Hydrogen peroxide-induced oxidative stress impairs redox status and damages aerobic metabolism of breast muscle in broilers.

Oxidative stress has always been a hot topic in poultry science. However, studies concerning the effects of redox status and glucose metabolism induced by hydrogen peroxide (H2O2) in the breast muscle of broilers have been rarely reported. This study was aimed to evaluate the impact of intraperitoneal injection of H2O2 on oxidative damage and glycolysis metabolism of breast muscle in broilers. We also explored the activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway to provide possible mechanism of the redox imbalance. Briefly, a total of 320 one-day-old Arbor Acres chicks were randomly divided into 5 treatments with 8 replicates of 8 birds each (noninjected control, 0.75% saline-injected, 2.5, 5.0, and 10.0% H2O2-injected treatments). Saline group was intraperitoneally injected with physiological saline (0.75%) and H2O2 groups received an intraperitoneal injection of H2O2. The dosage of the injection was 1.0 mL/kg BW. All birds in the saline and H2O2 groups were injected on days 16 and 37 of the experimental period. At 42 d of age, 40 birds (8 cages per group and one chicken per cage) were selected to be stunned electrically (50 V, alternating current, 400 Hz for 5 s each one), and then immediately slaughtered via exsanguination. The results showed that broilers in the H2O2 injection group linearly exhibited higher contents of reactive oxygen species, carbonyl and malondialdehyde, and lower total antioxidant capacity and glutathione peroxidase activities. With the content of H2O2 increased, the H2O2 groups linearly downregulated the mRNA expressions of GPX, CAT, HMOX1, NQO1, and Nrf2 and its downstream target genes. In addition, H2O2 increased serum activities of creatine kinase and lactate dehydrogenase. Meanwhile, in the pectoral muscle, the glycogen content was linearly decreased, and the lactate content was linearly increased in muscle of broilers injected with H2O2. In addition, the activities of glycolytic enzymes including pyruvate kinase, hexokinase, and lactate dehydrogenase were linearly increased after exposure to H2O2. In conclusion, H2O2 injection could impair antioxidant status and enhance anaerobic metabolism of breast muscle in broilers.

Morinda officinalis polysaccharides improve meat quality by reducing oxidative damage in chickens suffering from tibial dyschondroplasia.

Tibial dyschondroplasia (TD) is the common leg disease in commercial broilers. However, the effects of TD on meat quality and the protective of Morinda officinalis polysaccharide (MOP) are largely unknown. Three hundred broiler chicks (one-day-old) were equally allocated into control (CON), TD and MOP-treated groups for 15 days. The results indicated that TD influenced morphology and meat quality-related parameters of the breast muscle, and changed the activity and mRNA expression of antioxidant enzymes in plasma and breast muscles. Moreover, metabolomics profiling of breast muscle revealed that the main altered metabolites 4-guanidinobutyric acid and chenodeoxycholic acid, which are related to meat quality and oxidative stress. Additionally, 500 mg/L MOP effectively restored the content of meat metabolites and oxidative damage. These findings suggest that oxidative damage caused by TD may affect meat quality in broilers by changing the content of breast muscle metabolites and that MOP supplementation has a restorative effect.

Effect of early posthatch supplementation of vitamin E and omega-3 fatty acids on the severity of wooden breast, breast muscle morphological structure, and gene expression in the broiler breast muscle.

Wooden breast (WB) has arisen primarily in the breast muscle of commercial broilers. It is characterized by palpation of a rigid pectoralis major (p. major) muscle and is under severe oxidative stress and inflammation. Previous studies have shown that vitamin E (VE) has antioxidant properties and omega-3 (n-3) fatty acids have an anti-inflammatory effect. The objectives of this study were to identify the effects of VE and n-3 fatty acids on the severity of WB, morphological structure of the p. major muscle, expression of genes likely associated with WB and to determine the most beneficial supplementation period. A total of 210 Ross 708 broilers were randomly assigned into 7 treatments with 10 replicates of 3 birds each. The control group received a corn-soybean meal basal diet during the entire study (0-58 d). Supplementation of VE (200 IU/kg), n-3 fatty acids (n-6/n-3 ratio of 3.2:1), or combination of both were fed during the starter phase (0-10 d) or grower phase (11-24 d). All broilers were harvested at 58 d of age. Morphological assessment of the p. major muscle included myofiber width, perimysial and endomysial connective tissue space, overall morphological structure, and scoring of WB microscopically. Gene expression was measured using nanostring analysis. Genes associated with muscle development and growth factors, inflammation, extracellular matrix, and glucose metabolism were differentially expressed in the p. major muscle of the broilers supplemented with VE in the grower diet. Greater than 2 times more giant myofibers (≥70 µm) were found in the group supplemented with VE and n-3 fatty acids in the starter diet compared with the group fed VE in the grower diet (P = 0.02). Microscopic evaluation showed that VE supplementation in the grower diet had a 16.19% increase in muscle with no WB compared with the control group (P = 0.05). These data suggest that supplementation of VE during the grower phase may reduce the severity of WB in broilers.

Impact of aluminosilicates on productivity, carcass traits, meat quality, and jejunum morphology of broiler chickens.

The aim of the study was to compare production results and quality of meat, as well as histological features of the jejunum in broiler chickens administered feed with 1% addition of zeolite or halloysite, with the addition of aluminosilicates to litter (4.50 kg/m2) throughout the rearing. In the experiment, 300 male broilers were used for 6 wk. They were divided into 3 groups, each of 10 repetitions (10 birds each). Group 1 was a control, halloysite was added to feed and litter in group 2, while zeolite was applied instead of halloysite in group 3. After rearing, 10 selected birds from each group were slaughtered. Selected production properties and degree of footpad dermatitis were examined, and histomorphometric examination of the jejunum was performed. The lowest yield and the highest proportion of neck with skin in the carcass were demonstrated in group 2 (P < 0.05). The lowest percentage of skin with subcutaneous fat was found in group 3 (P < 0.05). A decrease in lightness (L∗) and yellowness (b∗) was demonstrated in group 2, while redness (a∗) was the lowest in group 3 (P < 0.05). Group 2 was characterized by the lowest water-holding capacity in breast muscles, and in group 3, in leg muscles (P < 0.05). In group 3, the highest fat content and the lowest water content in the breast muscles (P < 0.05) were found. The leg muscles in groups 2 and 3 were characterized by the highest a∗, and in group 2, by b∗. The control group had the lowest protein and the highest fat content in leg muscles. In the intestine from group 2, a higher height (P < 0.05) and surface area (P < 0.01) of intestinal villi were found, in comparison to group 3. The width of intestinal villi was higher in groups 2 and 1 than in group 3 (P < 0.05), similarly the depth of intestinal crypts. The addition of zeolite could be proposed because of the obtained production results, while the halloysite had a positive effect on the histomorphometric features of the jejunum.

Improvac immunocastration affects the development of thigh muscles but not pectoral muscles in male chickens.

Improvac has been tentatively used to immune-castrate roosters. The aim of this study was to investigate whether Improvac affected skeletal muscle development in chickens. The muscle fiber type and size and the expression levels of genes related to muscle development in pectoral and thigh muscles were examined at 5, 9, and 14 wk of age in the control, early, late, and early + late Improvac-treated groups. Immunocastration with Improvac affected the development of thigh muscles and the expression of MYH1B, MSTN, and SM. The cross-sectional area in the early group was significantly larger than in the control group at the 14th week (P < 0.01). At the fifth week, the expression levels of MYH1B, MYOD, and MSTN in the early group were significantly higher than those in the control group (P < 0.05), and at the ninth week, the expression level of SM1 in the control group was significantly lower than that in early and late groups (P < 0.05). Immunocastration did not affect pectoral muscle development or the expression of genes related to muscle development.

Evaluation of postoperative pain in patients undergoing modified radical mastectomy with pectoralis or serratus-intercostal fascial plane blocks.

BACKGROUND: Regional nerve blocks are an integral part of multimodal analgesia and should be chosen based on their efficacy, convenience, and minimal side effects. Here, we compare the use of pectoral (PEC II) and serratus-intercostal fascial plane (SIFP) blocks in breast carcinoma cases undergoing modified radical mastectomy (MRM) in terms of the postoperative analgesic efficacy and shoulder mobility. METHODS: The primary outcome of this prospective controlled study was to compare the postoperative static and dynamic pain scores, and the secondary outcome was to assess the shoulder pain, range of shoulder joint motion, and hemodynamic parameters. Sixty patients were randomly allocated to three groups and given general anesthesia. All patients received paracetamol, diclofenac, and rescue doses of tramadol based on the Institute's Acute Pain Service (APS) policy. No block was performed in group C (control), whereas groups P and S received PEC II and SIFP blocks, respectively, before surgical incision. RESULTS: The groups were comparable in terms of age, weight, height, and body mass index distribution (P > 0.05). Dynamic pain relief was significantly better 12 and 24 h postoperatively in groups P (P = 0.034 and P = 0.04, respectively) and S (P = 0.01 and P = 0.02, respectively) compared to group C. Shoulder pain relief and shoulder mobility were better in group S, while the hemodynamic parameters were more stable in group P. CONCLUSIONS: Both SIFP and PEC blocks have comparable dynamic and static pain relief with better shoulder pain scores in patients receiving SIFP.

Effects of dietary corticosterone on the central adenosine monophosphate-activated protein kinase (AMPK) signaling pathway in broiler chickens.

Glucocorticoids (GCs) induce the activation of the central adenosine 5'-monophosphate-activated protein kinase (AMPK) signaling pathway in birds. In this study, we aimed to investigate the effects of corticosterone (CORT) supplemented in diet on the central AMPK signaling pathway in broilers. The average daily gain was reduced by CORT treatment, and the average daily feed intake remained unchanged. Plasma glucose, triglyceride, total cholesterol, and CORT contents were increased by CORT administration. In addition, CORT treatment decreased the relative weights of heart, spleen, and bursa and increased the relative weights of liver and abdominal fat. The glycogen contents in the liver and breast muscle were higher in the chicks treated with CORT. CORT treatment upregulated the gene expression of mammalian target of rapamycin, glucocorticoid receptor, AMPKα2, neuropeptide Y(NPY), liver kinase B1 (LKB1), AMPKα1, and fatty acid synthase in the hypothalamus. Moreover, CORT treatment increased the protein levels of acetyl-coenzyme A carboxylase (ACC) phosphorylation and total AMPK and phosphorylated AMPK in the hypothalamus. Hence, CORT administration in the diet activated the LKB1-AMPK-NPY/ACC signaling pathway in the hypothalamus of broiler.

Transcriptome analysis reveals a molecular understanding of nicotinamide and butyrate sodium on meat quality of broilers under high stocking density.

BACKGROUND: In recent years, increased attention has been focused on breast muscle yield and meat quality in poultry production. Supplementation with nicotinamide and butyrate sodium can improve the meat quality of broilers. However, the potential molecular mechanism is not clear yet. This study was designed to investigate the effects of supplementation with a combination of nicotinamide and butyrate sodium on breast muscle transcriptome of broilers under high stocking density. A total of 300 21-d-old Cobb broilers were randomly allocated into 3 groups based on stocking density: low stocking density control group (L; 14 birds/m2), high stocking density control group (H; 18 birds/m2), and high stocking density group provided with a combination of 50 mg/kg nicotinamide and 500 mg/kg butyrate sodium (COMB; 18 birds/m2), raised to 42 days of age. RESULTS: The H group significantly increased cooking losses, pH decline and activity of lactate dehydrogenase in breast muscle when compared with the L group. COMB showed a significant decrease in these indices by comparison with the H group (P < 0.05). The transcriptome results showed that key genes involved in glycolysis, proteolysis and immune stress were up-regulated whereas those relating to muscle development, cell adhesion, cell matrix and collagen were down-regulated in the H group as compared to the L group. In contrast, genes related to muscle development, hyaluronic acid, mitochondrial function, and redox pathways were up-regulated while those associated with inflammatory response, acid metabolism, lipid metabolism, and glycolysis pathway were down-regulated in the COMB group when compared with the H group. CONCLUSIONS: The combination of nicotinamide and butyrate sodium may improve muscle quality by enhancing mitochondrial function and antioxidant capacity, inhibiting inflammatory response and glycolysis, and promoting muscle development and hyaluronic acid synthesis.

A feed restriction milieu for Pekin meat ducks that may improve gait characteristics but also affects gut leakiness.

In a previous study, we demonstrated that a 15% feed restriction (FR) during the first 2 wk after hatch could improve gait in Pekin meat ducks, but did result in reduced breast mass. We hypothesized that feed restriction after day 5 following muscle satellite cell development would allow the full growth of the breast meat. To accomplish this goal, 300 1-day-old ducklings (Maple Leaf Farms Inc.) were randomly allocated to 1 of the 3 groups (n = 4 pens, 25 ducks per pen): (1) Control group fed to ad libitum; (2) 85% daily feed intake from days 1 to 14 (FR 85% 1-14); 85% daily feed intake from days 5 to 14 (FR 85% 5-14). All ducks were vaccinated with inactivated Salmonella enteritidis on day 14 and boosted on day 26. The FR 85% 5-14 did show similar production standards to controls, and improved gait characteristics (P < 0.05). To determine if the partial feed restriction would have an impact on intestinal epithelial tight junction integrity, we treated ducks on days 7, 14, 21, 28, and 35 with 8.32 mg/kg FITC-d in water per os and blood samples were obtained via the tibial vein 1 h later. Serum samples were analyzed for presence and quantification of FITC-d. Feed restriction elicited a significant increase in FITC-d permeability at all points of evaluation. Anti-S. enteritidis specific IgY responses were assessed by ELISA from serum collected at 14 D, 28 D, and 35 D. Although all ducks showed an increase humoral immune response to the S. enteritidis, both feed restricted groups showed reduced IgY production compared to ad lib controls. Our data suggest that although the FR 5-14 feed restriction paradigm may reduce gait abnormalities without affecting production rates, some challenges exist due to increased gut leakiness or decreased acquired immune activity. Future studies will look at altering the feed restriction milieu to ameliorate these challenges.

Effects of supplemental pine needles powder (Pinus brutia) on growth performance, breast meat composition, and antioxidant status in broilers fed linseed oil-based diets.

This study was proposed to examine the effects of pine needles powder (Pinus brutia) supplementation on growth performance, breast meat composition, and antioxidant status in broilers fed linseed oil-based diets. For this purpose, a total of 210, Ross-308 1-day-old male broiler chicks were allocated to 5 experimental groups each containing 42 birds. Broilers were fed a linseed oil-based basal diet supplemented with 0% (control), 0.25% (P1), 0.50% (P2), 0.75% (P3), and 1% (P4) pine needles powder. During the 42-D feeding period, no significant differences were observed between experimental groups for body weight gain, feed intake, and feed conversion ratio; however, carcass yield was increased linearly with pine needles powder supplementation. No marked changes in the breast meat chemical composition were observed among experimental groups. Supplemental pine needles powder linearly decreased the malondialdehyde concentration in breast meat and liver tissues; however, 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity of breast meat samples remained unaffected. No significant variation was observed among experimental groups for superoxide dismutase enzyme activity in blood erythrocyte lysates, but blood serum total oxidation status tended to decrease with pine needles powder supplementation. In conclusion, results suggested that pine needles powder supplementation to broiler diets could be a viable option to improve the animal antioxidant status and meat oxidative stability; however, supplementation of Pinus brutia needles powder up to 1% into broiler diets was not sufficient to efficiently curb the fat-induced oxidation in meat. Further investigation is needed to determine the full antioxidant potential of pine needles powder supplementation in poultry by comparing different pine species, evaluating the bioavailability of their active compounds and determining most effective dietary concentration for broiler meat production without any adverse effects.

Spasticity-induced Pectoralis minor syndrome: a case-report.

Background: Pectoralis minor syndrome (PMS) develops when the neurovascular bundle compression occurs at the retropectoralis minor space. It may occur due to repetitive overhead activities, traumatic incident, structural causes, myofascial pain syndrome in the pectoralis minor muscle, as well as spasticity of the pectoralis minor muscle. In patients with hemiplegia, adductor muscles along with pectoralis minor muscle spasticity may be present in the upper extremity.Objective: We report a 19-year-old male patient with spastic hemiparesis who was diagnosed with PMS due to spasticity of the pectoralis minor muscle.Method: Diagnosis of PMS was confirmed by Ultrasound-guided 4 cc 1% lidocaine injection to the right pectoralis minor muscle and Ultrasound-guided onabotulinum toxin A injection was performed. Stretching exercises to the pectoral muscles were also added to the rehabilitation program.Result: Complaints of the patient were controlled by botulinum toxin injections at 3-month intervals.Conclusion: It should be kept in mind that spasticity in the upper extremity may develop in the pectoralis minor muscle, and may cause pressure on the neurovascular structures. Ultrasound-guided botulinum toxin injections can be a safe and effective treatment for PMS in a patent with post stroke spastic hemiparesis.

Pectoralis-II Myofascial Block and Analgesia in Breast Cancer Surgery: A Systematic Review and Meta-analysis.

BACKGROUND: Thoracic paravertebral block is the preferred regional anesthetic technique for breast cancer surgery, but concerns over its invasiveness and risks have prompted search for alternatives. Pectoralis-II block is a promising analgesic technique and potential alternative to paravertebral block, but evidence of its absolute and relative effectiveness versus systemic analgesia (Control) and paravertebral block, respectively, is conflicting. This meta-analysis evaluates the analgesic effectiveness of Pectoralis-II versus Control and paravertebral block for breast cancer surgery. METHODS: Databases were searched for breast cancer surgery trials comparing Pectoralis-II with Control or paravertebral block. Postoperative oral morphine consumption and difference in area under curve for pooled rest pain scores more than 24 h were designated as coprimary outcomes. Opioid-related side effects, effects on long-term outcomes, such as chronic pain and opioid dependence, were also examined. Results were pooled using random-effects modeling. RESULTS: Fourteen randomized trials (887 patients) were analyzed. Compared with Control, Pectoralis-II provided clinically important reductions in 24-h morphine consumption (at least 30.0 mg), by a weighted mean difference [95% CI] of -30.5 mg [-42.2, -18.8] (P < 0.00001), and in rest pain area under the curve more than 24 h, by -4.7cm · h [-5.1, -4.2] or -1.2cm [-1.3, -1.1] per measurement. Compared with paravertebral block, Pectoralis-II was not statistically worse (not different) for 24-h morphine consumption, and not clinically worse for rest pain area under curve more than 24 h. No differences were observed in opioid-related side effects or any other outcomes. CONCLUSIONS: We found that Pectoralis-II reduces pain intensity and morphine consumption during the first 24 h postoperatively when compared with systemic analgesia alone; and it also offers analgesic benefits noninferior to those of paravertebral block after breast cancer surgery. Evidence supports incorporating Pectoralis-II into multimodal analgesia and also using it as a paravertebral block alternative in this population.

Effects of in ovo injection of prebiotics and synbiotics on the productive performance and microstructural features of the superficial pectoral muscle in broiler chickens.

The aim of the study was to compare the effects of 2 prebiotics and 2 synbiotics injected in ovo on productivity parameters, quality, and microstructure of the superficial pectoral muscle in 35-day-old broiler chickens. On day 12 of incubation, 9,000 eggs Ross 308 were randomly divided into 5 experimental groups treated with different bioactives in ovo injected: C, control with physiological saline; PI, with 1.760 mg inulin; PB, with 0.528 mg of commercial prebiotic Bi2tos; SI, with 1.760 mg inulin and 1,000 CFU Lactococcus lactis spp. lactis IBB SL1; SB, with 0.528 mg Bi2tos and 1,000 CFU Lactococcus lactis spp. cremoris IBB SC1. The synbiotic solution contained 20 µl bacterial suspension and 180 µl prebiotic solution. For productive parameters and further tests ten male birds for each experimental group were used. The birds were slaughtered on day 35 of age. At slaughter, samples of the left pectoral muscles were taken and preserved by freezing in liquid nitrogen. The pH and color of the meat were evaluated at 45 min and 24 h post-mortem. Water holding capacity (WHC) was measured and expressed as the percentage of free water in meat. Microscopic specimens were analysed using MultiScan software for the measurement of the percentage of oxidative and glycolytic fibres and mean diameter of the muscle fibres. In ovo injection of prebiotics Bi2tos had a positive effect on body weight. In prebiotic group (PI) a negative impact on hatchability was observed. Prebiotics and synbiotics had no influence on the yield of the carcass and pectoral muscle. Bioactive compounds had a significant effect on the quality of meat parameters such as: pH 24 h (PI and PB group), L* 45' (SI and SB group), and WHC (groups PB, SI, and SB). The analysis of the enzymatic profile showed a significant increase in the percentage of glycolytic fibres in the pectoral muscle from chicken treated with a synbiotic with the addition of inulin (group SI).

Antioxidative effects of supplementing linseed oil-enriched diets with α-tocopherol, ascorbic acid, selenium, or their combination on carcass and meat quality in broilers.

In a previous study, we examined the synergistic effects of the dietary supranutritional supplementation with vitamin E, vitamin C, and Se on the in vivo antioxidative status of broilers under conditions of dietary oxidative stress induced by feeding a diet high in n-3 PUFA. In this study, we examined the effect of their inclusion on the quality characteristics and oxidative stability of raw or cooked meat, both fresh or after a long-term frozen storage. Four hundred 21-day-old Ross 308 male broilers were allocated to 5 experimental groups fed 5% linseed oil-enriched finisher diets (days 21 to 40): Cont (recommended levels of vitamin E, C, and selenium), +E (200 IU vitamin E/kg feed), +C (250 mg vitamin C/kg feed), +Se (0.2 mg selenium/kg feed), or +ECSe (concentrations as in the sole supplementation, combined). Animal performance and carcass characteristics were monitored at the age of 40 D. Breast meat samples of 12 chickens per group were analysed fresh, fresh after frozen storage, cooked fresh, and cooked after frozen storage (2 × 2 factorial design) for parameters of meat quality (water-holding capacity-WHC, pH, and color) and oxidative stability (concentrations of vitamin E, malondialdehyde-MDA, antioxidant capacity of the water-soluble compounds-ACW, and fatty acid composition). Vitamin E alone (+E) and combined with Se and vitamin C (+ECSe) increased the α-tocopherol concentration in breast muscle, and showed similar protective effects against lipid peroxidation measured as MDA regardless of the frozen storage or cooking. The sole supplementation of vitamin C or selenium showed no effects on the meat quality parameters. In conclusion, the dietary supranutritional inclusion of vitamin E inhibited the lipid peroxidation in fresh, frozen stored, cooked fresh, and frozen stored meat in broilers fed with diets rich in n-3 PUFAs. Even though no clear synergistic effects of the supranutritional supplementation of vitamin C and Se with vitamin E were detected, their dietary inclusion did not negatively affect broilers carcass and meat quality parameters.

Effects of methionine and guanidinoacetic acid supplementation on performance and energy metabolites in breast muscle of male broiler chickens fed corn-soybean diets.

1. Guanidinoacetic acid (GAA) is the single endogenous precursor of creatine, which plays a critical role in energy homeostasis of cells. Since GAA is endogenously converted to creatine by methylation, it was hypothesised that the effects of dietary GAA supplementation might determine the methionine (Met) availability in corn-soybean based diets. 2. A total of 540, one-day-old male Ross 308 broilers were allocated to nine dietary treatments with six replicates (10 birds each) in a 3 × 3 factorial arrangement with three graded levels of supplementary Met (+0.4 g/kg per level), whilst cystine was equal across groups, resulting in a low, medium and high level of total sulphur amino acids, and with three levels of GAA (0, 0.6 and 1.2 g/kg). Birds were fed for 42 days. 3. Increasing levels of supplemental Met enhanced performance indices in all rearing periods, although there was no effect on feed conversion ratio in the grower or feed intake in the finisher periods. Final body weight was 8.8% and 14.6% higher in the birds fed medium and high Met diets, respectively, compared to the low Met level. Relative breast weight and protein content in muscle on d 25 linearly increased with higher levels of Met. At low and high Met levels, growth in the finisher phase was negatively affected by supplementing GAA at 1.2 g/kg. It was suggested that disturbances in methylation homeostasis and/or changes in Arg metabolism might explain these findings. At the end of the grower phase, muscle creatine content was higher when feeding GAA at 0.6 and 1.2 g/kg (4464 and 4472, respectively, vs. 4054 mg/kg fresh muscle in the control group). 4. The effects of dietary GAA supplementation were influenced by the dietary Met level only in the finisher period, which indicates the need for proper sulphur amino acid formulation in diets when feeding GAA.

Weeping forsythia extract alleviates dexamethasone-induced oxidative injury of breast muscles in broilers.

Antioxidants have been always used to improve post-slaughter meat quality in broilers subjected to stress. Forsythia suspensa extract (FSE), a traditional Chinese herbal medicine, is generally regarded as a natural source of antioxidants. Therefore, the objective of this study was to test the hypothesis that FSE could protect post-slaughter breast muscles against oxidative injury induced by dexamethasone (DEX) mimicking chronic physiological stress in poultry production. Average daily gain and feed efficiency of poultry were suppressed by DEX and improved by FSE (P < 0.05). Dexamethasone caused the decrease in the redness value and the increase in the lightness and yellowness values and drip loss of the breast muscles (P < 0.05), and FSE had the converse effects (P < 0.05). Dietary FSE supplementation decreased monounsaturated fatty acid (FA) and increased polyunsaturated FA in breast muscles of broilers (P < 0.05). In addition, FSE decreased malondialdehyde and carbonyl content in the breast muscles of DEX-treated broilers (P < 0.05). The inhibition of 1,1-diphenyl-2-picryl-hydrazyl in the breast muscles was decreased by DEX and increased by FSE (P < 0.05). Total-antioxidant capacity and glutathione peroxidase activity in the breast muscles were decreased in birds subjected to DEX and increased in birds supplemented with FSE (P < 0.05). Totally, DEX suppressed growth performance and induced breast muscle oxidative injury in broilers, and FSE supplementation improved antioxidant capacity to attenuate these adverse effects. Therefore, FSE could be a potential natural antioxidant to alleviate oxidative injury of the breast muscles in broilers and to improve the meat quality for human consumption.

Augmentation of Lipopolysaccharide-Induced Production of IL-1α and IL-1ß in Mice Given Intravenous Zoledronate (a Nitrogen-Containing Bisphosphonate) and Its Prevention by Clodronate (a Non-nitrogen-containing Bisphosphonate).

Bisphosphonates (BPs) bind strongly to bone and exhibit long-acting anti-bone-resorptive effects. Among BPs, nitrogen-containing BPs (N-BPs) have far stronger anti-bone-resorptive effects than non-N-BPs. However, N-BPs induce acute inflammatory reactions (fever, arthralgia and myalgia, etc.) after their first injection. The mechanisms underlying these side effects remain unclear. Zoledronate (one of the most potent N-BPs) is given intravenously to patients, and the side-effect incidence is reportedly the highest among N-BPs. Our murine experiments have clarified that (a) intraperitoneally injected N-BPs induce various inflammatory reactions, including a production of interleukin-1 (IL-1) (a typical inflammatory cytokine), and these inflammatory reactions are weak in IL-1-deficient mice, (b) subcutaneously injected N-BPs induce inflammation/necrosis at the injection site, (c) lipopolysaccharide (LPS; a cell-wall component of Gram-negative bacteria) and N-BPs mutually augment their inflammatory/necrotic effects, (d) the non-N-BP clodronate can reduce N-BPs' inflammatory/necrotic effects. However, there are few animal studies on the side effects of intravenously injected N-BPs. Here, we found in mice that (i) intravenous zoledronate exhibited weaker inflammatory effects than intraperitoneal zoledronate, (ii) in mice given intravenous zoledronate, LPS-induced production of IL-1α and IL-1ß was augmented in various tissues, including bone, resulting in them increasing in serum, and (iii) clodronate (given together with zoledronate) prevented such augmentation and enhanced, slightly but significantly, zoledronate's anti-bone-resorptive effect. These results suggest that infection may be a factor promoting the acute inflammatory side effects of N-BPs via augmented production of IL-1 in various tissues (including bone), and that clodronate may be useful to reduce or prevent such side effects.

Sub-muscular Breast Augmentation Using Tumescent Local Anesthesia.

BACKGROUND: Tumescent local anesthesia (TLA) consists of infiltration of saline solution with lidocaine and epinephrine into the tissues to obtain regional anesthesia and vasoconstriction. The use of TLA in augmentation mammoplasty has been described for sub-glandular positioning. We describe a modified TLA technique for primary sub-muscular breast augmentation reporting our experience during the past 7 years. METHODS: From 2010 to 2017, 300 patients underwent bilateral primary sub-muscular breast augmentation under TLA and conscious sedation. The tumescent solution was prepared with 25 mL of 2% lidocaine, 8 mEq of sodium bicarbonate, and 1 mL of epinephrine (1 mg/1 mL) in 1000 mL of 0.9% saline solution. Firstly, the solution was infiltrated between the pectoral fascia and the mammary gland, secondarily, during surgery, under the pectoralis major muscle. RESULTS: The average amount of tumescent solution infiltrated while performing TLA was 740 mL per breast. No signs of adrenaline or lidocaine toxicity were reported and conversion to general anesthesia was never required. In all patients, no pain nor discomfort was reported during the pre-operating infiltration and surgical procedure. We reported a major complication rate of 3.3% (4 hematomas and 6 seromas) and a minor complication rate of 6.0% (8 implant dislocation and 10 dystrophic scars formation). CONCLUSIONS: TLA represents a safe and efficacious technique for performing breast augmentation surgery with sub-muscular implant positioning. This technique guarantees good pain control during and after surgery and has low incidence of postoperative side effects. Patients subjected to sub-muscular breast augmentation with TLA were satisfied. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Thoracic Outlet Syndrome Treated With Injecting Botulinum Toxin Into Middle Scalene Muscle and Pectoral Muscle Interfascial Planes: A Case Report.

Thoracic outlet compression syndrome is a complex syndrome of neurovascular compression at the superior thoracic aperture, thought to occur at 1 of 3 anatomical compartments: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Injection into the middle interscalene muscle (ISM) and/or pectoralis muscle plane (PECS I and II) is gaining popularity because it provides significant symptomatic relief. A 44-year-old woman was diagnosed with thoracic outlet compression syndrome, with failed conservative therapy, including physical therapy. She refused surgical intervention. ISM and PECS I and II blocks with botulinum toxin type A were successful. In combination, PECS I/II and ISM injections can provide excellent symptomatic relief.

Botulinum Toxin A Plays an Important Role in the Placement of Implants Deep Within the Pectoralis Major Muscle for Mammaplasty: A Systematic Review and Meta-analysis.

BACKGROUND: Breast prosthesis implants have been safely and efficiently used in the plastic surgery department. With the increasing demand for aesthetics, these silicon implants were not only used in breast augmentation surgery but also in breast reconstruction after mastectomy. Nevertheless, breast prosthesis implantation brings a lot of complications, such as: postoperative chronic pain, capsule contracture, prosthesis displacement and prosthesis rupture and infection in severe cases. From the year 1998, botulinum toxin A (BTX-A), a neurotoxin, has been reported to be effective for pain control, capsule contracture lessening, expander enlargement and so on. However, those articles included all kinds of study types: randomized, double-blinded controlled trial (RCT), nonrandomized trial, retrospective analysis and case series, besides the outcomes were varied. To clarify how BTX-A acts at the mammaplasty field, we made this systematic review and meta-analysis. PURPOSE: To review how BTX-A acts in the field of mammaplasty as well as discuss the relative mechanisms of BTX-A and the related research progress. METHODS: We searched Pubmed, Embase, Cochrane, Web of science, Clinical trials, Wanfang Database and VIP from inception until March 2018 for papers reporting the use of BTX-A in the breast surgery using implants deep within the pectoralis major muscle. System review, viewpoints and case reports were excluded. RESULTS: Ten articles met the criteria for inclusion including six prospective controlled (2 RCT; 4 other trails), three retrospective cohorts and one case series. These studies were all about patients using BTX-A during or after breast surgery with expanders or prostheses. A total of 682 patients were enrolled, 543 (79.61%) accepted BTX-A injection, 185 underwent mastectomies with immediate reconstruction, 13 with delayed reconstruction, 295 mastectomies with either immediate or delayed reconstruction and 189 with breast augmentation using silicone prostheses. The study time ranging from 4 months to 13 years, 15 patients (2.76%) received BTX-A injection more than two times, 9.2% received less than 75 U BTX-A, 34.3% 75-100 U, 0.18% 250 U, and in 56.4% the dosage was not stated. No complications associated with BTX-A were mentioned, almost all the studies reported efficacy for pain control. Other assessments included increased speed of expander enlargement and volume were mentioned in four papers, two articles analyzed the visual analogue scores, three suggested relief of capsular contracture, two reported lower narcotic use, three mentioned shorter hospital stays and one proved lowering the rate of unplanned expander. It seems all the studies demonstrate the valid usage of BTX-A, but the quality of this evidence still under the line. CONCLUSION: We could try to use BTX-A as a new method in the field of mammaplasty. There are so many advantages such as postoperative pain relief, reducing the hospital stay, and increasing operation success rate, but rigorous methodological evidence is still lacking. A lot of studies were retrospective, only two studies used the RCT method. Therefore, to obtain strong evidence to clarify the usage of BTX-A, more randomized double-blinded controlled trials will be required, meanwhile the mechanism study adds to the evidence. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .