RESUMEN
Apesar de não muito frequente, nos últimos 20 anos, houve um aumento significativo dos relatos sobre rotura do peitoral maior, normalmente associadas à prática de atividade física em que ocorre contração intensa e/ou uso de cargas pesadas exercendo resistência sobre o músculo. Neste relato de caso temos um paciente de 51 anos referindo dor no tórax à direita e no braço direito há 3 dias após tentar consertar o guidão da moto. Apresentava assimetria dos peitorais, perda de força do membro superior direito, dificuldade de movimentação e hematoma. A ressonância magnética demonstrou rotura completa da junção miotendínea do peitoral maior, com tendinopatia com fissuras insercionais e intrasubstanciais infraespinhal e tendinopatia com rotura parcial do tendão subescapular. Foi indicado por médico ortopedista o acompanhamento com o uso de medicação analgésica.
Although not very common, in the last 20 years, there has been a significant increase in reports of rupture of the pectoralis major, normally associated with the practice of physical activity in which intense contraction occurs and/or the use of heavy loads exerting resistance on the muscle. In this case report we have a 51-year-old patient reporting pain in his right chest and right arm for 3 days after trying to fix his motorcycle's handlebars. He had asymmetry of the pectorals, loss of strength in the right upper limb, difficulty moving and hematoma. Magnetic resonance imaging demonstrated complete rupture of the myotendinous junction of the pectoralis major, with tendinopathy with insertional and intrasubstantial infraspinatus fissures and tendinopathy with partial rupture of the subscapularis tendon. An orthopedic doctor recommended follow-up with the use of analgesic medication.
Aunque no es muy común, en los últimos 20 años se ha observado un aumento significativo en los reportes de rotura del pectoral mayor, normalmente asociado a la práctica de actividad física en la que se produce una contracción intensa y/o al uso de cargas pesadas ejerciendo resistencia sobre el mismo. el músculo. En este caso clínico tenemos un paciente de 51 años que refiere dolor en el pecho derecho y en el brazo derecho durante 3 días después de intentar arreglar el manillar de su motocicleta. Presentó asimetría de pectorales, pérdida de fuerza en miembro superior derecho, dificultad de movimiento y hematoma. La resonancia magnética demostró rotura completa de la unión miotendinosa del pectoral mayor, con tendinopatía con fisuras de inserción e intrasustancial del infraespinoso y tendinopatía con rotura parcial del tendón subescapular. Un médico ortopédico recomendó seguimiento con el uso de medicación analgésica.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Músculos Pectorales/lesiones , Músculos Pectorales/diagnóstico por imagen , Extremidad Superior/lesiones , Extremidad Superior/diagnóstico por imagen , Unión Miotendinosa/lesiones , Unión Miotendinosa/diagnóstico por imagenRESUMEN
Objective: To evaluate early complications in prepectoral breast reconstruction. Methods: A retrospective cohort study including 180 consecutive cases of nipple-sparing mastectomy, comparing immediate breast reconstruction with subpectoral to prepectoral mammary implants in 2012-2022. Clinical and demographic characteristics and complications in the first three months following surgery were compared between the two techniques. Results: The prepectoral technique was used in 22 cases (12.2%) and the subpectoral in 158 (87.8%). Median age was higher in the prepectoral group (47 versus 43.8 years; p=0.038), as was body mass index (25.1 versus 23.8; p=0.002) and implant volume (447.5 versus 409 cc; p=0.001). The prepectoral technique was more associated with an inframammary fold (IMF) incision (19 cases, 86.4% versus 85, 53.8%) than with periareolar incisions (3 cases, 13.6% versus 73, 46.2%); (p=0.004). All cases in the prepectoral group underwent direct-to-implant reconstruction compared to 54 cases (34.2%) in the subpectoral group. Thirty-eight complications were recorded: 36 (22.8%) in the subpectoral group and 2 (9.1%) in the prepectoral group (p=0.24). Necrosis of the nipple-areola complex/skin flap occurred in 27 patients (17.1%) in the subpectoral group (prepectoral group: no cases; p=0.04). The groups were comparable regarding dehiscence, seroma, infection, and hematoma. Reconstruction failed in one case per group (p=0.230). In the multivariate analysis, IMF incision was associated with the prepectoral group (aOR: 34.72; 95%CI: 2.84-424.63). Conclusion: The incidence of early complications was comparable between the two techniques and compatible with previous reports. The clinical and demographic characteristics differed between the techniques. Randomized clinical trials are required.
Asunto(s)
Neoplasias de la Mama , Mamoplastia , Pezones , Complicaciones Posoperatorias , Humanos , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Adulto , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Pezones/cirugía , Mamoplastia/métodos , Neoplasias de la Mama/cirugía , Estudios de Cohortes , Músculos Pectorales , Mastectomía Subcutánea/métodos , Factores de Tiempo , Implantes de MamaRESUMEN
RATIONALE: The pectoralis major and minor muscles, located in the anterior chest wall, are crucial for upper limb movements. PATIENT CONCERNS: Their nonsyndromic absence is rare but significant for surgical procedures involving the axillary and pectoral regions. DIAGNOSES: Ultrasound can confirm the diagnosis and delimit the extent of the muscular abnormality, detect abnormalities of the costal cartilages, among others. INTERVENTIONS: This descriptive, cadaveric case report involves a formalin-fixed 57-year-old North American male, with no clinical or family history of similar conditions. The study was conducted at the Human Anatomy Laboratory of the School of Medicine of the Universidad Finis Terrae in Santiago, Chile, in August 2022. OUTCOMES: We present a cadaveric case of bilateral partial agenesis of the pectoralis muscles discovered during routine dissection. The pectoralis major muscle exhibited only the clavicular portion, with the sternocostal and abdominal portions absent and replaced by a thin layer of connective tissue bilaterally. The pectoralis minor muscle showed partial muscle fibers only in the most distal and inferior portions bilaterally. LESSONS: This case report is significant due to the rarity of this condition without accompanying anatomical variations. Understanding this variant is valuable for clinical situations involving the shoulder and thorax region, such as trauma to the proximal third of the humerus, clavicular region, suprascapular region, and anterior chest wall. It may complicate conservative and/or surgical treatments due to different functional and irrigation patterns in the area and is also important for educating future professionals.
Asunto(s)
Cadáver , Músculos Pectorales , Humanos , Músculos Pectorales/anomalías , Músculos Pectorales/diagnóstico por imagen , Masculino , Persona de Mediana EdadRESUMEN
The study investigated guanidinoacetic acid (GAA) supplementation with varying dietary digestible arginine (Arg) and glycine+serine (Gly+Ser) concentrations in the starter phase, exploring respective carry-over effects on growth performance, blood chemistry, incidence of pectoral myopathies and proximate composition in broilers. A total of 2,800 one-day-old male broiler chicks were distributed in a central composite design with 2 factors and double experimental mesh, represented by supplementation or omission of 0.6 g per kg of GAA, with a central point represented by 107% of Arg and 147% of Gly+Ser, 4 factorial points (combinations of Arg/Gly+Ser concentrations: 96.4/132.5%; 117.6/132.5%; 96.4/161.5%, and 117.6/132.5%), and 4 axial points (combinations of axial points estimated for Arg and Gly+Ser, with the central points of 92/147%; 122/147%; 107/126.5, and 107/167.5%), totaling 18 treatments, 4 repetitions to factorial and axial points, 24 replicates to the central point, and 25 birds per pen. Feed conversion ratio (FCR) from d 1 to 10 had a linear response (P = 0.009) for the decreasing Arg content and a quadratic response (P = 0.047) for Gly+Ser concentrations. Broilers supplemented GAA had lower FCR compared with nonsupplemented groups from d 1 to 10 (P = 0.048) and d 1 to 42 (P = 0.026). Aspartate aminotransferase (AST) exhibited increasing and decreasing linear effects as a function of Arg (P = 0.008) and Gly+Ser (P = 0.020) concentrations, respectively. Guanidinoacetic acid decreased serum AST (P = 0.028). Guanidinoacetic acid reduced moderate + severe (P = 0.039) and mild (P = 0.015) Wooden Breast scores. The occurrence of normal White Striping increased (P = 0.002), while severe score was reduced (P = 0.029) with GAA supplementation. In conclusion, increased digestible Arg:Lys and 14% and 6% above the recommendations (107% and 147%), respectively, provided improved FCR during the starter phase. Dietary GAA supplementation (0.6 g per kg) improved FCR, reduced severity of breast myopathies and appears to have reduced muscle damage in broilers fed plant-based diets.
Asunto(s)
Alimentación Animal , Fenómenos Fisiológicos Nutricionales de los Animales , Arginina , Pollos , Dieta , Suplementos Dietéticos , Glicina , Serina , Animales , Pollos/fisiología , Pollos/crecimiento & desarrollo , Glicina/análogos & derivados , Glicina/administración & dosificación , Glicina/farmacología , Alimentación Animal/análisis , Arginina/administración & dosificación , Arginina/farmacología , Suplementos Dietéticos/análisis , Dieta/veterinaria , Masculino , Fenómenos Fisiológicos Nutricionales de los Animales/efectos de los fármacos , Serina/administración & dosificación , Serina/farmacología , Distribución Aleatoria , Músculos PectoralesRESUMEN
This study compares the physicochemical characteristics of breast meat (Pectoralis major) from conventional chicken and free-range chicken production systems. Analyses of pH, instrumental color measurement, weight loss from cooking (WLC), and water retention capacity (WRC) were carried out. Average pH values were slightly higher for conventional chicken samples. WLC did not show a significant difference between conventional and free-range chicken samples. The WRC was better and higher for the free-range chicken samples than the conventional ones. The mean values for luminosity (L*) were within the normal range, with slightly higher values for conventional chicken. In chromatids a* and b*, there was a tendency towards a more reddish color for free-range chicken samples. The differences found for types of production can be explained mainly by the difference in age at slaughter, the degree of physical activity, animal feeding, among other characteristics that differentiate an animal raised by the extensive system from the intensive system.
Asunto(s)
Pollos , Carne , Animales , Carne/análisis , Carne/normas , Músculos Pectorales/fisiología , Crianza de Animales Domésticos , Concentración de Iones de Hidrógeno , Calidad de los Alimentos , CulinariaRESUMEN
The aim of the present study was to identify and quantify the metabolites (metabolome analysis) of the pectoralis major muscle in male red-winged tinamou (Rhynchotus rufescens) selected for growth traits. A selection index was developed for females [body weight (BW), chest circumference (CC), and thigh circumference (TC)] and males [BW, CC, TC, semen volume, and sperm concentration] in order to divide the animals into 2 experimental groups: selection group with a higher index (TinamouS) and commercial group with a lower index (TinamouC). Twenty male offspring of the 2 groups (TinamouS, n = 10; TinamouC, n = 10) were confined for 350 d. The birds were slaughtered and pectoralis major muscle samples were collected, subjected to polar and apolar metabolites extractions and analyzed by proton nuclear magnetic resonance (1H NMR) spectroscopy. Analysis of the polar metabolomic profile identified 65 metabolites; 29 of them were differentially expressed between the experimental groups (P < 0.05). The TinamouS groups exhibited significantly higher concentrations (P < 0.05) of 25 metabolites, including anserine, aspartate, betaine, carnosine, creatine, glutamate, threonine, 3-methylhistidine, NAD+, pyruvate, and taurine. Significantly higher concentrations of cysteine, beta-alanine, lactose, and choline were observed in the TinamouC group (P < 0.05). The metabolites identified in the muscle provided information about the main metabolic pathways (higher impact value and P < 0.05), for example, phenylalanine, tyrosine and tryptophan biosynthesis; alanine, aspartate and glutamate metabolism; D-glutamine and D-glutamate metabolism; ß-alanine metabolism; glycine, serine and threonine metabolism; taurine and hypotaurine metabolism; histidine metabolism; phenylalanine metabolism. The NMR spectra of apolar fraction showed 8 classes of chemical compounds. The metabolome analysis shows that the selection index resulted in the upregulation of polyunsaturated fatty acids, unsaturated fatty acids, phosphocholines, phosphoethanolamines, triacylglycerols, and glycerophospholipids. The present study suggests that, despite few generations, the selection based on muscle growth traits promoted changes in metabolite concentrations in red-winged tinamou.
Asunto(s)
Ácido Aspártico , Músculos Pectorales , Femenino , Masculino , Animales , Pollos , Semen , Metaboloma , Metabolómica/métodos , Peso Corporal , Taurina , beta-Alanina , Fenilalanina , Treonina , GlutamatosRESUMEN
The purpose of the present study was to characterize the chemical composition, lipid oxidation, and physical characteristics of fresh sausages produced with meat from the pectoralis major muscle affected by deep pectoral myopathy. For the characterization of myopathy, samples were collected from broiler chickens slaughtered between 42- and 46-days old in a slaughterhouse in the state of São Paulo. The experiment consisted of samples from pectoralis major muscle of birds affected or not by DPM (normal-absence of myopathy and DPM category 3-progressive degeneration of the pectoralis minor with a greenish appearance). After classification of the samples, a part of raw products with the pectoralis minor removed, was submitted to microbiological and physical analyses for the characterization of DPM. Afterward, only the pectoralis major muscle was used to manufacture fresh sausages and 2 groups were established. The evaluated parameters were: color, pH, water-holding capacity (WHC), cooking loss (CL), shear force (SF), water activity (Aw), and chemical composition. Meat pH was higher (P < 0.05) in meats with DPM, however, WHC values were lower (71.92%), which made CL value increase (25.31%). In addition, the coloring increased and the technological characteristics of raw breasts were less favorable with the presence of DPM. All fresh sausages' color (except a* higher control group), pH, and Aw values were higher in DPM group. No effect on SF values was observed between fresh sausages. In chemical composition, only protein content increased in fresh sausages with DPM. Microbiological analyses did not indicate bacterial contamination of raw samples and fresh sausages. Data obtained in the present study suggest fresh sausages produced with breasts affected by DPM are a viable alternative and may confer more favorable qualitative characteristics to sausages than the raw marketed meat.
Asunto(s)
Pollos , Enfermedades Musculares , Animales , Pollos/fisiología , Brasil , Carne/análisis , Enfermedades Musculares/etiología , Enfermedades Musculares/veterinaria , Músculos Pectorales/fisiología , Agua/análisisRESUMEN
This study aimed to investigate the level of lipid and protein oxidation in poultry breasts with severe white striping (WS; striation thickness > 1 mm) and nonaffected meats (N; normal breast) during storage under refrigeration (1°C for 14 d) and freezing (-18°C for 90 d). WS presented higher lipid content, although no difference in protein content was detected, compared to normal broiler breast (N). Regarding oxidative damages, a reduction in malondialdehyde and carbonyl protein, hexanal, octanal and nonanal levels, alongside the interaction of these compounds with other compounds in raw, roasted, and reheated breasts was observed under refrigerated storage (14 d). Freezing storage promotes an increase in carbonyls proteins, hexanal, octanal and nonanal levels at 45 d of storage in poultry meats and subsequent decrease, indicating the evolution of oxidative reactions. Regardless of the type of storage, in general, breasts with WS myopathy have higher levels of lipid and protein oxidation.
Asunto(s)
Pollos , Calor , Animales , Pollos/metabolismo , Carne/análisis , Proteínas/metabolismo , Estrés Oxidativo , Lípidos , Músculos Pectorales/metabolismoRESUMEN
The objective of the present study was to characterize possible variations in the quality of wooden chicken breast meat during freezing for 12 mo, in order to prove whether the shelf life recommended by the industry allows the storage of that type of meat without compromising its consumption. Three hundred samples of male Cobb 500 broilers slaughtered at 42 d of age were used. Part of the samples (n = 20 normal-control group; n = 20 moderate degree; n = 20 severe degree) were analyzed on the day of collection (beginning), previously kept under refrigeration (4°C). The other samples were stored (-18°C) for up to 12 mo. At the end of each proposed freezing period (3, 6, 9, and 12 mo), physical and chemical analyses were performed (per period: n = 20 normal-control group; n = 20 moderate degree; n = 20 severe degree). Color (L*, a*, and b*), pH, water-holding capacity, cooking losses, tenderness, lipid oxidation, chemical composition, cholesterol concentration, mineral profile, and collagen concentration were evaluated. The physicochemical quality of wooden chicken breast meat is significantly altered during frozen storage for 12 mo, being of inferior quality when compared to normal chicken breast meat, which can negatively affect consumer acceptance. However, it should be noted that even after 12 mo of freezing, the meats did not show oxidative rancidity.
Asunto(s)
Pollos , Enfermedades Musculares , Masculino , Animales , Congelación , Carne/análisis , Culinaria , Enfermedades Musculares/etiología , Enfermedades Musculares/veterinaria , Músculos Pectorales/químicaRESUMEN
El músculo esternal corresponde a una variante muscular supernumeraria de la musculatura torácica, cuya descripción más antigua se remonta al año 1604. A lo largo de la historia ha sido denominado músculo "epiesternal", "preesternal", "recto torácico" o "recto esternal". Se ubica entre la fascia superficial y el músculo pectoral mayor, tiene una prevalencia de entre 3 % y 8 % en la población general, se presenta de forma unilateral o bilateral exhibiendo una alta variabilidad interracial y puede ser motivo de dilemas diagnósticos durante cirugías y exámenes de imagen. Disección en un cadáver adulto de sexo masculino. Se encontraron dos músculos esternales conectados superiormente por un tendón central. El músculo esternal derecho se extendía desde el manubrio esternal hasta el séptimo cartílago costal derecho. El músculo esternal izquierdo se extendía desde el manubrio esternal hasta el sexto cartílago costal izquierdo. Su inervación estaba dada por ramos cutáneos anteriores de los nervios intercostales y su vascularización por ramas perforantes provenientes de los vasos torácicos internos. El músculo esternal presenta una alta variabilidad morfológica y su prevalencia se ve influenciada por factores raciales. Conocer esta variación muscular enriquece la capacidad diagnóstica y quirúrgica reduciendo la posibilidad de iatrogenia.
SUMMARY: The sternal muscle corresponds to a supernumerary muscle variant of the thoracic musculature, whose oldest description dates to 1604. Throughout history it has been called the "episternal", "presternal", "rectus thoracis" or "rectus sternalis" muscle. It is located between the superficial fascia and the pectoralis major muscle, has a prevalence of between 3 % and 8 % in the general population, presents unilaterally or bilaterally, exhibits a high interracial variability and can be the cause of diagnostic dilemmas during surgery and imaging examinations. Dissection in an adult male cadaver. Two sternal muscles were found connected superiorly by a central tendon. The right sternal muscle extended from the sternal manubrium to the right seventh costal cartilage. The left sternal muscle extended from the sternal manubrium to the left sixth costal cartilage. The innervation was given by anterior cutaneous branches of the intercostal nerves and the vascularization by perforating branches coming from the internal thoracic vessels. The sternal muscle presents a high morphological variability and the prevalence is influenced by racial factors. Knowing this muscle variation enriches the diagnostic and surgical capacity, reducing the possibility of iatrogenesis.
Asunto(s)
Humanos , Masculino , Anciano , Músculos Pectorales/anomalías , Esternón , CadáverRESUMEN
The study aimed to investigate biochemical mechanisms occurred in Wooden breast (WB) chicken meat, with attention to the impact on meat quality. Commercial chicken breasts were classified as Normal (N, n = 12), WB-M (moderate degree; focal hardness on cranial region, n = 12) and WB-S (severe degree; extreme and diffused hardness over the entire surface, n = 12). Samples were analyzed for physico-chemical properties, oxidative damage to lipids and proteins, and discriminating sarcoplasmic proteins by using a Q-Exactive mass spectrometer. WB meat presented impaired composition and functionality and higher levels of lipid and protein oxidation markers than N meat. The proteomic profile of WB-S presents a dynamic regulation of the relevant proteins involved in redox homeostasis, carbohydrate, protein and lipid metabolisms. Proteomics results demonstrate that the physiological and metabolic processes of muscles affected by WB myopathy are involved in combating the inflammatory process and in repairing the damaged tissue by oxidative stress.
Asunto(s)
Enfermedades Musculares , Enfermedades de las Aves de Corral , Animales , Proteómica , Músculos Pectorales/química , Carne/análisis , Enfermedades Musculares/genética , Enfermedades Musculares/metabolismo , Proteínas/metabolismo , Oxidación-Reducción , Estrés Oxidativo , Lípidos/análisis , Pollos/metabolismo , Enfermedades de las Aves de Corral/metabolismoRESUMEN
Introducción. La reconstrucción mamaria inmediata con implantes prepectorales permite realizar la mastectomía oncológica con un resultado estético en un solo tiempo quirúrgico y con menor morbilidad del área dadora. Las indicaciones son precisas, en directa relación con las condiciones de la mastectomía. Material y métodos. Se presentan 83 pacientes en el período comprendido entre febrero de 2020 a febrero de 2022 con mastectomías uni- y bilaterales, con conservación del complejo areola-pezón los cuales fueron injertados en 7 casos. La incisión en surco submamario se realizó en 60 casos, radiada externa en 8 casos, vertical en 8 casos y 7 casos con patrón de reducción en el Instituto Oncológico Alexander Fleming. Los criterios de exclusión que utilizamos son tumores mamarios a menos de 1 cm del complejo areola pezón y tumores localmente avanzados. Resultados. En total se realizaron 98 mastectomías, de las cuales 86 fueron terapéuticas y 12 profilácticas por mutaciones genéticas. La extracción de ganglios se realizó por una incisión axilar, excepto en el patrón de reducción donde se realizó a través de la incisión de la mastectomía. En 42 pacientes se utilizaron implantes anatómicos y en 56 casos redondos texturizados. El seguimiento de las pacientes fue a 25 meses. Conclusión. La reconstrucción mamaria prepectoral lleva a la reconstrucción de la mama en el mismo espacio con una baja morbilidad y resultado natural. Las indicaciones para esta técnica deben ser muy precisas para lograr obtener los resultados deseados. En nuestra experiencia, la reconstrucción mamaria inmediata con implante directo es una técnica segura y reproducible, con excelentes resultados en pacientes en las que está debidamente indicada la técnica, con una baja tasa de complicaciones y disminución en el tiempo de tratamiento y de recuperación.
Introduction. Immediate breast reconstruction with pre pectoral implants allows to perform oncologic mastectomy with an aesthetic result in a single surgical time and with less morbidity of the donor area. The indications are precise and directly related to the conditions of the mastectomy. Material and methods. We present 83 patients in the period from February 2020 to February 2022 with uni and bilateral mastectomies, with preservation of the nipple-areola complex which was grafted in 7 cases. The incision in the submammary sulcus was performed in 60 cases, external radiated in 8 cases, vertical in 8 cases and 7 with reduction pattern at the Alexander Fleming Oncological Institute. The exclusion criteria we used are breast tumors less than 1 cm from the nipple areola complex and locally advanced tumors. Results. A total of 98 mastectomies were performed, of which 86 were therapeutic and 12 prophylactic for genetic mutations. Node removal was performed through an axillary incision, except in the reduction pattern where it was performed through the mastectomy incision. Anatomical implants were used in 42 patients and textured round implants in 56 cases. The follow-up of the patients was 25 months. Conclusion. Pre pectoral breast reconstruction leads to reconstruction of the breast in the same space with low morbidity and natural results. The indications for this technique must be very precise to achieve the desired results. In our experience, immediate breast reconstruction with direct implant is a safe and reproductible technique, with excellent results in patients in whom the technique is properly indicated, with a low rate of complications and decrease in treatment and recovery time.
Asunto(s)
Humanos , Femenino , Músculos Pectorales , Mamoplastia , Implantes de Mama , MastectomíaRESUMEN
BACKGROUND: Computed tomographies (CT) are useful for identifying muscle loss in non-small lung cancer (NSCLC) cachectic patients. However, we lack consensus on the best cutoff point for pectoralis muscle loss. We aimed to characterize NSCLC patients based on muscularity, clinical data, and the transcriptional profile from the tumor microenvironment to build a cachexia classification model. METHODS: We used machine learning to generate a muscle loss prediction model, and the tumor's cellular and transcriptional profile was characterized in patients with low muscularity. First, we measured the pectoralis muscle area (PMA) of 211 treatment-naive NSCLC patients using CT available in The Cancer Imaging Archive. The cutoffs were established using machine learning algorithms (CART and Cutoff Finder) on PMA, clinical, and survival data. We evaluated the prediction model in a validation set (36 NSCLC). Tumor RNA-Seq (GSE103584) was used to profile the transcriptome and cellular composition based on digital cytometry. RESULTS: CART demonstrated that a lower PMA was associated with a high risk of death (HR = 1.99). Cutoff Finder selected PMA cutoffs separating low-muscularity (LM) patients based on the risk of death (P-value = 0.003; discovery set). The cutoff presented 84% of success in classifying low muscle mass. The high risk of LM patients was also found in the validation set. Tumor RNA-Seq revealed 90 upregulated secretory genes in LM that potentially interact with muscle cell receptors. The LM upregulated genes enriched inflammatory biological processes. Digital cytometry revealed that LM patients presented high proportions of cytotoxic and exhausted CD8+ T cells. CONCLUSIONS: Our prediction model identified cutoffs that distinguished patients with lower PMA and survival with an inflammatory and immunosuppressive TME enriched with inflammatory factors and CD8+ T cells.
Asunto(s)
Neoplasias Pulmonares , Microambiente Tumoral , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Tomografía Computarizada por Rayos X/métodos , Músculos Pectorales/patologíaRESUMEN
OBJECTIVE: We aimed to investigate whether sarcopenia measured from pectoralis muscles is a risk factor for long-term mortality in left ventricular assist device patients. METHODS: Patients aged >18 years implanted with a left ventricular assist device in a single center between 2013 and 2019 were retrospectively included. Patients without a thoracic computed tomography scan performed within 3 months of left ventricular assist device implantation and without computed tomography scans appropriate for pectoralis muscle measurement were excluded. Pectoralis muscle measurements were made on thoracic computed tomography slices, and pectoralis muscle indices were calculated for each patient. Sarcopenia was defined as being in the gender-specific lowest tertile of pectoralis muscle index. Survival was compared between patients with and without sarcopenia. RESULTS: The study was conducted on 64 left ventricular assist device patients who met the inclusion criteria. Notably, 21 (32.8%) of the study patients were sarcopenic. Diabetes mellitus and sarcopenia were more common in patients with 2-year mortality in our cohort. Patients with sarcopenia had a worse 2-year survival (p<0.001). Sarcopenia had an adjusted hazard ratio of 4.04 (95% confidence interval (CI) 1.36-12.02, p=0.012), while diabetes mellitus was associated with an adjusted hazard ratio of 3.14 (95%CI 1.17-8.39, p=0.023). CONCLUSION: Sarcopenia defined by low pectoralis muscle index increases the risk for 2-year mortality in left ventricular assist device patients.
Asunto(s)
Corazón Auxiliar , Sarcopenia , Humanos , Sarcopenia/complicaciones , Músculos Pectorales , Estudios Retrospectivos , Factores de RiesgoRESUMEN
This study combined surface electromyography with panoramic ultrasound imaging to investigate whether non-uniform excitation could lead to acute localized variations in cross-sectional area and muscle thickness of the clavicular and sternocostal heads of pectoralis major (PM). Bipolar surface electromyograms (EMGs) were acquired from both PM heads, while 13 men performed four sets of the flat and 45° inclined bench press exercises. Before and immediately after exercise, panoramic ultrasound images were collected transversely to the fibers. Normalized root mean square (RMS) amplitude and variations in the cross-sectional area and muscle thickness were calculated separately for each PM head. For all sets of the inclined bench press, the normalized RMS amplitude was greater for the clavicular head than the sternocostal head (P < 0.001), and the opposite was observed during the flat bench press (P < 0.001). Similarly, while greater increases in cross-sectional area were observed in the clavicular than in the sternocostal head after the inclined bench press (P < 0.001), greater increases were quantified in the sternocostal than in the clavicular head after the flat bench press exercise (P = 0.046). Therefore, our results suggest that the PM regional excitation induced by changes in bench press inclination leads to acute, uneven responses of muscle architecture following the exercise.
Asunto(s)
Músculos Pectorales , Entrenamiento de Fuerza , Masculino , Humanos , Músculos Pectorales/diagnóstico por imagen , Músculos Pectorales/fisiología , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/fisiología , Electromiografía , Terapia por Ejercicio , Ultrasonografía , Entrenamiento de Fuerza/métodos , Levantamiento de Peso/fisiología , Fuerza Muscular/fisiologíaRESUMEN
Wooden breast (WB) is a recurrent myopathy in fast-growing birds, which alters the appearance, functionality, and the texture of the breast muscle. The objectives of this study were (i) to evaluate the effect of a combined use of papain enzyme and ultrasound on the texture of WB chicken using response surface methodology and (ii) to assess the effect of marinating on the quality of WB chicken meat. Full factorial experimental design method was used to obtain the ideal conditions to soften the WB meat. The independent variables were the concentration of papain (0.1%-0.3%) and the time in ultrasonic bath (10-30 min); shear force (SF) was the dependent variable. The optimum results were obtained at a concentration of 0.2% papain and 20 min on ultrasound. Papain enzyme had a great influence on the texture of WB meat, reducing its hardness. However, the effect of the ultrasound time on the SF response was not observed. The marinated WB meat showed similar SF values and texture profile than those from normal (N) meat, with reduction in the parameters of protein and lipid oxidation. The use of papain without ultrasound bath proved to be an efficient means for improving the tenderness of WB breasts. PRACTICAL APPLICATION: This study shows the efficiency of the application of two technological procedures (enzymatic treatment and ultrasound) to improve the texture profile and technological properties of chicken breasts affected by the wooden breast myopathy. The economic loss caused by the world-wide occurrence of wooden breast is enormous, and the application of papain has been found to counteract the impaired properties of this abnormal chicken breasts. Since papain is already widely used in the food industry to tenderize meat, its application in improving the quality of WB meat is straightforward.
Asunto(s)
Pollos , Enfermedades Musculares , Animales , Hidrólisis , Carne/análisis , Enfermedades Musculares/veterinaria , Papaína , Músculos Pectorales/diagnóstico por imagenRESUMEN
Deep sternal wound infection and dehiscence has been classified as complex wound, and its treatment is a challenge for the surgeon. There are many flap choices for its treatment, each one having advantages and drawbacks. The article by Wang et al. evidenced that the unilateral pectoralis major muscle flap is a simple and effective option for wound closure resulting from sternotomy dehiscence in infants and children. The report discussed herein highlights that the unilateral pectoralis major muscle flap has been a good and feasible option for the reconstruction of the sternal wound in adults, as previously described by our group and other authors. This technique presents low morbidity and acceptable esthetic and functional results, providing stability to the sternal region.
Asunto(s)
Músculos Pectorales , Esternón , Adulto , Niño , Humanos , Lactante , Músculos Pectorales/trasplante , Estudios Retrospectivos , Esternotomía , Esternón/cirugía , Colgajos Quirúrgicos , Dehiscencia de la Herida Operatoria/cirugía , Infección de la Herida Quirúrgica/cirugía , Resultado del TratamientoRESUMEN
To develop and validate a deep convolutional neural network (CNN) method capable of selecting the greatest Pectoralis Major Cross-Sectional Area (PMM-CSA) and automatically segmenting PMM on an axial Magnetic Resonance Imaging (MRI). We hypothesized a CNN technique can accurately perform both tasks compared with manual reference standards. Our method is based on two steps: (A) segmentation model, (B) PMM-CSA selection. In step A, we manually segmented the PMM on 134 axial T1-weighted PM MRIs. The segmentation model was trained from scratch (MONAI/Pytorch SegResNet, 4 mini-batch, 1000 epochs, dropout 0.20, Adam, learning rate 0.0005, cosine annealing, softmax). Mean-dice score determined the segmentation score on 8 internal axial T1-weighted PM MRIs. In step B, we used the OpenCV2 (version 4.5.1, https://opencv.org ) framework to calculate the PMM-CSA of the model predictions and ground truth. Then, we selected the top-3 slices with the largest cross-sectional area and compared them with the ground truth. If one of the selected was in the top-3 from the ground truth, then we considered it to be a success. A top-3 accuracy evaluated this method on 8 axial T1-weighted PM MRIs internal test cases. The segmentation model (Step A) produced an accurate pectoralis muscle segmentation with a Mean Dice score of 0.94 ± 0.01. The results of Step B showed top-3 accuracy > 98% to select an appropriate axial image with the greatest PMM-CSA. Our results show an overall accurate selection of PMM-CSA and automated PM muscle segmentation using a combination of deep CNN algorithms.
Asunto(s)
Aprendizaje Profundo , Músculos Pectorales , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Redes Neurales de la Computación , Músculos Pectorales/diagnóstico por imagenRESUMEN
OBJECTIVE: To evaluate magnetic resonance imaging (MRI) features of the contralateral side in weightlifting athletes with pectoralis major (PM) tears. We hypothesized that MRI of the non-injured side may present increased pectoralis major tendon (PMT) length and thickness and greater pectoralis major muscle (PMM) volume and cross-sectional area when compared with the control group. METHODS: We retrospectively identified MRI cases with unilateral PM injury and reviewed imaging findings of the contralateral side. Also, we evaluated MRI from ten asymptomatic control weightlifting athletes, with PM imaging from both sides. Two musculoskeletal radiologists independently reviewed MRI and measured PMT length, PMT thickness, PMM volume (PMM-vol) and PMM cross-sectional area (PMM-CSA), as well as humeral shaft cross-sectional area (Hum-CSA) and the ratio between PMM-CSA and Hum-CSA (PMM-CSA/Hum-CSA). Data were compared between the non-injured side and controls. The MRI protocol from both groups was the same and included T1 FSE and T2 FATSAT axial, coronal, and sagittal images, one side at a time. RESULTS: We identified 36 male subjects with unilateral PM injury with mean age 35.7 ± 8 years and 10 age- and gender-matched controls (p = 0.45). A total of 36 PM MRI with non-injured PM and 20 PM MRI studies were included in this study. PMT length and PMT thickness were significantly higher in contralateral PM injury versus control subjects (both P < 0.001). Also, PM-CSA and Hum-CSA were greater in the contralateral PM injury group (P = 0.032 and P < 0.001, respectively). PMT thickness > 2.95 mm had 80.6% sensitivity and 90.0% specificity to differentiate the non-injured PM group from controls. CONCLUSION: Non-injured side MR imaging of patients with previous contralateral PM lesion demonstrates greater PMT thickness and length as well as PM-CSA and Hum-CSA than controls.