Histochemical properties and innervation pattern of fast and slow-tonic fibre types of the anterior latissimus dorsi muscle of the chick

Summary The anterior latissimus dorsi muscle of the chick is largely composed of slow-tonic fibres but contains a few fast fibres defined by their acid-labile, alkali-stable myofibrillar ATPase activity. These fibres are referred to as fibres. Differing from the slow-tonic ( and ) fibres which are multiply innervated withen grape endings, the (fast) fibres are innervated by typicalen plaque endings. The innervation of thirty-two fibres were studied closely and it was concluded that about a half of the fibres were focally innervated whereas a half were innervated in two distinct loci byen plaque endings. In only one case, a fast fibre with three widely spaceden plaque endings was observed. The mean intersynaptic length was significantly larger on fibres than on and fibres. No variation in the histochemical properties of myofibrillar ATPase was observed either along the entire length of singly and dually innervated fibres, or along and fibres. It is concluded that the three extrafusal fibre types of the anterior latissimus dorsi muscle maintain uniform histochemical characteristics along their length in spite of a possible innervation by several motoneurons.     

Harvesting the latissimus dorsi muscle for cardiomyoplasty

The development of cardiomyoplasty over the past several years has provided a surgical alternative for management of patients with severe heart failure. It may be indicated in patients for whom transplant is not indicated or must be delayed. Optimal results can be obtained when the maximum amount of viable muscle is used to wrap the heart. Between May of 1997 and October of 1998, five patients underwent cardiomyoplasty in our institution. All operations were performed using the left latissimus dorsi muscle wrap with postoperative stimulated muscle training. Presented is a review of cardiomyoplasty and our technique for harvesting the muscle flap, which has proven to be successful.     

Properties of standard avian slow muscle grafts following long-term regeneration

The tonic anterior latissimus dorsi (ALD) of adult pigeons was orthotopically homografted and evaluated after 11 months of regeneration for histological, histochemical, electromyographic (EMG), and mechanical properties. The resting EMG activity of the grafts was lower in amplitude than that of the controls, but showed the tonic pattern typical for these tonic muscles. The control and grafted muscles had a histochemically homogeneous population of fibers with moderate myofibrillar adenosine triphosphatase activity. Succinic dehydrogenase activity was moderate for the control muscles, but low for the grafts. The regenerated muscles had fewer and smaller fibers and had much larger intersynaptic distances. Both the regenerated and the contralateral control muscles were slow contracting and maintained tetanic tension for prolonged periods with direct electrical stimulation. The relaxation was slower in the grafted muscle than in the control. The grafts produced 40% of the maximum tension of the control muscles, but the rate of tension development was similar between the two groups. The results indicate that the tonic properties were regenerated, but the innervation pattern was altered and the grafted muscles did not have normal mature fibers even after long-term regeneration.     

The reverse latissimus dorsi muscle flap for closure of meningomyelocele

Closure of the meningomyelocele wound requires stable coverage of the dural repair. In the case presented, multiple conventional attempts at reconstruction failed. A modification of the "reverse" latissimus dorsi flap is presented that successfully managed this low lumbar defect.     

Preconditioning of latissimus dorsi muscle flaps with monophosphoryl lipid a

The use of dynamic myoplasty to restore function to failing organs is an exciting new application of skeletal muscle flaps. A complication of large flap elevation that can compromise flap function is ischemia-induced necrosis; one approach to minimizing this is to pretreat tissues with ischemic preconditioning. The purpose of this study was to determine whether systemic administration of monophosphoryl lipid A, a drug known to mimic late-phase ischemic preconditioning in the heart, could reduce ischemia-induced necrosis in latissimus dorsi muscle flaps. Forty latissimus dorsi muscle flaps from 20 Sprague-Dawley rats were allocated into four groups. In group I (n = 10), flaps were not preconditioned and served as controls. In group II (n = 10), flaps received ischemic preconditioning with two 30-minute periods of ischemia interspersed by 10 minutes of reperfusion. In group III (n = 10), rats received an intravenous bolus of approximately 0.3 ml of monophosphoryl lipid A vehicle only. In group IV (n = 10), rats received an intravenous bolus of 450 microg/kg of monophosphoryl lipid A and vehicle. Twenty-four hours after treatment, all latissimus dorsi muscle flaps were elevated on a single neurovascular pedicle and subjected to 4 hours of ischemia. After 72 hours of reperfusion, latissimus dorsi muscles were harvested, weighed, stained with nitroblue tetrazolium, and assessed for percent necrosis using digitized images of muscle sections and computerized planimetry. The percent necrosis in ischemic preconditioning-treated flaps (group II) was significantly reduced by 57 percent (p < 0.05) compared with control flaps (group I). The percent necrosis in flaps treated with monophosphoryl lipid A (group IV) was significantly reduced by 58 percent (p < 0.05) compared with vehicle-control flaps (group III). There was no difference in mean percent necrosis between ischemic preconditioning (group II) and monophosphoryl lipid A-treated (group IV) flaps or between ischemic preconditioning-control (group I) and monophosphoryl lipid A vehicle-control (group III) flaps. Intravenous administration of systemic monophosphoryl lipid A mimics the late-phase protective effect of ischemic preconditioning in the authors' rat latissimus dorsi muscle flap model.     

Effects of electrical stimulation upon post-hatching development of fibre types in normally innervated fast and slow latissimus dorsii muscles of the chicken

In chicken, the main characteristic properties of muscle fibre types in slow anterior (ALD) and fast posterior (PLD) latissimus dorsii are acquired during post-hatching development. At day 4 it becomes possible to distinguish between alpha' and beta' fibre types in ALD muscle. At the same time, mATPase staining and NADH-TR activity permit recognition of alpha w and alpha R fibres within PLD muscle. During further development, muscle fibre typology progressively changes towards the adult slow and fast type. Chronic stimulation at a slow rhythm (5 Hz) of PLD prevents the change in relative proportions of alpha R and alpha W fibres within the muscle that occurs in normal post-hatching development and increases the number of beta R fibres. Moreover, oxidative activity is increased in all muscle fibre types following stimulation. In ALD muscle, chronic stimulation at a fast rhythm (40 Hz) results in a decrease in oxidative activity and inhibits the differentiation of alpha' and beta' muscle fibre types. This study demonstrates that in young chicken, the pattern of activity influences the differenciation of fibre types in slow and fast muscles.     

Regional injury and the terminal differentiation of satellite cells in stretched avian slow tonic muscle.

In the avian stretch model, the application of a weight overload to the humerus induces enlargement of the anterior latissimus dorsi (ALD) muscle and an increase in muscle fiber number which is accompanied by satellite cell activation. Myofiber injury may be an important stimulus to muscle fiber hyperplasia; therefore, light and electron microscopic evaluation was undertaken to determine if myofiber injury occurs in the stretch-enlarged ALD muscle of the adult quail. Autoradiographic studies were used to determine the terminal differentiation of labeled myogenic cells. A weight equal to 10% of body mass was attached to one wing of 27 adult quail and 3 birds were euthanized at 9 intervals of stretch, from 1 to 30 days. Birds were injected with tritiated thymidine at intervals ranging from 1 hr to 3 days prior to euthanization. Labeled nuclei were detected by light microscopic examination and identified by electron microscopy of a serial section. Three regions of the muscle were examined for disorganization of contractile elements, presence of cytoplasmic vacuoles, and/or phagocytic cell infiltration. The percentage of fibers exhibiting one or more of these criterion was significantly greater in the stretched ALD by Days 5 and 7 and declined at Day 10, reaching near control values by Day 14. Myofiber necrosis and phagocytic cell infiltration were only observed in the middle and distal regions of the stretched ALD muscle. Traditional signs of regeneration and repair were observed, including clusters of labeled myoblast-like cells and myotube formation within an existing basal lamina. New myotube formation with labeled central nuclei was also noted in the interstitial space, outside of basal lamina of persisting fibers. Labeled myonuclei were observed in the stretched fibers. These results demonstrate that chronic stretch produces regional injury and fiber degeneration and resultant regeneration in the ALD muscle of the adult quail. This may be an important stimulus for new fiber formation in this model.     

A variation of the vascular pedicle of the latissimus dorsi muscle

A case of a rare variation of the vascular pedicle of the latissimus dorsi musculocutaneous flap is described. Its main vascular pedicle was the circumflex scapular vessel.     

Staged transfer of a free microvascular latissimus dorsi myocutaneous flap using saphenous vein grafts

The use of long vein grafts in the axilla adds a new dimension to the versatility of the latissimus dorsi myocutaneous flap. When suitable recipient vessels are not available for a microvascular anastomosis, long vein grafts can be used in the axilla to double the arc of rotation of the flap, allowing it to cover the buttocks, lower torso, and scalp (Fig. 8). A case is presented in which the latissimus dorsi myocutaneous flap was transferred in stages to cover a large radiation ulcer of the right buttock.     

Treatment of total sternal necrosis using the latissimus dorsi muscle flap

Complications after a median sternotomy incision, which is used currently in most cardiac and mediastinal surgical procedures, although infrequent, are serious. If sternal dehiscence follows median sternotomy, infection extends to vital underlying structures, exposing the anterior part of the heart and ascending aorta. Permanent hemorrhage, septic thrombosis, or septic perforation of prosthetic material demand soft-tissue coverage. In 5 patients with total sternum necrosis the retrosternal space was covered with a latissimus dorsi muscle flap in order to achieve stable protection of the exposed mediastinal organs.     

Functional transformation of fast posterior latissimus dorsi muscle by "slow" nerve implanted in newly hatched chickens.

1. Contraction properties and the activity of Ca2+ - ATPase were investigated 2 and 5 to 6 1/2 months after transposition of the fast posterior latissimus dorsi muscle (PLD) to the other side in newly hatched chickens. At the same time the muscle was cross-innervated by the nerve originally supplying the slow anterior latissimus dorsi muscle (ALD). 2. The mean isometric twitch contraction time of these transposed, cross-innervated PLD muscles in the 2-month-old and 5 to 6 1/2-month-old groups was 61.6 +/- 4.2 msec and 72.5 +/- 10.8 msec respectively. When compared with values obtained in control PLD and ALD muscles (21.9 +/- 0.6 msec and 107.7 +/- 5.6 msec), contraction time was significantly prolonged by this procedure. 3. Ca2+ - ATPase activity was also found to change towards the slow muscle (activity in control PLD was 0.600 micronmoles Pi/mg myosin/min, in the transposed, cross-innervated PLD 0.462 and in control ALD muscle 0.156 respectively). 4. Foreign innervation may thus induce changes in functional and biochemical properties even in muscles considerably different in structure and function, if transformation is allowed to take place at a sufficiently early stage of development. The muscle transposition itself, by introducing the element of muscle dedifferentiation and regeneration, probably assists the transformation process by making the muscle more plastic to the neural influences.     

Use of the latissimus dorsi muscle to restore elbow flexion in arthrogryposis

The successful use of ipsilateral pedicle latissimus dorsi muscle to restore elbow flexion in a child with arthrogryposis multiplex congenita is described. In appropriately selected patients, use of the latissimus dorsi muscle for elbow flexor reconstruction is a strong, reliable flexorplasty without significant donor-site morbidity.     

Mechanical properties of the latissimus dorsi muscle after cyclic training.

Cardiomyoplasty is a procedure developed to improve heart performance in patients suffering from congestive heart failure. The latissimus dorsi (LD) muscle is surgically wrapped around the failing ventricles and stimulated to contract in synchrony with the heart. The LD muscle is easily fatigued and as a result is unsuitable for cardiomyoplasty. For useful operation as a cardiac-assist device, the fatigue resistance of the LD muscle must be improved while retaining a high power output. The LD muscle of rabbits was subjected to a training regime in which cyclic work was performed. Training transformed the fiber-type composition from approximately equal proportions of fast oxidative glycolytic (FOG) and fast glycolytic (FG) fibers to one composed of almost entirely of FOG with no FG, which increased fatigue resistance while retaining rapid contraction kinetics. Muscle mass and cross-sectional area increased but power output decreased, relative to control muscles. This training regime represents a significant improvement in terms of preserving muscle mass and power compared with other training regimes, while enhancing fatigue resistance, although some fiber damage occurred. The power output of the trained LD muscle was calculated to be sufficient to deliver a significant level of assistance to a failing heart during cardiomyoplasty.