evoked by
文摘Breast cancer(BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation. He denied any first- or second degree family medical history of cancer of any type and he never received radiotherapy. Ultrasound guided minimal-invasive 14-gauge core biopsy revealed a moderately differentiated encapsulated papillary carcinoma with high expression of estrogen and progesterone receptors(both > 80%, IRS 12) and HER2-negative. Because of the tumor size a mastectomy with axillary dissection and chest wall reconstruction using a latissimus dorsi flap was performed. Histological analysis showed invasive growth besides typical(non-invasive) papillary carcinoma and was classified as invasive solid papillary carcinoma; p T3(10 cm), p N0(0/15), M0,R0; Oncotype DX Recurrence Score indicated low risk(RS: 2). After discussion in the interdisciplinary tumor board meeting, radiation therapy and tamoxifen were recommended. The patient had an uneventful recovery and is disease-free after two years of follow-up. Male BC is typically diagnosed at an advanced stage, most likely due to a lack of awareness that men can develop BC. Therefore, in case of a large tumor, a flap-based thoracic reconstruction may be required.
文摘Rotator cuff tears(RCTs) occur more commonly with advanced age,with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness RCTs.Irreparable postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population,and the incidence of irreparable RCTs in young patients is still unknown.Several surgical procedures have been proposed for young patients with irreparable postero-superior RCTs,such as rotator cuff debridement,partial rotator cuff repair,biceps tenotomy/tenodesis,rotator cuff grafting,latissimus dorsi tendon transfer,and reverse shoulder arthroplasty.After being thoroughly investigated in open surgery,arthroscopic techniques for latissimus dorsi tendon transfer have been recently described.They have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management.
文摘Objective： To discuss the suitable immediate breast reconstruction modalities for Chinese patients by comparing the pedicled transverse rectus abdominis myocytaneous flap （TRAM） reconstruction with latissimus dorsi myocytaneous flap （LTD） reconstruction plus implants or not after mastectomy due to breast cancer. Methods： From Jan. 2000 to Jul. 2005, 74 staged 0-II patients （mean age 39） were performed immediate breast reconstruction with autologous tissue either using LTD flaps or pedicled TRAM flaps with supplemental implants when necessary after mastectomy due to breast cancer and the charts were reviewed. Results： The age, marriage and menses status did not affect the selection of modalities and the need of implants. In 74 patients, 62 cases （83.8%） were performed LTD reconstruction with 13 implants and 12 cases received TRAM with 1 implant. The difference in need of implants or not between the two modalities had no statistical significance （P=0.442, Fisher＇ exact test）. Aesthetic results judged as good or fair were in 88% patients and the cosmetic effects between LTD and TRAM groups or implant and non-implant groups had no differences. All reconstructions were successful, with 4.1% cumulative locoregional recurrence and 100% overall survival by following up to 66 months （median 9 months）. The DFS and RFS between the two modalities had no significant differences by log rank test. Conclusion： Immediate autologous tissue reconstruction makes it possible to regain the natural and symmetric contour of breast without increased local recurrence. The LTD flap reconstruction is a suitable option for most Chinese women as well as the pedicled TRAM flap.
文摘Amputation is frequently used to treat malignant tumors invading into the shoulder joint. When the vessels and major nerves of the upper arm are preserved, however, the limb may be salvaged with a combined osseous, myocutaneous flap. We reconstructed large defects, which included the shoulder joint, using a vascularized rib-latissmus dorsi combined flap. Ribs were connected via the ninth or tenth posterior intercostal artery. Several slits were cut in the ribs, and the rib was glass stick fractured to straighten it. The thoracodorsal nerve was preserved and the latissmus dorsi muscle was transferred to the defect previously occupied by the biceps humerus. The ribs were connected to the residual clavicle via a Leeds-Keio artificial ligament. The flaps completely engrafted. The patient was able to flex her elbow relatively early postoperatively. The function of the hand was preserved intact. In conclusion, the combined vascularized rib-latissmus dorsi flap is useful for patients who require functional or bony reconstruction of large defects involving the shoulder joint.
文摘Background: The latissimus dorsi (LD) muscle flap plays an essential role in breast reconstruction after partial mastectomy for cancer because of its stability and versatility. We evaluated both oncologic and aesthetic outcomes in addition to the related complications of this flap as an adjunct to breast conserving surgery in the management of breast cancer patients. Methods: All patients underwent a one-stage procedure with immediate reconstruction through two-steps operation;wider local excision utilizing oncoplastic principles and mini flap harvest & volume replacement. Results: The study included 34 cases with early breast cancer;30 patients had partial breast resection and defect refilling by LD mini-flap, three patients underwent mastectomy and one patient underwent extended LDF. The mean defect volume was (212.63 cm<sup>3</sup> ± 59.57) cm<sup>3</sup>, while the mean flap volume was (218.27 cm<sup>3</sup> ± 53.64 cm<sup>3</sup>). Patient self-evaluation of the cosmetic outcome was excellent in 20%, good in 60% and satisfactory in 20% of patients. Panel evaluation according to Harvard scale showed excellent in 36.7%, good in 36.7%, fair in 26.7% of patients. The median hospital stay was 4 days. The postoperative complications included wound gap in 4 patients (13.3%), postoperative donor site seroma in 16 patients (53.3%). No flap loss or necrosis, no affection on arm or shoulder mobility occurred. Lastly, no tumor recurrence till now. Conclusion: Latissimus dorsi mini-flap can achieve adequate cosmetic and oncologic outcomes with a low incidence of complications in patients with early stage (I/II) breast cancer and small to medium sized breasts.
文摘Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery.The entire treatment period was divided into two stages,during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I,the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively;the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch;and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II,the chest scars were excised,and breast tissues were repositioned;the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery.Results From October 2010 to October 2019,21 patients(on 24 sides)underwent reconstructive procedures for extensive scar contractures on the anterior chest.All flaps survived,and their donor sites were sutured directly.During a follow-up of 3 months to 8 years,the flaps became soft and exhibited color similar to that of the adjacent tissues.The limited neck and shoulder movements improved,and postoperatively,all female patients were satisfied with the shape of their breasts.Additionally,neither apparent weakening on the adduction,internal rotation,or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed.Conclusion Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thora
文摘Surgical resection of soft tissue sarcoma of the trunk can result in large defects requiring complex reconstruction for coverage of vital neurovascular structures and tissue defect. Large defects of the back could be reconstructed with multiple random pattern or local pedicled flaps. We present the case of a 48-year-old patient with a locally advanced dermatofibrosarcoma protuberans of the back. Wide local excision of the lesion was performed. The soft tissue defect measured 22 cm × 20 cm × 4 cm and was reconstructed with bilateral reverse latissimus dorsi myocutaneous (RLDM) flap. Each RLDM flap measured 24 cm × 10 cm. The donor site on the back was closed directly on both sides. The patient recovered well and the two flaps healed uneventfully. Twelve months after surgery the patient is disease-free. The use of a RLDM flap in mid-back reconstructions provided wide well-vascularized soft tissue, minimized risk of infection, and maximized back coverage. This flap is an excellent choice for reconstruction of large defects of the mid-back.
文摘Developments of digital technology and three-dimensional(3D)reconstruction allowed a precise description of anatomic structures.With the introduction of Visible Human Project and Virtual Chinese Human(VCH)techniques,more detailed anatomic images could be obtained.Digitized visible models of these structures can be applied as a useful tool in clinical training.The aim of this study was to reconstruct the normal structures of thoracodorsal artery in 3D images and to establish the digitized visible models of latissimus dorsi myocutaneous(LDM)flap.The cross-sectional images from the four VCH datasets were reviewed to study LDM and thoraco-dorsal artery structures on a section-by-section basis.Next,two adult fresh cadaver specimens were perfused with lead oxide-gelatine mixture and subject to radio-graphic CT scanning on their torsos.The cross-sectional images from the CT images were reviewed to study thor-acodorsal artery structures.Three-dimensional computer-ized reconstructions of LDM flap structures were conducted from these datasets by using Amira 3.1(TGS)software respectively.The 3D reconstructed visible models established from these datasets perfectly displayed the anatomic characteristics of LDM flap.
文摘Aim:Permanent expanders allow for breast reconstruction as a single stage.These prostheses are more expensive than conventional tissue expanders,but this excess cost is markedly offset as only one operation is required.However,if the revision rate is sufficiently high,then this effect is negated.We aim to compare costs of one-stage vs.two-stage reconstruction at a single center,taking into account explantation and unexpected admissions following complications.Methods:A retrospective review was carried out on all patients who underwent one-stage and two-stage reconstruction over a 5-year period by a single surgeon.A cost analysis was performed taking into account,explantation and additional admissions.Results:One hundred and forty-three one-stage and 45 two-stage procedures were included.The explantation rate for one-stage procedures is 36%,at a mean of 12.9 months postimplantation,the majority of which were exchanged for silicone implants to improve cosmesis.Four(9%)of the two-stage procedures were explanted a mean of 18 months postreconstruction.Overall,one-stage reconstructions were significantly more expensive than the two-stage group(P=0.016).Conclusion:There are many benefits of one-stage breast reconstruction.However,it does not appear to be cost-effective when additional admissions for explantation surgery are taken into account.
文摘Necrotizing fasciitis (NF) is a severe soft tissue infection which has to be treated with a radical debridement as the key element. In the further course often large tissue defects occur, so that a long-term stable defect reconstruction plays a crucial role after any successful debridement. The reconstruction can include split skin grafting or local and free flaps. Here we present a case of a 41-year-old male patient with a NF in the trochanter major region after spondylodesis and spinal cord stimulation (SCS) device implantation. After multiple operations including local and free flaps we performed a defect reconstruction using an arteriovenous (AV) loop and subsequent free latissimus dorsi transplantation leading to no further operations. This complex reconstruction can be considered as the final stage of any reconstruction latter.
文摘Aim: The aim was to study the effectiveness of the reverse latissimus dorsi muscle flap in reconstruction of complex defects of the back. Methods: This is a retrospective study of patients who underwent reverse latissimus dorsi flap for reconstruction of the back, in a tertiary care hospital. The patient demographics, etiology, surgery indications and complications were studied. Results: The study had five patients between 2012 and 2016 who underwent reverse latissimus dorsi flap for reconstruction. The flaps survived in all the patients. Two patients had complications, unrelated to the latissimus dorsi muscle flap. Conclusion: The vascularity of the flap is reliable can be used to obliterate the dead space, can be used to control the infection, in complex cases of the back.
文摘Objective: Bronchopleural fistula (BPF) is a life threatening complication after pneumonectomy. Extra thoracic skeletal muscle transposition especially latissimus dorsi muscle flap (LDMF) had been used to prevent this complication. The aim of this study was to assess the effectiveness of LDMF in preventing BPF developing after extrapleural pneumonectomy (EPP) and external radiation therapy in malignant pleural mesothelioma (MPM). Methods: Between May 1999 and Dec. 2008, 37 patients with MPM were operated upon by EPP using LDMF prophylactically to reinforce the bronchial stump, and then received external radiation therapy with or without postoperative chemotherapy. Results: The mean age of all patients was 46.7 (range 26-57) years. Twenty five patients were males and 12 patients were females. Twenty three patients had MPM of the right side and 14 patients had MPM of the left side. The peri-operative mortality was 2.7% and only few flap related postoperative morbidity were reported in the form of minor seroma and subcutaneous surgical emphysema. The median follow up was 17 (range 9-43) months. All cases completed their postoperative external radiation therapy with no reported cases of early or late BPF. Conclusion: Intrathoracic pedicled LDMF transposition is proved to be effective in prevention of BPF developing after EPP and external radiation therapy in MPM and it is advised to be a routine step in EPP in these cases and to use more sophisticated technique of postoperative external beam radiotherapy (3D conformal or IMRT) to minimize this complication.
