A nonsemen copulatory fluid influences the outcome of sperm competition in Japanese quail.

Sperm competition is a powerful and widespread evolutionary force that drives the divergence of behavioural, physiological and morphological traits. Elucidating the mechanisms governing differential fertilization success is a fundamental question of sperm competition. Both sperm and nonsperm ejaculate components can influence sperm competition outcomes. Here, we investigate the role of a nonsemen copulatory fluid in sperm competition. Male Japanese quail possess a gland that makes meringue-like foam. Males produce and store foam independent of sperm and seminal fluid, yet transfer foam to females during copulation. We tested whether foam influenced the outcome of sperm competition by varying foam state and mating order in competitive matings. We found that the presence of foam from one male decreased the relative fertilization success of a rival, and that foam from a given male increased the probability he obtained any fertilizations. Mating order also affected competitive success. Males mated first fertilized proportionally more eggs in a clutch and had more matings with any fertilizations than subsequent males. We conclude that the function of foam in sperm competition is mediated through the positive interaction of foam with a male's sperm, and we speculate whether the benefit is achieved through improving sperm storage, fertilizing efficiency or retention. Our results suggest males can evolve complex strategies to gain fertilizations at the expense of rivals as foam, a copulatory fluid not required for fertilization, nevertheless, has important effects on reproductive performance under competition.

Reconstructive versatility of the pectoralis major myocutaneous flap.

The pectoralis major myocutaneous flap is presented in its two basic forms: a muscle flap carrying a skin paddle and the continuous skin-muscle flap technique. The pertinent anatomy of the enveloping fascial planes is reviewed, stressing the increased latitude of safety afforded by elevating the vascular pedicle from the undersurface of the lateral muscle edge. The advantages of a deltopectoral flap outline in approaching the formation of the skin-muscle paddle are introduced. Clinical applications, advantages, and disadvantages are discussed.

Plastic surgery in rural Ethiopia.

From this brief experience in Ethiopia I believe that plastic and reconstructive surgery can contribute much to the lives of many people in such underdeveloped regions of the world. If one will teach the principles of plastic surgery to the general surgeons and paramedical people who do most of the work in these areas, it can amplify and expand their capabilities. Surgery is, of course, only one link in the long chain of basic health issues, and the ultimate solutions are on a different level. Yet, the magnitude of the problems is a compelling reason to make the effort, to take the time, and to contribute our skills in developing regions of the world. Though we cannot alone conquer the entire problem, we can do our bit.

Clinical salvage of three failing skin flaps by treatment with a vasodilator drug.

We present 3 clinical cases, one skin flap and two myocutaneous flaps, in which we believe postoperative treatment with isoxsuprine resulted in the salvage of considerable areas that would otherwise have necrosed.

An experimental neurovascular island skin flap for the study of the delay phenomenon.

We present an experimental neurovascular island skin flap. It is a consistent, reproducible model which produces a definite pattern of surviving skin flap area versus skin flap necrosis. There is a constant, anatomically definable nerve and vascular supply to the flap. This model permits independent experimental manipulation of the neural, arterial, and venous supply to the skin. It is useful, therefore, for the study of the vascular mechanisms of the skin microcirculation. We also demonstrated that increased flap survival can be produced by a delay involving denervation alone (leaving the vascular supply intact) or by devascularization alone (leaving the nerve supply intact). We conclude that both the adrenergic denervation and the ischemia contribute to the production of the delay phenomenon. We suggest that sustained vasodilation--vascular smooth muscle relaxation--is the vascular mechanism that accounts for the delay phenomenon.

Epidermolysis bullosa: current concepts and management of the advanced hand deformity.

A current classification of the types of epidermolysis bullosa is reviewed, in conjunction with some etiological concepts. The pathomechanics of the advanced hand deformity are discussed, and applied to a sequential plan of reconstructive surgery. The objective is the restoration of elementary hand function. Two illustrative cases are presented.

Prevention of necrosis in island myocutaneous flaps in the pig by treatment with isoxsuprine.

Experimental gracilis myocutaneous flaps were designed in the pig which consistently resulted in 81 cm2 of surviving tissue and 194 cm2 of necrotic tissue. When these same flaps were raised in animals treated for two weeks preoperatively and 6 days postoperatively with isoxsuprine, there was 100 percent survival in all (8) flaps.

Prevention of muscle necrosis in an experimental neurovascular island muscle flap by a vasodilator drug--isoxsuprine.

We report an experiment that demonstrates one means to prevent necrosis in an experimental island muscle flap. The results imply that necrosis of skeletal muscle in a clinical flap could be prevented by treatment with isoxsuprine.

Prevention of skin flap necrosis by a course of treatment with vasodilator drugs.

Large island skin flaps, comprising the entire abdominal covering in rats, were raised on one neurovascular pedicle in the groin. A standard area of necrosis was produced on the other side from the pedicle. However, when the animals were treated with certain vasodilator drugs for 15 days before and 7 days after the flaps were raised, there was little or no necrosis. The effect of the drug therapy was the same as a surgical delay.

Experimental work with isoxuprine for prevention of skin flap necrosis and for treatment of the failing flap.

The administration of isoxuprine intraperitoneally resulted in the complete survival of abdominal island skin flaps in rats that otherwise underwent a standard pattern of necrosis. The drug was effective when administered for two weeks before and one week after raising the flap, or when administered afterwards alone. The mechanisms of its action were investigated and are described.

The anterior chest approach for obtaining free osteocutaneous rib grafts.

Fresh cadaver dissections indicated that the anterior chest approach for obtaining a free osteocutaneous rib graft, based on the anterior intercostal vessels, would be feasible. Following this, a mandibular defect in radiated tissue was successfully repaired in one stage by a free osteocutaneous graft with microvascular anastomoses. A 22-cm segment of rib, with overlying muscle and skin measuring 10 X 30 cm, was transferred. Follow-up, with selective arteriography at 6 months, confirmed the belief that the periosteal blood supply alone could support the rib segment. The anterior chest approach, to obtain a free osteocutaneous rib graft, is easier, faster, and safer than the posterior approach.

Nicotine and its effect on wound healing.

Our data demonstrate that nicotine impairs wound contraction in the rabbit ear model from the 4th to the 10th day of wound healing. However, the wounds contracted at essentially the same rate from the 12th to the 20th day in the experimental and control groups of animals. This study would suggest that cigarette smoking, with its associated nicotine ingestion, is adverse for a time to wound healing. It is clearly possible that in cases of extremity injury, or surgery, cigarette smoking may adversely affect wound healing.

Ring avulsion injury.

Dependent upon the age, the occupation, and the requisites of an individual patient, the less important ulnar fingers may be of great value; in these the philosophy of discriminate preservation should be given considerable weight in the choice of treatment. Revascularization of fingers injured by a ring avulsion, and restoration of tactile gnosis with esthetic coverage make salvage of the valued ulnar fingers feasible. Three illustrative cases are described.

Experience with the temporoparietal fascial free flap.

The temporoparietal fascia is an ideal tissue source for free transfer to distant sites where ultrathin coverage is either desirable or mandatory. The fascia's dependable vascular anatomy facilitates the technical aspects of microvascular transfer by means of its large vessels, ample pedicle, and ability to be grafted on either side. Furthermore, this highly vascular tissue is available in surprisingly large quantities, and its donor scar is hidden in the hair. The authors have found this flap useful (1) in covering exposed bone and tendon without adding unwanted bulk, (2) in providing thin flap coverage or lining in major facial reconstruction, (3) in covering vital structures such as exposed nerves and vessels, (4) in providing neovascularity both as a recipient graft bed and for control of chronic infection, and (5) in reestablishing gliding-tendon mechanisms. The authors have successfully employed this free flap in 15 cases which involved deformities of the ankle, foot, Achilles tendon, forearm, hand, nose, and contralateral ear and scalp. Seven cases are utilized to illustrate the broad application of this unique and versatile free flap.

Thumb and digit reconstruction: toe-to-hand microvascular composite tissue transplantation.

Methods of finger reconstruction using a free toe transplantation are described. The thumb, and in some particular cases also the index finger, can be successfully replaced by toes using microsurgical techniques for vascular and nervous anastomosis. Functional results are quite satisfactory and allow the patient to recover complete use of the hand.