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We present an algorithm for accurately controlling delays during the placement of large standard cell integrated circuits. Previous approaches to timing driven placement could not handle circuits containing 20,000 or more cells and yielded placement qualities which were well short of the state of the art. Our timing optimization algorithm has been added to(More)
The purpose of this study was to compare the sensitivity of a 20-mHz ultrasonic Doppler device to detect microvascular thrombosis placed on the vein with that placed on the artery. A feasibility study in animals preceded a comparative clinical study in patients. Six rabbits were used to develop a bilateral hind limb perfusion model. The femoral artery and(More)
Microfil injections in 8 cadavers and clinical experience with 26 patients have demonstrated a reliable blood supply to the lateral border of the scapula based on branches of the circumflex scapular artery. This tissue has been used successfully for reconstruction of a variety of defects resulting from maxillectomy and mandibular defects from cancer and(More)
A new muscle flap based on the ascending branch of the deep circumflex iliac artery is described. Twenty internal oblique muscle flaps have been dissected and studied in 10 fresh cadavers. This muscle flap has been used successfully as a free-tissue transfer in seven lower extremity defects. There was one loss of flap due to venous thrombosis. Other(More)
The 20-MHz ultrasonic Doppler probe was used to determine its efficacy as a continuous monitoring technique for microvascular anastomoses. A 1-mm2 piezoelectric crystal embedded in a soft silicone sleeve was sutured directly to the blood vessel distal to the anastomosis. Using the dog femoral artery, simultaneous measurement of velocity and blood flow with(More)
Three hundred five microsurgical free flaps have been performed for defects of the head and neck by a team of two head and neck surgeons and two plastic surgeons over a 9-year period, with a success rate of 91.2%. The most common flaps used were the jejunum (89), radial forearm (57), rectus abdominis (48), latissimus dorsi (40), scapular (32), fibula (15),(More)
BACKGROUND Effective teamwork in the operating room (OR) is often undermined by the "silo mentality" of the differing professions. Such thinking is formed early in one's professional experience and is fostered by undergraduate medical and nursing curricula lacking interprofessional education. We investigated the immediate impact of conducting(More)
A further modification of the free vascularized fibular bone graft is described in which a transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to the entry of the nutrient artery. This produces two vascularized bone struts that may be folded parallel to each other but that remain connected by the periosteum and muscle(More)
Postoperative assessment of the continued viability of a "buried" free jejunal transfer remains a difficult problem. The reliability of a 20 MHz pulsed ultrasonic Doppler probe to detect arterial or venous occlusion has been investigated experimentally in isolated vascularised jejunal segments in dogs. Clinically, the probe has been used intraoperatively to(More)