Delineation the anatomy of posterior tibial artery perforator flaps using human cadavers with a modified technique.

BACKGROUND: To delineate the distribution and course layer of the perforator vessels using a modified technique. METHODS: Twelve perforator flaps were obtained from the crura of six fresh adult cadavers. The flaps were randomized into three groups (n = 4 per group): the full-thickness flap group; the deep fascia-free flap group, and the subcutaneous adipose layer-free group. The flaps were smoothened on a silk screen on a batten frame and the isolated flaps were perfused at a perfusion pressure of 140 mmHg for 10 min via the trunk of the posterior tibial artery. Perforator flaps were photographed using a digital camera and radiographed using a mammography device. The imaging data were processed by digital software system. RESULTS: The mean number of the posterior tibial artery perforator was 4.17 ± 0.94. The three relatively constant perforators varied in the projection points as well as the diameter and the length. The vascular branches and courses of the perforators were clearly visible on the mammograms. Elimination of all the deep fascia or the subcutaneous adipose tissues in the distal portion had no significant impact on the blood supply of posterior tibial artery perforator flaps while the vascular areas of the artery perforators were significantly reduced after the subcutaneous adipose tissue was eliminated in the proximal portion. CONCLUSIONS: We developed an effective modified technique for delineating the vascular territory on perforator flaps of different thicknesses. Our results provide significant guidance for clinical surgeons by providing them with more detailed anatomical knowledge of perforator flaps.

Use of pedicled latissimus dorsi myocutaneous flap to reconstruct the upper limb with large soft tissue defects.

OBJECTIVE: To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu-taneous flaps. METHODS: Six patients with large skin and soft tissue defects were included in this report. There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar. All wounds were in the upper extremity. The sizes of defects ranged from 15 cm multiply 6 cm to 30 cm multiply 18 cm. Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissimus dorsi. The thoracodorsal artery and its perforators were carefully protected during surgery. RESULTS: All flaps healed primarily without flap congestion, margin necrosis or infection. The skin donor sites either received split-thickness skin graft (3 cases, mostly from the anterior thigh) or was closed primarily (3 cases) and had minimal morbidity. Follow-up of 6-12 months showed that the contour of flap was aesthetic and the function of limb was excellent. CONCLUSION: Our experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for reconstruction of large skin and soft tissue defects in the upper extremity.

[Long-term effectiveness of tendon allograft for repairing tendon defect].

OBJECTIVE: To observe the long-term effectiveness of tendon allograft to repair tendon defect. METHODS: Between October 1996 and September 1999, 24 patients with tendon defect were treated with tendon allograft which was cultured with deoxyguanosine and preserved at low-temperature or ultra-deep-low-temperature. There were 19 males and 5 females, aged from 12 to 46 years with an average of 25.9 years. These patients included 7 cases of total extensor tendon defect of 2nd-5th fingers, 7 cases of index finger extensor tendon defect, 3 cases of deep flexor tendon defect of 2nd-5th fingers, 1 case of ring finger deep flexor tendon defect, 3 cases of long extensor tendon defect of 2nd-5th toes, 2 cases of long extensor hallucis tendon defect, and 1 case of shoulder adduction missing. The sizes of tendon defect ranged from 5 to 15 cm. The mean time from injury to operation was 1.3 months (range, 2 hours to 3 months). RESULTS: Incisions healed by first intention. No deep infection, infectious diseases, and obvious immune rejection occurred. All patients were followed up from 10 to 12 years with an average of 10.8 years. When compared with contralateral sides, at 10 years of follow-up, 1 patient lost 6-100 flexion function; after 10.6 years, flexion tendon releasing was performed; allografted tendon had normal color and elasticity with decreased diameter and with mild and moderate adherence; and after releasing, function was improved. According to Hand Surgery Association assessment standard, the results were excellent in 12 cases, good in 6, and poor in 6; the excellent and good rate was 75%. CONCLUSION: Tendon allograft which is cultured with deoxyguanosine and preserved at low-temperature or ultra-deep-low-temperature is safe to use in clinical, which has good long-term effectiveness in treating tendon defect.

Aesthetic reconstruction of thumb or finger partial defect with trimmed toe-flap transfer.

A new concept of esthetic reconstruction for partial loss of distal finger segment was introduced. In a series of 77 patients, 80 thumb or finger partial defects of lateral, dorsal, or volar half, or composite tissue defect of the finger body were reconstructed with lateral skin-nail flap, dorsal skin-nail flap, pulp flap, or composite tissue transplant taken from corresponding part of the toes. The blood circulations were reestablished by anastomosing digit arteries of the toe transplants and fingers. Seventy-eight fingers in 75 patients of this series were successfully reconstructed. The overall survival rate was 97.5%. Follow-up examinations made half to 12 years postoperatively showed normal length, outward appearance, and function of the reconstructed digits. Their nails are preserved or reconstructed. The pulps are full. Sweating is present. 2-PD was 4-6 mm. Esthetic reconstruction can achieve the goal of mending any part of tissue loss precisely with good result.

Determination of bovine serum albumin by a resonance light-scattering technique with the mixed-complex La(Phth)(phen)(3+).

A mixed-complex of La(Phth)(phen)(3+) was synthesized. Resonance light-scattering characteristics of interaction between La(Phth)(phen)(3+) with bovine serum albumin (BSA) were studied. When BSA was added, aggregation of La(Phth)(phen)(3+) on the molecular surface of bovine serum albumin occurred in the pH 5.5-6.3, resulted in an enhanced resonance light-scattering (RLS) peak at 360 nm. The intensity of resonance light-scattering was found to be proportional to the concentration of BSA.

[Decorative repair and reconstruction of subtotal thumb and finger defect with trimmed toe flap transfer].

OBJECTIVE: In partial loss of distal finger segment, a corresponding part of the toe tissue compound is harvested and transplanted for repair or reconstruction. This new procedure gives forth a new concept and is called decorative repair or reconstruction. METHODS: In a series of 77 patients with 88 thumb and/or finger subtotal defects in forms of lateral half, dorsal half or volar half composite tissue defects were reconstructed with lateral nail-skin flap, dorsal skin-nail flap or pulp flap taken from corresponding part of the toes. The blood circulations were re-established by anastomosing digital arteries of the toe transplants and fingers. RESULTS: In this series 75 patients with 78 fingers reconstructed are successful. The overall survival rate is 97.5%. Follow-up examinations made half to 12 years postoperatively showed the fingers are having a normal length, outward appearance and function. There are nails preserved. The pulps are full. Sweating function are present. Two-point-discrimination tests are between 4-6 mm. CONCLUSION: By decorative reconstruction of subtotal dorsal, lateral, or volar halves defect of thumb and/or fingers by transplanting corresponding part of soft tissue taken from the toe has the merit of repair of any parts of tissue loss precisely what is needed. This procedure is better than any traditional toe-to-hand transfer and realizing the exact meaning of decorative reconstruction.

[Synthesis of mixed complexes of lanthanum with 2,2-bipyridyl and 1,10-phenanthroline and study of the interaction of the complexes with DNA].

A mixed complex of La with 2,2-bipyridyl (dpy) and 1,10-phenanthroline(phen) was synthesized. Elemental analysis, IR and TGA of the complex were investigated, thus it was proved that the conformation of it was La(dpy)(phen)Cl3. The interaction of the complex with DNA has been studied also. The spectra showed that the interaction between La(dpy)(phen)Cl3 and DNA experienced intercalation of long-range self-assembly. The study made it clear that the synthesized mixed complex La(dpy)(phen)Cl3 can interact with DNA, and La(dpy)(phen)Cl3 can be used for probing a nucleic acid.

[Free pulp flap of toe in repairing thee pulp defect of finger].

OBJECTIVE: To investigate a method in repairing pulp defects of thumb and finger. METHODS: To examine and analyze 19 case of pulp defect of thumb and finger repaired with free pulp flap of toe since 1987. RESULTS: All the transplanted pulp flaps in 19 cases are survived and are followed up from 3 months to 12 years. All the digits recovered good out appearance with normal skin creases and ridges. The two-point discriminations are 6-8 mm. The repaired thumb or finger are free of paint during pinching and grasping. The split thickness skin grafts on the donor toes yield no hypertrophic scar and no callousity occurred on the donor feet. No detrimental influence occurred on the donor feet. CONCLUSION: The free pulp flap transfer has obvious advantages than any other methods in repairing pulp defects of single finger by, first, good outward appearance, second, quality of the skin over donor flap is almost as rub resistant as recipient finger, third, anastomosis of the digital nerves give functional influence, finally, short rehabilitation period however, the operation requires microsurgical technique and has a risk of failure.

Fluorometric determination of DNA using a new ruthenium complex Ru(bpy)2PIP(V) as a nucleic acid probe.

A new ligand, 2-phenyl(5-fluoro)imidazo[f]-1,10-phenanthroline (PIP(V)), and its coordination compounds, Ru(bpy)2PIP(V), were synthesized. The fluorescence spectrum of the interaction between Ru(bpy)2PIP(V) and DNA was studied, and a very strong fluorescence peak at a wavelength of 589 nm appeared. The optimum condition of analyzing DNA was decided. The method is simple, convenient and fast, and also has high sensitivity and good selectivity. It has been satisfactorily employed for determinations in synthesized samples.

[Determination of DNA by fluorimetry with flow injection].

A highly sensitive fluorimetry determination of DNA is developed in this paper. The maximum fluorescence intensity was produced in the pH 3.05, with the maximum excitation and emission wavelength of 362 and 531 nm, respectively. Under the optimum conditions, the fluorescence intensity was proportional to the concentration of DNA. The linear range for calf thymus DNA is of 0-120 mg.L-1. The limit of determination was 0.07 mg.L-1. When the proposed method was used to determine DNA in the presence of some coexisting substances, a satisfactory result was obtained.