Anatomical Basis of the Intermediate Dorsal Pedal Neurocutaneous Perforator Pedicled Propeller Flap: A Cadaveric Dissection.

Soft tissue defects of the forefoot represent a challenging surgical modality to reconstructive microsurgeons. This study describes the anatomical basis and design of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap. Thirty fresh human lower limb specimens were injected with red latex and used for dissection of the dorsal vascular and neural anatomy of the foot. The direction and distribution of the intermediate dorsal cutaneous nerve and the vascular anatomy of the third dorsal artery of the plantar arch, along with the intermediate dorsal neurocutaneous nutrient vessels, were mapped. A simulated flap elevation procedure was performed on one fresh cadaver specimen. A clinical series of five cases is presented to demonstrate the feasibility of using the perforator-based intermediate dorsal pedal neurocutaneous vascular flap to reconstruct soft-tissue defects of the forefoot. The intermediate dorsal cutaneous nerve usually originates from the lateral branch of the superficial peroneal nerve. Crossing the surface of the cruciate ligament, it descends distally to the proximal part of the fourth intermetatarsal space and divides into the third and fourth dorsal metatarsal branches. The intermediate dorsal cutaneous neural nutrient vessels, which are multi-segmental and polyphyletic, offer innervation to the skin paddle of the flap elevated on the basis of the third dorsal perforator of the plantar arch. This perforator occupies a relatively constant position in the proximal part of the intermetatarsal space. It sends multiple tiny branches toward the intermediate dorsal cutaneous neural or paraneural nutrient vessel chain. In terms of clinical application, all flaps survived completely; one patient had partial loss of the skin graft. The design and anatomical basis of the intermediate dorsal pedal neurocutaneous vascular flap based on the third dorsal perforator of the plantar arch is a reliable reconstructive option for reconstructing small soft tissue defects in the forefoot. Clin. Anat. 31:1077-1084, 2018. © 2018 Wiley Periodicals, Inc.

Synthesis and herbicidal activity of optically active α-(substituted phenoxyacetoxy) (substituted phenyl) methylphosphonates.

α-(Substituted phenoxyacetoxy) alkylphosphonates containing one chiral carbon atom have been demonstrated to be PDHc inhibitor with good herbicidal activity and some of them could be used as potential herbicide. In order to determine any difference in herbicidal activities between (R) and (S) isomers, the synthetic method of optically active substituted phenylalkylphosphonates IB were explored. A highly practical, enantioselective hydrophosphonylation was developed to prepare optically active O,O-dimethyl α-hydroxyalkylphosphonates 3 as key intermediate by asymmetric addition reaction of dimethylphosphite 1 and several kinds of aldehydes 2 using tridentate Schiff base Al(III) complexes as catalysts. A series of novel O,O-dimethyl α-(substituted phenoxyacetoxy)(substituted phenyl)methylphosphonates IB including (R) and (S) enantiomers were further synthesized with excellent enantioselectivity (95-99% ee) by the condensation of optically active α-hydroxyl (substituted phenyl)methylphosphonates 3 and substituted phenoxyacetyl chlorides 4. The herbicidal activities of title compound IB including their racemates, (R) and (S) enantiomers were evaluated in greenhouse for post-emergence application. All compounds IB showed significant inhibitory activity against dicotyledonous plants. A difference in herbicidal effect among racemate, (R) and (S) enantiomers were observed. Especially IB7 and IB10 showed obvious chiral selectivity in inhibitory activity against chickweed. (S)-IB7 with ED50 of 22.8gai/ha was found to be most effective enantiomer against chickweed and its inhibitory activity was 8.17 times higher than (R)-IB7. (S)-IB7 as potential herbicide would be effective at lower rates than (R)-IB7 or (rac)-IB7.

[Anatomical basis of the flap based on the perforator of the deep palmar arch].

Objective: To investigate the morphological characters of the dorsal perforators originated from the deep palmar arch,so as to provide anatomic basis for V-Y advanced perforator flap. Methods: The following contents were investigated in 30 aduh hand specimens perfused with red latex under surgical magnifier:① The origin, courses, branches and distribution of the dorsal perforators originated from the deep palmar arch. ②The characters of anastomosis among the dorsal perforators, the dorsal carpal and metacarpal arteries. Mimic operation was performed on another fresh specimens perfused with red latex. Results: There were three perforators originated from the deep palmar arch, which passed through the 2nd-4th dorsal interossei and then divided into an ascending branch and a descending branch at the dorsum of hand. Then the ascending branch anastomosed with the dorsal carpal artery, and the descending branch stretched to the 2nd-4th dorsal metacarpal arteries. The originating outer diameters of the 1st-3rd perforators were (1.1 ±0.2) mm,(0.9 ±0.3) mm and (0.7 ±0.1) mm respectively, and the length of the stems were (1.1 ±0.3) cm,(1.0 ±0.2)cm and (0.9 ±0.1) cm respectively. Conclusions: The V-Y advanced perforator flap with the dorsal perforator of the deep palmar arch as its vascular pedicle could be used to repair the dorsal carpal or dorsal metacarpal soft tissue defects.