The Vascular Basis of the Pronator Quadratus Muscle Flap and Its Use in Clinical Cases.

Background Pronator quadratus (PQ) is a deeply situated muscle in the forearm which may occasionally be utilized for soft-tissue reconstruction. The purpose of this anatomical and clinical study was to confirm vascular supply of PQ muscle (PQM) in order to optimize its transfer and confirm its utility in clinical situations. Methods In Part A of the anatomical study, fresh human cadavers ( n = 7) were prepared with an intra-arterial injection of lead oxide and gelatin solution, and PQM and neurovascular pedicle were dissected ( n = 14). In the anatomical study Part B, isolated limbs of embalmed human cadavers ( n = 12) were injected with India ink-gelatin mixture and PQ were dissected. Results PQ is a type II muscle flap, with one major pedicle, the anterior interosseous (AI) vessels and two minor pedicles from the radial and ulnar vessels. The mean dimensions of the muscle were 5.5 × 5.0 × 1.0 cm 3 , mean pedicle length was 9.6 cm, and the mean diameter of the artery and the vein was 2.3 mm and 2.8 mm, respectively. The dorsal cutaneous perforating branch (DPB) of the artery supplied the skin over the dorsal forearm and wrist. This branch also anastomosed with the 1, 2 intercompartmental supraretinacular artery (ICSRA). Conclusion This study confirms the potential utility and vascular basis of the PQM flap and its associated cutaneous paddle. In the clinical part, two patients with nonhealing wounds exposing the median nerve and flexor tendons in the distal forearm were treated using the PQM flap with good results.

Three-Dimensional Vascular Anatomical Study of the Tensor Fasciae Latae Muscle and Perforators.

BACKGROUND: To harvest any flap on the lateral circumflex femoral artery (LCFA) including tensor fasciae latae (TFL) muscle, a precise description of the vascular anatomy is required. There have been conflicting reports of the vascular supply of TFL and its overlying skin. The objective of this study was to evaluate the anatomy of the TFL muscle according to the location, origin, type, caliber, and length of vessels that supply the muscle. METHODS: This study was performed on human cadavers (n = 16 thighs) that were injected with a mixture of lead oxide and gelatin through the femoral artery. Whole body computed tomography scans were performed. Three-dimensional images of the arterial anatomy were created using Materialise Interactive Medical Image Control Software (MIMICS). Anatomical dissection of all cadaver thighs was performed to visualize the arterial blood supply of the muscle and its regional perforators. RESULTS: Sixteen thighs were included in the study. The main arterial supply of the TFL muscle was in all cases, the ascending branch of the LCFA (LCFA-asc) artery. The mean external diameter of the LCFA-asc artery was 2.7 mm ± 0.4 and the mean length was 3.6 cm ± 0.6. The distance from the anterior superior iliac spine to point where the vascular pedicle reaches the muscle ranged from 6.7 to 10.2 cm. The average number of cutaneous perforators was 10.9 ± 4. There were musculocutaneous perforators in all of our dissections (n = 16) and 14 of our specimens had septocutaneous perforators. CONCLUSION: The main vascular supply to the TFL muscle is the ascending branch of the LCFA, which also gives rise to septocutaneous and musculocutaneous perforators. MIMICS provides excellent three-dimensional anatomical information about the vascular supply of the TFL.

Computed Tomographic Angiography Used for Localization of the Cutaneous Perforators and Selection of Anterolateral Thigh Flap "Bail-Out" Branches.

BACKGROUND: The purpose of this study was to evaluate the territory supplied by the lateral circumflex femoral artery for the consistency of a proximal perforator that could be used as an alternative pedicle for the anterolateral thigh flap if a tedious intramuscular course is encountered during elevation of the perforator used to develop the initial surgical plan. It is hypothesized that a consistent "bail-out" perforator supplying the proximal thigh would facilitate a simpler anterolateral thigh flap harvest, with minimal modification to flap design. METHODS: Computed tomographic images of 9 fresh cadavers were imported using Materialize's Interactive Medical Imaging Control System software to create surface-rendered 3-dimensional reconstructions of 15 lower limbs. Perforators emerging proximally and laterally to a 3-cm radius circle drawn at the midpoint of the anterior superior iliac spine and superolateral patella were considered potential bail-out perforators and evaluated for their number emerging diameter, length, course, and location relative to the anterior superior iliac spine. RESULTS: An average of 2.9 ± 1.8 perforators per limb were identified. Mean pedicle length was 111 ± 20 mm, measured from the origin in the lateral circumflex femoral artery to where the perforators emerged through the deep fascia directly overlying the thigh muscles. Average diameter at origin in the lateral circumflex femoral artery was 2.8 ± 0.8 mm, and that at emergence through the deep fascia was 1.1 ± 0.3 mm. Vessel course was predominantly musculocutaneous (90%). CONCLUSIONS: A significant bail-out perforator routinely supplies the proximal anterolateral thigh and may be used as an alternative vascular pedicle for an anterolateral thigh flap if a tedious intramuscular course is encountered during elevation of a perforator identified within the conventional landmarks (3-cm radius circle at the midpoint of the anterior superior iliac spine and superolateral patella).

The Lumbar Artery Perforator Flap: 3-Dimensional Anatomical Study and Clinical Applications.

BACKGROUND: The lumbar region is a potential donor site for perforator-based rotational or free flaps or as a recipient site for free flaps to obtain coverage for deficits in the sacral region. Because of the lack of consensus regarding the microvascular anatomy of this potential flap site, a robust investigation of the anatomy of this region is required. METHODS: Three-dimensional reconstructions (n = 6) of the microvasculature of the lumbar region were generated using MIMICS software (Materialise, Belgium) for each of the four paired lumbar vessels. Diameter, course, and pedicle length were recorded for all lumbar artery (LA) perforators. Statistical analysis was performed using SigmaStat 4.0 and graphs were generated using GraphPad Prism 6 Software. RESULTS: Perforators arising from the first pair of LAs are reliably detected along the inferior margin of the 12th rib, extending inferiorly and laterally from the midline while perforators arising from the fourth pair of LA perforate the fascia along a horizontal plane connecting the posterior iliac crests. There are significantly more cutaneous perforators arising from the first (L1) and fourth (L4) pairs of LA than from the second (L2) and third (L3) (mean ± SD: L1, 5.5 ± 1.2; L2, 1.4 ± 0.7; L3, 1.3 ± 0.7; L4, 4.8 ± 1.0; P < 0.05). The average perforator diameter arising from L1 is greater than those arising from L4 (diameter ± SD: L1, 1.2 mm ± 0.2 >L4, 0.8 mm ± 0.2; P < 0.0001). L1 and L4 perforators have longer pedicle lengths than those arising from L2 and L3 (length ± SD: L1, 98.2 mm ± 57.8; L4, 106.1 mm ± 23.3 >L2, 67.5 mm ± 27.4; L3, 78.5 mm ± 30.3; P < 0.05). CONCLUSIONS: Perforators arising from the first and fourth LAs arise in a predictable fashion, have adequate pedicle lengths, and are of suitable diameter to support a perforator flap. We present a case to support the potential use of this flap for microvascular breast reconstruction.

Anatomical Study of the Princeps Pollicis Artery Perforator Flap.

BACKGROUND: The volar aspect of the thumb often requires local flaps for reconstruction. This study characterizes perforators of the princeps pollicis artery (PPA) and evaluates the potential of a local propeller-type flap raised using these perforators for reconstruction of these defects. METHODS: Cadavers underwent whole-body lead-oxide injection and were then imaged using a 64-slice spiral computed tomographic scanner. The DICOM images were imported into Materialise's Interactive Medical Imaging Control System (Materialise, Belgium) for 3-dimensional reconstruction of the microvasculature. The number, length, caliber, and location of perforators arising from the PPA were determined and a plot was generated illustrating the relative distribution of perforators. RESULTS: A total of 16 PPA perforators were identified in the 8 specimen hands. Perforators had a mean (SD) diameter of 1.2 (0.4) mm and mean (SD) length of 8.9 (4.8) mm. The PPA perforators were consistently identified along the radial aspect of the thenar region. Seventy percent of all PPA perforators can be found over the distal 50% of the MC [20%-54%; mean (1SD)]. CONCLUSIONS: Perforators of the PPA were found in all hands and the average caliber and length of the perforators identified is sufficient for the creation of a local perforator flap. This, coupled with the mean location of these perforators, arising near the base of the thumb, confirms that a cutaneous flap from the thenar region can be raised based on this perforator as a propeller flap to obtain coverage of distal cutaneous defects of the thumb.

Reverse Radial Artery Flap Perforator Anatomy and Clinical Applications.

The pedicled reverse radial forearm flap is a well-known option for the treatment of a variety of soft tissue wounds including dorsal hand wounds. We document the number, emerging diameter, length from origin, course, and location of all perforators of the radial artery in a series of 6 fresh human cadavers after whole body lead oxide and gelatin injection to confirm and comprehensively document the anatomy of the radial artery perforators. This data provide an anatomic basis for a modification to the reversed radial forearm flap used to decrease venous congestion in the postoperative period. Two case reports are presented to provide clinical demonstration of the importance of this modification.

Confirmatory factor analysis of the Michigan Hand Questionnaire.

BACKGROUND: When the Michigan Hand Questionnaire (MHQ) was originally developed, an exploratory factor analysis (EFA) was used to reduce the originally large number of generated items to the 63 items currently present on the questionnaire. Confirmation of the implied factor model of the existing MHQ has never been performed. The objective of this study was to confirm the factor model used to create the existing MHQ, and to possibly shorten the existing MHQ using factor analysis. METHODS: Patients attending the Plastic Surgery Clinic at the QEII Health Sciences Centre with a hand complaint were asked to complete the MHQ. Confirmatory factor analysis was performed to explore the implied factor structure of the original EFA and to examine the interplay between the MHQ subscales. Further item-reduction was performed using clinically guided decisions as well as factor analysis-guided statistics. RESULTS: Initial confirmatory factor analysis showed that original EFA model does not optimally explain the relationships between items in the existing MHQ and their corresponding factors. Our abbreviated model of the MHQ consists of 23 items, and performed more favorably in all goodness-of-fit parameters than the original 63-item questionnaire. CONCLUSIONS: The factor model of the existing MHQ does not fully take advantage of the relationship between items in the MHQ and the proposed factors. This study proposes a shortened version of the MHQ that more accurately reflects hand health as well as a factor-based interpretation of the subscales that takes interdependent relationships into account.

Reliability and internal validity of the michigan hand questionnaire.

BACKGROUND: The Michigan Hand Outcomes Questionnaire (MHQ) remains one of very few to be based on validated and systematic methods in its creation. However, test-retest reliability and internal validity have not been appropriately investigated in any other English-speaking population outside the original development sample. The objective of this study is to examine the reliability and internal validity of the MHQ in a Canadian population. METHODS: All patients with a clinical hand problem but no hand immobilization who attended our Plastic Surgery Clinic were invited to participate in this study. Patients were asked to complete the MHQ, and then contacted to arrange for completion of the MHQ a second time. Internal validity was estimated using Cronbach alpha. Reliability was estimated using the method of Bland and Altman, and intraclass correlation coefficients. Correlation analysis between score differences and time between tests was performed. RESULTS: Full versions of the MHQ were completed by 116 participants on their initial visit, while only 77 participants completed a second MHQ. Cronbach alpha ranged from 0.84 to 0.95 for the MHQ subscales. Intraclass-correlation coefficients ranged from 0.71 to 0.84 for the subscales. The magnitude of the limits of agreement for the subscales ranged from 13.8 to 26.2. The difference in scores between the first and second tests was not related to the time between tests. CONCLUSION: The high values of Cronbach alpha indicate high internal validity, but that there may be redundancy between items in the MHQ, which could be eliminated without losing information. Reliability of the MHQ is considered moderate. The limits of agreement are considered wide, indicating potential issues with respect to interpretation of a change in score between 2 administrations of the MHQ.

The use of retrograde limb of internal mammary vein in autologous breast reconstruction with DIEAP flap: anatomical and clinical study.

BACKGROUND: It has been postulated that the abdominal skin may have either predominantly deep or superficial venous drainage. This may account for complications arising from autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEAP) flap. In this study, we evaluate the use of the retrograde limb of the internal mammary vein (IMV) as a second recipient vein in reconstructions with the DIEAP flap. METHODS: In Part A, 10 IMVs were harvested from 5 fresh cadavers and the flow of methylene blue through the retrograde limb and the presence of valves were evaluated under a stereoscopic microscope.In Part B, the clinical outcomes of 38 patients who underwent single or bilateral autologous breast reconstruction using the DIEAP flap technique between January 2007 and March 2011 were reviewed. A total of 48 flaps were evaluated: 31 with single vein anastomosis and 17 with 2-vein anastomosis. RESULTS: In Part A, no valves were identified in the IMVs. In all 10 cadaver IMVs, there was free flow of methylene blue in both antegrade (superior) and retrograde (inferior) directions.In Part B, a retrospective analysis of the 2 patient outcomes was performed. Outcomes assessed included total flap loss, partial flap necrosis, fat necrosis, wound infection, wound dehiscence, and hematoma. Results were compared using a 2-tailed Fisher exact test with a critical P value of 0.05. No statistically significant differences between groups were identified. CONCLUSIONS: The retrograde limb of the IMV seems to be a safe alternate recipient vein in DIEAP and muscle sparing free TRAM autologous breast reconstruction. This study does not identify a significant reduction in overall fat necrosis or overall complications when using the 2 venous repair techniques versus the simple venous repair technique.

Propeller DICAP flap for a large defect on the back-case report and review of the literature.

Reconstruction of large soft tissue defects of the back is a challenging problem. Large defects of the back were reconstructed with multiple random pattern or local pedicled muscle (and skin graft) or musculocutaneous flaps. The clinical use of perforator flaps has demonstrated that harvesting of flaps on a single perforator is possible for reconstruction of large defects. We present a 71-year-old male with a lesion on his left mid back that measured 10 × 10 × 4 cm(3) . Biopsy of the lesion was consistent with dermatofibrosarcoma protruberans. Wide local excision of the lesion with 4 cm margin was performed. The soft tissue defect, ~20 cm in diameter, was reconstructed with a large propeller dorsal intercostal artery perforator (DICAP) flap. The DICAP flap measured 40 × 15 cm(2) based on a single perforator-lateral branch of dorsal rami of the seventh posterior intercostal artery on the right side. The perforator flap was elevated at the subfascial level and transposed 180° into the defect. The donor site on the right side of the back was closed directly. This case illustrates the size of the propeller DICAP flap that could be safely harvested on a single perforator from the dorsal rami of the posterior intercostal artery. To our knowledge this is the largest reported pedicled perforator flap harvested on a single perforator on the posterior trunk.

Dr Patricia Clugston-A Spirit of Determination.

Dr Patricia Clugston was a British Columbia native who completed her plastic surgery residency training in Vancouver in 1993 before pursuing a fellowship in Nashville with Dr Patrick Maxwell in 1994. When Dr Clugston returned to Vancouver, she helped to establish a comprehensive and renowned breast reconstruction program. She spent her career advocating for and working towards better treatment options for women seeking breast reconstruction. As a determined surgeon and accomplished athlete, Dr Clugston was truly a tour de force in all aspects of her life. Patty, as she was affectionately known by her colleagues, loved her job. Dr Clugston was an avid advocate for medical education and an outstanding clinical researcher and speaker that established her as a shining star in Canadian plastic surgery. Patty had always lived life to the fullest and was determined that scleroderma would not change this. Her sharp wit, intellectual curiosity, and pragmatism masked an incredible courage as she fought bravely against a cruel disease. Dr Clugston died on March 1, 2005, at the age of 46 surrounded by the loving company of her husband, friends, and family at the Vancouver General Hospital. The Dr Patricia Clugston Chair in Breast Reconstruction was established in her name to honour her legacy and continue to improve the care of patients with breast cancer.

Originaire de la Colombie-Britannique, la docteure Patricia Clugston a terminé sa résidence en plasturgie à Vancouver en 1993 avant d'effectuer des études postdoctorales à Nashville avec le docteur Patrick Maxwell en 1994. À son retour à Vancouver, elle a contribué à mettre sur pied un programme de reconstruction mammaire complet et réputé. Elle a consacré sa carrière à préconiser et à rechercher de meilleures possibilités thérapeutiques pour les femmes qui veulent une reconstruction mammaire. Chirurgienne déterminée et athlète accomplie, elle dominait dans tous les aspects de sa vie. Patty, comme l'appelaient affectueusement ses collègues, adorait son travail. Cette défenseure passionnée de l'enseignement de la médecine était une chercheuse clinicienne et une conférencière remarquable, ce qui l'a établie comme une tête d'affiche de la plasturgie au Canada. Elle a toujours vécu sa vie au maximum et était déterminée à ne pas laisser la sclérodermie y changer quelque chose. Sa vivacité d'esprit, sa curiosité intellectuelle et son pragmatisme cachaient un courage incroyable, car elle luttait contre une maladie cruelle. Elle est décédée le 1er mars 2005 au Vancouver General Hospital à l'âge de 46 ans, entourée de l'amour de son mari, de ses amis et de sa famille. La chaire Dre Patricia Clugston en reconstruction mammaire a été créée en son nom pour commémorer sa mémoire et continuer d'améliorer les soins aux patientes atteintes du cancer du sein.

Role of activated protein C and its receptor in inhibition of tumor metastasis.

Engagement of endothelial protein C receptor (EPCR) by activated protein C (aPC) decreases expression of endothelial adhesion molecules implicated in tumor-endothelium interactions. We examined the role of the aPC/EPCR pathway on tumor migration and metastasis. In vitro, B16-F10 melanoma cells showed decreased adhesion to and transmigration through endothelium treated with recombinant human aPC (rhaPC). In murine B16-F10 metastasis models, transgenic EPCR overexpressing (Tie2-EPCR) mice exhibited marked reductions in liver (50%) and lung (92%) metastases compared with wild-type (WT) animals. Intravital imaging showed reduced B16-F10 entrapment within livers of Tie2-EPCR compared with WT mice. A similar reduction was observed in WT mice treated with rhaPC. Strikingly, rhaPC treatment resulted in a 44% reduction in lung metastases. This was associated with decreased lung P-selectin and TNF-alpha mRNA levels. These findings support an important role for the aPC/EPCR pathway in reducing metastasis via inhibition of tumor cell adhesion and transmigration.

Medial plantar artery perforator flap for soft-tissue reconstruction of the heel.

Soft-tissue wounds of the foot and especially the heel are challenging problems for reconstructive surgeons. An important principle that guides heel reconstruction is to provide sensate skin with a similar thickness to resurface the weight-bearing heel and avoid late flap ulceration. Among various techniques to achieve this result, the sensate medial plantar perforator flap is an excellent option, which provides durability to friction, a cushioning effect, and sensation. An anatomic study was performed to clarify the anatomy of the cutaneous perforators of the medial plantar artery and to determine the optimal method of medial plantar artery perforator flap harvest. Fifteen cases of heel reconstruction with the sensate medial plantar perforator flap are presented. The outcome of surgery at a mean follow-up of 12 months is reported. The indications for surgery, operative procedures, advantages and disadvantages, and results are presented. Satisfactory results were obtained with a good color and texture match for heel repair and a good sensory recovery. No functional deficit was found at the donor site.

An unusual case of turban tumor syndrome treated with total scalp excision and advancement flap and skin graft reconstruction.

We report an unusual case of aggressive turban tumor syndrome in a 38-year-old woman with nodules covering her scalp and involving her face, neck, chest, and back. To address concerns regarding hygiene of the scalp and cosmetic disfigurement, she underwent total scalp excision with advancement flap and skin graft reconstruction. Histologic examination of the scalp tumors revealed a predominance of spiradenomas, along with cylindromas and trichoepitheliomas, and tumors containing elements of all 3 of these adnexal neoplasms. We review the literature regarding turban tumor syndrome including the genetic basis for this condition, clinical features, pathology, and treatment.

Fast Organic Vapor Phase Deposition of Thin Films in Light-Emitting Diodes.

Fast deposition of thin films is essential for achieving low-cost, high-throughput phosphorescent organic light-emitting diode (PHOLED) production. In this work, we demonstrate rapid and uniform growth of semiconductor thin films by organic vapor phase deposition (OVPD). A green PHOLED comprising an emission layer (EML) grown at 50 Å/s with bis[2-(2-pyridinyl-N)phenyl-C](acetylacetonato)iridium(III) (Ir(ppy)2(acac)) doped into 4,4'-bis(N-carbazolyl)-1,1'-biphenyl (CBP) exhibits a maximum external quantum efficiency of 20 ± 1%. The morphology, charge transport properties, and radiative efficiency under optical and electrical excitation of the PHOLED EML are investigated as functions of the deposition rate via both experimental and theoretical approaches. The EML shows no evidence for gas phase nucleation of the organic molecules at deposition rates as high as 50 Å/s. However, the roll-off in quantum efficiency at high current progressively increases with deposition rate due to enhanced triplet-polaron annihilation. The roll-off results from accumulation of stress within the PHOLED EML that generates a high density of defect states. The defects, in turn, act as recombination sites for triplets and hole polarons, leading to enhanced triplet-polaron annihilation at high current. We introduce a void nucleation model to describe the film morphology evolution that is observed using electron microscopy.

Impact of arteriogenesis in plastic surgery: choke vessel growth proceeds via arteriogenic mechanisms in the rat dorsal island skin flap.

OBJECTIVE: We examined the molecular mediators of postoperative choke-vessel growth. Our focus was the possible overlap between choke-vessel growth and arteriogenesis. METHODS: A rat perforator flap model, encompassing four vascular territories, was used. Flaps were surgically elevated, re-inset, and allowed to survive for one, three, five, or seven days. Tissue samples for Western and histological analyses were collected from the choke zone along the dorsal midline. Tissue from territories linked by the choke zone was analyzed to distinguish between global and local effects. The proteins examined included CD11b, ICAM-1, and MMP-2, three markers associated with arteriogenesis, as well as Hsp70 and vascular endothelial growth factor, markers of physiological stress and hypoxia/ischemia. RESULTS: Arteriogenesis markers, as shown by Western analysis, increased at three and five days after flap elevation, and the increase was localized by immunohistochemistry to the growing arteries and veins. The marker of physiological stress increased at Days 5 and 7. The hypoxia-ischemia marker did not increase in the choke zone. CONCLUSIONS: The growth of choke arteries and veins proceeds in an inflammatory environment that resembles arteriogenesis. Ischemia did not appear to play a role in choke-vessel changes.

Tissue-engineered blood vessel graft produced by self-derived cells and allogenic acellular matrix: a functional performance and histologic study.

INTRODUCTION: Current prosthetic alternatives to autologous vascular grafts remain poor in terms of patency. Growing biologic blood vessels has been proposed as an alternative. In this work, the authors demonstrate a method for producing a tissue-engineered vascular graft (TEVG) with self-derived endothelial cells, smooth muscle cells, and allogenic acellular matrix in vitro. The aim of this study was to find out if the graft is suitable as the carotid artery substitute. METHODS: A canine model was developed for this study. Endothelial and smooth muscle cells were used as seeding cells, and allogenic acellular matrix was used as scaffold to produce the TEVG. Endothelial and smooth muscle cells from the saphenous vein were harvested by trypsin and collagenase digestion respectively. These isolated cells were cultured and expanded by routine cell culture technique. The common carotid artery was harvested from other fresh dog cadavers and processed by a multistep decellularizing technique to remove original cells and preserve elastic and collagen fibers. Then, the inner surface of the acellular matrix as a scaffold was sequentially seeded with cells. Smooth muscle cells were seeded onto the scaffold. It was placed in bioreactors filled Dulbecco modified Eagle medium supplemented with growth factors. After 4 weeks, the vessels were harvested from the bioreactors and seeded with endothelial cells at the lumen for 7 days. Finally, the cell-seeded graft was transplanted to the cell-donated dog to substitute part of the native common carotid artery (2 cm in length). All animals were followed up for 6 months. Twenty-four dogs were divided into 3 groups randomly: group A (native artery graft), group B (allogenic acellular matrix graft only), and group C (acellular allogenic matrix coated with endothelial and smooth muscle cells). These grafts were subjected to regular echocardiography at 1, 3, and 6 months postoperatively. Then, the TEVG were harvested for histologic evaluation at 6 months after transplantation. The vascular luminal surfaces were observed by electronic scanning microscopy. RESULTS: The TEVG showed good functional performance demonstrated by regular Doppler ultrasonography at 1, 3, and 6 months postoperatively, compared with that of native arteries. All vascular grafts in group A and C provided patent rates of 100%; however, the patency rate of group B was 50% at 3 and 6 months postoperatively. The TEVG had a similar macroscopic appearance to that of native vessels. Histologic and immunohistochemical analyses indicated the presence of high cell density and development of a highly organized structure of ECM. CONCLUSION: Cultured self-derived endothelial and smooth muscle cells could be used as seeding cells and allogenic acellularized matrix could be used as scaffold in producing the TEVG. The TEVG had histologic and functional properties consistent with native arteries.

Refinement and extension of AOAC Method 2005.06 to include additional toxins in mussels: single-laboratory validation.

A single-laboratory validation study was undertaken for the analysis of paralytic shellfish poisoning (PSP) toxins in common mussels, extending AOAC Official Method 2005.06 to include the additional toxins dcNEO and dcGTX2,3. The method was refined to improve toxin oxidation product stability, analytical sensitivity of N-hydroxylated toxins, and throughput. Validation was performed to characterize the method for selectivity, sensitivity, linearity, precision, repeatability, recovery, ruggedness, and uncertainty. Parallel testing of naturally contaminated mussels enabled comparison of sample toxicities obtained using mouse bioassay (MBA) and high-performance liquid chromatographic (HPLC) methodologies. Performance characteristics of the method are reported for all commercially available certified reference toxins. Results from the MBA and HPLC methods were well correlated, and the analytical method has been instigated as the sole monitoring tool for UK official control surveillance of PSP toxins in common mussels.

Dr Henry Shimizu: The Journey of a Canadian Plastic Surgeon, Advocate, and Artist.

Dr Henry Shimizu was a dedicated Canadian plastic surgeon with Japanese roots who spent his career practicing in Edmonton at the University of Alberta Hospital. He relished the opportunity to share his expertise by training residents and medical students. Dr Shimizu completed his plastic surgery training in the United States and was central to establishing the plastic surgery training program in Edmonton. Beyond clinical practice, Dr Shimizu was a prominent advocate in his community, serving as the Chairman of the Redress committee for Japanese internment. As a talented painter, he had produced magnificent oil paintings based on childhood recollections as an internee in the Slocan Valley. Dr Shimizu has made significant contributions to Canadian plastic surgery serving as president of the Canadian Society of Plastic Surgeons in 1978. His clinic work and dedication to the community at large were recognized with the Order of Canada in 2004 and more recently an honorary degree from the University of Victoria. Dr Shimizu continues to golf, paint, and travel in his retirement. He is happily married to his wife Joan and is the proud father of 4 children and 6 grandchildren.

Le docteur Henry Shimizu, un plasticien canadien dévoué d'origine japonaise, a exercé pendant toute sa carrière à l'University of Alberta Hospital d'Edmonton. Il adorait partager ses compétences par l'enseignement aux résidents et aux étudiants en médecine. Il a terminé sa formation en chirurgie plastique aux États-Unis et a joué un rôle essentiel dans la création du programme de chirurgie plastique à Edmonton. Au-delà de la pratique clinique, le docteur Shimizu était un militant réputé dans sa communauté : il a présidé le comité de redressement pour l'internement des Japonais. Peintre talentueux, il a produit de magnifiques peintures à l'huile sur ses souvenirs d'enfance alors qu'il était interné dans la vallée de Slocan. Le docteur Shimizu a contribué largement à la chirurgie plastique au Canada et a présidé la Société canadienne des chirurgiens plasticiens en 1978. Il a été nommé membre de l'Ordre du Canada en 2004 pour son travail clinique et son dévouement envers l'ensemble de la communauté, et plus récemment, a reçu un doctorat honorifique de l'université de Victoria. Maintenant à la retraite, le docteur Shimizu continue de jouer au golf, de peindre et de voyager. Il vit un mariage heureux avec sa femme, Joan, et est le fier père de quatre enfants et de six petits-enfants.