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The authors review the principles of reconstructive surgery for lower limb salvage after severe lower limb trauma to determine factors that have been used as decision-making criteria for limb salvage or amputation in severe lower extremity injuries and the methods of reconstruction and their outcome. The use of scoring systems and their value in acute decision making (primary amputation or limb salvage) are described. Soft-tissue reconstructive techniques, with emphasis on the use of flaps and the importance of selecting the best technique and time for the reconstruction are reviewed. Skeletal reconstructive techniques are described, including available options and currently held views on indications and use of the best contemporary methods. It is essential for the physician to make a good initial decision on the need for primary amputation or limb salvage. A multidisciplinary approach is fundamental to successful salvage. 相似文献
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J Barrette R Bellwied P Braun-Munzinger WE Cleland T Cormier G Dadusc G David J Dee O Dietzsch M Fatyga SV Greene JV Germani JR Hall TK Hemmick N Herrmann RW Hogue B Hong K Jayananda D Kraus BS Kumar R Lacasse D Lissauer WJ Llope TW Ludlam R Majka SK Mark JT Mitchell M Muthuswamy E O'Brien C Pruneau FS Rotondo da Silva NC J Simon-Gillo U Sonnadara J Stachel H Takai EM Takagui TG Throwe L Waters C Winter D Wolfe CL Woody N Xu Y Zhang Z Zhang C Zou 《Canadian Metallurgical Quarterly》1995,52(5):2679-2683
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DJ Benos BH Hahn JK Bubien SK Ghosh NA Mashburn MA Chaikin GM Shaw EN Benveniste 《Canadian Metallurgical Quarterly》1994,91(2):494-498
Infection by human immunodeficiency virus type 1 (HIV-1) is often complicated by a variety of neurological abnormalities. The most common clinical syndrome, termed acquired immunodeficiency syndrome (AIDS) dementia complex, presents as a subcortical dementia with cognitive, motor, and behavioral disturbances and is unique to HIV-1 infection. The pathogenesis of this syndrome is poorly understood but is believed to involve interactions among virally infected macrophages/microglia, astrocytes, and neurons. In this study, we show that exposure of primary rat and human astrocytes to heat-activated HIV-1 virions, or to eukaryotically expressed HIV-1 and HIV-2 envelope glycoproteins (gp120) stimulates amiloride-sensitive Na+/H+ antiport, potassium conductance, and glutamate efflux. These effects are blocked specifically by amiloride, an inhibitor of Na+/H+ antiport and by the selective removal of gp120 with immobilized monoclonal antibody. As a result of modulation of astrocytic function by gp120, the ensuing neuronal depolarization and glutamate exposure could activate both voltage-gated and N-methyl-D-aspartate-regulated Ca2+ channels, leading to increases in intraneuronal Ca2+ and neuronal death. These findings implicate the astrocyte directly in the pathogenesis of AIDS dementia complex. 相似文献
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The impacts of CVD tungsten polycide (WSix) on MOSFET performance and reliability are studied in this letter. The WSix process is shown to enhance the S/D lateral extent for both N- and P-channel devices via CGD and Leff measurements, confirming previous suspicion. This enhanced S/D extent is found to be easily modulated by drain-to-gate bias, which is favorable for achieving both higher drive currents and higher S/D punch-through voltages than those of non-WSix devices. Both electron and hole mobility for the WSix device are also slightly higher and closer to the published data compared to the non-WSix case. These effects together yield about >5% improvement for nMOSFET and >10% improvement for pMOSFET in drive current at a given punch-through voltage. The channel hot-electron lifetime for the n-channel WSix device is about 10 times higher than that of the non-WSix one. These enhancements in both performance and reliability make the WSix device very attractive fog VLSI CMOS technologies 相似文献