Fingertip reconstructions using partial-toe transfers

Fifty-six partial toes were transferred to reconstruct fingertip deficits. The transfers from the big toe mainly consisted of 3 trimmed big toetips, 3 vascularized nail grafts, 3 onychocutaneous flaps, 19 thin osteo-onychocutaneous flaps, and 2 hemipulp flaps. The transfers from the second toe mainly consisted of 8 trimmed second toetips, 5 reduced second toes, and 9 whole distal phalanges. The average values of postoperative sensory recovery of the osteo-onychocutaneous flaps including the vascularized nail grafts were 3.1 (Semmes-Weinstein test) and 6.3 mm (moving two-point discrimination) at 2.6 years after the transfer; those of the thin osteo-onychocutaneous flaps were 3.1 and 7.2 mm at 2.0 years after surgery; those of the trimmed big toe tip transfers were 3.61 and 6.5 mm at 1.8 years after surgery; and those of the trimmed second toetip transfers were 3.37 and 6.3 mm at 2.6 years after transfer. Those of the distal phalanx of the second toe were 3.41 and 7.9 mm at 1.2 years after surgery, and those of the reduced second toe were 3.2 and 6.7 mm at 10.6 months after surgery.     

Replantation of fingertip amputation by using the pocket principle in adults

There are several treatment modalities for zone 1 or zone 2 fingertip amputations that cannot be replanted by using microsurgical techniques, such as delayed secondary healing, stump revision, skin graft, local flaps, distant flaps, and composite graft. Among these, composite graft of the amputated digit tip is the only possible means of achieving a full-length digit with a normal nail complex. The pocket principle can provide an extra blood supply for survival of the composite graft of the amputated finger by enlarging the area of vascular contact. The surgery was performed in two stages. The amputated digit was debrided, deepithelialized, and reattached to the proximal stump. The reattached finger was inserted into the abdominal pocket. About 3 weeks later, the finger was removed from the pocket and covered with a skin graft. We have consecutively replanted 29 fingers in 25 adult patients with fingertip amputations by using the pocket principle. All were complete amputations with crushing or avulsion injuries. Average age was 33.64 years, and men were predominant. The right hand, the dominant one, was more frequently injured, with the middle finger being the most commonly injured. Of the 29 fingers, 16 (55.2 percent) survived completely and 10 (34.5 percent) had partial necrosis less than one-quarter of the length of the amputated part. The results of the above 26 fingers were satisfactory from both functional and cosmetic aspects. Twenty of the 29 fingers, which had been followed up for more than 6 months (an average of 16 months), were included in a sensory evaluation. Fifteen of these 20 fingers (75 percent) were classified as "good" (static two-point discrimination of less than 8 mm and normal use). From the overall results and our experience, we suggest that the pocket principle is a safe and valuable method in replantation of zone 1 or zone 2 fingertip amputation, an alternative to microvascular replantation, even in adults.     

Calculating genetic risk figures using a programmable pocket calculator

Summary In autosomal irregular dominant as well as in sex-linked recessive inheritance, heterozygosity probabilities for up to six or eight pedigree members with unknown genotype can easily be calculated using a programmable pocket calculator. The application of the underlying combinatorial programs is explained by means of two relevant examples. Genetic counsellors without a computer at hand are provided with a simple and accurate method for calculating genetic risk figures taking into account pedigree data, incidence and/or mutation rate, reproductive fitness, as well as penetrance or results of heterozygosity tests of the disease in question.     

Elastic and viscoelastic properties of porcine subdermal fat using MRI and inverse FEA

There is a scarcity of investigation into the mechanical properties of subdermal fat. Recently, progress has been made in the determination of subdermal stress and strain distributions. This requires accurate constitutive modelling and consideration of the subdermal tissues. This paper reports the results of a study to estimate non-linear elastic and viscoelastic properties of porcine subdermal fat using a simple constitutive model. High-resolution magnetic resonance imaging (MRI) was used to acquire a time series of coincident images during a confined indentation experiment. Inverse finite element analysis was used to estimate the material parameters. The Neo Hookean model was used to represent the elastic behaviour (μ = 0.53 ± 0.31 kPa), while a single-element Prony series was used to model the viscoelastic response (α = 0.39 ± 0.03, τ = 700 ± 255 s).     

Estimating species richness using the jackknife procedure

An exact expression is given for the jackknife estimate of the number of species in a community and for the variance of this number when quadrat sampling procedures are used. The jackknife estimate is a function of the number of species that occur in one and only one quadrat. The variance of the number of species can be constructed, as can approximate two-sided confidence intervals. The behavior of the jackknife estimate, as affected by quadrat size, sample size and sampling area, is investigated by simulation.     

An evaluation of fMLP pocket dimensions and features using formyltetrapeptides.

The formyltetrapeptides for-Met-Leu-Leu-Phe-OMe 1, for-Met-Leu-Aib-Phe-OMe 2, for-Met-Leu-Ac6c-Phe-OMe 3, for-Met-Leu-Pro-Phe-OMe 4, for-Met-Pro-Pro-Phe-OMe 5, for-Met-Aib-Aib-Phe-OMe 6, for-Met-Pro-Aib-Phe-OMe 7 and for-Met-Aib-Pro-Phe-OMe 8 were synthesized and biologically tested on human neutrophils in an attempt to evaluate the specific receptor pocket dimensions and features. Our results indicate that the shift in the Phe residue to the fourth position in these compounds strongly reduces chemotactic response, but is efficacious in triggering superoxide anion production and lysozyme release (order of potency 3 > 2 > 1 > 4 > 6 > 8 > 5 > 7). The potency of the two latter responses correlates well with the affinity data obtained in binding experiments.     

MANOVA multiple comparisons using the generalized step-down procedure

If the variables in MANOVA problem can be arranged according to the order of their importance, then J. ROY'S (1958) step-down procedure may be more appropriate than the conventional invariant inference techniques. However, it may often be possible only to identify subsets such that variables within subsets are equally important and subsets are of unequal importance. In experimental situations, it is common to have a set of variables of primary interest and another of “addon” variables. The step-down reasoning is extended to such cases and a set of simultaneous confidence bounds based upon the procedure which uses the largest root criterion at each stage are derived. The confidence bounds are on all linear functions of means only that do not involve nuisance parameters, and are therefore suitable for studying the configuration of means. This method yields shorter intervals for contrasts among the means of the variables of primary interest compared with the conventional intervals based upon the largest root. The method is illustrated using BARNARD'S data (1935) on skull characters.     

Microsurgical replantation of the amputated nose

A case of successful replantation of the nose is presented. Two arteries and one vein were anastomosed, providing a stable framework for direct revascularization of the amputated nasal segment. This resulted in complete survival of the nose, with an excellent aesthetic result. However, despite successful microsurgical arterial and venous repair, significant postoperative blood loss still occurred as a result of anticoagulation. In cases of the amputation of specialized structures, the improved functional and cosmetic result obtained with replantation must be weighed against the risk of blood-borne disease transmission when postoperative transfusion is required. Recognizing the potential need for postoperative transfusion in these cases is important in allowing the surgeon to exercise appropriate judgment in deciding whether replantation should be performed.     

Mapping quantitative trait loci using the MCMC procedure in SAS

The MCMC procedure in SAS (called PROC MCMC) is particularly designed for Bayesian analysis using the Markov chain Monte Carlo (MCMC) algorithm. The program is sufficiently general to handle very complicated statistical models and arbitrary prior distributions. This study introduces the SAS/MCMC procedure and demonstrates the application of the program to quantitative trait locus (QTL) mapping. A real life QTL mapping experiment in wheat female fertility trait was used as an example for the demonstration. The fertility trait phenotypes were described under three different models: (1) the Poisson model, (2) the Bernoulli model and (3) the zero-truncated Poisson model. One QTL was identified on the second chromosome. This QTL appears to control the switch of seed-producing ability of female plants but does not affect the number of seeds produced once the switch is turned on.