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Sample records for capital femoral epiphysis

  1. Slipped capital femoral epiphysis in down syndrome.

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    Dietz, Frederick R; Albanese, Stephen A; Katz, Danielle A; Dobbs, Matthew B; Salamon, Peter B; Schoenecker, Perry L; Sussman, Michael D

    2004-01-01

    Slipped capital femoral epiphysis (SCFE) and Down syndrome are both uncommon in the population at large, and rarely are both conditions present in a single individual. Institutional records were searched for both Down syndrome and SCFE. At least 2 years of follow-up was required. Eight patients were identified. At presentation four patients could not walk due to pain and four could walk. Six of eight hips presented with grade III SCFE. Four hips were treated with internal fixation in situ and four were manipulatively reduced in the operating room at the time of fixation with percutaneous screws or pins. Three hips healed uneventfully. Five hips developed aseptic necrosis (three partial, two whole head). This small retrospective study suggests an extremely high rate of complications in adolescents with Down syndrome and SCFE.

  2. Eosinophilic granuloma of the capital femoral epiphysis.

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    Goto, Takahiro; Nemoto, Tetsuo; Ogura, Koichi; Imanishi, Jungo; Hozumi, Takahiro; Funata, Nobuaki

    2011-05-01

    Eosinophilic granuloma occurs almost exclusively in the diaphysis or metaphysis, when tubular bones are affected. The investigators present an extremely rare case of eosinophilic granuloma arising at the epiphysis of the femoral head in an 8-year-old boy. Plain radiographs and computed tomography showed a well-circumscribed radiolucent lesion, suggesting chondroblastoma or Brodie's abscess. However, the findings on magnetic resonance images were different from typical features of chondroblastoma or Brodie's abscess. The lesion was curetted. Histological diagnosis was eosinophilic granuloma. Differential diagnoses of a radiolucent lesion at the epiphysis in a child should include, though quite rare, eosinophilic granuloma.

  3. Gait abnormalities following slipped capital femoral epiphysis.

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    Song, Kit M; Halliday, Suzanne; Reilly, Chris; Keezel, William

    2004-01-01

    The authors evaluated 30 subjects with treated unilateral slipped capital femoral epiphysis and a range of severity from mild to severe to characterize gait and strength abnormalities using instrumented three-dimensional gait analysis and isokinetic muscle testing. For slip angles less than 30 degrees, kinematic, kinetic, and strength variables were not significantly different from age- and weight-matched controls. For moderate to severe slips, as slip angle increased, passive hip flexion, hip abduction, and internal rotation in the flexed and extended positions decreased significantly. Persistent pelvic obliquity, medial lateral trunk sway, and trunk obliquity in stance increased, as did extension, adduction, and external rotation during gait. Gait velocity and step length decreased with increased amount of time spent in double limb stance. Hip abductor moment, hip extension moment, knee flexion moment, and ankle dorsiflexion moment were all decreased on the involved side. Hip and knee strength also decreased with increasing slip severity. All of these changes were present on the affected and to a lesser degree the unaffected side. Body center of mass translation or pelvic obliquity in mid-stance greater than one standard deviation above normal correlated well with the impression of compensated or uncompensated Trendelenburg gait.

  4. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

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    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  5. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

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    Yoshihiro Kotoura

    2017-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1; however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.

  6. Slipped capital femoral epiphysis caused by neurogenic heterotopic ossification.

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    Chang, Sam Yeol; Yoo, Won Joon; Park, Moon Seok; Chung, Chin Youb; Choi, In Ho; Cho, Tae-Joon

    2013-11-01

    Slipped capital femoral epiphysis (SCFE) is rare in nonambulatory patients, as mechanical factors play important roles in the development of the disease. We report a case of SCFE, which occurred in a 12-year-old girl with a nonambulatory status after cerebral infarction. SCFE occurred after she received passive range of motion exercise and extracorporeal shock wave treatment for neurogenic heterotopic ossification around the hip joint. The patient was successfully managed by a stepwise approach, with radiological and clinical improvements.

  7. Residual hip growth after pinning of slipped capital femoral epiphysis.

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    Breaud, Jean; Rubio, Amandine; Leroux, Julien; Griffet, Jacques

    2009-01-01

    Screwing of slipped capital femoral epiphysis must prevent its further slipping by prematurely fusing the physis. Whichever material is used, persistent femoral growth has been described, thereby increasing the risk of bone deformation. The objective of this study is to evaluate the residual growth after screwing of slipped capital femoral epiphysis. This study concerned 26 children, among which 13 children have been included, and 13 children excluded because of an incomplete clinical or radiological follow-up, or treatment by another technique. The pathological hip was treated with one screw (in eight cases) or two screws (in five cases). The controlateral hip was fixed with one screw. The different measures were taken on anteroposterior radiographs done the days after surgery, and on the first radiograph on which the growth plate had fused. Growth plate fusion was obtained after an average of 20 months. Each patient had presented a residual growth of at least one hip, thus 85% of the 26 fixed screws. Among the four hips, which did not grow, three were pathological, and were fixed by one screw (in one case) or two screws (in two cases), in a central or medial position. There was not any statistical relationship between the growth persistence and the other studied criteria. These results, proving the growth persistency, suggest that the follow-up must be extremely careful, as the number of threads crossing the growth plate will decrease, with the risk of loss of mechanical stability and reappearance of the femoral epiphysis slippage.

  8. Progressive slippage after pinning for slipped capital femoral epiphysis.

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    Sanders, James O; Smith, William J; Stanley, Earl A; Bueche, Matthew J; Karol, Lori A; Chambers, Henry G

    2002-01-01

    The authors retrospectively reviewed seven cases of progressive slipped capital femoral epiphysis after screw fixation. All seven patients initially presented with chronic symptoms, and five had an acute exacerbation of symptoms with the appearance of an acute-on-chronic slip. Of the other two, one had obvious motion at the proximal femoral physis and the other had increased symptoms but did not have an obvious acute slip radiographically. All underwent percutaneous screw fixation. In four patients a single screw was placed, and in three patients two screws were placed. No patient became symptom-free after surgery. Slip progression was noted on average 5 months after treatment. Radiographs in all patients revealed an increase in slip severity and loss of screw purchase in the femoral neck while fixation in the proximal femoral epiphysis remained secure. One patient had hypothyroidism and another Cushing disease, both diagnosed after the slipped epiphysis. Slips occurring in children with underlying endocrinopathies, and unstable slips in children with a history of antecedent knee or hip pain (commonly called an acute-on-chronic slip) may be susceptible to screw fixation failure. In such patients, close radiographic follow-up, particularly in the presence of continued symptoms, is required to document slip progression and fixation failure as soon as possible.

  9. Nonoperative treatment of slipped capital femoral epiphysis: a scientific study

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    Pinheiro Pedro

    2011-02-01

    Full Text Available Abstract Background Treatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis. The conservative treatment remains controversial; it has been overlooked in the studies and subjected to intense criticism. The purpose of this study is to investigate the results of treatment on the hip of patients displaying slipped capital femoral epiphysis, using the plaster cast immobilization method and its link to chondrolysis. Methods The research was performed based on the study of the following variables: symptomatology, and the degree of slipping. A hip spica cast and bilateral short/long leg casts in abduction, internal rotation with anti-rotational bars were used for immobilizing the patient's hip for twelve weeks. Statistical analysis was accomplished by Wilcoxon's marked position test and by the Fisher accuracy test at a 5% level. Results A satisfactory result was obtained in the acute group, 70.5%; 94%; in the chronic group (chronic + acute on chronic. Regarding the degree of the slipping, a satisfactory result was obtained in 90.5% of hips tested with a mild slip; in 76% with moderate slip and 73% in the severe slip. The statistical result revealed that a significant improvement was found for flexion (p = 0.0001, abduction (p = 0.0001, internal rotation (p = 0.0001 and external rotation (p = 0.02. Chondrolysis was present in 11.3% of the hips tested. One case of pseudoarthrosis with aseptic capital necrosis was presented. There was no significant variation between age and chondrolysis (p = 1.00.Significant variation between gender/non-white patients versus chondrolysis (p = 0.031 and (p = 0.037, respectively was verified. No causal association between plaster cast and chondrolysis was observed (p = 0.60. In regard to the symptomatology group and the slip degree versus chondrolysis, the p value was not

  10. Progressive slip after removal of screw fixation in slipped capital femoral epiphysis: two case reports

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    Engelsma Yde

    2012-11-01

    Full Text Available Abstract Introduction In slipped capital femoral epiphysis the femoral neck displaces relative to the head due to weakening of the epiphysis. Early recognition and adequate surgical fixation is essential for a good functional outcome. The fixation should be secured until the closure of the epiphysis to prevent further slippage. A slipped capital femoral epiphysis should not be confused with a femoral neck fracture. Case presentation Case 1 concerns a 15-year-old boy with an adequate initial screw fixation of his slipped capital femoral epiphysis. Unfortunately, it was thought that the epiphysis had healed and the screw was removed after 11 weeks. This caused new instability with a progressive slip of the femoral epiphysis and subsequently re-fixation and a subtrochanteric correction osteotomy was obligatory. Case 2 concerns a 13-year-old girl with persistent hip pain after screw fixation for slipped capital femoral epiphysis. The screw was removed as lysis was seen around the screw on the hip X-ray. This operation created a new unstable situation and the slip progressed resulting in poor hip function. A correction osteotomy with re-screw fixation was performed with a good functional result. Conclusion A slipped epiphysis of the hip is not considered ‘healed’ after a few months. Given the risk of progression of the slip the fixation material cannot be removed before closure of the growth plate.

  11. Prophylactic pinning for slipped capital femoral epiphysis: does it affect proximal femoral morphology?

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    Cousins, Gerard R; Campbell, Donald M; Wilson, Neil I L; Maclean, Jamie G B

    2016-05-01

    This study was designed to determine whether prophylactic pinning of the unaffected hip in unilateral slipped capital femoral epiphysis affects the proximal femoral morphology. Twenty-four hips prophylactically pinned were compared with 26 cases observed. The articulotrochanteric distance (ATD) and the trochanteric-trochanteric distance (TTD) were measured. Postoperative radiographs were compared with final follow-up radiographs. The final TTD : ATD ratio was higher (P=0.048) in the pinned group, suggesting relative coxa vara/breva. There was a smaller difference between the two hips in the prophylactically pinned group (0.7) as opposed to those observed (1.47). Prophylactic pinning does not cause growth to stop immediately but alters the proximal femoral morphology.

  12. Can GnRH-agonist treatment cause slipped capital femoral epiphysis?

    NARCIS (Netherlands)

    Kempers, MJE; Noordam, C; Rouwe, CW; Otten, BJ

    2001-01-01

    Slipped capital femoral epiphysis (SCFE) mainly occurs in pubertal children and is associated with delayed skeletal maturation, obesity, high growth velocity and tall stature. Furthermore, SCFE often coincides with endocrine disorders. This is the first report of a possible relationship between SCFE

  13. Osteotomy does not improve early outcome after slipped capital femoral epiphysis.

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    Diab, Mohammad; Daluvoy, Sanjay; Snyder, Brian D; Kasser, James R

    2006-03-01

    We performed a retrospective, nonrandomized cohort study of unilateral, chronic, severe, stable slipped capital femoral epiphysis comparing five girls and five boys who underwent in-situ screw fixation alone with five girls and five boys who underwent in-situ screw fixation combined with staged flexion intertrochanteric femoral osteotomy to restore proximal femoral alignment. Functional outcome was measured by the Harris hip score, with 20% selected as a goal for improvement in functional outcome after corrective osteotomy. While flexion intertrochanteric femoral osteotomy improved hip range of motion, we found no significant difference in functional outcome between the two groups at early follow-up. This is a level 3 evidence study.

  14. Subtrochanteric Femur Fracture after Slipped Capital Femoral Epiphysis Pinning: A Novel Treatment

    OpenAIRE

    2011-01-01

    Slipped capital femoral epiphysis is a common injury suffered by adolescents worldwide. Treatment of most slips can be accomplished by percutaneous screw fixation, as this is an accepted and proven method associated with minimal morbidity. Complications, although limited, can be problematic for both the patient and treating physician. These include avascular necrosis, chondrolysis, infection, and fracture. We report a case of an individual who sustained a subtrochanteric...

  15. Subtrochanteric Femur Fracture after Slipped Capital Femoral Epiphysis Pinning: A Novel Treatment

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    Michael Paloski

    2011-01-01

    Full Text Available Slipped capital femoral epiphysis is a common injury suffered by adolescents worldwide. Treatment of most slips can be accomplished by percutaneous screw fixation, as this is an accepted and proven method associated with minimal morbidity. Complications, although limited, can be problematic for both the patient and treating physician. These include avascular necrosis, chondrolysis, infection, and fracture. We report a case of an individual who sustained a subtrochanteric femure fracture three weeks after in situ pinning of his left hip treated with a reconstruction intramedullary nail. This option allowed both the subtrochanteric fracture and SCFE to be treated concomitantly with minimized morbidity.

  16. Silent slipped capital femoral epiphysis in overweight and obese children and adolescents.

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    Wabitsch, Martin; Horn, Michael; Esch, Ulrich; Mayer, Herrmann; Moss, Anja; Günther, Klaus-Peter; Nelitz, Manfred

    2012-10-01

    Abnormal loading of the hip in obese children may lead to anatomic alterations and an increased prevalence of slipped capital femoral epiphysis (SCFE). The aims of this study were to examine the hip motion in obese children and adolescents and to estimate the prevalence of SCFE in a subgroup of patients characterized by pathological clinical examination and/or pain in the knee or hip joint. A total of 411 individuals (196 males), mean age 14.5 ± 2.5 years (7.8-20.4), mean BMI of 32.9 ± 5.6 kg/m(2) (20.3-51.5, z score +2.65) who were consecutively admitted for an inpatient weight loss program were included in the study. Twenty-six percent of the patients had load-dependent and 11.7 % had load-independent pain in the knee joint. A total of 9.3 % had load-dependent and 4.7 % had load-independent pain in the hip joint. Two patients (0.5 %) underwent surgical treatment of SCFE prior to entry. A total of 18.2 % of the patients showed a reduced range of motion for hip flexion (hips in the clinically conspicuous subgroup (n = 54) revealed an abnormal head-neck ratio as a sign of prior silent slipped capital femoral epiphysis in 11 patients (20.4 % of the 54 patients, 2.7 % of total cohort). In conclusion, these data show a high prevalence of SCFE-like tilt deformities in a selected group of severely obese children. Mild deformation of the epiphysis at young age might be a major predisposing factor for the development of hip osteoarthritis in obese adults.

  17. Slipped capital femoral epiphysis after septic arthritis of the hip in an adolescent: report of a case.

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    Marx, R G; Wright, J G

    1999-04-01

    Septic arthritis of the hip must be managed promptly to avoid the serious complications associated with the condition. In the case reported here, the diagnosis was delayed and was complicated by a slipped capital femoral epiphysis. The patient, an adolescent boy previously in good health, presented with a 2-week history of hip pain and systemic illness. Septic arthritis was diagnosed and was managed by incision and drainage and antibiotic therapy. Two weeks later he presented with a subcutaneous abscess and a slipped capital femoral epiphysis, which was pinned in situ. There was a 2.5-cm leg-length discrepancy. Avascular necrosis of the femoral head subsequently developed leaving the boy with a permanent disability.

  18. Levels of evidence in the treatment of slipped capital femoral epiphysis: a systematic review

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    Andrew Moriarity

    2016-06-01

    Full Text Available The primary aim of this study was to analyze the current level of evidence available on the surgical management of Slipped Capital Femoral Epiphysis (SCFE. Secondary aims were to correlate the level of evidence with the impact factor of the journal to evaluate the level of evidence over time, and to evaluate the geographic distribution of the studies. Therapeutic studies published in English between January 1991 and August 2014 that reported on SCFE were identified via electronic search was performed using the databases PubMed, EMBASE, and the Cochrane Library. The search terms used included: Slipped capital femoral epiphyses OR SCFE OR Slipped upper femoral epiphyses OR SUFE AND Management OR Treatment. Correlation between the level of evidence and the impact factor of the journal were analyzed together with linear regression models to reveal any significant trends over time. A total of 1516 studies were found, of which 321 were included in the final analysis. The most frequent study type was the case series (51.1% followed by case reports (22.4% and expert opinion (14.0%. Randomized control trial accounted for only 0.6%. The Journal of Pediatric Orthopedics (American had the most studies (22.6% and the highest number of level 2 (n=1 and level 3 (n=15 type evidence. There was no progression of level of evidence over time. There was no correlation between level of evidence and impact factor of journal. The majority of therapeutic studies on SCFE are of low level of evidence. High-level RCTs are difficult to perform in pediatric orthopedic surgery, however the management of SCFE would benefit from well-designed, multicenter, clinical RCTs to advance evidence-based practice.

  19. Chronic Bilateral Slipped Capital Femoral Epiphysis as an Unusual Presentation of Congenital Panhypopituitarism due to Pituitary Hypoplasia in a 17-Year-Old Female

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    Sasigarn A. Bowden

    2009-01-01

    Full Text Available We report an interesting case of a 17-year-old normal-statured female who was diagnosed with congenital panhypopituitarism due to pituitary hypoplasia at the presentation of bilateral slipped capital femoral epiphysis. We emphasized the importance of endocrinologic evaluation in patients with atypical slipped capital femoral epiphysis to prevent potential complication of adrenal crisis during surgery. This case also demonstrates growth without growth hormone which resulted in a delay in diagnosis of congenital hypopituitarism in this patient.

  20. Chronic Bilateral Slipped Capital Femoral Epiphysis as an Unusual Presentation of Congenital Panhypopituitarism due to Pituitary Hypoplasia in a 17-Year-Old Female

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    Klingele KevinE

    2009-11-01

    Full Text Available We report an interesting case of a 17-year-old normal-statured female who was diagnosed with congenital panhypopituitarism due to pituitary hypoplasia at the presentation of bilateral slipped capital femoral epiphysis. We emphasized the importance of endocrinologic evaluation in patients with atypical slipped capital femoral epiphysis to prevent potential complication of adrenal crisis during surgery. This case also demonstrates growth without growth hormone which resulted in a delay in diagnosis of congenital hypopituitarism in this patient.

  1. Fibular Allograft and Demineralized Bone Matrix for the Treatment of Slipped Capital Femoral Epiphysis.

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    Murray, Travis; Morscher, Melanie A; Krahe, Amy M; Adamczyk, Mark J; Weiner, Dennis S

    2016-05-01

    Previous studies documented the use of fibular allograft in the treatment of slipped capital femoral epiphysis (SCFE) with bone graft epiphysiodesis (BGE). This study describes the results of using a 10-mm diameter premilled fibular allograft packed with demineralized bone matrix placed across the physis in an open surgical approach under image intensification. A review identified 45 cases of BGE using fibular allograft and demineralized bone matrix in 34 patients with a diagnosis of SCFE performed by a single surgeon during an 8-year period. Thirty-four cases (25 patients) had at least 1 year of follow-up and were included in the study. Medical records were reviewed for complications, subsequent surgeries, and time to physeal closure. Of the 34 cases included, there were no cases of acute chondrolysis. Complications included 1 case of bone graft extrusion that required surgical replacement and 1 re-slip requiring surgical stabilization. Five cases of avascular necrosis (AVN) were encountered (1 unstable slip with total head AVN, and 4 stable slips with 3 total head and 1 partial head AVN). In 1 patient, small loose bony fragments were noted on postoperative radiographs that appeared outside of the articular surface of the hip and were asymptomatic. Two patients encountered wound healing issues that resolved with appropriate wound care. In light of the occurrence of AVN in stable cases, BGE with autogenous corticocancellous graft is preferable to BGE with autologous fibular graft for the treatment of SCFE. [Orthopedics. 2016; 39(3):e519-e525.].

  2. The role of pre-treatment MRI in established cases of slipped capital femoral epiphysis

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    Tins, Bernhard [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY 10 7 AG (United Kingdom)], E-mail: Bernhard.Tins@rjah.nhs.uk; Cassar-Pullicino, Victor; McCall, Iain [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY 10 7 AG (United Kingdom)

    2009-06-15

    Background: Slipped capital femoral epiphysis (SCFE) often results in functional impairment and premature osteoarthritis despite surgical treatment. Treatment decisions are commonly based on the clinical history and radiographic appearance. This study assesses the pre-treatment features of SCFE and correlates them to the clinical history to: (1) define the underlying pathological mechanisms; (2) correlate the morphological hip abnormalities with the clinical classifications; (3) identify specific magnetic resonance imaging (MRI) features that could carry prognostic implications for treatment approach and outcome. Methods: Clinical history and pre- and posttreatment radiographs and pre-treatment MRIs of 14 patients with 15 affected hips were reviewed. Alignment, impingement, fulcrum formation, remodelling, osteopenia, synovitis, joint effusion, bone marrow and soft tissue oedema and status of the physis and the periosteal sleeve were assessed and related to the clinical history, in particular history of trauma, duration of clinical symptoms and ability to bear weight. Results: Bone marrow oedema around the growth plate and joint effusion occurred in all patients. Synovitis occurred in 13/15 patients. 6 patients had a fall before presenting with SCFE. 5/6 had periarticular soft tissue oedema, complete disruption of the physis and partial periosteal sleeve disruption. 9 patients had no fall prior to presentation, physis and periost were intact in 7/9; periarticular oedema was not seen. 14/15 showed evidence of chronic remodelling. Despite an acute clinical history remodelling was present. A fulcrum-like alignment, impingement of the epiphysis on the metaphysis with a small area of physical contact, was seen in 8 patients, 6/8 had a prior fall. There was no case of avascular necrosis. Spontaneous reduction of SCFE occurred in 1 case, the only case without chronic remodelling. With MRI as gold standard radiographs underestimate the severity of SCFE. Conclusion

  3. Early diagnosis of slipped capital femoral epiphysis on magnetic resonance imaging: A case report with review of literature

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    Sanjay M Khaladkar

    2015-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common hip condition occurring in adolescents, with a prevalence of 10 cases per 100,000 children. It usually affects younger age group from 10 to 17 years. The condition is usually found to be coexistent with various other conditions such as obesity, growth surges, and endocrine disorders such as hypothyroidism, growth hormone supplementation, hypogonadism, and pan-hypopituitarism. Patients present with limping and a poorly localized pain in the hip, groin, thigh, or knee. Diagnosis of the condition is often delayed due to its nonassociation with trauma and hence increases the chances of developing various complications such as avascular necrosis, chondrolysis and deformity. Majority of researches of SCFE are from Europe and North America, while studies in Asian populations are rare. Delay in diagnosis of SCFE is usually due to patients presenting with knee pain. Imaging can thus aid in early diagnosis and appropriate treatment of the disease, which in turn reduces incidence of deformity and disability in the affected children. Bilateral hip radiography - anteroposterior and frog′s-leg lateral views and magnetic resonance imaging (MRI are the radiological techniques that help in early diagnosis. MRI detects early physeal changes of both preslip and SCFE even when radiographs and computed tomography are normal. MRI should be routinely used to diagnose early SCFE in preslip stage to avoid further complications.

  4. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

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    Zilkens, Christoph, E-mail: Christoph.Zilkens@med.uni-duesseldorf.de [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Miese, Falk [Department of Radiology, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Bittersohl, Bernd; Jaeger, Marcus; Schultz, Johannes [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Holstein, Arne [Department of Radiology, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Kim, Young-jo; Millis, Michael B. [Department of Orthopaedic Surgery, Childrens Hospital Boston, Harvard Medical, School, 300 Longwood Avenue, Boston, MA 02115 (United States); Mamisch, Tallal C. [Department of Orthopaedic Surgery, Inselspital Bern, University Hospital, Bern (Switzerland); Krauspe, Ruediger [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany)

    2011-09-15

    Objective: The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Methods: 28 young-adult subjects (32 hips) with a mean age of 23.8 {+-} 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle <50{sup o}), group 2 = subjects with mild offset decrease (alpha-angle 50{sup o}-60{sup o}), and group 3 = subjects with severe offset decrease (alpha-angle >60{sup o}). Results: There was statistically significant difference noted for the T1{sub Gd} values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1{sub Gd} values measured within the lateral portion were slightly lower compared with the T1{sub Gd} values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference. Conclusion: By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.

  5. Slipped capital femoral epiphysis and associated hypothyroidism. A review of the literature with two classic case examples.

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    Moyer, James; Jacks, Laura; Hunter, Janel Darcy; Chan, Gilbert

    2016-04-01

    Slipped capital femoral epiphysis (SCFE) is a relatively common hip disorder often seen in overweight, peripubertal children. Although the exact etiology is uncertain, it is generally accepted that underlying endocrinopathies play a role in the pathogenesis. Hypothyroidism is the endocrine disorder cited most commonly in association with SCFE, and patients often have no history of thyroid dysfunction at the time of presentation. Despite being a well-recognized risk factor, recommendations for screening thyroid function in patients with typical presentations of SCFE have not been deemed cost-effective; however, there is data to support screening for hypothyroidism in patients with atypical presentations of SCFE or short stature. Hypothyroidism may have a significant impact on healing and bone union after surgical management of SCFE and there is a paucity of case reports in the literature describing potential peri- and postoperative complications. We performed a systematic review of the literature of all reported cases of SCFE with associated hypothyroidism using the search terms, which demonstrated a physiologic relationship between hypothyroidism and SCFE. Two case reports of SCFE in patients with hypothyroidism and associated complications are presented with the literature review. There is a physiologic relationship between thyroid dysfunction and SCFE, and we postulate that profound hypothyroidism may contribute to delayed healing or nonunion in patients undergoing operative management. We support the recommendation to screen patients with short stature, atypical presentation of SCFE, or perisistent nonunion after surgery. In cases of hypothyroidism, we recommend thyroid hormone replacement and laboratory confirmation of return to euthyroid state prior to operative intervention.

  6. Slipped upper femoral epiphysis with hemophilia A

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    Iyer Deepa

    2007-01-01

    Full Text Available A 13-year-old boy who had hemophilia A was reported with pain in the left thigh and hip on walking. He had no history of trauma. Severe hemophilia A is diagnosed with a Factor VIII level of < 1 iu/dl. The presumptive diagnosis was that of a spontaneous bleed into the hip joint. Factor VIII mutational analysis revealed a C to G substitution at nucleotide 6683 which results in a cystine change at codon 2194. However, the symptoms persisted and an X-ray demonstrated the presence of an acute on chronic slip of the upper femoral epiphysis. The patient was transferred to the center treating his hemophilia where the hip was pinned in situ under cover with Factor VIII. This case demonstrates the need to be aware of a possible traumatic diagnosis of hip pain in a hemophiliac child with a longstanding history of spontaneous bleeding into joints.

  7. Long-term evolution of slipped capital femoral epiphysis treated by in situ fixation: a 26 years follow-up of 11 hips

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    Jérôme Murgier

    2014-06-01

    Full Text Available Slipped capital femoral epiphysis (SFCE may lead to femoro acetabular impingement and long-term function impairment, depending on initial displacement and treatment. There are several therapeutic options which include in situ fixation (ISF. The objective of this study was to evaluate long-term functional and radiographic outcomes of patients with SFCE treated with ISF. We conducted a single-center, retrospective study evaluating the clinical and radiographic outcomes of SCFE in situ fixation with a mean follow-up of 26 years (10- 47. Analysis of preoperative and last follow up radiographs was performed. The functional status of the hip was evaluated according to the Oxford hip score-12 and the radiographic osteoarthritis stage was rated according to Tönnis classification. Signs of femoro acetabular impingement were sought. Ten patients (11 hips were included. The average initial slip was 33.5° (10-62. At final follow up, the average Oxford hip score was 19.3 (12-37, it was good for groups who had a small initial slip (16.7 or moderate (17 and fair for the severe group (27. Average Tönnis grade was 1.3 (0- 3. The average alpha angle was 65.3° (50- 80°. Femoro acetabular impingement was likely in 100% of patients with severe slip, in 50% of patients with moderate slip and in 33% of patients with a slight slip. In situ fixation generated poor functional results, substantial hip osteoarthritis and potential femoro acetabular impingement in moderate to severe SCFE’s. However, in cases with minor displacement, functional and radiographic results are satisfactory. The cut off seems to be around 30° slip angle, above which other treatment options should be considered.

  8. 股骨头骨骺滑脱的手术治疗%Early and middle-term results after surgical treatment for slipped capital femoral epiphysis

    Institute of Scientific and Technical Information of China (English)

    孙伟; 李子荣; 史振才; 杨雨润; 王佰亮; 郭万首; 刘朝晖

    2010-01-01

    目的 探讨应用单枚空心螺钉原位固定和转子下截骨外固定架治疗股骨头骨骺滑脱的早中期疗效.方法 1998年6月至2008年7月,收治股骨头骨骺滑脱患者11例12髋,男7例8髋,女4例4髋;年龄9~18岁,平均14.3岁.体重指数27~35 g/m2,平均31.1 g/m2.Ⅰ度滑脱6例7髋,Ⅱ度滑脱2例2髋,Ⅲ度滑脱3例3髋.Ⅰ度和Ⅱ度患者均采用单枚空心螺钉原位固定,Ⅲ度患者行转子下截骨外固定架治疗.术后3个月、6个月、1年及之后每年1次随访,随访时摄X线片观察固定情况,并根据Harris髋关节评分对髋关节功能进行评估.结果 全部病例均获得随访,随访时间2~12年,平均5.6年.Harris髋关节评分由术前70~85分(平均74.8分)提高至随访2年时的70~100分(平均90.6分),优良率达91.7%(11/12).随访X线片显示单枚空心螺钉原位固定者股骨头骨骺闭合,滑脱角度未增大.转子下截骨外固定架治疗者骨骺部分复位,股骨头及髋臼无骨质增生,关节间隙未变窄.结论 单枚空心螺钉原位固定骨骺滑脱能有效防止股骨头骨骺滑脱进一步进展,缓解患者症状,是Ⅰ度及Ⅱ度儿童股骨头骨骺滑脱的有效治疗手段.对Ⅲ度及晚期儿童股骨头骨骺滑脱患者应采用转子下截骨以矫正畸形,重建力线,避免或延缓骨关节炎发生.%Objective To evaluate the early and middle-term results of in-situ single-screw fixation and subtrochanteric osteotomy of femur with external fixator for slipped capital femoral epiphysis(SCFE).Methods From June 1998 to July 2008, eleven patients (12 hips) with SCFE were treated, including 7males (8 hips) and 4 females (4 hips) with an average age of 14.3 years (range, 9-18). The average BMI was 31.1 g/m2. According to the Southwick measurement, mild (<30°) in 6 cases (7 hips), moderate (30°-50°) in 2 cases (2 hips), and severe (>50°) in 3 cases (3 hips). All the mild and moderate cases were undergone insitu single screw

  9. Early Reversible Ischemia of Femoral Head Epiphysis in Piglets on Gadolinium-enhanced MRI: An experimental study

    Institute of Scientific and Technical Information of China (English)

    LI Xiaoming; HU Junwu; ZHEN Hongwei; TANG Lihua; XU Anhui

    2006-01-01

    The purpose of this study is to demonstrate if Gadolinium-enhanced MRI can detect early reversible ischemia of the femoral head epiphysis caused by hip hyper-abduction in piglets. Between 3 and 6 h consistent hyper-abduction, gadolinium-enhanced MRI was performed in 20 femoral heads of 10 piglets. After completion of MRI scan, the piglets were allowed to ambulate freely for 1 or 7 days and re-imaged. The enhanced-MRI results of epiphyseal and physeal cartilage and the secondary center of ossification were observed. MRI appearances and histological findings were compared. On Gadolinium-enhanced MRI, decreased or absent enhancement was seen in 14 cartilaginous epiphyses of all 20 femoral heads. Reperfusion was completed in 10 of 14 femoral heads after one day of ambulation and in the rest 4 after 7 days of ambulation. Gadolinium-enhanced MRI can identify early ischemia and its reversal of the capital femoral epiphysis induced by hip hyper-abduction.

  10. Spina bifida and unilateral focal destruction of the distal femoral epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Wolverson, M.K.; Sundaram, M.; Graviss, E.R.

    1981-03-01

    Focal destruction of the postero-lateral distal femoral epiphysis was present on radiographs in two children with spina bifida and objective lower limb sensory loss. Each patient presented with painless swelling of the knee. In one patient the epiphysis showed sclerosis and fragmentation associated with a defect. In the second patient the destructive change was the dominant radiographic abnormality and simulated bone tumor. Computed tomography in this patient showed a bone fragment occupying the defect suggesting epiphyseal fracture. The lesions in each patient were believed to be traumatic in origin and to represent a stage in the development toward neuropathic arthropathy.

  11. Brodie's abscess of the proximal femoral epiphysis in an adult woman with systemic lupus erythematosus.

    Science.gov (United States)

    Miyanishi, Keita; Yamamoto, Takuaki; Irisa, Takahiko; Jingushi, Seiya; Noguchi, Yasuo; Iwamoto, Yukihide

    2002-06-01

    We report an unusual case of pathologically proved femoral head Brodie's abscess mimicking avascular necrosis of bone in a 51-year-old woman with a 2-year history of corticosteroid treatment for systemic lupus erythematosus. On plain radiographs, a rounded lucency and thin sclerotic margins together with subchondral collapse and a lytic region were observed in the femoral head. The histopathologic examination revealed a central abscess formation surrounded by fibrous tissue with the aggregation of neutrophils and plasma cells. To our knowledge, this is the first case report describing a Brodie's abscess which had developed within the proximal femoral epiphysis in an adult.

  12. 髋关节外科脱位入路切开复位手术治疗中重度股骨头骨骺滑脱的临床疗效%Results of surgical treatment for moderate or severe slipped capital femoral epiphysis through the approach of surgical hip dislocation

    Institute of Scientific and Technical Information of China (English)

    杨璇; 蔡奇勋; 李海; 张自明; 陈珽; 赵黎

    2014-01-01

    Objective To evaluate the results of surgical treatment for moderate or severe slipped capital femoral epiphysis (SCFE) using modified Dunn procedure through the approach of surgical hip dislocation at the interval of minimum 12 months follow-up.Methods From November 2011 to June 2013,6 patients (7 hips) with SCFE were treated in department of pediatric orthopedics,Hospital Affiliated to Shanghai Jiaotong University School of Medicine,they all had trauma history.The patients were aged from 10-15 years,mean 13.6 years.The duration of symptoms ranged from 4 to 35 days,average 14.2 days.The degree of slip was averagely 45% (25%-55%).In 6 patients (except right side of 1 case was treated in situ with cannulated screws) were surgically treated using modified Dunn procedure through the approach of surgical hip dislocation.Postoperatively the brace was used for immobilizing the hip for 4 weeks,then 4 weeks of bed traction combined with rehabilitation program of hip joint activity.Eight weeks later,the gradual touchdown weight bearing was being allowed.Results The follow-up time ranged from 12 to 30 months,average 23.8 months.Six patients have been able to walk without crutches,no obvious limp.X-ray film showed femoral epiphysis line on the bit of good recovery,no appearance of avascular necrosis of the femoral head,joint space was normal.The Harris score of hip evaluation was 94.7 averagely,ranging 85 -100,at the time of last follow-up.Conclusions Application of surgical treatment for moderate or severe SCFE with open reduction through the approach of surgical hip dislocation is a valid alternative method.The femoral head epiphysis can be capable of restoring anatomy,at present no case occurred avascular necrosis,and patients are satisfied with the function of the hip joint.%目的 总结应用髋关节外科脱位入路行切开复位手术治疗青少年中、重度股骨头骨骺滑脱后至少12个月的随访效果.方法 2011年11月至2013年6月上海交通

  13. Effect of arterial deprivation on growing femoral epiphysis: Quantitative magnetic resonance imaging using a piglet model

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun; Yoo, Won Joon; Kim, In One; Kim, Woo Sun; Choi, Young Hun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    To investigate the usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion MRI for the evaluation of femoral head ischemia. Unilateral femoral head ischemia was induced by selective embolization of the medial circumflex femoral artery in 10 piglets. All MRIs were performed immediately (1 hour) and after embolization (1, 2, and 4 weeks). Apparent diffusion coefficients (ADCs) were calculated for the femoral head. The estimated pharmacokinetic parameters (Kep and Ve from two-compartment model) and semi-quantitative parameters including peak enhancement, time-to-peak (TTP), and contrast washout were evaluated. The epiphyseal ADC values of the ischemic hip decreased immediately (1 hour) after embolization. However, they increased rapidly at 1 week after embolization and remained elevated until 4 weeks after embolization. Perfusion MRI of ischemic hips showed decreased epiphyseal perfusion with decreased Kep immediately after embolization. Signal intensity-time curves showed delayed TTP with limited contrast washout immediately post-embolization. At 1-2 weeks after embolization, spontaneous reperfusion was observed in ischemic epiphyses. The change of ADC (p = 0.043) and Kep (p = 0.043) were significantly different between immediate (1 hour) after embolization and 1 week post-embolization. Diffusion MRI and pharmacokinetic model obtained from the DCE-MRI are useful in depicting early changes of perfusion and tissue damage using the model of femoral head ischemia in skeletally immature piglets.

  14. Deslizamientos epifisarios femorales proximales >30º. Procedimiento de Dunn modificado. Evaluación anatómica y funcional en una cohorte retrospectiva. [Slipped capital femoral epiphysis >30º. Modified Dunn procedure. Anatomical and functional evaluation in a retrospective cohort

    OpenAIRE

    Francisco Praglia; Daniel Visona Dallapozza; Jorge Sueiro; Eduardo Stefano

    2013-01-01

    Introducción La deformidad residual resultante de un deslizamiento epifisario femoral proximal moderado o grave conduce a osteoartritis prematura debida al choque femoroacetabular. Los objetivos del trabajo fueron evaluar la mejoría de la anatomía del fémur proximal y evaluar la función de la cadera en pacientes con deslizamiento epifisario femoral proximal >30 grados tratados con el procedimiento de Dunn modificado, a corto plazo. Material y Métodos Cohorte retrospectiva de ...

  15. Deslizamientos epifisarios femorales proximales >30º. Procedimiento de Dunn modificado. Evaluación anatómica y funcional en una cohorte retrospectiva. [Slipped capital femoral epiphysis >30º. Modified Dunn procedure. Anatomical and functional evaluation in a retrospective cohort

    Directory of Open Access Journals (Sweden)

    Francisco Praglia

    2013-12-01

    Full Text Available Introducción La deformidad residual resultante de un deslizamiento epifisario femoral proximal moderado o grave conduce a osteoartritis prematura debida al choque femoroacetabular. Los objetivos del trabajo fueron evaluar la mejoría de la anatomía del fémur proximal y evaluar la función de la cadera en pacientes con deslizamiento epifisario femoral proximal >30 grados tratados con el procedimiento de Dunn modificado, a corto plazo. Material y Métodos Cohorte retrospectiva de pacientes con deslizamiento epifisario femoral proximal >30 grados, tratados con luxación controlada de cadera y el procedimiento de Dunn modificado. Se evaluaron mediciones clínicas y radiológicas preoperatorias y posoperatorias, hallazgos intraoperatorios y funcionalidad con los puntajes de Harris y de D’aubigne-Postel. Resultados Trece casos, mediana de edad 12 años y mediana de seguimiento 14 meses. El ángulo de deslizamiento de Southwick preoperatorio (75 grados, ri 67-85 y posoperatorio (10 grados, ri 5-17 mostró una disminución estadísticamente significativa (p <0,001. El offset radio cabeza-cuello preoperatorio (-0,13 versus el posoperatorio (0,12 obtuvo una mejoría significativa (p 0,002. El 69,2% de los pacientes presentó daño de alguna estructura intraarticular. Los puntajes promedio de funcionalidad fueron 14,6 (muy buena mejoría y 83,4 (bueno. Complicaciones: necrosis avascular 15,3% y condrólisis 15,3%. Conclusion Esta técnica restaura la anatomía del fémur proximal y la funcionalidad de la cadera a corto plazo. aunque no disponemos de resultados a largo plazo, al menos en teoría, serían buenos. Sin embargo, la luxación controlada con Dunn modificado no está exenta de complicaciones y el riesgo de necrosis avascular y condrólisis persiste.

  16. Salter-Harris Type III and Type IV Combined Fracture of the Distal Femoral Epiphysis: A Case Report

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    Ali Aydin

    2012-01-01

    Full Text Available Distal femoral physeal fractures are not common but have a high rate of complications. They generally follow one of the patterns described in the Salter-Harris classification. We present a case of combination of Salter-Harris type III and type IV injury. Our case was a 15-year-old boy who had a motor vehicle accident. There was swelling, ecchymosis, severe pain, and valgus deformity, because of medial proximal fracture fragment, on the left knee. We deemed that Salter-Harris type III and type IV combination fracture in our case has not been previously reported. We prepared this paper in consideration of its contribution to the literature.

  17. A Huge Capital Drop with Compression of Femoral Vessels Associated with Hip Osteoarthritis

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    Tomoya Takasago

    2015-01-01

    Full Text Available A capital drop is a type of osteophyte at the inferomedial portion of the femoral head commonly observed in hip osteoarthritis (OA, secondary to developmental dysplasia. Capital drop itself is typically asymptomatic; however, symptoms can appear secondary to impinge against the acetabulum or to irritation of the surrounding tissues, such as nerves, vessels, and tendons. We present here a case of unilateral leg edema in a patient with hip OA, caused by a huge bone mass occurring at the inferomedial portion of the femoral head that compressed the femoral vessels. We diagnosed this bone mass as a capital drop secondary to hip OA after confirming that the mass occurred at least after the age of 63 years based on a previous X-ray. We performed early resection and total hip arthroplasty since the patient’s hip pain was due to both advanced hip OA and compression of the femoral vessels; moreover, we aimed to prevent venous thrombosis secondary to vascular compression considering the advanced age and the potent risk of thrombosis in the patient. A large capital drop should be considered as a cause of vascular compression in cases of unilateral leg edema in OA patients.

  18. MR evaluation of femoral neck version and tibial torsion

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

    2012-01-15

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  19. Chondroblastoma of the femoral head: management and outcome.

    Science.gov (United States)

    Strong, D P; Grimer, R J; Carter, S R; Tillman, R M; Abudu, A

    2010-03-01

    Chondroblastoma of the femoral head presents particular problems in treatment because the tumour is surrounded by articular cartilage on one side and epiphyseal plate on the other. Ten patients underwent treatment for a chondroblastoma involving the proximal femoral capital epiphysis. The patients were aged between eight and 19 years and in four the epiphysis was not yet fused. Five had curettage via a drill hole created up the femoral neck, of whom two developed local recurrence. Five had a direct approach to the chondroblastoma through the femoral neck, and there were no local recurrences in this group. Both patients with local recurrence were under 14 years of age-one was cured by a direct approach through the neck of the femur and the other by lifting a trap door of articular cartilage. Apart from one patient with a temporary leg length discrepancy, there were no other complications. We conclude that a direct approach is likely to lead to the best outcome for this rare condition.

  20. Current practice in the management of acute/unstable slipped capital femoral epiphyses in the United Kingdom and the Netherlands: results of a survey of the membership of the British Society of Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie.

    Science.gov (United States)

    Witbreuk, Melinda; Besselaar, Philip; Eastwood, Deborah

    2007-03-01

    A questionnaire was sent to all members of the British Society for Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie to identify points of agreement/disagreement on the management of the acute unstable slip of the upper femoral epiphysis and to compare these European results with those from a similar North American survey. Sixty-five per cent responded. Overall, both countries evaluated cases similarly and believed in their urgent management. Sixty-six per cent did not reposition the slip. Significant differences were observed in attitude towards single screw usage, prophylactic pinning and metalwork removal both between the two countries and in comparison with North America.

  1. Radiologic aspects of epiphysial dysplasia in adults

    Energy Technology Data Exchange (ETDEWEB)

    Andreeva, V.F. (Leningradskij Inst. Usovershenstvovaniya Vrachej (USSR))

    The results of radiologic examination of 40 patients aged 15 to 64 years with epiphysial (spondyloepiphysial) displasia, adequate in manifestness to developmental anomaly are analyzed. The radiologic examination involved standard radiographs in standard and atypical projections, radiography with direct enlargement of X-ray appearance, and tomography. Various types of epiphysial deformation have been distinguished as a manifest feature of the above-mentioned dysplastic process. Possible combinations of the tubular bones epiphysial hypoplasia with the damage of other articular components are pointed out. Concomitant degenerative-dystrophic processes are characterized as deforming arthrosis, degenerative-dystrophic lesions with cystoid reconstruction of the articulating bones, and aseptic epiphysial necrosis. X-ray picture of the degenerative-dystrophic lesion with cystoid reconstruction of the hinging bones is disclosed most comprehensively.

  2. Asymmetry and structural system analysis of the proximal femur meta-epiphysis: osteoarticular anatomical pathology

    Directory of Open Access Journals (Sweden)

    Baydoun Safaa

    2008-02-01

    Full Text Available Abstract Background The human femur is commonly considered as a subsystem of the locomotor apparatus with four conspicuous levels of organization. This phenomenon is the result of the evolution of the locomotor apparatus, which encompasses both constitutional and individual variability. The work therein reported, therefore, underlies the significance of observing anatomical system analysis of the proximal femur meta-epiphysis in normal conditions, according to the anatomic positioning with respect to the right or left side of the body, and the presence of system asymmetry in the meta-epiphysis structure, thus indicating structural and functional asymmetry. Methods A total of 160 femur bones of both sexes were compiled and a morphological study of 15 linear and angulated parameters of proximal femur epiphysis was produced, thus defining the linear/angulated size of tubular bones. The parameters were divided into linear and angulated groups, while maintaining the motion of the hip joint and transmission of stress to the unwanted parts of the limb. Furthermore, the straight and vertical diameters of the femoral head and the length of the femoral neck were also studied. The angle between the neck and diaphysis, the neck antiversion and angle of rotation of the femoral neck were subsequently measured. Finally, the condylo-diaphyseal angle with respect to the axis of extremity was determined. To visualize the force of intersystem ties, we have used the method of correlation galaxy construction. Results The absolute numeral values of each linear parameter were transformed to relative values. The values of superfluity coefficient for each parameter in the right and left femoral bone groups were estimated and Pearson's correlation coefficient has been calculated (> 0.60. Retrospectively, the observed results have confirmed the presence of functional asymmetry in the proximal femur meta-epiphysis. On the basis of compliance or insignificant difference in

  3. Subchondral bone density distribution in the human femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Wright, David A.; Meguid, Michael; Lubovsky, Omri; Whyne, Cari M. [Sunnybrook Research Institute, Orthopaedic Biomechanics Laboratory, Toronto, Ontario (Canada)

    2012-06-15

    This study aims to quantitatively characterize the distribution of subchondral bone density across the human femoral head using a computed tomography derived measurement of bone density and a common reference coordinate system. Femoral head surfaces were created bilaterally for 30 patients (14 males, 16 females, mean age 67.2 years) through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the greyscale values (linearly related to bone density) within 5 mm of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of 30 from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Mean values for each region were compared using repeated measures ANOVA and a Bonferroni post hoc test, and side-to-side correlations were analyzed using a Pearson's correlation. The regions representing the medial side of the femoral head's superior portion were found to have significantly higher densities compared to other regions (p < 0.05). Significant side-to-side correlations were found for all regions (r {sup 2} = 0.81 to r {sup 2} = 0.16), with strong correlations for the highest density regions. Side-to-side differences in measured bone density were seen for two regions in the anterio-lateral portion of the femoral head (p < 0.05). The high correlation found between the left and right sides indicates that this tool may be useful for understanding 'normal' density patterns in hips affected by unilateral pathologies such as avascular necrosis, fracture, developmental dysplasia of the hip, Perthes disease, and slipped capital femoral head epiphysis. (orig.)

  4. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

  5. Proximal Tibial Epiphysis Injury (Flexion Type, Salter–Harris Type 1)

    Science.gov (United States)

    Israni, Pratik; Panat, Mangesh

    2016-01-01

    Introduction: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. Case Report: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries. Plain radiographs were taken which revealed, separated proximal tibial epiphysis (salter harris Type 1 injury) The epiphysis was anteriorly displaced fracture line extending beyond growth plate through metaphysis and tibial tuberosity also displaced anteriorly, the proximal fibular epiphysis fragment was displaced anteriorly with no injury to femoral epiphysis and no patellar fracture, radiograph also revealed no intra-articular fracture as joint appears congruent. Under spinal anesthesia, under all aseptic precautions traction was applied for few minutes, the fracture was reduced closed as the hamstring spasm gave way, reduction was confirmed under image intensifier in both AP and lateral planes, and joint congruity was examined. Proximal fibular epiphysis also snapped back in place. Post-operative patient was immobilized with nil weight bearing for 4 weeks, check X-rays taken, he was mobilized in wheelchair. After 4 weeks slab was removed, K-wires were removed, and partial weight bearing was started with rehabilitation for full range of motion of the left knee. At 6 weeks, both the knee joints appeared symmetrical with no abnormalities or limb length discrepancy or instability with knee from 0° to 140°, with full weight bearing. Conclusion: Although less commonly seen, Salter

  6. A Single Centre Study to Assess the Long-term Performance of the Pinnacle™ Cup With a Ceramic-on-ceramic Bearing in Primary Total Hip Replacement

    Science.gov (United States)

    2016-10-06

    Rheumatoid Arthritis; Osteoarthritis; Post-traumatic Arthritis; Collagen Disorders; Avascular Necrosis; Traumatic Femoral Fractures; Nonunion of Femoral Fractures; Congenital Hip Dysplasia; Slipped Capital Femoral Epiphysis

  7. Multicentric osteoid osteoma with a nidus located in the epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Tamam, Cueneyt [Kasimpasa Military Hospital, Kasimpasa Asker Hastanesi, Orthopedics and Traumatology, Istanbul (Turkey); Yildirim, Duezguen [Kasimpasa Military Hospital, Department of Radiology, Istanbul (Turkey); Tamam, Muge [Okmeydani Training and Research Hospital, Nuclear Medicine, Istanbul (Turkey)

    2009-11-15

    We present a 13-year-old girl who was referred to our clinic with a 5-month history of right leg pain relieved by salicylates. Initial CT examination demonstrated a lesion in the posterior tibial cortex in keeping with an osteoid osteoma. This was resected and the diagnosis confirmed by histology. However, her pain recurred 2 weeks after the operation and further imaging identified a further nidus in the epiphysis. We present the imaging findings in this unique case of multicentric osteoid osteoma with one nidus located in the epiphysis. (orig.)

  8. Biomechanical optimization of different fixation modes for a proximal femoral L-osteotomy

    Directory of Open Access Journals (Sweden)

    Chen Hsih-Hao

    2009-09-01

    Full Text Available Abstract Background Numerous proposed surgical techniques have had minimal success in managing greater trochanter overgrowth secondary to retarded growth of the femoral capital epiphysis. For reconstruction of residual hip deformities, a novel type of proximal femur L-osteotomy was performed with satisfactory results. Although the clinical outcome was good, the biomechanical characteristics of the femur after such an osteotomy have not been clearly elucidated. Therefore, this study presents a three dimensional finite element analysis designed to understand the mechanical characteristics of the femur after the L-osteotomy. Methods A patient with left hip dysplasia was recruited as the study model for L-osteotomy. The normal right hip was used as a reference for performing the corrective surgery. Four FEA models were constructed using different numbers of fixation screws but the same osteotomy lengths together with four FEA models with the same number of fixation screws but different osteotomy lengths. The von Mises stress distributions and femoral head displacements were analyzed and compared. Results The results revealed the following: 1. The fixation devices (plate and screws sustained most of the external loading, and the peak value of von Mises stress on the fixation screws decreased with an increasing number of screws. 2. Additional screws are more beneficial on the proximal segment than on the distal segment for improving the stability of the postoperative femur. 3. The extent of osteotomy should be limited because local stress might be concentrated in the femoral neck region with increasing length of the L-osteotomy. Conclusion Additional screw placement on the proximal segment improves stability in the postoperative femur. The cobra-type plate with additional screw holes in the proximal area might improve the effectiveness of L-osteotomies.

  9. Femoral non-elongating rodding in osteogenesis imperfecta - The importance of purchasing epiphyseal plate

    Directory of Open Access Journals (Sweden)

    Wei-Chun Li

    2015-04-01

    Full Text Available Background: Corrective osteotomy and intramedullary rodding are widely used in children with osteogenesis imperfecta (OI, but revision rodding is often required. This study aims to investigate the effect of purchasing distal femoral epiphysis on the longevity of fixation using non-elongating rod. Methods: We investigated children with Sillence type III or IV OI who received antegrade femoral Rush rod fixations at age between 4 and 10 years in our institution. The fixations were classified into group A in which the rod reached distal femoral epiphysis and group B in which the rod stopped at femoral metaphysis. Failure of fixation is defined as rod cutting out of the cortex or when revision surgery was performed. Calculation of longevity of each rod fixation and Kaplan-Meier survival analysis were performed and compared between the two groups. Results: Eighteen children had the first femoral rodding at a mean age of 6.9 years and received a total of 61 femoral roddings with a mean follow-up of 11.4 years. Group A included 38 roddings performed at a mean age of 7.1 years and group B included 23 roddings performed at a mean age of 6.6 years. Group A had less revision rate (58% vs. 87%, more chance of survival > 3 years (74% vs. 43%, and longer median survival time (80 months vs. 33 months than group B. Conclusions: Less revision rate and better 3-year and 5-year survival rate were proved in the roddings that purchased epiphysis. We emphasize on using the precise implant length to purchase distal femoral epiphysis when non-elongating rod is the only available implant for fixation in children with OI.

  10. Comparative study of technique to obtain stem cells from bone marrow collection between the iliac crest and the femoral epiphysis in rabbits Estudo comparativo da técnica para a obtenção de células tronco pela coleta de medula óssea entre a crista ilíaca e epífise do fêmur em coelhos

    Directory of Open Access Journals (Sweden)

    Lilian Piñero Eça

    2009-10-01

    Full Text Available PURPOSE: To assess the technique for the collection of rabbit bone marrow stem cells from different regions to be used as an experimental model in regenerative medicine. METHODS: Thirty rabbits were allocated into 2 groups: GROUP A, n=8, animals that underwent bone marrow blood (BMB harvesting from the iliac crest; and GROUP B: including 22 rabbits that underwent BMB harvesting from the femur epiphysis. After harvesting, mononuclear cells were isolated by density gradient centrifugation (Ficoll - Histopaque. The number of mononuclear cells per ml was counted in a Neubauer chamber and cell viability was checked through Tripan Blue method. RESULTS: Harvesting from the iliac crest yielded an average of 1 ml of BMB and 3,6.10(6 cells/ml over 1 hour of surgery, whereas an average of 3ml of BMB and 11,79.10(6 cells./ml were obtained in 30 min from the femur epiphysis with a reduced animal death rate. CONCLUSION: The analysis for the obtention of a larger number of mononuclear cells/ml from rabbit bone marrow blood was more satisfactory in the femur epiphysis than in the iliac crest.OBJETIVO: Avaliar a técnica mais promissora para a coleta de células tronco adultas de medula óssea de coelhos para a utilização do mesmo como modelo experimental na medicina regenerativa. MÉTODOS: Foram utilizados 30 coelhos divididos em 2 grupos: GRUPO A, n=8, onde realizamos a coleta de sangue de medula óssea (MO da crista ilíaca e grupo B, n=22, onde realizamos a coleta de sangue da medula óssea da epífise do fêmur. Após as coletas, realizamos a separação das células mononucleadas através do gradiente de densidade (Ficoll-Hystopaque. Através da câmara de Neubauer realizamos a contagem das células mononucleadas por ml. Testamos a viabilidade celular através do método Tripan Blue. RESULTADOS: Na coleta de sangue de MO na crista ilíaca obtivemos a média de 1 ml durante 1 hora de procedimento cirúrgico, obtendo a quantidade de 3,6 .10(6 c

  11. Avascular necrosis of the distal phalangeal epiphysis following physeal fracture: a case report.

    Science.gov (United States)

    Nissenbaum, M

    1999-05-01

    Avascular necrosis of the distal phalangeal epiphysis following an unrecognized angulated Salter II fracture of the distal phalanx treated by open reduction and internal fixation resulted in premature closure of the growth plate and mild shortening. The epiphysis itself revascularized and good function of the distal interphalangeal joint was maintained.

  12. Therapeutic effect of osteogenically induced adipose derived stem cells on vascular deprivation-induced osteonecrosis of the femoral head in rabbits

    Institute of Scientific and Technical Information of China (English)

    Abudusaimi Aimaiti; Yilixiati Saiwulaiti; Maimaitiming Saiyiti; WANG Yun-hai; CUI Lei; Aihemaitijiang Yusufu

    2011-01-01

    Objective: To explore the therapeutic effect of osteogenically induced adipose-derived stem cells (ADSCs) on vascular deprivation-induced osteonecrosis of the femoral head (ONFH) in rabbit model. Methods: Vascular deprivation-induced ONFH was established by intramuscular injection of methylprednisolone, and vascular occlusion of the capital femoral epiphysis by electrocoagulation in adult New Zealand white rabbits. Eight weeks after the establishment of vascular deprivation-induced ONFH, animals were randomly divided into three equal groups. In Group A (control), no therapy was given. In Group B, core decompression was performed by drilling a hole (1.2 mm in diameter) from the outer cortex 2.5 cm distal to the proximal end of the greater trochanter. In Group C, 1 ×107 osteogenically induced ADSCs were resuspended in 0.5 ml PBS, and then injected directly into the femoral head. Femoral head specimens were obtained at postoperative 8 weeks. The bone formation and three-dimensional microstructure of the femoral head was evaluated by micro-computed tomography scans (μ-CT). Immunohistochemical analysis was performed to detect the expression of osteocalcin. Angiogenesis and repair of the femoral head were observed histologically. Results: In trabecular bone at the proximal femur region, the trabecular volume was higher in Group C (130.70 mm3± 4.33 mm3) than that in Groups A (101.07 mm3±7.76 mm3) and B (107.89 mm3±8.68 mm3, P<0.01). Bone volume was significantly increased in Group C (40.09 mm3±6.35 mm3) than in Groups A (29.65 mm3±4.61 mm3) and B (31.80 mm3± 4.01 mm3, P<0.01). The trabecular number was higher in Groups C (1.58±0.25) than other two groups (1.15±0.18, 1.16± 0.21, P<0.01). Bone mineral density showed statistically significant difference between Groups C and A or B (375.38± 23.06) mg HA/ccm, vs (313.73 ±19.30) mg HA/ccm and (316.09± 16.45) mg HA/ccm, P<0.01). Histological examination indicated that there was more new bone formation in

  13. Proximal focal femoral deficiency: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [National Naval Medical Center, Department of Radiology, Bethesda, MD (United States); Uniformed Services University of Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (United States); Davidson, Richard [The Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Pena, Andres; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2012-01-15

    Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

  14. Effect of pathological fracture on limb salvage surgery with preservation of the epiphysis in children with osteosarcoma of the distal femur: Two case reports.

    Science.gov (United States)

    Zheng, Kai; Yu, Xiuchun; Chang, Zhengqi; Xu, Songfeng; Xu, Ming

    2016-04-01

    The outcome of limb salvage treatment for femoral osteosarcoma with pathological fractures in children is currently unknown. The aim of the present study was to present two cases of patients who received limb salvage surgery with preservation of the epiphysis at the Department of Orthopedics of The General Hospital of Jinan Military Commanding Region (Shandong, China). Between January, 2007 and January, 2013, two pediatric patients were admitted to our hospital with pathological fractures. One of the patients was a girl, aged 11 years, with confirmed osteosarcoma of the right distal femur; the other patient was a boy, aged 9 years, with osteosarcoma of the left distal femur. After receiving two cycles of neoadjuvant chemotherapy following tumor biopsy, the patients received limb salvage surgery with epiphyseal preservation, with wide resection of the tumor and biological reconstruction by allogeneic bone and fibular autograft, followed by 10 cycles of adjuvant chemotherapy. With a mean follow-up of 64 months, there were no postoperative complications, local recurrence or metastasis. The limb function recovered well, although limb shortening was observed. The female patient underwent a second fixation and limb lengthening after epiphyseal closure. Therefore, with effective neoadjuvant chemotherapy, limb salvage surgery with epiphyseal preservation is not contraindicated for pediatric patients with pathological fractures from femoral osteosarcoma. Biological reconstruction by allogeneic bone and vascularized fibular autograft following wide tumor resection is a viable option for such patients, with a good postoperative functional outcome.

  15. [Biogenic amines in the epiphysis and hypothalamus under normal conditions and following ovariectomy].

    Science.gov (United States)

    Grishchenko, V I; Koliada, L D; Demidenko, D I

    1977-01-01

    Melatonin content in the epiphysis, serotonin, noradrenaline, dopamine-in the hypothalamus, gonadotropins--in the hypophysis of rats was studied under normal conditions and following ovariectomy; regularly of the estral cycle phases was studied as well. Two series of experiments were conducted on 120 rats with regular estral cycles. The animals were divided into groups according to the estral cycle phase. Melatonin concentration in the epiphysis, serotonin, noradrenaline, dopamine--in the hypothalamus was subject to variations coinciding with the estral cycle phases. Serotonin, noradrenaline, and dopamine content decreased in the hypophysis of ovariectomized rats in comparison with control; melatonin content rose in the epiphysis. There was no complete extinction of the estral cycle in the course of investigation (20 days). The action of castration on the sexual cycle depended on the phase at which the rats were subjected to ovariectomy. A reverse relationship existed between the melatonin content in the epiphysis and serotonin content in the hypothalamus, this serving as one of the important factors in the regulation of the sexual function.

  16. Forum. Femoral neck surgery using a local anaesthetic technique.

    Science.gov (United States)

    Howard, C B; Mackie, I G; Fairclough, J; Austin, T R

    1983-10-01

    Thirty cases of femoral sub-capital fractures, Garden grades 1-4, were reduced and internally fixed with crossed Garden screws using femoral nerve block. In addition, sedation and analgesia was provided by low dose ketamine and diazepam. No deaths or other complications occurred in these patients. In a similar group of patients who received spinal analgesia in the same unit under similar conditions there was one death and two cerebrovascular accidents.

  17. Femoral bowing plane adaptation to femoral anteversion

    Directory of Open Access Journals (Sweden)

    Alp Akman

    2017-01-01

    Full Text Available Background: Femoral bowing plane (FBP is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years. Results: The anteversion values were found as the angle between a distal condylar axis (DCA and femoral neck anteversion axis (FNAA along an imaginary longitudinal femoral axis (LFA in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°. On the other hand, FBP does not lie close to the sagittal femoral plane (SFP; instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P0 < 0.001; r = 0.680 and r = −0.682, respectively. Combined correlation is perfect (R[2] = 1 as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component

  18. Femoral bowing plane adaptation to femoral anteversion

    Science.gov (United States)

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Background: Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21–84 years). Results: The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78–102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P < 0.001; r = 0.680 and r = −0.682, respectively). Combined correlation is perfect (R2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning

  19. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

    2003-02-01

    To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)

  20. Femoral hernia causing pneumoperitoneum.

    OpenAIRE

    King, H. A.; Boulter, P. S.

    1986-01-01

    Richter's hernia, in which only a portion of the circumference of the intestine lies within the sac, is a common complication of femoral hernia. This case report is of 39 year old female who presented with a pneumoperitoneum and was found at laparotomy to have a right femoral Richter's hernia containing a knuckle of perforated small bowel. This is a previously unreported presentation of femoral hernia.

  1. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  2. From capital to capital

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    HOW easy it is for one who lives in Beijing, capital of the country, to have the impression that all things significant happen there! This is to forget how there are now many provincial capitals in China, that are rapidly modernizing. In order to achieve such modernization, these cities, like

  3. Chondroblastoma of the femoral neck as a cause of hip synovitis.

    Science.gov (United States)

    Kaneko, Hiroshi; Kitoh, Hiroshi; Wasa, Junji; Nishida, Yoshihiro; Ishiguro, Naoki

    2012-03-01

    Chondroblastoma is a rare benign chondroid bone tumor, which typically arises from the epiphysis of a long tubular bone. We present a 13-year-old girl with persistent hip synovitis caused by a chondroblastoma that arose from the femoral neck (metaphysis) and uniquely extended extraosseously into the hip joint. Computed tomography scan clearly demonstrated a tumoral lesion of the left femoral neck and a periosteal reaction along the anterior cortex of the femur, distal to the legion. Magnetic resonance imaging showed reactive synovitis with marked joint effusion of the hip and an extensive edema in the proximal femur and the surrounding soft tissues. Aneurysmal bone cysts formation secondary to chondroblastoma was confirmed by histologic examinations of the excised specimens. Complete relief of pain and an improvement in the range of movement of the hip joint was obtained after surgical resection of the tumor.

  4. Nonossifying fibroma developed in metaphysis and epiphysis--a case report.

    Science.gov (United States)

    Noh, Jung Ho; Ryu, Kyung Nam; Bae, Ji Yoon; Roh, Young Hak; Choi, In Seok

    2013-04-01

    Nonossifying fibroma is developed in childhood and adolescence and is usually asymptomatic. It is typically arises in the metaphysis of long bone and migrates toward the diaphysis with growth. We present a very rare case of nonossifying fibroma involving metaphysis and epiphysis of the distal femur in a 20-year-old man. Nonossifying fibroma is a benign fibroblastic lesion, which is also termed benign cortical defect and fibroxanthoma. A nonossifying fibroma rarely causes problems and does not interfere with healing or growth. The lesions are usually asymptomatic. With growth and remodeling of the bone, the lesion typically disappears and is replaced with normal bone. However, the lesion may weaken the involved bone, causing fracture. The lesion typically arises in the metaphysis of long bones and may migrate toward the diaphysis with growth. There have never been reports of nonossifying fibroma involving epiphysis that we know of. We report a very rare case of nonossifying fibroma involving metaphysis and epiphysis in a young adult. Written, informed consent was obtained from the patient to publish this case report, including the images.

  5. Social capital

    OpenAIRE

    Landhäußer, Sandra; Ziegler, Holger

    2003-01-01

    This paper surveys research on social capital. We explore the concepts that motivate the social capital literature, efforts to formally model social capital using economic theory, the econometrics of social capital, and empirical studies of the role of social capital in various socioeconomic outcomes. While our focus is primarily on the place of social capital in economics, we do consider its broader social science context. We argue that while the social capital literature has produced many i...

  6. Radiographic femoral varus measurement is affected unpredictably by femoral rotation

    DEFF Research Database (Denmark)

    Miles, James Edward

    Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral c...

  7. Medial Collateral Ligament (MCL) Injuries

    Science.gov (United States)

    ... THIS TOPIC Jumper's Knee Safety Tips: Basketball Knee Injuries Sports and Exercise Safety Slipped Capital Femoral Epiphysis (SCFE) Anterior Cruciate Ligament (ACL) Injuries Contact Us Print Resources Send to a friend ...

  8. Proximal femoral epiphysiolysis during reduction of hip dislocation in adolescents.

    Science.gov (United States)

    Herrera-Soto, Jose Antonio; Price, Charles T; Reuss, Bryan L; Riley, Patrick; Kasser, James R; Beaty, James H

    2006-01-01

    Traumatic hip dislocation is an uncommon injury in children. The urgency of closed reduction to prevent possible osteonecrosis may present some pitfalls. Adolescents with open proximal femoral physis may have sustained trauma to the physis at the time of dislocation that can lead to displacement of the epiphysis during the reduction maneuver. The purpose of this study is to report 5 cases with this complication and discuss potential etiology and management. All of the 5 patients were between 12 and 16 years old and underwent closed reduction under conscious sedation. Epiphysiolysis of the femoral head was diagnosed after reduction in all 5 patients. Every patient underwent emergent open reduction and internal fixation of the femur and open hip reduction. Avascular necrosis was identified in all 5 patients within 3 to 15 months postinjury. If there is any suspicion of associated physeal injury or if there is any physeal instability noted under fluoroscopy, an open reduction is recommended in the operating room under radiograph guidance to prevent displacement.

  9. Capital y capital social

    OpenAIRE

    Bolívar Espinoza, Gardy Augusto; Elizalde, Antonio

    2012-01-01

    La perspectiva teórica del Capital, del siglo XIX, aparece alejada del capital social del siglo XXI.  Ambas, con la misma raíz, sin embargo, pareciera que no se tocan, ni teórica ni prácticamente.  Quizás, sería pertinente escudriñar esta relación. Desde la década de los noventa, el tema del “capital social” ha sido visto por muchos estudiosos de la realidad social contemporánea como una propuesta promisoria, transversal y hegemónica. Tanto desde la economía, las ciencias morales, la ciencia ...

  10. Capital y capital social

    OpenAIRE

    Avalos-Lozano, José Antonio; Barrientos,Jaime; Bolívar Espinoza, Gardy Augusto; Brower Beltramin, Jorge; Cabrera, Cecilia; Caloca Osorio, Oscar Rogelio; Castro Sáez, Bernardo; Ceberio de León, Iñaki; Cleary, Eda; Córdova, María Gabriela; Cuéllar Saavedra, Óscar; Elizalde, Antonio; Flores Vega, Leonel; Gajardo Cornejo, Claudio; Garcés, Alejandro

    2011-01-01

    Desde la década de los noventa, el tema del “capital social” ha sido visto por muchos estudiosos de la realidad social contemporánea como una propuesta promisoria, transversal y hegemónica. Tanto desde la economía, las ciencias morales, la ciencia y la sociología política, expertos de diversas instituciones internacionales han concurrido a este campo en busca de soluciones para el diseño de políticas públicas, que es donde parece brillar más este concepto. El “capital social”, sin embargo, –a...

  11. [Long-term consequences of resection of 1/3 proximal epiphysis of child's right tibia--a case study].

    Science.gov (United States)

    Duda, Sławomir; Jasiewicz, Barbara; Potaczek, Tomasz; Tęsiorowski, Maciej

    2015-01-01

    Authors report a case of a patient with varus deformity of right knee, caused by wide resection of proximal metaphysis and epiphysis of right tibia. Afore mentioned procedure led to loss of right knee joint integrity, with its lateral instability, shortening, and axis deviation of right tibia. Surgical treatment of this complications was performed in several stages and took about 5 years, starting from temporal, lateral hemiepiphysiodesis of proximal tibial epiphysis, subacute epiphysiolysis of proximal tibial epiphysis and high valgus tibia osteotomy, at the end finished with medial tibia condyle reconstruction with autogenic graft and osteoconductive substances. The proper mechanical and anatomical axis of the right limb, with full stability and movement of right knee was achieved after those surgeries. The process of treatment of lower extremity axis deviation takes long time, frequently involves several surgeries and needs firm cooperation between doctor and patient.

  12. [Subtrochanteric femoral fractures].

    Science.gov (United States)

    Ulmar, B; Simon, S; Eschler, A; Mittlmeier, T

    2013-12-01

    Subtrochanteric femoral fractures are proximal femoral fractures which are located between the trochanter minor and an area of 3 cm below the minor trochanter on the femoral shaft. About 10-15% of all proximal femoral fractures correspond to this fracture site. Elderly or geriatric patients are generally affected and the injury is often the result of a fall in the home, while high-energy trauma is the cause in a small group of generally younger patients. Clinical evaluation of the affected extremity shows disability of axial weight-bearing and pain during compression and rotation of the hip joint. Basic diagnostics include conventional x-rays of the injured femur in the anterior-posterior and lateral planes. These subtrochanteric femoral fractures are almost always treated surgically due to the inherent high degree of instability. The main goals of surgical intervention are to achieve anatomic fracture reduction and primary full weight-bearing stability of the corresponding leg. Intramedullary interlocking nails are used for primary treatment, while extramedullary implants are often used in revision surgery. Early mobilization and intensive respiratory exercises are necessary to prevent early postoperative complications.

  13. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

    Miles, James Edward; Svalastoga, Eiliv Lars; Eriksen, Thomas

    Agreement and reliability of femoral varus measurements: a comparison of four techniques Three different techniques have been described for measuring femoral varus radiographically in the dog, but how the measurements from these techniques compare is unknown. Further, measurement reliability has ...

  14. Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis.

    Science.gov (United States)

    Beckmann, Nicholas; Crawford, Lindsay

    2016-08-01

    Sternoclavicular injuries are relatively rare, composing less than 1 % of all musculoskeletal fractures or dislocations. When sternoclavicular injuries do occur, they typically present as an isolated dislocation of the sternoclavicular joint without associated fracture of the clavicle or manubrium. However, in patients with unfused medial clavicle physis, sternoclavicular joint injuries can present as a fracture-dislocation through the unfused physis. These physeal injuries are important to recognize as the displaced epiphysis can block reduction of the sternoclavicular joint. We present a case of a 15-year-old female basketball player presenting with suspected sternoclavicular joint injury after sustaining a direct blow to the left shoulder. An initial shoulder CT confirmed the presence of the clinically suspected posterior sternoclavicular dislocation without fracture identified. An MRI of the left sternoclavicular joint was then performed for suspected physeal fracture, which confirmed the presence of a fracture through the medial clavicle physis with anterior displacement of the unossified epiphysis, blocking reduction of the metaphysis. Given the findings on MRI, the pediatric orthropedic surgeon was able to counsel the family of the high likelihood of failed closed reduction of the sternoclavicular joint requiring conversion to open reduction and internal fixation. The patient underwent successful open reduction and internal fixation of the medial clavical physeal fracture after an initial gentle attempt at closed reduction was unsuccessful.

  15. Laparoscopic repair of femoral hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, ...

  16. 3D-printed navigation template in proximal femoral osteotomy for older children with developmental dysplasia of the hip

    Science.gov (United States)

    Zheng, Pengfei; Xu, Peng; Yao, Qingqiang; Tang, Kai; Lou, Yue

    2017-01-01

    To explore the feasibility of 3D-printed navigation template in proximal femoral varus rotation and shortening osteotomy for older children with developmental dysplasia of the hip (DDH). Between June 2014 and May 2015, navigation templates were designed and used for 12 DDH patients. Surgical information and outcomes were compared to 13 patients undergoing the same surgery but without navigation template. In template-guided patient group, operation time (21.08 min vs. 46.92 min), number of X-ray exposures (3.92 vs. 6.69), and occurrence of femoral epiphysis damage (0 vs. 0.92) were significantly decreased (P < 0.05). Furthermore, after 12–18 months follow-up, 66.7% and 16.7% of the hips in template-guided group were rated as excellent or good, respectively, according to the McKay criteria; 83.3% and 16.7% by using the Severin criteria respectively. By contrast, 46.2% and 23.1% of the hips in traditional operation group were classed as excellent or good, respectively, using the McKay criteria; 46.2% and 30.8% by using the Severin criteria respectively. The template-guided group achieved a better outcome; however, there was no significant difference. Application of the navigation template for older DDH children can reduce the operation time, radiation exposure, and epiphysis damage, which also simplifies surgery and improves precision. PMID:28322290

  17. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  18. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    Energy Technology Data Exchange (ETDEWEB)

    Citak, Musa; Jagodzinski, Michael; Krettek, Christian; Huefner, Tobias [Hannover Medical School, Trauma Department, Hannover (Germany); Citak, Mustafa [BG-University Hospital Bergmannsheil, Department of Surgery, Bochum (Germany); Kendoff, Daniel; O' Loughlin, Padhraig F. [Hospital for Special Surgery, Orthopaedic Department, New York, NY (United States); Tavassol, Frank [Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover (Germany)

    2009-12-15

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  19. Isolation and characterization of novel murine epiphysis derived mesenchymal stem cells.

    Directory of Open Access Journals (Sweden)

    Chun-Chun Cheng

    Full Text Available BACKGROUND: While bone marrow (BM is a rich source of mesenchymal stem cells (MSCs, previous studies have shown that MSCs derived from mouse BM (BMMSCs were difficult to manipulate as compared to MSCs derived from other species. The objective of this study was to find an alternative murine MSCs source that could provide sufficient MSCs. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we described a novel type of MSCs that migrates directly from the mouse epiphysis in culture. Epiphysis-derived MSCs (EMSCs could be extensively expanded in plastic adherent culture, and they had a greater ability for clonogenic formation and cell proliferation than BMMSCs. Under specific induction conditions, EMSCs demonstrated multipotency through their ability to differentiate into adipocytes, osteocytes and chondrocytes. Immunophenotypic analysis demonstrated that EMSCs were positive for CD29, CD44, CD73, CD105, CD166, Sca-1 and SSEA-4, while negative for CD11b, CD31, CD34 and CD45. Notably, EMSCs did not express major histocompatibility complex class I (MHC I or MHC II under our culture system. EMSCs also successfully suppressed the proliferation of splenocytes triggered by concanavalin A (Con A or allogeneic splenocytes, and decreased the expression of IL-1, IL-6 and TNF-α in Con A-stimulated splenocytes suggesting their anti-inflammatory properties. Moreover, EMSCs enhanced fracture repair, ameliorated necrosis in ischemic skin flap, and improved blood perfusion in hindlimb ischemia in the in vivo experiments. CONCLUSIONS/SIGNIFICANCES: These results indicate that EMSCs, a new type of MSCs established by our simple isolation method, are a preferable alternative for mice MSCs due to their better growth and differentiation potentialities.

  20. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

  1. Proximal Focal Femoral Deficiency

    OpenAIRE

    Vishal Kalia, Vibhuti

    2008-01-01

    Proximal focal femoral deficiency (PFFD) is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contra...

  2. Photopenia of the femoral head on 3 phase bone scan using Tc-99m MDP with acute irritable hip in the preschool children: comparison with MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Young Hoon; Lee, Jong Doo; Yoon, Choon Sik; Suh, Jin Suck; Jeon, Tae Joo [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    1998-07-01

    The child with acute irritable hip is always a diagnostic challenge. Photopenia of femur head is described in Legg-Calve-Perthes disease (LCP). However, it can be seen in cases of septic arthritis (SA) with interruption of vascular supply. Despites being uncommon, recognition of SA as a cause of photopenia is important and requires urgent referral to decompression and drainage. This study was to evaluate causes and scintigraphic features of photopenia of femur head in patients with acute irritable hip and to correlate them with MR findings. 15 patients with acute irritable hip showed photopenia of femur head on bone scan were included. Mean age was 5.3 yrs ( 9 months to 8 yrs). There were 9 patients with LCP and 3 with septic arthritis combined with osteomyelitis. All parents underwent 3 phase bone scan and hip MRI within 2 days interval. Patterns of photopenia of femur head was divided into partial, complete and extending to the metaphysis. All patients with LCP showed partial photopenia confined to femur epiphysis. Whereas, 1 with septic arthritis demonstrated complete photopenia of femur head and in 2 with septic arthritis and 3 with septic arthritis combined with osteomyelitis revealed complete photopenia of femur head extending to the metaphyseal area. In cases with septic arthritis, increased uptake affecting both sides of hip joint except for photopenic area is also noted. On MRI, all patients with LCP showed abnormalities confined to the epiphysis. In cases with septic arthritis, abnormalities are not confined to the epiphysis and marrow edema and joint effusion were also noted. In evaluating photopenia of the femur head, it would be helpful to distinguish between the photopenia localized to the femoral epiphysis as seen in cases of LCP and complete photopenia of femur head with extension to the metaphysis as seen in cases of septic arthritis. Recognition of complete with extension to the metaphysis help guide urgent proper management of septic arthritis.

  3. Inactivated Bone Replantation with Preservation of the Epiphysis in Children with Osteosarcoma- Clinical Report of Two Cases

    Institute of Scientific and Technical Information of China (English)

    YUXiuchun; LIUXiaoping; ZHOUYin; LIKaihua; QUZaiping

    2005-01-01

    Objective: To evaluate the value of inactivated bone replantation with preservation of the epiphysis following the effective chemotherapy in avoiding postoperative discrepancy of the affected limb in children with osteosarcoma. Methods: Two children (aged 5 and 10 years, 1 male and 1 female) with osteosarcoma underwent inactivated bone replantation with preserving epiphysis following chemotherapy (MMIA protocol, including high-dose methotrexate, adriamycin and ifosfamide). After two cycles of preoperative chemotherapy, pain vanished, the local mass shrank and there was no pain on pressing the affected parts. Sera AKP and LDH were reduced to normal levels; marked shrinkage and sclerotic changes and good margin of lesions were seen on plain radiographs and MR images. Two courses of the same protocol as preoperative chemotherapy were administered postoperatively. Results: Postoperative histological examination of the specimens demonstrated absence of vital tumor cells. Incisions healed well and no complications occurred. The replanted inactivated bone healed with host at 6 months after operation.In the two patients, no evidence was seen of metastasis and recurrence and discrepancy of the affected limbs in postoperative 36 and 48 months. Functions of the affected limbs were satisfactory. Conclusion:Inactivated bone replantation with preserving epiphysis was a viable option for osteosarcoma in children.The long-term outcomes remain to be further proven.

  4. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  5. CAPITAL STRUCTURE AND VENTURE CAPITAL

    Directory of Open Access Journals (Sweden)

    Becsky-Nagy Patricia

    2015-07-01

    Full Text Available Venture capital significantly changes the capital structure of the portfolio company at the time of the investment. Venture capitalists contribute to the company’s success through their active involvement in the management and their added value appears in the increase of the value of the equity. At the same time with taking active role in the management, agency problem occurs, that complicates the cooperation and the success of exit. In this article we search the answer for the question whether the preferred equity, that are commonly used in the US for bridging the agency problem, are used and able to help Hungarian venture capitalists to manage agency problems. On the other hand we examined how the venture capital affect capital structure, how the venture capitalists value added appear in the capital structure. During the evaluation of the three case studies, we came to the conclusion, that the venture capital investments have positive effect on the liabilities of the enterprises, as the capital structure indexes show. However, the investors need the ownership, which help them to step up resolutely, when things change for the worse, and companies need the expertise, which the investors bring with their personal assistance. The investor’s new attitude also has positive effect on a mature company, which has an experienced leader, because he can show another aspect, as a person who come from outside. During the examination of the capital structure, we cannot disregard the events of the company’s environment, which have effects on the firm. The investor’s decisions also appear different ways. Because of this, every venture capital investment is different, just as the capital structure of the firms, in which they invest.

  6. Femoral shaft fracture fixed with intramedullary nailing in a child resulting in femoral neck narrowing deformity and fracture

    Institute of Scientific and Technical Information of China (English)

    WAN Lin; ZHAO Lin; LIU Yan-qing; WANG Xu; LIU Jing-sheng

    2008-01-01

    @@ Treatment of factures in children is different from that of adults because improper internal fixation,including selection of internal fixation device and epiphysis approaching,may cause epiphysis injury,which may result in a series of secondary lesions in bone development,such as growth arrest,limb length discrepancy, osteonecrosis, and other deformities.

  7. Allergy Capitals

    Science.gov (United States)

    ... Health Professionals Partners Media Donate Research 2016 Fall Allergy Capitals If you’re one of the millions ... needs of their residents with allergic diseases. Fall Allergies by the Numbers Nasal allergies affect more than ...

  8. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  9. Capitalizing China

    OpenAIRE

    Joseph Fan; Randall Morck; Bernard Yeung

    2011-01-01

    Despite a vast accumulation of private capital, China is not embracing capitalism. Deceptively familiar capitalist features disguise the profoundly unfamiliar foundations of "market socialism with Chinese characteristics." The Chinese Communist Party (CCP), by controlling the career advancement of all senior personnel in all regulatory agencies, all state-owned enterprises (SOEs), and virtually all major financial institutions state-owned enterprises (SOEs), and senior Party positions in all ...

  10. Understanding Capitalism

    DEFF Research Database (Denmark)

    du Gay, Paul; Morgan, Glenn

    2013-01-01

    if they are to be sustained. Such logics are stabilized to the degree that they can pass the tests which they set themselves. The chapter shows how the projective city has increasingly failed these tests. It has instead created a privileged group of ‘mobile citizens’ working with mobile, global capital in ways...... general application particularly in the context of the current crisis of capitalism....

  11. DOSTOYEVSKI'S "CAPITAL"

    OpenAIRE

    GUNAL, E. Zeynep

    2012-01-01

    Dostoyevski who was always in need of money and in debt, wrote two great novels about capital: "Idiot" and "Crime and Punishment". In these novels the writer tries to prove the negative effects of capital on people. This article particularly focuses on "Crime and Punishment". Because crime is discussed as the multi-dimensional factor in this work. Moreover, it is claimed that in the troika of crime which formed of Raskolnikov, Svidrigaylov and Luzhin, Luzhin is the most dangerous character w...

  12. Chondroblastoma with secondary aneurysmal bone cyst of the capitate.

    Science.gov (United States)

    Sato, Eiichi; Ichikawa, Jiro; Ando, Takashi; Sato, Nobutaka; Kawasaki, Tomonori; Haro, Hirotaka

    2014-05-01

    Chondroblastoma is a benign tumor that typically arises in the epiphysis of a long bone. There have been only 2 reported cases of chondroblastoma involving the capitate. This is the first report of chondroblastoma with secondary aneurysmal bone cyst involving the capitate. A 33-year-old man presented with a 3-year history of pain and swelling of the right wrist. Radiography as well as computed tomography showed a radiolucent area and no matrix calcification within the capitate. Magnetic resonance imaging revealed a homogeneous signal that was low on T1-weighted images and high on T2-weighted images and showed only slight enhancement. On the basis of imaging findings, the authors chose excisional biopsy. The bone tumor in the capitate was explored through a dorsal approach by dividing the extensor tendons. After repeated curettages, bone graft substitute using allograft bone was packed into the capitate. Histologically, the authors diagnosed this tumor as a chondroblastoma with a secondary aneurysmal bone cyst. At the final 2-year follow-up, there was evidence of bone union, full range of motion, and recovery and no evidence of recurrence. Although the recurrence of chondroblastoma is occasionally reported, the principal treatment is intralesional curettage and bone graft. High-speed burring, phenol, bone cement, and cryosurgery have been reported to reduce local recurrence. Complete excision of the carpal bone seems to be overtreatment.

  13. Femoralni trikotnik: The femoral triangle:

    OpenAIRE

    Mlakar, Boštjan; Ravnik, Dean

    1999-01-01

    The topography and structures of the femoral triangle are presented. The femorai triangle lies between the inguinal ligament at the base, the sartoriusmuscle at the lateral border and the long adductor muscle at the medial border. The apex of the femoral triangle is situated at the meeting point of the medial borders of the sartorius and long adductor muscles. The subinguinal space, which is divided into the lacuna musculorum and lacuna vasorum, provides a passageway for the lateral cutaneous...

  14. Intelligence Capital

    Directory of Open Access Journals (Sweden)

    Maid Pajevic

    2011-08-01

    Full Text Available The author of this article presents a new theoretical concept of intelligence capital, with which he explains the multi-meaningful term ‘intelligence’. The author offers a conceptual frame „intelligence capital“ as a generic complex consisting of four interactively linked elements. The contribution of this article is, among other things, an answer to a question: What is an applicative value of intelligence capital as a new theoretical concept for the sys­tem of security and intelligence of BiH? Historical context implies greater responsibility of OSA BiH in realising its preventive function of protecting security of BiH and its citizens. Theoretical frame of the intelligence capital implies that the system of security and intelligence of BiH should be able to respond to strategic questions: to know-what, to know – why, to know – how, to know – who.

  15. Capital Unchained

    DEFF Research Database (Denmark)

    Bryan, Dick; Rafferty, Michael; Wigan, Duncan

    2017-01-01

    The rise of intangible assets such as brand names, research and development, patents and other forms of abstract capital such as digital platforms and data flows has confounded extant measures and concepts of capital and accumulation. What used to be a residual asset category known as ‘goodwill......’ has now overtaken so-called fixed or tangible assets in the profitability and valuation of many leading corporations. Yet these intangible assets lead a double life as both spatial and temporal in some dimensions, yet fluid and spatio-temporally elusive in others. Using a framework focused...... on measuring (by accountants), managing (by corporations) and monitoring (by International Political Economy scholars and regulators), this article explores the longer term implications of accumulation of internationalised capital in intangible and abstract forms, and the prominent role of finance and offshore...

  16. Intelligence Capital

    OpenAIRE

    Maid Pajevic

    2011-01-01

    The author of this article presents a new theoretical concept of intelligence capital, with which he explains the multi-meaningful term ‘intelligence’. The author offers a conceptual frame „intelligence capital“ as a generic complex consisting of four interactively linked elements. The contribution of this article is, among other things, an answer to a question: What is an applicative value of intelligence capital as a new theoretical concept for the sys­tem of security and intelligence of Bi...

  17. Capital Challenge

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    China is on its way to establishing its own venture capital industry Venture capitalists will find no safe haven worldwide as the prospects for the majority of economies to pick up remain dim for the next two years. Still, if some of them have the money and

  18. Intra-epiphyseal stress injury of the proximal tibial epiphysis: Preliminary experience of magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Tony, G., E-mail: drgtony@gmail.com [Stafford General Hospital, Weston Road, Stafford, Staffordshire ST16 3SA (United Kingdom); Charran, A., E-mail: amandacharran@yahoo.com [Hillingdon Hospital, Pield Heath Rd, Uxbridge, Middlesex UB8 3NN (United Kingdom); Tins, B., E-mail: bernhard.tins@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Lalam, R., E-mail: radhesh.lalam@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Tyrrell, P.N.M., E-mail: prudencia.tyrrell@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Singh, J., E-mail: jaspreet.singh@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Cool, P., E-mail: paul.cool@rjah.nhs.uk [Orthopaedic Oncology, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Kiely, N., E-mail: nigel.kiely@rjah.nhs.uk [Paediatric Orthopaedics, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Cassar-Pullicino, V.N., E-mail: Victor.Pullicino@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom)

    2014-11-15

    Highlights: • Purely intra-epiphyseal stress injuries of the proximal tibial epiphysis are described for the first time. • The variation in the MRI findings of these injuries depending on the stage of maturation is demonstrated. • We postulate a patho-mechanism to explain the variations in site and appearance of stress injuries in this region. - Abstract: Stress induced injuries affecting the physeal plate or cortical bone in children and adolescents, especially young athletes, have been well described. However, there are no reports in the current English language literature of stress injury affecting the incompletely ossified epiphyseal cartilage. We present four cases of stress related change to the proximal tibial epiphysis (PTE) along with their respective magnetic resonance imaging (MRI) appearances ranging from subtle oedema signal to a pseudo-tumour like appearance within the epiphyseal cartilage. The site and pattern of intra-epiphyseal injury is determined by the type of tissue that is affected, the maturity of the skeleton and the type of forces that are transmitted through the tissue. We demonstrate how an awareness of the morphological spectrum of MRI appearances in intra-epiphyseal stress injury and the ability to identify concomitant signs of stress in other nearby structures can help reduce misdiagnosis, avoid invasive diagnostic procedures like bone biopsy and reassure patients and their families.

  19. Trinidadian capitalism

    Directory of Open Access Journals (Sweden)

    Kevin A. Yelvington

    1999-07-01

    Full Text Available [First paragraph] Capitalism: An Ethnographic Approach. DANIEL MILLER. Oxford: Berg, 1997. x + 357 pp. (Cloth £39.00, Paper £17.99 Women, Labour and Politics in Trinidad and Tobago: A History. RHODA E. REDDOCK. London: Zed, 1994. vi + 346 pp. (Cloth £39.95, Paper £15.95 Despite the underdeveloped state of the scholarship on its admittedly short sugar plantation slavery period, we now have a corpus of studies on various aspects of capitalism in Trinidad - from its historical advent (Sebastien 1978 to its twentieth-century manifestation in the petroleum sector (Seers 1964; Sandoval 1983, and from the ethnic structure of labor markets (Camejo 1971; Harewood 1971 and the role of capitalism in racial/ethnic inequality (Henry 1993; Coppin & Olsen 1998 to the way ethnicity affects business, big (Button 1981; Parris 1985; Centre for Ethnic Studies 1993 and small (Ryan & Barclay 1992; Griffith 1997, and the way ethnicity and gender are used in class recruitment (Yelvington 1995. There are also a number of fine working-class histories (e.g., Rennie 1973; Ramdin 1982; Basdeo 1983 and important works on the labor riots and strikes and the nature of the colonial state during the crises of the 1930s (e.g., Thomas 1987; Singh 1994. The two books under review here complement the works mentioned above, and they complement each other as well: Reddock's deals with the way capitalism up to the mid-century was buttressed by colonial politics, and explores how this formation engendered certain kinds of political responses, while Miller approaches capitalism through the assumption that fundamental changes in the post-Oil Boom period (ca. 1973-80 brought about considerable autonomy between production and consumption that can and should now be read through an analysis of the cultural circulation of images and commodities in the society. These books are both noteworthy because they engage in explicit theorizing on what capitalism was and is, and what it did and

  20. Recurrent femoral hernia and associated ovarian pathology.

    Science.gov (United States)

    Gately, Ryan Patrick; Concannon, Elizabeth Sarah; Hogan, A; Ryan, R S; O'Leary, M; Barry, K

    2012-08-27

    The following case describes an ovarian tumour presenting in a highly unusual manner-in the form of a recurrent femoral hernia. Recurrent femoral herniae are unusual and should prompt awareness of underlying pathology causing increased intra-abdominal pressure.

  1. Femoral hernia; Clinical significance of radiologic diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bergenfeldt, M.; Lasson, A. (Lund University (Sweden). Department of Surgery Malmo General Hospital (Sweden)); Ekberg, O.; Kesek, P. (Lund University (Sweden). Department of Radiology Malmo General Hospital (Sweden))

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs.

  2. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  3. Age-related Marrow Conversion and Developing Epiphysis in the Proximal Femur: Evaluation with STIR MR Imaging

    Institute of Scientific and Technical Information of China (English)

    NIU Jinliang; FENG Gansheng; KONG Xiangquan; WANG Jun; HAN Ping

    2007-01-01

    In order to observe the feature of age-related marrow conversion and maturation of epi-physeal cartilage and analyze the distribution of red and yellow marrow in the proximal femur at STIR MR imaging, STIR and T1 weighted MR imaging of the proximal femur in 52 subjects, aged 4 months to 25 years old, were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The subjects with no known bone marrow abnormalities were divided into 6 age groups. The signal intensity of the marrow in the proximal epiphysis, proximal metaphysis, proximal diaphysis, distal diaphysis and greater trochanter was compared with the signal intensity and homo- geneity of surrounding muscle and fat and graded by two observers. The results showed that the con- version of hematopoietic marrow in the proximal femur followed a well-defined sequence, occurring first in the proximal epiphysis, followed by the distal diaphysis, and then greater trochanter and metaphysis. STIR in combination with T1-weighted imaging could display clearly the origin of ossi-fication center and the course of conversion from red to yellow marrow in proximal epiphysis and greater trochanter. STIR imaging showed that the marrow conversion in proximal metaphysic began below epiphyseal plate and intertrochanter. The site of red yellow was distributed in weight-bearing axis by 20 years of age. The marrow conversion of diaphysis was from distal end to proximal end, and the consequence of conversion was that distal diaphysis contained yellow marrow but proximal diaphysis partly red marrow connected with the red marrow of metaphysic. The epiphyseal cartilage had different characters of signal-intensity with age in STIR sequence. The distribution of red marrow in STIR imaging was more close to that of anatomy than T1-weighted imaging. It was concluded that STIR could dynamically display the feature of morrow conversion and the development of epiphyseal cartilage and accurately reveal the age

  4. Flexible Capitalism

    DEFF Research Database (Denmark)

    Approaching “work” as at heart a practice of exchange, this volume explores sociality in work environments marked by the kind of structural changes that have come to define contemporary “flexible” capitalism. It introduces anthropological exchange theory to a wider readership, and shows how...... the perspective offers new ways to enquire about the flexible capitalism’s social dimensions. The essays contribute to a trans-disciplinary scholarship on contemporary economic practice and change by documenting how, across diverse settings, “gift-like” socialities proliferate, and even sustain the intensified...

  5. Salter-Harris type IV fracture of the proximal phalanx of the thumb with rotation of the epiphysis: Outcome 10 years following open reduction and K-wire fixation

    Directory of Open Access Journals (Sweden)

    Mohammad M. Al-Qattan

    2017-01-01

    Conclusion: We present a rare case of Salter-Harris type IV fracture of the proximal phalanx of the thumb with rotation of the epiphysis. Long term outcome was satisfactory but there was diaphyseal constriction leading to a narrower thumb.

  6. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  7. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right fem...

  8. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

    Directory of Open Access Journals (Sweden)

    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  9. Femoral revision surgery with impaction bone grafting

    NARCIS (Netherlands)

    B.L.E.F. ten Have (Bas); R.W. Brouwer (Reinoud); F.C. van Biezen (Frans); J.A.N. Verhaar (Jan)

    2012-01-01

    textabstractThe purpose of this prospective study was to evaluate the long-term clinical and radiological outcomes of revision of the femoral component of a total hip replacement using impaction bone grafting. Femoral revision with an impacted allograft was performed on 29 patients (31 hips). In all

  10. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  11. Classification of subtrochanteric femoral fractures.

    Science.gov (United States)

    Loizou, C L; McNamara, I; Ahmed, K; Pryor, G A; Parker, M J

    2010-07-01

    A review of the literature identified 15 different classification methods for subtrochanteric femoral fractures. Only eight of those classifications defined the area of bone, which constituted a subtrochanteric fracture. The actual length of femur defined as the subtrochanteric zone varied from 3 cm up to the level of the femoral isthmus. There was no agreement between the different classifications regarding the proximal and distal border or for those fractures, which traverse anatomical boundaries. In the various classifications, fractures were subdivided into 2-15 subgroups. The majority of the identified studies were unable to find the classifications useful in either determining treatment or predicting the outcome after treatment. We subdivided subtrochanteric fractures into three types based on the degree of fracture comminution. We examined the inter- and intra-observer agreement of our recommended classification. One orthopaedic consultant, one specialist hip fracture surgeon, two trainee registrar orthopaedic surgeons and one specialty trainee in orthopaedics, on two different occasions, 8 weeks apart, independently classified the radiographs of 20 patients with a subtrochanteric fracture. The mean kappa value for inter- and intra-observer variation was 0.71 and 0.79, respectively, with both showing substantial agreement and, therefore, this simpler classification is recommended. Based on the review of previous classification methods, we also recommend that the subtrochanteric zone be defined as the one in which the fracture line crossing the femur is predominantly within the area of bone extending 5 cm below the lower border of the lesser trochanter.

  12. Incarcerated Femoral Hernia Containing Ipsilateral Fallopian Tube

    Directory of Open Access Journals (Sweden)

    Stefanos Atmatzidis

    2010-01-01

    Full Text Available Femoral hernias are more common in women and lead to a substantial higher rate for an emergency operation, due to strangulation. Incarcerated femoral hernia with fallopian tube as a content is an extremely rare condition. A 20-year-old woman presented to the emergency department complaining of a 6-day right groin swelling, which became painful and tender to palpation during the last 48 hours. Preoperative ultrasonography detected an oedematous hernia sac, above the femoral vessels, suggesting the presence of an incarcerated femoral hernia. The patient eventually underwent emergency surgery and the diagnosis of a strangulated femoral hernia sac, containing fallopian tube, was established. No resection of the uterine tube was performed and the hernia was repaired with polypropylene plug. The postoperative period was uneventful and the woman was discharged on the second postoperative day.

  13. Probabilistic age classification with Bayesian networks: A study on the ossification status of the medial clavicular epiphysis.

    Science.gov (United States)

    Sironi, Emanuele; Pinchi, Vilma; Taroni, Franco

    2016-01-01

    In the past few decades, the rise of criminal, civil and asylum cases involving young people lacking valid identification documents has generated an increase in the demand of age estimation. The chronological age or the probability that an individual is older or younger than a given age threshold are generally estimated by means of some statistical methods based on observations performed on specific physical attributes. Among these statistical methods, those developed in the Bayesian framework allow users to provide coherent and transparent assignments which fulfill forensic and medico-legal purposes. The application of the Bayesian approach is facilitated by using probabilistic graphical tools, such as Bayesian networks. The aim of this work is to test the performances of the Bayesian network for age estimation recently presented in scientific literature in classifying individuals as older or younger than 18 years of age. For these exploratory analyses, a sample related to the ossification status of the medial clavicular epiphysis available in scientific literature was used. Results obtained in the classification are promising: in the criminal context, the Bayesian network achieved, on the average, a rate of correct classifications of approximatively 97%, whilst in the civil context, the rate is, on the average, close to the 88%. These results encourage the continuation of the development and the testing of the method in order to support its practical application in casework.

  14. Interrelationship of the Risser sign, knee epiphysis, and bone age in determining skeletal maturity: a case-control study.

    Science.gov (United States)

    Kim, Hak Jun; Yoon, Jung-Ro; Modi, Chetna; Modi, Hitesh; Song, Hae-Ryong; Song, Sang-Youn

    2011-05-01

    The purpose of our study was to correlate the chronological age with Risser staging, knee epiphyseal closure, and bone age by the Tanner and Whitehouse (TW3) or Greulich and Pyle (GP) method simultaneously, to find out the most correlated methods used to calculate the age in a Korean population. A case-control study was carried out in 293 children between the age of 9 and 18 years. Skeletal age was estimated by using the atlas of the GP and TW3 methods; knee epiphysis closure and the Risser staging were also noted. Spearman's correlation coefficient test showed that in both the sexes the GP method is more correlated (r=0.58 for female patients, range: 0.55-0.61; and 0.58 for male patients, range: 0.54-0.61) with the Risser staging and physeal stages of the knee joint than the TW3 method (r=0.52 for female patients, range: 0.44-0.61; and 0.55 for male patients, range: 0.48-0.61) in Korean children. Our results suggested that by using the combination of Risser sign, knee epiphyseal closure, and GP bone age, one can calculate a person's chronological age most accurately.

  15. Preservación ósea femoral con tallos cortos de fijación cervicometafisaria. [Femoral bone preservation using short stems with metaphyseal fixation

    Directory of Open Access Journals (Sweden)

    Martín Buttaro

    2014-10-01

    Full Text Available Introducción: los tallos no cementados recubiertos con hidroxiapatita de fijación metafisaria han logrado excelentes resultados a largo plazo. La segunda generación de tallos cortos de fijación cervicometafisaria ha surgido a principios de la década de 1990, con el objetivo de preservar capital óseo femoral. Sin embargo, la preservación ósea femoral teóricamente propuesta no ha sido comprobada. El objetivo de este trabajo es determinar radiográficamente la preservación del capital óseo femoral cuando se utilizó un tallo corto de fijación cervicometafisaria, comparando las radiografías posoperatorias con la programación del tallo que se debería haber utilizado en caso de ser un diseño convencional con fijación metafisaria. Materiales y Métodos: los primeros 50 tallos cortos de fijación cervicometafisaria (MiniHipTM, Corin, Cirencester, Reino Unido fueron analizados por dos observadores independientes, con radiografías de frente, en cuanto a nivel de resección cervical y longitud del tallo, comparándolos con las filminas de un tallo convencional de fijación metafisodiafisaria (MetaFixTM, Corin, Cirencester, Reino Unido. Resultados: según el análisis radiográfico, los tallos cortos de fijación cervicometafisaria ocuparon una longitud femoral promedio de 79 mm (rango 68-102. Los tallos convencionales de fijación metafisaria hubiesen ocupado, en promedio, 73 mm más que los tallos cortos (rango 47-94. Esta distribución se observó en el corte de cuello (promedio 10 mm más distal y en la longitud del implante (promedio 66 mm mayor longitud (p <0,001. Esta diferencia permite preservar un 42% el capital óseo femoral.  Conclusión: la preservación ósea relacionada con el uso de tallos cortos de fijación cervicometafisaria podría traer beneficios a largo plazo en pacientes jóvenes con alta demanda funcional.

  16. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  17. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

  18. O outro capital The other capital

    Directory of Open Access Journals (Sweden)

    Vinicius Prates da Fonseca Bueno

    2012-01-01

    Full Text Available Capital social uma forma de mobilizao cujo cerne no est nos indivduos nem nas formas de produo econmica, mas nas redes complexas de solidariedade e confiana. O livro Comunicao e poltica: capital social, reconhecimento e deliberao pblica traz uma coleo de artigos de pesquisadores em comunicao sobre este tema, organizado por ngela Marques e Heloiza Matos.Social capital is a form of mobilization whose core is not on individuals or in forms of economic production, but in the complex networks of solidarity and trust. The book Comunicao e poltica: capital social, reconhecimento e deliberao pblica (that translated to English means Communication and politics: social capital, recognition and public deliberation is a collection of articles written by researchers in communication about this subject, organized by ngela Marques and Heloiza Matos.

  19. Triads of capital

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase

    represented by Putnam and Portes. The paper raises the following question: Is it possible to detect the historical driving forces behind the building of both beneficial and harmful social capital? Driving forces are defined as structural determinants, which change human organization at all levels......Within current research on social capital, a gap exists between political history analyses at the macro level and classical, sociological analyses at the meso and micro levels. Following up on  earlier work, the main purpose of this paper is to mediate between the two conflicting stances....... The hypothesis is that three forms of capital have the potential to act as driving forces: social capital, cultural capital and physical capital, the latter operationaliz­ed as buildings. A new concept, triad of capital, is introduced to analyze the interrelationship between these three forms of capital. A triad...

  20. Femoral hernia sac laparoscopy: a case report.

    Science.gov (United States)

    Ramirez Valderrama, Alexander; Ruiz, Dan; Malik, Manmeet; Tiszenkel, Howard

    2014-01-01

    We present the case of a 64-year-old female with an incarcerated right femoral hernia, associated with a small bowel obstruction that was successfully treated with an open femoral hernia repair with plug. At the same time we performed a hernia sac laparoscopy to evaluate the viability of the previously reduced small bowel. The hernioscopy was performed with a 0° 5 mm scope with reliable evaluation of the peritoneal cavity. We confirm that hernioscopy is a safe and feasible procedure and provides useful information for the appropriate management of acute incarcerated femoral/inguinal hernias.

  1. Theorizing Emotional Capital

    NARCIS (Netherlands)

    Cottingham, M.D.

    2016-01-01

    Theorizing a sociology of emotion that links micro-level resources to macro-level forces, this article extends previous work on emotional capital in relation to emotional experiences and management. Emerging from Bourdieu’s theory of social practice, emotional capital is a form of cultural capital t

  2. Hydrocoele of a femoral hernia sac.

    Science.gov (United States)

    Mote, D G; Chakravarty, K B

    2009-12-01

    Hydrocoele of a femoral hernia sac is an extremely rare entity. Extensive literature review and Internet searching revealed only a few authentically reported cases. It mostly occurs in females during the fourth to sixth decades of life. The most common clinical presentation is groin swelling. It is diagnosed as an irreducible or incarcerated femoral hernia or subcutaneous lipoma. In almost all of the reported cases, the diagnosis of hydrocoele of a femoral hernia sac has been made only after surgical exploration. The present case is a 40-year-old lady who presented with a painless lump in the right groin and was diagnosed as a case of hydrocoele of a femoral hernia sac only after exploration.

  3. Herniography off femoral, obturator and perineal hernias

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Nordblom, I.; Fork, F.T.; Gullmo, A.

    1985-08-01

    Positive contrast herniography was used in the workup of 550 patients with unclear groin pain. The majority of these patients had rather characteristic hernias of indirect, direct or femoral type. However, now and then diagnostic problems arose. A femoral hernia may look like a direct or even obturator hernia. There is also a variety of multilocular femoral hernias and other types. A femoral hernia may be present together with other hernias in the ipsilateral or contralateral groin. Obturator hernias are usually small but are always confined to the obturator canal laterally in the obturator foramen. Abnormalities in the pouch of Douglas may include a deep rectogenital pouch, diverticula and true herniations. These uncommon herniographic findings are described and discussed.

  4. Acute appendicitis in a femoral hernia

    Directory of Open Access Journals (Sweden)

    Zdravković Darko

    2007-01-01

    Full Text Available INTRODUCTION Acute appendicitis in a femoral hernia is an uncommon condition that can be serious. Complications are more frequent if the diagnosis is delayed and surgery is not performed on time. CASE REPORT We present a 71-year-old man with a painful swollen mass. The patient presented with fatigue and loss of appetite, while body temperature was normal. The abdomen was not painful, and peristaltic was normal. All laboratory findings were normal. After anamnesis and physical examination, the presumed diagnosis was incarcerated femoral hernia and the patient was sent to the operating room. Intraoperative findings revealed an incarcerated femoral hernia within a phlegmonous inflammated appendix. Appendectomy and McVay hernioplastics were done. The postoperative course was without complications. CONCLUSION It is very important to bear in mind that right femoral hernia with signs of incarceration and inflammation may contain an acutely inflamed appendix. Delayed diagnosis and misdiagnosis cause greater morbidity and mortality.

  5. Is Capitalism Ethical?

    Directory of Open Access Journals (Sweden)

    Suciu T.

    2009-12-01

    Full Text Available The author of this paper have set off from the question: is the present capitalism ethical? We started with the delimitation and correlation of the concepts of ethics, morals, morality. Further on, we analysed the evolution of capitalism in connection with morals. Based on this research, we came to the conclusion that the capitalist system has undergone through three stages: moral capitalism, amoral capitalism, and immoral capitalism. We concluded by implying that the corporate capitalist society is immoral, that it cannot regulate itself and that the government’s assistance is needed to inoculate the ethics.

  6. 股骨头血供:我国《外科学》教材之因袭及其商榷%Blood supply to the femoral head:discussion of textbook “Surgery”

    Institute of Scientific and Technical Information of China (English)

    梅炯

    2016-01-01

    Modern medicine textbooks first appeared in China at the end of the 19th century when Western missionaries initiated church medical schools in several Chinese cities. From early oral notes to the translation of Western medical books, Chinese medicine textbooks basically achieved localization in the 1960s after repeated practice and exploration. The content in the textbook “Surgery” has been substantially updated from the 1950’s trial version to the current eighth edition; however, that about the blood supply to the femoral head has been kept almost unchanged. The descriptions as well as the illustrations are almost the same in the first edition of the unified “Surgery” in 1979 to the eighth edition published in 2014. According to domestic and foreign research, content regarding the blood supply to the femoral head in Chinese surgical textbooks has not been properly updated and follows the literature from more than 60 years ago. In this paper, based on a review of the development of medicine textbooks, we compared the content about the blood supply to the femoral head in more than 10 versions of textbooks since the 1950 s, including the brief Soviet textbooks. It is suggested that the content about the blood supply to the femoral head in current textbooks should be updated and modified according to the latest research progress and the textbooks currently used in the United States. For example, the terminal branches of the medial and lateral femoral circumflex arteries should be termed as “retinacular arteries” as described in most modern literatures, rather than “lateral epiphysial artery”, “superior metaphysial artery”, and “inferior metaphyseal artery”.

  7. Limited Quadricepsplasty for Contracture during Femoral Lengthening

    OpenAIRE

    Khakharia, Saurabh; Fragomen, Austin T.; Rozbruch, S. Robert

    2009-01-01

    Extension contracture of the knee is a common complication of femoral lengthening. Knee flexion exercises to stretch the contracture with physical therapy can be effective but take a prolonged amount of time to work and place increased stress across the patellofemoral joint. We developed a minimal-incision limited quadricepsplasty surgical technique to treat knee extension contracture secondary to femoral lengthening and retrospectively reviewed 16 patients treated with this procedure. The me...

  8. 肉鸡胫骨干骺软骨的形态学观察%Morphological Observation of the Proximal Cartilage between Diaphysis and Epiphysis of Avian tibia

    Institute of Scientific and Technical Information of China (English)

    张洁; 张金龙

    2012-01-01

    对3周龄肉鸡胫骨近端干骺软骨进行解剖学观察,发现干骺软骨内除了有骺软骨生长板外,还有次级骨化中心生长板。%The proximal cartilage between the diaphysis and epiphysis of avian tibia were observed in ten normal chickens at three weeks of age. It was discovered that there was not only the epiphyseal plate but also the growth plate of the second ossification center in the proximal cartilage between diaphysis and epi- physis of the Avian tibia.

  9. Femoral nerve entrapment: a new insight.

    Science.gov (United States)

    Vázquez, M T; Murillo, J; Maranillo, E; Parkin, I G; Sanudo, J

    2007-03-01

    Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.

  10. 75 FR 4635 - Risk-Based Capital Guidelines; Capital Adequacy Guidelines; Capital Maintenance: Regulatory...

    Science.gov (United States)

    2010-01-28

    ... 325 Risk-Based Capital Guidelines; Capital Adequacy Guidelines; Capital Maintenance: Regulatory... structures designed for current regulatory capital treatment and/or adopt the more risk-sensitive capital... FAS 167 on banking organizations' risk-based capital ratios will result in regulatory...

  11. THE EFFECT OF HUMAN CAPITAL ON SOCIAL CAPITAL AMONG ENTREPRENEURS

    OpenAIRE

    HANNES OTTÓSSON; KIM KLYVER

    2010-01-01

    Using data collected from 714 entrepreneurs in a random sample of 10,000 Danes, this study provides an investigation of the effect of human capital on social capital among entrepreneurs. Previous entrepreneurship research has extensively investigated the separated effect of human capital and social capital on different entrepreneurial outputs. The study takes a step back and investigates how these two capital concepts are related — specifically how human capital influences social capital. In ...

  12. Aetiology of femoral hernias revisited: bilateral femoral hernia in a young male (two cases).

    Science.gov (United States)

    Kochupapy, R T; Ranganathan, G; Dias, S; Shanahan, D

    2013-01-01

    Bilateral femoral hernias are less common in men than in women and rare in young adults. Only one case of a bilateral femoral hernia in a young man has been reported in the literature before. Three main theories have been postulated for femoral hernias. The theory that they are an acquired disease is the most accepted due to the common occurrence of such hernias in multiparous women but the theory lacks enough evidence. We report two cases in young men. Anatomical variations in the femoral canal could be the primary aetiological factor in these patients. A unilateral femoral hernia in young men with acquired aetiological factors requires a clinical examination of the opposite side.

  13. Modern Human Capital Management

    OpenAIRE

    Feldberger, Madita

    2008-01-01

    Title: Modern Human Capital Management Seminar date: 30th of May 2008 Course: Master thesis in Business Administration, 15 ECTS Authors: Madita Feldberger Supervisor: Lars Svensson Keywords: Human capital, SWOT Analysis, Strategic Map, Balanced Scorecard Research Problem: Despite of the success of Human Capital Management (HCM) in research it did not arrive yet in the HR departments of many companies. Numerous firms even have problems to set their strategic goals with focus on HR. The HR Bala...

  14. Handbook of Social Capital

    DEFF Research Database (Denmark)

    The Handbook of Social Capital balances the ‘troika' of sociology, political science and economics by offering important contributions to the study of bonding and bridging social capital networks. This inter-disciplinary Handbook intends to serve as a bridge for students and scholars within all...... the social sciences. The contributors explore the different scientific approaches that are all needed if international research is to embrace both the bright and the more shadowy aspects of social capital....

  15. Clinical observation of epiphysis preservation in children with distal femur osteosarcoma%保留股骨骨肉瘤儿童骨骺的临床研究

    Institute of Scientific and Technical Information of China (English)

    高嵩涛; 蔡启卿; 姚伟涛; 王家强; 张鹏; 王鑫

    2012-01-01

    目的 探讨通过骨骺牵开术保留骨肉瘤患儿患侧股骨远端骨骺及膝关节功能的可行性.方法 对7例股骨下段骨肉瘤患儿行外固定架牵引以分离股骨远端骨骺,配合瘤骨切除、大段同种异体骨置换术.术后对肿瘤控制、并发症、关节功能、肢体长度等指标进行分析.结果 随访12~58个月,所有患儿无局部复发.按照国际保肢学会(ISOLS)评估标准,优良率为71.4%.末次复查患儿健、患侧肢体长度分别为(65.7±2.3)cm、(64.9±2.0)cm,两者比较差异无统计学意义(P>0.05).结论 骨骺牵开术可较好地保留骨肉瘤患儿的患肢生长机能及肢体功能.%Objective To explore the feasibility of epiphysis and joint function preservation in children with distal femur osteosarcoma using epiphysis distraction by external fixator.Methods Total 7 cases of children with distal femur osteosarcoma underwent epiphysis distraction using external fixator combined with tumor resection and repair of defect with massive allograft bone transplantation,aiming to preserve the epiphysis of the distal femur and knee joint function.The tumor control probability (TCP),complications,joint function and limb length after operation were targeted to analysis.Results The follow-up study (Ranging from 12 to 58 months) was conducted in all case.No recurrence was found in them and 1 case died due to lung metastasis in 2nd year after surgery.Referring to the functional evaluation criteria from ISOLS,excellent were seen in 3 cases,good in 2 cases,fair in 2 cases and poor was not found in them.71.4 percent of cases achieved satisfactory curative efficacy.The final examination in follow up study showed that affect limbs length were (64.9 ± 2.0) cm and normal limbs length were (65.7 ± 2.3) cm respectively.No statistical significance was found between the affected limbs and normal limbs.Conclusions The epiphysis distraction using external fixator is a better way to preserve limb length

  16. Social Capital Database

    DEFF Research Database (Denmark)

    Paldam, Martin; Svendsen, Gert Tinggaard

    2005-01-01

      This report has two purposes: The first purpose is to present our 4-page question­naire, which measures social capital. It is close to the main definitions of social capital and contains the most successful measures from the literature. Also it is easy to apply as discussed. The second purpose...... is to present the social capital database we have collected for 21 countries using the question­naire. We do this by comparing the level of social capital in the countries covered. That is, the report compares the marginals from the 21 surveys....

  17. Electronic Capitalization Asset Form

    Data.gov (United States)

    Department of Transportation — National Automated Capitalization Authorization Form used by ATO Engineering Services, Logistics, Accounting for the purpose of identifying and capturing FAA project...

  18. Pseudoarthrosis in atypical femoral fracture: case report.

    Science.gov (United States)

    Giannotti, S; Bottai, V; Dell'Osso, G; De Paola, G; Ghilardi, M; Guido, G

    2013-11-01

    Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment; they have a high frequency of delayed healing. The authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy. Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment even if, in the literature, there is no clarity on the exact pathogenetic mechanism. The Task Force of the American Society for Bone and Mineral Research described the major and minor features to define atypical fractures and recommends that all the five major features must be present while minor features are not necessary. Another controversial aspect regarding the atypical femoral fractures is the higher frequency of the delayed healing that can be probably related to a suppressed bone turnover caused by a prolonged period of bisphosphonates treatment. This concept could be corroborated by the Spet Tc exam. In the case of a pseudoarthrosis, there is not a standardization of the treatment. In this report, the authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy; the patient was studied with clinical, bioumoral end SPECT-Tc exam of both femurs. Many studies show the relationship between bisphosphonates and the presence of atypical fractures. These fractures should be monitored more closely due to the risk of nonunion and they require considering an initial treatment with pharmacological augmentation to reduce the complications for the patient and the health care costs.

  19. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Directory of Open Access Journals (Sweden)

    Sampat S Dumbre Patil

    2016-01-01

    Full Text Available Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN or surface implants like Dynamic Condylar Screw (DCS are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years and mean followup period was 52.1 months (range 27-72 months. Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  20. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Science.gov (United States)

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  1. Femoral hernia: a review of 83 cases.

    Science.gov (United States)

    Alimoglu, O; Kaya, B; Okan, I; Dasiran, F; Guzey, D; Bas, G; Sahin, M

    2006-03-01

    We evaluate the factors that affect morbidity and mortality in patients who underwent surgery due to femoral hernia. The medical records of 83 patients who underwent femoral hernia repair between January 1996 and June 2004 were retrospectively analyzed. The femoral hernias were repaired either with McVay or mesh plug hernioplasty. Sex, age, surgical repair technique, presence of incarceration/strangulation, incarcerated/strangulated organs, postoperative complications, duration of hospitalization, recurrence rate, and factors that affect mortality and morbidity were studied. There were 83 patients with femoral hernia in our study. Patients' age ranged from 10 to 75 years (mean age was 46.84) with a predominance of female (71%). Thirty-six patients (40%) underwent emergency surgery with the diagnosis of strangulation or incarceration of femoral hernia. Seventeen patients had strangulation and underwent resection; eleven of these patients had omentum in the hernial sac, whereas six patients had intestines. Four of these patients underwent laparotomy. The remaining 19 patients had incarceration and underwent simple reduction of hernial sac content without resection. Forty-seven (60%) patients underwent elective surgery. McVay technique was used for 79 patients, while the other four patients were treated with mesh-plug. Twelve patients (15%) developed a variety of complications (nine patients (25%) in emergency, three patients (6%) in elective group). There was one mortality. Recurrences occurred in two patients. Femoral hernia is an important surgical pathology with high rates of incarceration/strangulation and intestinal resection. Emergency surgery can increase morbidity and mortality especially in the elderly. Early elective surgery may reduce complication.

  2. Measuring Social Capital

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard; Bjørnskov, Christian

    2007-01-01

    How to construct a robust measure of social capital? This paper contains two contributions. The first is an attempt to establish a broad social capital measure based on four indicators, the Freedom House Index, an index of perceived corruption from Transparency International, and scores on civic...

  3. Venture capital and internationalization

    NARCIS (Netherlands)

    Schertler, Andrea; Tykvova, Tereza

    2011-01-01

    Cross-border investments represent a substantial share of venture capital activities. We use a comprehensive dataset on investments worldwide to analyze the internationalization of venture capital financing. We postulate that cross-border activity is shaped by macroeconomic factors in the venture ca

  4. Social Capital in Asia

    DEFF Research Database (Denmark)

    Li, Peter Ping

    2014-01-01

    This article provides an overview of social capital in Asia. Social capital is trust and appears in two main forms: relational, based on societal norms, and systemic, based on societal institutions. The relational encourages personalistic transactions; and systemic trust, supports more formal...

  5. Aggregating economic capital

    NARCIS (Netherlands)

    Dhaene, J.; Goovaerts, M.; Lundin, M.; Vanduffel, S.

    2005-01-01

    In this paper we analyze and evaluate a standard approach financial institutions use to calculate their so-called total economic capital. If we consider a business that faces a total random loss S over a given one-year horizon then economic capital is traditionally defined as the difference between

  6. Human Capital and Retirement

    NARCIS (Netherlands)

    P. Alders

    1999-01-01

    textabstractThis paper investigates the relation between human capital and retirement when the age of retirement is endogenous. This relation is examined in a life-cycle earnings model. An employee works full time until retirement. The worker accumulates human capital by training- on-the-job and by

  7. Linguistic Capital Pays Dividends

    Science.gov (United States)

    Linse, Caroline

    2013-01-01

    Some 37 million U.S. residents speak Spanish at home and more than 55% of them say they also speak English. That creates what is called linguistic capital. Although linguistic capital is difficult to quantify, it is enormously valuable and is determined by an individual's language competency, and is too frequently wasted instead of being…

  8. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

  9. 76 FR 42768 - Capital Distribution

    Science.gov (United States)

    2011-07-19

    ... Office of Thrift Supervision Capital Distribution AGENCY: Office of Thrift Supervision (OTS), Treasury... concerning the following information collection. Title of Proposal: Capital Distribution. OMB Number: 1550..., the information provides the OTS with a mechanism for monitoring capital distributions since...

  10. Cultural Capital Today

    DEFF Research Database (Denmark)

    Prieur, Annick; Skjøtt-Larsen, Jakob; Rosenlund, Lennart

    2008-01-01

    Based on Danish survey data subjected to correspondence analysis, this article aims at carrying out a critical assessment of Pierre Bourdieu's theory of social differentiation in advanced societies as a multi-dimensional phenomenon. As his theory goes, capital volume (economic + cultural capital......) and capital composition (the relative weight of the two) are the main dimensions of social differentiation, which structure the space of social positions as well as the space of lifestyles. The central discussion of the article concerns the character of cultural capital, and the role it plays in the formation......, as those adhering to the preferences that are most typical for the cultural elite tend to simultaneously avoid or mark distance to popular expressions of taste. Fourth, are there traces of new forms of cultural capital? The study uncovers a cleavage between a global orientation or a form of cosmopolitanism...

  11. 77 FR 52977 - Regulatory Capital Rules: Advanced Approaches Risk-Based Capital Rule; Market Risk Capital Rule

    Science.gov (United States)

    2012-08-30

    ... Regulatory Capital Rules: Advanced Approaches Risk-Based Capital Rule; Market Risk Capital Rule; Proposed... 325 RIN 3064-AD97 Regulatory Capital Rules: Advanced Approaches Risk-Based Capital Rule; Market Risk... ``Regulatory Capital Rules: Advanced Approaches Risk-based Capital Rule; Market Risk Capital Rule''...

  12. Radographic changes of the revascularized femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Rindell, K. (Orthopaedic Hospital of the Invalid Foundation, Helsinki (Finland). Department of Orthopeadic Surgery); Tallroth, K. (Orthopaedic Hospital of the Invalid Foundation, Helsinki (Finland). Department of Radiology); Lindholm, T.S. (Tampere University Central Hospital (Finland). Department of Surgery, Section of Orthopaedics and Traumatology)

    Twenty-two nerotic femoral heads in young adults were radiologically followed-up after grafting with vascularized bone by comparing the preoperative and the postoperative state of the hip joint. Three parameters were observed and followed; the flattening of the femoral head: the degree of osteoarthrosis of the joints; and the degree of incorporation of the graft into the recipient bone. The results, expressed by index figures, showed that the femoral head flattened during the first two years postoperatively; that the maximal incorporation occurred during the same period of time; and that the appearance of postoperative osteoarthrosis was slow during the first year and increased subsequently. This numerical characterization of radiological finding allows systematic individual analysis after revascularization of the femoral head with bone grafts. It is also suited for comparisons between patients, between series of patients and of various treatment techniques. Furthermore, this quatification provides a numerical index that seems to correlate with the outcome of the treated hip joint. (author). 12 refs.; 6 figs.; 1 tab.

  13. Postmortem Femoral Blood Concentrations of Risperidone

    DEFF Research Database (Denmark)

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration ...

  14. [Femoral venous catheter: an unusual complication].

    Science.gov (United States)

    Garcia, P; Mora, A; Trambert, P; Maler, E; Courant, P

    2000-08-01

    We report an erratic course of a venous femoral catheter which was in the abdominal cavity in a patient with an haemoperitoneum and an hepatic injury. This complication led to an inefficiency of the transfusion and a worsening of the haemoperitoneum.

  15. Atypical subtrochanteric and diaphyseal femoral fractures

    DEFF Research Database (Denmark)

    Shane, Elizabeth; Burr, David; Abrahamsen, Bo;

    2014-01-01

    that distinguish AFFs from ordinary osteoporotic femoral diaphyseal fractures and to provide guidance on the importance of their transverse orientation. The requirement that fractures be noncomminuted was relaxed to include minimal comminution. The periosteal stress reaction at the fracture site was changed from...

  16. Tension free femoral hernia repair with plug

    Directory of Open Access Journals (Sweden)

    Milivoje Vuković

    2013-01-01

    Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  17. Prophylactic Nailing of Incomplete Atypical Femoral Fractures

    Directory of Open Access Journals (Sweden)

    Chang-Wug Oh

    2013-01-01

    Full Text Available Introduction. Recent reports have described the occurrence of low-energy subtrochanteric and femoral shaft fractures associated with long-term bisphosphonate use. Although information regarding the surgical treatment of these atypical femoral fractures is increasing, it is unclear if the preventive operation is useful in incomplete fractures. This study examined the results of preventive intramedullary nailing for incomplete atypical femoral fractures. Material and Methods. A retrospective search was conducted for patients older than 50 years receiving bisphosphonate therapy, with incomplete, nondisplaced fractures in either the subtrochanteric or diaphyseal area of the femur. Seventeen patients with a total of 20 incomplete, non-displaced lesions were included. The mean duration of bisphosphonate use was 50.5 months. Eleven of the 17 (64.7% patients had complete or incomplete fractures on the contralateral femur. All were treated with prophylactic fixation of an intramedullary (IM nail. The minimum followup was 12 months. Results. All cases healed with a mean period of 14.3 weeks. Nineteen of the 20 cases healed with the dissolution of incomplete fractures of the lateral aspect. A complete fracture developed at the time of nailing in one patient, but it healed with callus bridging. Conclusion. IM nailing appears to be a reliable way of preventing the progress of incomplete atypical femoral fractures.

  18. 保留骨骺的保肢技术在治疗青少年膝关节周围骨肉瘤患者中的应用进展%Treatment progress of osteosarcoma around the knee joint in adolescents with epiphysis preservation in limb salvage operation

    Institute of Scientific and Technical Information of China (English)

    阎洪亮; 董扬

    2015-01-01

    Osteosarcoma is one of the most common primary malignant bone tumors,which attacks the children and adolescents under 20 years.The knee joint,the distal femur and proximal tibia are the most predilection sites.With the emergence of new adjuvant chemotherapy and continuous development of surgical techniques,5 years' survival rate of osteosarcoma patients has been improved.The epiphysis of the adolescent patient has not been closed,so growth disorders will be caused if the epiphysis is removed in operation.In recent years,limb salvage operation with the preservation of the epiphysis has become one focus of osteosarcoma salvage therapy.

  19. Cultural Capital in Context:

    DEFF Research Database (Denmark)

    Andersen, Ida Gran; Jæger, Mads Meier

    This paper analyzes the extent to which the effect of cultural capital on academic achievement varies across high- and low-achieving schooling environments. We distinguish three competing theoretical models: Cultural reproduction (cultural capital yields higher returns in high-achieving schooling...... to be higher in low-achieving schooling environments than in high-achieving ones. These results support the cultural mobility explanation and are in line with previous research suggesting that children from low-SES families benefit more from cultural capital than children from high-SES families....

  20. Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Hideto Irifune

    2015-01-01

    Full Text Available Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures.

  1. Surgical management of multiple posttraumatic arteriovenous fistulas of femoral vessels.

    Science.gov (United States)

    Pokrovsky, A V; Shubin, A A; Kuntsevich, G I; Subbotin, V V; Suntsov, D S

    2008-01-01

    Presented herein are two case reports concerning surgical management of posttraumatic arteriovenous fistulas of femoral vessels. Case 1. A 45-year-old female patient attended with a history of a shotgun injury wound of her left femur and crus sustained when a girl of eight. She sought medical attention for a progressively deteriorating condition, accompanied by pain, and breathlessness dyspnea at rest. Detected were multiple fistulas between the deep femoral artery and superficial femoral artery and femoral vein. Management consisted in separation of the arteriovenous fistulas, followed by prosthetic repair of the deep femoral artery. Case 2. A 32-year-old male patient after an accidentally inflicted shotgun injury of the his left femur underwent within a time period of 3 year three vascular operations including ligation of the deep femoral artery and femoral vein followed by having later on developed secondary lymphedema of his left lower limb and pronounced manifested chronic venous insufficiency. Management included dissociation of the numerous arteriovenous fistulas between the branches of the deep femoral artery and the common femoral artery, as well as between the superficial femoral artery and femoral vein.

  2. Capital Projects Application (CPA)

    Data.gov (United States)

    General Services Administration — Capital Projects application (CPA) provides users with the ability to maintain project related financial data for Budget Activity (BA) 51, 55, 64, 01, 02, 03, 04....

  3. The Genesis of Capitalism

    DEFF Research Database (Denmark)

    Li, Xing

    2004-01-01

     This paper aims to offer a framework of interpreting the “evolution” of capitalism that is reaching every corner of the world and has achieved greater legitimacy than at any time in human history. It covers an interdisciplinary discussion on the development of market capitalism that has been...... characterized by a dual process: unanticipated origin (cultural and historical) and anticipated progress (political economy). The point of departure of this paper is that although the advancement of market capitalism is a process of societal development involving historical, cultural and religious causes...... (historical, divine, spiritual, miraculous), the establishment of capitalism is less the result of a force for cultural and economic dynamism than the realization of a political project. In other words, from being an enterprise within defined geographical boundaries to becoming a global project is first...

  4. Unsustainable growth, unsustainable capitalism

    DEFF Research Database (Denmark)

    Næss, Petter

    2006-01-01

    problems, but serve to further highlight the difficulties of changing capitalism towards sustainability. In a profit-oriented economy, capital accumulation is a prime driving force, and non-growth for the economy at large tends to result in serious economic and social crises. On the other hand, a de...... according to which the powers and mechanisms of the natural world are considered totally controllable by humans as if they were mere epiphenomena of the human world. On the other hand, the assumptions of certain ecological economists about the possibility of steady-state capitalism disregard the relation...... between capital and surplus value, which constitutes a strong mechanism driving the capitalist economy toward limitless growth....

  5. Piketty’s Capital

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    2016-01-01

    Piketty’s Capital in Twenty-First Century has posed a totally new platform for the discussion of the economy and capitalism. Piketty has reinvented the classical political economy founded by Adam Smith in his 1776 Wealth of Nations. Piketty has shown via massive historical research how growth...... and inequality have developed since 1793. Piketty’s conclusion is that the French Revolution did not change the existing inequality either in the medium or in the long term. Piketty’s prediction is that a new form of global capitalism will arise, patrimonial capitalism, in which inequality will develop further...... and the 1% of the World population will control 95% of all wealth in the World....

  6. 76 FR 35351 - Capital Plans

    Science.gov (United States)

    2011-06-17

    ..., many bank holding companies made significant distributions of capital, in the form of stock repurchases... Act may result in additional limitations on a company's capital distributions than the prior notice... bank holding company's consolidated capital. A capital distribution would be defined as a redemption...

  7. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

    Science.gov (United States)

    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.

    2013-01-01

    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

  8. The Performance of Intellectual Capital

    DEFF Research Database (Denmark)

    Murthy, Vijaya; Mouritsen, Jan

    2011-01-01

    Purpose – This paper aims to analyse the relationship between intellectual capital and financial capital using a case study. This makes it possible to discuss how intellectual capital is related to value creation with a degree of nuance that is absent from most statistical studies of relationships...... between human, organisational, relational and financial capital. Design/methodology/approach – The paper uses a case study of a firm that invests in intellectual capital in order to develop financial capital. It traces the relationship between intellectual capital elements and financial capital via...... interviews. This allows the development of a nuanced account of the performance of intellectual capital. This account questions the universality of the linear model typically found in statistical studies. The model makes it possible to show how items of intellectual capital not only interact but also compete...

  9. Entrepreneurs’ human and social capital

    DEFF Research Database (Denmark)

    Shayegheh Ashourizadeh, Shayegheh; Rezaei, Shahamak; Schøtt, Thomas

    2014-01-01

    Abstract: It is widely acknowledged that entrepreneurs’ human capital in form of education and social capital in form of networking are mutually beneficial and also that both human and social capital benefit their performance. Here, the hypothesis is that human and social capital, in combination......, provide added value and jointly add a further boost to performance, specifically if the form of exporting. Global Entrepreneurship Monitor provides data on 52,946 entrepreneurs, who reported on exporting and networking for advice. Hierarchical linear modelling shows that human capital promotes social...... capital, that human capital and social capital (specifically networking in the international environment, work-place, professions and market, but not in the private sphere) both benefit export directly and that human capital amplifies the benefit of social capital, especially through international...

  10. 78 FR 62417 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy...

    Science.gov (United States)

    2013-10-22

    ... Part 324 RIN 3064-AD95 Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy, Transition Provisions, Prompt Corrective Action, Standardized Approach for Risk-Weighted Assets, Market Discipline and Disclosure Requirements, Advanced Approaches Risk-Based Capital Rule,...

  11. Femoral bifurcation disease: balloon or knife.

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen

    2009-10-01

    Arterial occlusive disease at the level of the femoral bifurcation mostly occurs in combination with inflow and/or outflow lesions. Surgical endarterectomy of the femoral bifurcation is a well-proven low-risk and easy surgical intervention with known durable success, while, although proven to be safe, evidence is lacking about the durability of the endovascular approach. Based on the evidence at hand, the surgical approach should be recommended for the vast majority of patients and the endovascular approach should only be indicated as the first strategy in selected cases presenting with factors that might compromise the outcome of surgery in the groin. If feasible, the hybrid approach with endarterectomy at the level of the bifurcation and endovascular repair of the inflow and outflow lesions is preferred in patients with multilevel disease.

  12. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  13. Treatment of subtrochanteric femoral fracture with long proximal femoral nail antirotation

    Institute of Scientific and Technical Information of China (English)

    WANG Wen-yue; YANG Tian-fu; FANG Yue; LEI Ming-ming; WANG Guang-lin; LIU Lei

    2010-01-01

    Objective:Subtrochanteric femoral fractures are severe injuries.Although many treatment methods have been developed,controversy exists regarding the optimal management of these fractures.This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation(PFNA-long).Methods:Between October 2006 and February 2008,25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long.Closed reduction and fixation were performed in 20 cases.In the remaining 5 cases,closed reduction was difficult,so limited open reduction was performed,with bone grafting in 4 cases and circumferential wiring in 4 cases.Results:The average follow-up time was 16.1 months.All subtrochanteric femoral fractures healed uneventfully except one case of delayed union.The mean union time was 26.2 weeks.Technical difficulties with nail insertion were encountered in 3 cases.No implant failure was observed.Conclusion:PFNA-long is effective in treatment of subtrochanteric femoral fractures,with a high rate of bone union,minor soft tissue damage,early return to functional exercise and few implant-related complications.

  14. Bisphosphonate-induced atypical subtrochanteric femoral fracture

    OpenAIRE

    2013-01-01

    The use of bisphosphonates (BPs) is universally accepted in the management of osteoporosis. However, a small percentage of patients have been recognised to develop atypical subtrochanteric fractures of the femur with the prolonged use of BPs. We report a rare case of bilateral insufficiency lesions in the proximal femora, where a major subtrochanteric fracture developed with a minor fall. This was successfully treated with internal fixation using proximal femoral nail.

  15. Radiofrequency ablation of two femoral head chondroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Petsas, Theodore [Department of Radiology, University of Patras (Greece); Megas, Panagiotis [Department of Orthopaedic Surgery, University of Patras (Greece)]. E-mail: panmegas@med.upatras.gr; Papathanassiou, Zafiria [Department of Radiology, University of Patras (Greece)

    2007-07-15

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed.

  16. Current concepts in total femoral replacement

    OpenAIRE

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K.; Higuera, Carlos A.; Barsoum, Wael K.; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing li...

  17. Proximal femoral reconstruction with custom mega prosthesis

    OpenAIRE

    2003-01-01

    Seventy-seven patients with proximal femoral tumours underwent limb salvage surgery with custom mega prostheses between July 1989 and January 2002. We describe 44 cases with a mean follow-up of 57.8 months. Forty-one patients presented with malignant neoplasms of which 11 were malignant giant cell tumours, eight were chondrosarcoma and five were metastases. Wide margins were achieved for all malignant tumours, and marginal resection was done for all benign and metastatic lesions. Six patients...

  18. Ipsilateral femoral neck and trochanter fracture

    Directory of Open Access Journals (Sweden)

    Devdatta S Neogi

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  19. Human Capital and Optimal Positive Taxation of Capital Income

    OpenAIRE

    Jacobs, B.; Bovenberg, A.L.

    2005-01-01

    This paper analyzes optimal linear taxes on capital and labor incomes in a life-cyclemodel of human capital investment, financial savings, and labor supply with heteroge-nous individuals. A dual income tax with a positive marginal tax rate on not onlylabor income but also capital income is optimal. The positive tax on capital incomeserves to alleviate the distortions of the labor tax on human capital accumulation.The optimal marginal tax rate on capital income is lower than that on labor inco...

  20. Capital Expert System

    Science.gov (United States)

    Dowell, Laurie; Gary, Jack; Illingworth, Bill; Sargent, Tom

    1987-05-01

    Gathering information, necessary forms, and financial calculations needed to generate a "capital investment proposal" is an extremely complex and difficult process. The intent of the capital investment proposal is to ensure management that the proposed investment has been thoroughly investigated and will have a positive impact on corporate goals. Meeting this requirement typically takes four or five experts a total of 12 hours to generate a "Capital Package." A Capital Expert System was therefore developed using "Personal Consultant." The completed system is hybrid and as such does not depend solely on rules but incorporates several different software packages that communicate through variables and functions passed from one to another. This paper describes the use of expert system techniques, methodology in building the knowledge base, contexts, LISP functions, data base, and special challenges that had to be overcome to create this system. The Capital Expert System is the successful result of a unique integration of artificial intelligence with business accounting, financial forms generation, and investment proposal expertise.

  1. ANCAMAN CAPITAL INFLOW

    Directory of Open Access Journals (Sweden)

    Teguh Sihono

    2011-01-01

    Full Text Available Capital inflow can be interpreted as an increase in the amount of money available from external or foreign sources for the purchase of local capital assets such as securities, houses, buildings, land, machinery. These short-term asset purchase, so if at any time be withdrawn in large quantities, it will endanger the country's economy. The swift flow of foreign funds may be a threat to the country which became the capital inflow in the form of options: pressure of inflation, high cost economy, the defisit Central Bank balance, the economic turbulence, and the threat of economic growth. Improvement of high economic growth accompanied by rising foreign exchange reserves that high also, it turns out is not free from the risk of unbridled inflation and economic cricis, destabilizing the economy during those funds withdrawn by foreign investors. For the avoidance of economic risk, should the government together with the Central Bank made a rule to direct capital inflow into the real sektor. Keywords: capital inflows, global likuiditas

  2. Organizational networks and social capital

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Waldstrøm, Christian

    2013-01-01

    This chapter presents a framework for understanding organizational networks and social capital through the lens of “social capital ownership” as well as the private and collective goods provided through this ownership. More specifically, it argues that ownership of social capital in organizations...... is closely connected to four types of social capital – two belonging to the bridging social capital type, and two belonging to the bonding social capital type. The chapter first reviews literature on organizational social capital and then directly focuses on ownership of social capital in organizations......, as well as the derived benefits, or losses. Next, the chapter presents an empirical case apt to illustrate the theoretical findings in part one, namely the nineteenth-century Danish Cooperative Dairy Movement (Svendsen and Svendsen 2004). It is demonstrated how social capital among Danish peasants...

  3. Hybrid approach to limb salvage in the setting of an infected femoral-femoral bypass graft.

    Science.gov (United States)

    Jones, Douglas W; Meltzer, Andrew J; Schneider, Darren B

    2014-08-01

    Prosthetic vascular graft infection in patients with advanced peripheral arterial disease can lead to multiple additional procedures, including extra-anatomic bypass or even amputation. We report the case of an 88-year-old woman with critical limb ischemia and an infected prosthetic femoral-femoral bypass graft. Using a planned hybrid 2-stage approach, we performed endovascular recanalization of the native left iliac arterial system using remote access via the superficial femoral artery to avoid infected groin wounds. Recanalization of the patient's Trans-Atlantic Inter-Society Consensus II D chronic iliac occlusion allowed for removal of the infected graft and placement of a profunda femoris artery to proximal posterior tibial artery bypass, thereby restoring inflow and avoiding the infected left groin. Newer endovascular techniques coupled with open surgical options may lead to limb salvage in patients with previously unreconstructable peripheral arterial disease.

  4. Ipsilateral femoral neck and shaft fractures: An overlooked association

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA)); Riemer, B.L.; Butterfield, S.L. (Dept. of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA))

    1991-05-01

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG).

  5. Management of femoral artery pseudoaneurysm due to addictive drug injection

    Institute of Scientific and Technical Information of China (English)

    李建文; 王三明; 陈小东

    2004-01-01

    Objective: To study surgical management for patients with femoral pseudoaneurysm resulting from addictive druginjection.Methods: Clinical data of 34 patients with femoral pseudoaneurysm resulting from addictive drug injection were retrospectively reviewed.Results: Thirteen patients underwent bypass graft ( end to side) of external iliac artery and superficial femoral artery using expanded polytetrafluoroethylene (ePTFE).Three patients who had an autogenous saphenous vein graft in situs, one of whom was then performed an ePTFE graft when rupture and bleeding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved.Conclusions: Ligating femoral artery is an effective way to treat femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificial vessel graft is notapplicable.

  6. Thinking strategically about capitation.

    Science.gov (United States)

    Boland, P

    1997-05-01

    All managed care stakeholders--health plan members, employers, providers, community organizations, and government entitites--share a common interest in reducing healthcare costs while improving the quality of care health plan members receive. Although capitation is a usually thought of primarily as a payment mechanism, it can be a powerful tool providers and health plans can use to accomplish these strategic objectives and others, such as restoring and maintaining the health of plan members or improving a community's health status. For capitation to work effectively as a strategic tool, its use must be tied to a corporate agenda of partnering with stakeholders to achieve broader strategic goals. Health plans and providers must develop a partnership strategy in which each stakeholder has well-defined roles and responsibilities. The capitation structure must reinforce interdependence, shift focus from meeting organizational needs to meeting customer needs, and develop risk-driven care strategies.

  7. Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results

    Directory of Open Access Journals (Sweden)

    EJ Yeap

    2007-05-01

    Full Text Available We conducted a retrospective review on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification between January 2004 and December 2004. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15 to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Schatzker scoring system. Results showed that four patients had excellent results, four good, two fair and one failure.

  8. Compartment Syndrome following Open Femoral Fracture with an Isolated Femoral Vein Injury Treated with Acute Repair

    Directory of Open Access Journals (Sweden)

    David Walmsley

    2014-01-01

    Full Text Available Acute compartment syndrome is a surgical emergency and its diagnosis is more difficult in obtunded or insensate patients. We present the case of a 34-year-old woman who sustained a Gustilo-Anderson grade III open midshaft femur fracture with an isolated femoral vein injury treated with direct repair. She developed lower leg compartment syndrome at 48 hours postoperatively, necessitating fasciotomies. She was subsequently found to have a DVT in her femoral vein at the level of the repair and was started on therapeutic anticoagulation. This case highlights the importance of recognition of isolated venous injuries in a trauma setting as a risk factor for developing compartment syndrome.

  9. Five models of capitalism

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Bresser-Pereira

    2012-03-01

    Full Text Available Besides analyzing capitalist societies historically and thinking of them in terms of phases or stages, we may compare different models or varieties of capitalism. In this paper I survey the literature on this subject, and distinguish the classification that has a production or business approach from those that use a mainly political criterion. I identify five forms of capitalism: among the rich countries, the liberal democratic or Anglo-Saxon model, the social or European model, and the endogenous social integration or Japanese model; among developing countries, I distinguish the Asian developmental model from the liberal-dependent model that characterizes most other developing countries, including Brazil.

  10. Updating cultural capital theory

    DEFF Research Database (Denmark)

    Prieur, Annick; Savage, Mike

    2011-01-01

    of ‘‘highbrow’’ culture, cultural oppositions can nonetheless readily be detected. We point to nine oppositions, mostly shared between the nations. Three tensions between (a) participation and non-participation in cultural activities; (b) knowledge and ignorance in cultural issues (such as for music, literature...... than absolute terms, and that a field analytic perspective provides the means of understanding cultural capital as such a relative entity. Second, the move from the empirical observation of oppositions to the conceptualisation of cultural capital also demands that the functioning of features...

  11. Contabilidad del capital intelectual

    OpenAIRE

    2007-01-01

    El capital intelectual es un valor intangible que debe incorporarse a los estados financieros, como parte de la generación de valor de todos los trabajadores de una organización. Existen algunos modelos que permiten cuantificarlo, aunque es preciso reconocer que debemos ahondar con más precisión con el objeto de contar con un mayor número de adeptos a esta importante referencia. The intellectual capital is an intangible value that should incorporate to the financial states, like part of t...

  12. Magnetic resonance imaging and histopathology in the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Takatori, Yoshio; Kamogawa, Morihide; Nakamura, Toshitaka; Ninomiya, Setsuo; Kokubo, Takashi

    1989-05-01

    To correlate the magnetic resonance (MR) images with the histopathological findings in the femoral head, the histopathology of 24 femoral heads, 15 with osteonecrosis, five with osteoarthritis and four with other hip disorders were subjected to preoperative MR imaging which demonstrated low intensity areas due to long T1 relaxation time in the femoral head. The MR signal was low where fibrovascular tissue, disintegrated fibrovascular tissue, amorphous necrotic material, bone, or cartilagenous tissue occupied the medullary space. From this study, it seems possible to predict the histopathologic changes in the femoral head using MR images. (author).

  13. A rare and frequently unrecognised pathology in children: femoral hernia.

    Science.gov (United States)

    Temiz, A; Akcora, B; Temiz, M; Canbolant, E

    2008-10-01

    A femoral hernia is the protrusion of the abdominal contents through the femoral canal. It accounts for less than 1% of all groin hernias in children and is often confused with inguinal hernia or other inguinal pathologies. Preoperative misdiagnosis has been reported to be between 40 and 75%. We believe that misdiagnosis and mistreatment usually occur due to insufficient physical examination, knowledge and experience about childhood femoral hernias. Here, we report and discuss the clinical appearance and treatment approach of three patients operated with the diagnosis of femoral hernias.

  14. Thin Capitalization Rules and Multinational Firm Capital Structure

    NARCIS (Netherlands)

    Blouin, J.; Huizinga, H.P.; Laeven, L.; Nicodeme, G.

    2014-01-01

    Abstract: This paper examines the impact of thin capitalization rules that limit the tax deductibility of interest on the capital structure of the foreign affiliates of US multinationals. We construct a new data set on thin capitalization rules in 54 countries for the period 1982-2004. Using confide

  15. Human Capital and Optimal Positive Taxation of Capital Income

    NARCIS (Netherlands)

    B. Jacobs (Bas); A.L. Bovenberg (Lans)

    2005-01-01

    textabstractThis paper analyzes optimal linear taxes on capital and labor incomes in a life-cycle model of human capital investment, financial savings, and labor supply with heteroge- nous individuals. A dual income tax with a positive marginal tax rate on not only labor income but also capital inco

  16. Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures.

    Science.gov (United States)

    Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long

    2015-11-01

    The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

  17. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  18. Cooperative social capital

    Directory of Open Access Journals (Sweden)

    Oscar Acera Manero

    2005-12-01

    Full Text Available Social capital consists of the contributions of members and associates, both mandatory and voluntary. From an accounting point of view, it is a liability figure that expresses the value of a portion of the equity of the cooperative. Its inclusion in the liability is not the fact that it is a debt but by its nature unenforceable.

  19. On Representative Social Capital

    NARCIS (Netherlands)

    Bellemare, C.; Kroger, S.

    2004-01-01

    This paper analyzes data for a random sample drawn from the Dutch population who reveal their propensity to invest and reward investments in building up social capital by means of an economic experiment.We find substantial heterogeneity and asymmetries in the propensity to invest and in the propensi

  20. Understanding your capital options.

    Science.gov (United States)

    Payne, Christopher T

    2012-05-01

    When planning capital expenditures, hospitals and health systems should understand the following financing considerations: Traditional fixed-rate tax-exempt bonds; Variable-rate financing alternatives; Basel III Accord requirements; Direct tax-exempt bank loans; Total return swaps Taxable financings; Interest-rate swaps and collateral requirements

  1. Human Capital and Sustainability

    Directory of Open Access Journals (Sweden)

    Garry Jacobs

    2011-01-01

    Full Text Available A study of sustainability needs to consider the role of all forms of capital—natural, biological, social, technological, financial, cultural—and the complex ways in which they interact. All forms of capital derive their value, utility and application from human mental awareness, creativity and social innovation. This makes human capital, including social capital, the central determinant of resource productivity and sustainability. Humanity has entered the Anthropocene Epoch in which human changes have become the predominant factor in evolution. Humanity is itself evolving from animal physicality to social vitality to mental individuality. This transition has profound bearing on human productive capabilities, adaptability, creativity and values, the organization of economy, public policy, social awareness and life styles that determine sustainability. This article examines the linkages between population, economic development, employment, education, health, social equity, cultural values, energy intensity and sustainability in the context of evolving human consciousness. It concludes that development of human capital is the critical determinant of long-term sustainability and that efforts to accelerate the evolution of human consciousness and emergence of mentally self-conscious individuals will be the most effective approach for ensuring a sustainable future. Education is the primary lever. Human choice matters.

  2. Risk capital allocation

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Smilgins, Aleksandrs

    Risk capital allocation problems have been widely discussed in the academic literature. We consider a company with multiple subunits having individual portfolios. Hence, when portfolios of subunits are merged, a diversification benefit arises: the risk of the company as a whole is smaller than...

  3. Towards Transnational Academic Capitalism

    Science.gov (United States)

    Kauppinen, Ilkka

    2012-01-01

    This paper contributes to current debates on the relationship between globalisation and higher education. The main argument of the paper is that we are currently witnessing transnationalisation of academic capitalism. This argument is illustrated by examining the collaboration between transnational corporations and research universities, and how…

  4. Corruption and Social Capital

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    2003-01-01

    I examine the causal relation between social capiatl and corruption. A simple model illustrates potential mechanisms and yields testable implications, which I estimate in a sample of European countries. The estimated effect of social capital on corruption is found to be robust to the inclusion...... redistribution, which in turn reduces corruption....

  5. Microfoundations of Social Capital

    DEFF Research Database (Denmark)

    Thöni, Christian; Tyran, Jean-Robert; Wengström, Erik Roland

    We show that the standard trust question routinely used in social capital research is importantly related to cooperation behavior and we provide a microfoundation for this relation. We run a large-scale public goods experiment over the internet in Denmark and find that the trust question is a proxy...

  6. Microfoundations of Social Capital

    DEFF Research Database (Denmark)

    Thöni, Christian; Tyran, Jean-Robert Karl; Wengström, Erik Roland

    2012-01-01

    Research on social capital routinely relies on survey measures of trust which can be collected in large and heterogeneous samples at low cost. We validate such survey measures in an incentivized public good experiment and show that they are importantly related to cooperation behavior in a large...

  7. NANNING China's Green Capital

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ Nanning,the capital city of Guangxi province,is not only the political,economic and cultural center of the province,but also plays an important role in the economic development of southwest China.Nanning's advantageous location makes the city a commercial and communication center,opening China to Southeast Asia.

  8. Manage "Human Capital" Strategically

    Science.gov (United States)

    Odden, Allan

    2011-01-01

    To strategically manage human capital in education means restructuring the entire human resource system so that schools not only recruit and retain smart and capable individuals, but also manage them in ways that support the strategic directions of the organization. These management practices must be aligned with a district's education improvement…

  9. Capital Structure and Assets

    DEFF Research Database (Denmark)

    Flor, Christian Riis

    2008-01-01

    post optimally sell the assets or re-optimize the capital structure. Ex ante, more uncertain asset value decreases leverage, but not firm value, and selling the assets becomes less likely. Firms should tend to invest in assets whose value is less correlated to changes in earnings and, in addition...

  10. Is capitalism possible?

    NARCIS (Netherlands)

    Gaay Fortman, B. de

    1998-01-01

    In the two ages of its existence capitalism has given proof of its reformability. It was, however, anti-capitalist blueprints and ideas that constituted a continuous spiritual driving force towards reform. Today, after the collapse of real existing socialism there is an urgent need for new alternati

  11. To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kaushik, Abhishek, E-mail: abhiortho27@gmail.co [Department of Orthopedics, 513, Thermal Colony, Sector-22, Faridabad 121005, Haryana (India); Sankaran, Balu; Varghese, Mathew [Department of Orthopedics, St Stephen' s Hospital, Tis hazari, Delhi, New Delhi 110054 (India)

    2010-09-15

    Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

  12. Capitalism: A System of Conspiracy

    OpenAIRE

    Das, Subhendu

    2010-01-01

    There are some myths about American capitalism. Some of them are (1) Capitalism made America the richest nation, (2) Capitalism is based on self interest, and (3) America has democracy. We show that the survival of capitalism is based on several powerful conspiracy theories. We briefly describe these conspiracies. Our analysis is based on the following principles: (a) Laws of conservation, (b) System theoretic concepts, and (c) The global space time (GST) environment. Using these princip...

  13. Social capital and sports clubs

    OpenAIRE

    Tacon, Richard

    2014-01-01

    Book synopsis: \\ud \\ud This volume provides a collection of critical new perspectives on social capital theory by examining how social values, power relationships, and social identity interact with social capital. This book seeks to extend this theory into what have been largely under-investigated domains, and, at the same time, address long-standing, classic questions in the literature concerning the forms, determinants, and consequences of social capital.\\ud \\ud Social capital can be unders...

  14. MODELLING SOCIAL CAPITAL AND GROWTH

    OpenAIRE

    Chou, Yuan K.

    2002-01-01

    This paper proposes three theoretical growth models incorporating social capital, based on varied expositions on the concept of social capital and the empirical evidence gathered to date. In these models, social capital impacts growth by assisting in the accumulation of human capital, by affecting financial development through its effects on collective trust and social norms, and by facilitating networking between firms that result in the creation and diffusion of business and technological i...

  15. How venture capital works.

    Science.gov (United States)

    Zider, B

    1998-01-01

    The popular mythology surrounding the U.S. venture-capital industry derives from a previous era. Venture capitalists who nurtured the computer industry in its infancy were legendary both for their risk taking and for their hands-on operating experience. But today things are different, and separating the myths from the realities is crucial to understanding this important piece of the U.S. economy. Today's venture capitalists are more like conservative bankers than the risk takers of days past. They have carved out a specialized niche in the capital markets, filling a void that other institutions cannot serve. They are the linch-pins in an efficient system for meeting the needs of institutional investors looking for high returns, of entrepreneurs seeking funding, and of investment bankers looking for companies to sell. Venture capitalists must earn a consistently superior return on investments in inherently risky businesses. The myth is that they do so by investing in good ideas and good plans. In reality, they invest in good industries--that is, industries that are more competitively forgiving than the market as a whole. And they structure their deals in a way that minimizes their risk and maximizes their returns. Although many entrepreneurs expect venture capitalists to provide them with sage guidance as well as capital, that expectation is unrealistic. Given a typical portfolio of ten companies and a 2,000-hour work year, a venture capital partner spends on average less than two hours per week on any given company. In addition to analyzing the current venture-capital system, the author offers practical advice to entrepreneurs thinking about venture funding.

  16. Working Paper on Social capital

    DEFF Research Database (Denmark)

    Lassen Hanan, Anne

    2013-01-01

    This paper outlines the major schools within social capital theory. Contemporary authors such as Coleman, Putnam and Bourdieu are elaborated on. The paper also presents a non-exhaustive review on studies of social capital. Furthermore, a criticial discussion on social capital is reviewed, before...

  17. Bank capital management : International evidence

    NARCIS (Netherlands)

    De Jonghe, O.G.; Öztekin, Ö.

    2015-01-01

    We examine the dynamic behavior of bank capital using a global sample of 64 countries during the 1994-2010 period. Banks achieve deleveraging through active capital management (equity growth) rather than asset liquidation. In contrast, they achieve leveraging through passive capital management (redu

  18. 75 FR 6151 - Minimum Capital

    Science.gov (United States)

    2010-02-08

    ... sound operations.\\4\\ Also, section 1362(e) provides for additional capital and reserve requirements to... provide additional authorities for FHFA regarding minimum capital requirements. Section 1362(a... section.\\6\\ \\3\\ The Bank Act's current minimum capital requirements apply to the eleven banks that...

  19. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  20. The duplicated longitudinal epiphysis or ''kissing delta phalanx'': evolution and variation in three different disorders

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Alison M. [Department of Biochemistry and Medical Genetics, University of Manitoba, 770 Bannatyne Avenue, R3E 0W3, Winnipeg, Manitoba (Canada); Evans, Jane A.; Chudley, Albert E. [Department of Biochemistry and Medical Genetics, University of Manitoba, 770 Bannatyne Avenue, R3E 0W3, Winnipeg, Manitoba (Canada); Department of Pediatrics and Child Health, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba (Canada); Reed, Martin H. [Department of Biochemistry and Medical Genetics, University of Manitoba, 770 Bannatyne Avenue, R3E 0W3, Winnipeg, Manitoba (Canada); Department of Pediatrics and Child Health, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba (Canada); Department of Radiology, University of Manitoba and Health Sciences Centre, Winnipeg, Manitoba (Canada)

    2004-06-01

    The delta phalanx, also known as the delta bone, or longitudinal epiphyseal bracket (LEB), has been described in a variety of syndromes and dysplasias. However, the ''kissing delta phalanx'' is not as well recognized in the literature; it consists of a duplicated longitudinal bracketed epiphysis, or a complex of two adjacent delta bones, with opposing convex portions facing each other. Magnetic resonance imaging of the kissing delta phalanx has not been previously described. To describe the evolution, variation and associated osseous anomalies of the kissing delta phalanx in three patients with distinct distal limb malformations using both plain films and magnetic resonance imaging. Patient 1 had Rubinstein-Taybi syndrome and, in addition to a kissing delta phalanx in both feet, had corresponding delta metatarsals (MT1). Patient 2 had Cenani-Lenz syndactyly with distinct variation of the kissing delta phalanx in each hand. He had a disorganized appearance to the phalanges, metacarpal fusions and carpal coalitions. Patient 3 had an isolated oligosyndactyly of the left hand with metacarpal fusions and carpal coalitions. All three patients were followed over time. We describe two types of kissing delta phalanges: separated (without fusion of the corresponding epiphyseal brackets) and nonseparated (with fusion of the corresponding epiphyseal brackets). Both types can be seen in the same patient and are a reflection of the relative degree of segmentation of the two delta bones. (orig.)

  1. Reference values for local arterial stiffness. Part B : femoral artery

    NARCIS (Netherlands)

    Bossuyt, Jelle; Engelen, Lian; Ferreira, Isabel; Stehouwer, Coen D; Boutouyrie, Pierre; Laurent, Stéphane; Segers, Patrick; Reesink, Koen; Van Bortel, Luc M

    2015-01-01

    OBJECTIVE: Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (C

  2. Femoral compressive neuropathy from iliopsoas haematoma complicating dengue hemorrhagic fever

    Institute of Scientific and Technical Information of China (English)

    Sneha Ganu; Yesha Mehta

    2013-01-01

    Dengue fever is a debilitating mosquito-borne disease caused by dengue virus. We reported a case of femoral compression neuropathy due to iliopsoas hematoma complicating dengue hemorrhagic fever. Iliopsoas muscle hematoma can cause femoral neuropathy with resultant pain and paralysis. Such manifestations are not well documented in the literature. The pathogenesis of hematoma and compressive neuropathy with its appropriate management is discussed.

  3. STRANGULATED FEMORAL HERNIA IN A MALE PATIENT – DIAGNOSTIC DILEMMA

    Directory of Open Access Journals (Sweden)

    Sapna

    2014-01-01

    Full Text Available Strangulated femoral hernia in a male patient is a very rare clinical presentation. Here we report a case of right inguinal swelling mimicking that of lymphadenopathy , later developing perforation due to strangulation of femoral hernia. Laparotomy with ileostomy was done

  4. Normal neurodynamic responses of the femoral slump test.

    Science.gov (United States)

    Lai, Weng-Hang; Shih, Yi-Fen; Lin, Pei-Ling; Chen, Wen-Yin; Ma, Hsiao-Li

    2012-04-01

    Femoral slump test is a neurodynamic testing, which could be used to assess the mechanosensitivity of the femoral component of the nervous system. Although Trainor and Pinnington reported the diagnosis accuracy of the femoral slump test, the neurodynamic responses of the femoral slump test have never been studied. The purposes of this study were to evaluate whether maneuvers that changed the nerve tension altered the responses of the femoral slump test and if these responses were influenced by gender and leg dominance; and to identify the correlations between flexibility and measured hip extension angle. Thirty-two asymptomatic subjects (16 males, 16 females) were recruited. The femoral slump test was performed in trunk slump and neutral positions, and cervical extension was used as the structure differential technique. Hip extension angle and visual analog scale (VAS) of thigh pain was measured during the test. Our results showed the decrease of nerve tension significantly increased hip extension ROM (P  0.05). These findings indicated that femoral slump test resulted in normal neurodynamic responses in individuals free of lower extremity problems, and these responses were independent of the influence of muscle flexibility or gender. Future research should emphasize the use of femoral slump test in patient groups such as low back and anterior knee pain.

  5. Ensayo sobre el Capital Social

    Directory of Open Access Journals (Sweden)

    Ramón Frediani

    2011-08-01

    Full Text Available En la teoría económica existen distintas definiciones de capital: capital físico, el capital en recursos naturales, el capital financiero, el capital en infraestructura económica, el capital en infraestructura social y el capital humano. Todos ellos son condiciones necesarias para que un país alcance el desarrollo económico y social y un alto estándar y calidad de vida de sus habitantes, pero no suficientes puesto que hace falta una categoría adicional de capital. En los últimos años ha surgido el análisis de una nueva categoría: el Capital Social. El concepto se ha convertido en uno de los temas más debatidos de las ciencias sociales y políticas. Se refiere a un elemento invisible, etéreo, menos tangible que el capital humano (conocimientos y/o habilidades de los individuos o el capital físico (bienes materiales, pero que resulta decisivo para la actividad productiva, la satisfacción de las necesidades personales y el desarrollo comunitario y de una sociedad toda.

  6. SEXUAL DIMORPHISM OF MAXIMUM FEMORAL LENGTH

    Directory of Open Access Journals (Sweden)

    Pandya A M

    2011-04-01

    Full Text Available Sexual identification from the skeletal parts has medico legal and anthropological importance. Present study aims to obtain values of maximum femoral length and to evaluate its possible usefulness in determining correct sexual identification. Study sample consisted of 184 dry, normal, adult, human femora (136 male & 48 female from skeletal collections of Anatomy department, M. P. Shah Medical College, Jamnagar, Gujarat. Maximum length of femur was considered as maximum vertical distance between upper end of head of femur and the lowest point on femoral condyle, measured with the osteometric board. Mean Values obtained were, 451.81 and 417.48 for right male and female, and 453.35 and 420.44 for left male and female respectively. Higher value in male was statistically highly significant (P< 0.001 on both sides. Demarking point (D.P. analysis of the data showed that right femora with maximum length more than 476.70 were definitely male and less than 379.99 were definitely female; while for left bones, femora with maximum length more than 484.49 were definitely male and less than 385.73 were definitely female. Maximum length identified 13.43% of right male femora, 4.35% of right female femora, 7.25% of left male femora and 8% of left female femora. [National J of Med Res 2011; 1(2.000: 67-70

  7. Continuous blood gas monitoring in femoral arteries

    Science.gov (United States)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  8. Current concepts in total femoral replacement.

    Science.gov (United States)

    Ramanathan, Deepak; Siqueira, Marcelo Bp; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-12-18

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20(th) century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure.

  9. Capital Requirements and Banks' Leniency

    DEFF Research Database (Denmark)

    Dietrich, J. Kimball; Wihlborg, Clas

    2003-01-01

    We investigate the effect of changes in capital regulation on the strictness(leniency) of loan terms using a simple model of bank capital requirements andasset quality examinations. Banks offer different levels of `leniency' in the senseof willingness to offer automatic extensions of loans...... in the presence of temporarypayment difficulties of borrowers. Banks offering lenient (less strict) loan termsmust have higher initial levels of capital and charge higher loan rates. Whencapital requirements are increased, both strict and lenient banks hold higher levelsof initial capital and they raise loan...... rates. As capital requirements increase thedifference between initial capital levels and between interest rates of strict andlenient banks decrease. Thus, higher capital requirements in recessions tend toreduce the interest rate premium paid for leniency. If a recession is interpreted asan increase...

  10. Leveraging organisational cultural capital

    Directory of Open Access Journals (Sweden)

    R Scheel

    2007-01-01

    Full Text Available Organisational culture discourse mandates a linear approach of diagnosis, measurement and gap analysis as standard practice in relation to most culture change initiatives. Therefore, a problem solving framework geared toward “fixing�? and/or realigning an organisation’s culture is usually prescribed. The traditional problem solving model seeks to identify gaps between current and desired organisational cultural states, inhibiting the discovery of an organisation’s unique values and strengths, namely its cultural capital. In pursuit of discovering and leveraging organisational cultural capital, a descriptive case study is used to show how an Appreciative Inquiry process can rejuvenate the spirit of an organisation as a system-wide inquiry mobilises a workforce toward a shared vision.

  11. Governing Global Capital

    DEFF Research Database (Denmark)

    Harrington, Brooke

    an institutionalist perspective, the paper examines three ways in which wealth managers, both individually and through their professional society, influence regional competition for power and wealth: 1) by finding loopholes in existing policies that limit the global flow of capital; 2) by lobbying national......How do professions affect the configuration of political economies worldwide? This study addresses the question through interviews with members of a new transnational profession - wealth management - whose innovations are reshaping the balance of power in global finance. Wealth managers specialize...... in helping elites avoid taxes and other forms of regulation. The study documents how the means through which they achieve this objective - shifting billions in private capital wealth between Asia, Africa, India and Europe - and how this affects the balance of regional economic power. Drawing from...

  12. Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity

    DEFF Research Database (Denmark)

    Greve, Sara V; Blicher, Marie K; Kruger, Ruan;

    2016-01-01

    BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular risk prediction, but is not widely available. Therefore, it would be helpful if cfPWV could be replaced by an estimated carotid-femoral pulse wave velocity (ePWV) using age and mean blood pres...

  13. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

  14. Spontaneous fracture of the femoral neck in preexisting avascular necrosis of femoral head in sickle cell disease

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya

    2012-01-01

    Avascular necrosis of the femoral head is a known complication of femoral neck fracture but on the contrary,femoral neck fracture in a case of preexisting avascular necrosis is a very rare phenomenon.We present a case study of a 47 year old Iraqi male who developed spontaneous ipsilateral subcapital femoral neck fracture under the condition of preexisting sickle cell disease and avascular necrosis of the femoral head.The fracture was unnoticed for a few months.The patient was managed successfully by uncemented total hip arthroplasty.Postoperative recovery was uneventful and he was discharged 4 days after surgery.At 1 year's follow-up,the patient had normal gait and hip function,with no sign of loosening or any other complications on radiograph.

  15. fuente de capital humano

    Directory of Open Access Journals (Sweden)

    Ligia Becerra

    2005-01-01

    Full Text Available El capital intelectual es una concepción novedosa, tipificada como un activo intangible que agrega valor a la empresa; está formado por tres componentes: el capital organizacional, el humano y el relacional. El capital humano está relacionado con el desarrollo y los conocimientos del individuo, que permite diferenciar a un profesional de otro. El objetivo de este trabajo es analizar la formación del Contador Público egresado de la Universidad de Los Andes (ULA de Trujillo, como fuente de capital humano para su desempeño profesional. Los datos se recolectaron aplicando un cuestionario a una muestra aleatoria de 47 de estos profesionales, empleando para el análisis y presentación de los resultados técnicas estadísticas. La investigación evidencia que la mayoría de los encuestados poseen un nivel de satisfacción de medio a bajo con su formación de pregrado, señalando como principales debilidades del Plan de Estudio las áreas tributaria y cambiaria, el manejo instrumental del inglés y el conocimiento de las normativas que rigen el sistema económico. La formación en algunas de estas áreas la han mejorado a través de otras actividades de capacitación. No obstante reconocen algunas fortalezas tales como: el aprendizaje y dominio de conceptos y Principios Contables de Aceptación General, las matemáticas y estadística, el manejo de la contabilidad computarizada y las habilidades para analizar e interpretar problemas contables. Se concluye que a pesar de las deficiencias, la realización de cursos de actualización, junto con las fortalezas en la formación de la carrera, ha contribuido a que el contador público egresado de la ULA de Trujillo constituya un capital humano con ventaja competitiva.

  16. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  17. On the capitalization and cultivation of social capital

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Waldstrøm, Christian

    2008-01-01

    Bourdieu's (1986) seminal definition of social capital as "the aggregate of the actual or potential resources" is reflected in older definitions, as well as in many current within sociology (e.g. Portes, 2000) and organization (Adler & Kwon, 2002). The definition is interesting, because it directs...... a dual focus on social capital as both immediately and potentially productive resources, i.e. assets that can be immediately capitalized by individuals as well as ‘cultivated' for future use. We argue that to further operationalize this concept we must distinguish between actual/potential social capital...

  18. Treatment of postcatheterization femoral arteriovenous fistulas with simple prolonged bandaging

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; LIU Zhen-jiang; ZHOU Sheng-hua; SHEN Xiang-qian; LIU Qi-ming; FANG Zhen-fei; HU Xin-qun; LI Jiang; L(U) Xiao-lin

    2007-01-01

    Background The methods for the treatment of postcatheterization femoral arteriovenous fistulas (AVF-s) - simple observation, ultrasound guided compression, covered stents implantation and coil embolization have poor outcome.Surgery is the standard method for treatment of femoral AVFs, but it is a traumatic operation. In this study, we report the results of the treatment of postcatheterization femoral AVFs by simple prolonged compressing bandage.Methods To treat iatrogenic femoral AVFs caused by transfemoral catheterization, prolonged binding with elastic or common bandage was applied in 16 cases. Catheterization was performed in 7 cases for radiofrequency current catheter ablation, in 4 for occlusion of congenital heart disease, in 3 for percutaneous coronary intervention, in 1 for coronary angiography and in 1 for right heart catheterization.Results All iatrogenic femoral AVFs were healed after simple binding with elastic or common bandage for 4-46 days (mean (15±10) days). During the period of binding, local skins ulceration occurred at puncture site in two cases and femoral vein thrombus was found in one patient. During 6-24 months (mean (11.8±3.6) months) followup with colour Doppler ultrasonography, no recurrent arteriovenous shunting or other complications were observed.Conclusion The results suggest that simple prolonged bandaging for postcatheterization femoral AVFs is an effective and economical procedure.

  19. Intestinal Obstruction due to Bilateral Strangulated Femoral Hernias

    Directory of Open Access Journals (Sweden)

    Ioannis Nikolopoulos

    2014-01-01

    Full Text Available Introduction. Femoral hernias are at high risk of strangulation due to the narrow femoral canal and femoral ring. This can lead to symptoms of obstruction or strangulation requiring emergency surgery and possible bowel resection. To our knowledge, there is only one previous published report of bilateral strangulated femoral hernia. We present our case of this phenomenon. Case Report. An 86-year-old woman presented with symptoms of small bowel obstruction. Examination revealed two tender lumps in the area of the femoral triangle. CT scan revealed bilateral femoral hernias. Both hernias were repaired and a small bowel resection on the right side was performed with side to side anastomosis. She made an uneventful recovery. Conclusion. Bilateral femoral hernias are a rare occurrence with only one reported case of bilateral strangulation. Our case highlights the importance of meticulous history taking and clinical examination as any delay in diagnosis will increase the risk of mortality and morbidity for the patient. Hernias should always be considered as a cause if one presents with symptoms of abdominal pain or obstruction.

  20. [Femoral angioplasty. Long-term results].

    Science.gov (United States)

    Foucart, H; Carlier, C; Baudrillard, J C; Joffre, F; Cécile, J P

    1990-01-01

    A study on the long-term efficacy of femoral-popliteal angioplasty was carried out on 185 angioplasty cases over a 5 year follow-up period. A classification of data according to the type of lesion treated, revealed that results were favorable in case of stenosis (87%), short obstruction (70%) and long obstruction (35%). A special study of the outcome of treatments for stage IV arteritis was carried out. After comparing results with those obtained by other teams, the authors list the complications encountered, hematomas, and thromboses, and show their current tendency for regression. Lastly, the authors stress the advantages of angioscopy, which permits to identify the nature of the treated lesions and to predict possible complications, which are usually underrated by angiography.

  1. FEMORAL MONONEUROPATHY: COMPLICATING A DIFFICULT PELVIC URETEROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    D. Mehraban

    1996-07-01

    Full Text Available Femoral mononeuropathy is a complication of gynecological and urological operations. Tlte objective of this citse report is to bring to the attention of fellow urologists the very existence of this complication and offer measures to prevent it. A 48 year old obese worman with a 2 year history of frequent left renal colics, anil a nonfunction left kidney on IVP underwent a retrograde ureterogram study anil a transvaginal ureterolithotomy, in an exaggerated lithotomy position. Postoperatively, a left leg paralysis required 3 weeks of care and encouragement to heal. To prevent this complication, avoid putting too long and too much pressure by retractors on the psoas muscles. During the abdomino-perineal procedures, frequent change of retractor site and monitoring of distal arterial pulses would he helpful. Also, do not use the exaggerated lithotomy position for an extended period of time.

  2. Treatment of the femoral neck peudoarthrosis in childhood: Case report

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2013-01-01

    Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

  3. MORPHOLOGICAL STUDY OF MEDIAL CIRCUMFLEX FEMORAL ARTERY IN HUMAN CADAVERS

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49% medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80% a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%. Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG flap, medial thigh flap and medial circumflex femoral (gracilis perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

  4. Social Capital in Rural Denmark

    DEFF Research Database (Denmark)

    Svendsen, G.L.; Svendsen, Gert Tinggaard

    1999-01-01

    What are the roots of social capital and how can it be measured and built? Social capital is considered as a new production factor which must be added to the conventional concepts of human and physical capital. Social capital is productive because it increases the level of trust in a society...... and allows more transactions to take place without third-party enforcement. Theory and lessons from empirical evidence lead to the general recommendation that any loss in social capital must be deducted from the economic gain following market forces. For example, the voluntary organization of small......-sized groups in the Danish Cooperative Dairy Movement was eliminated due to economies of scale. It may be so that an alternative way of production, taking social capital into account, could have increased economic growth further....

  5. Social capital and psychological distress.

    Science.gov (United States)

    Song, Lijun

    2011-12-01

    The author proposes a conceptual model to explain the diverse roles of social capital--resources embedded in social networks--in the social production of health. Using a unique national U.S. sample, the author estimated a path analysis model to examine the direct and indirect effects of social capital on psychological distress and its intervening effects on the relationships between other structural antecedents and psychological distress. The results show that social capital is inversely associated with psychological distress, and part of that effect is indirect through subjective social status. Social capital also acts as an intervening mechanism to link seven social factors (age, gender, race-ethnicity, education, occupational prestige, annual family income, and voluntary participation) with psychological distress. This study develops the theory of social capital as network resources and demonstrates the complex functions of social capital as a distinct social determinant of health.

  6. Our Experience with Patello femoral joint replacement

    Science.gov (United States)

    Ramos, Pablo; Arteaga, Gonzalo; Vargas, Medardo; Naranjo, Juan

    2017-01-01

    Background: Ten to fifteen percent of knee arthritis is reported to be isolated patellofemoral arthritis. Total knee arthroplasty is not recommended for isolated patella femoral arthritis particularly in young patients. We present the retrospective review our series in 7 years. Objectives: The aim of this presentation is to describe our experience in the management of patellofemoral osteoarthritis with the use of the partial patellofemoral arthroplasty, as well as to delineate the pitfalls and causes of revision in our initial series of 153 cases. Methods: between 2009 and 2016, our group performed 157 patellofemoral arthroplasties (PFA) 74% being in women, and 26% in men, the mean age for women was 58 yrs. And 38 yrs. for men, our initial 13 cases were managed with the Avon prosthesis (Stryker Corporation Kalamazoo, Michigan), and then we switched to the Vanguard PF (Zimmer-Biomet Warsaw In), both systems are an On-Lay design that is more flexible for addressing dysplastic trochleas that are more common in our population. Results: We performed a Knee Osteoarthritis Outcome Score (KOOS) for the assessment of the success of the procedure and obtained 87% of patients with excellent results (95 to 100), 10% with fair results (70 to 90) and 3% with poor outcomes (50), we performed a total of 3 revisions due to pain or progress to global arthritis. Conclusion: The PFA is a successful, safe and reproducible surgery that can be used in the group of patients that have isolated patellofemoral osteoarthritis. It requires a thorough knowledge of the patello femoral joint biomechanics, and physiopathology.

  7. Re-Thinking Social Capital

    Directory of Open Access Journals (Sweden)

    Zlatko Bukač

    2011-06-01

    Full Text Available The concept of social capital has been used very often in sociological researches over the last two decades. Measuring social capital in civil society, neighborhoods and educational systems is merely a part of its popular usage. Many sociologists tend to use the concept of social capital very freely and therefore expand the definition of social capital. The author’s personal experience indicates that there have been a great number of academic discussions, research planning and public speeches implementing the notion of social capital without taking a detailed consideration of what that concept truly entails. By overviewing the available literature on social capital, it is actually no wonder that both sociologists and the noted concept were in this confusing situation. As Field stated in his book Social Capital (Key Ideas, published in 2008, his work was “the first attempt to provide an extended introduction on increasingly influential concept of social capital” (Field 1. Quibria notes that even though there is a vast number of research conducted on social capital in many academic fields and with various approaches ‘the concept of social capital remains largely elusive’’(1. That obviously is not an obstacle because there is a constantly growing interest in social capital. A vast body of research concerning, measuring, and defining social capital is available today, which helps a researcher to analyze and compare all of the perspectives concerning social capital. This can be of great importance when researchers approach a somewhat new subject of research such as online communication and, more specifically, online games.

  8. CSR, SMEs and Social Capital

    DEFF Research Database (Denmark)

    Murillo, David; Vallentin, Steen

    2012-01-01

    capital are interrelated, turning social capital into a powerful instrument to better explain what academic literature has called silent CSR practices. The analysis that follows questions some of the basic tenets that underpin the branch of business ethics that deals with the nature of SMEs' approach...... this type of action d) Any study of this kind of practice requires a dual approach: a) normative when using tools developed by CSR; and b) descriptive and instrumental using the notion of social capital....

  9. Neurapraxia of the femoral nerve in a modern dancer.

    Science.gov (United States)

    Sammarco, G J; Stephens, M M

    1991-01-01

    We have presented a case of an acute onset femoral nerve neurapraxia in a pure modern dancer. Repeated mild stretching of the femoral nerve during an established dance routine over a period of several months is implicated as the etiology. The thigh muscles quickly weakened, but regained strength within 3 months. Electromyographic evidence of specific femoral nerve injury initially was negative, but was evident 6 weeks following injury. Overuse syndrome in dancers can cause rapid loss of strength. Other conditions such as herniated intervertebral disc, acute hemorrhage, trauma, iliopsoas rupture, and acute stretching must be ruled out. Complete recovery was the natural outcome.

  10. Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

    Science.gov (United States)

    Steinwender, G; Hosny, G A; Koch, S; Grill, F

    1995-01-01

    We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

  11. Bilateral impacted femoral neck fracture in a renal disease patient

    Directory of Open Access Journals (Sweden)

    Pramod Devkota

    2013-01-01

    Full Text Available Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

  12. Microfoundations of Social Capital

    DEFF Research Database (Denmark)

    Thöni, Christian; Tyran, Jean-Robert; Wengström, Erik Roland

    We show that the standard trust question routinely used in social capital research is importantly related to cooperation behavior and we provide a microfoundation for this relation. We run a large-scale public goods experiment over the internet in Denmark and find that the trust question is a proxy...... for cooperation preferences rather than beliefs about others' cooperation. To disentangle the preference and belief channels, we run a (standard) public goods game in which beliefs matter for cooperation choices and one (using the strategy method) in which they do not matter. We show that the "fairness question...

  13. Contratos de capital humano

    Directory of Open Access Journals (Sweden)

    Oscar Alejandro Goyes Viteri

    2005-01-01

    Full Text Available Este documento busca dar a conocer el tema de la inversión en capital humano a través de la celebración de contratos atípicos y utilizando la fiducia mercantil y la titularización como vehículos financieros. Por medio de estos contratos un estudiante obtiene los recursos que requiere para financiar su educación superior, a cambio de entregar un porcentaje de sus ingresos después de su graduación a quien financió la operación.

  14. Taxes and Venture Capital Support

    DEFF Research Database (Denmark)

    Keuschnigg, Christian; Nielsen, Søren Bo

    2003-01-01

    -set may paradoxically contribute to higher quality of venturecapital finance and welfare. Subsidies to physical investment in VC-backed startupsare detrimental in our framework.Keywords: Venture capital, capital gains taxation, double moral hazard.JEL-Classification: D82, G24, H24, H25......'s success, but is not verifiable. Asa result, the market equilibrium is biased towards inefficiently low venture capitalsupport. The capital gains tax becomes especially harmful, as it further impairsadvice and causes a first-order welfare loss. Once the capital gains tax is in place,limitations on loss off...

  15. Human capital and career success

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Kato, Takao

    evidence for the first time for the population of workers in an entire economy (as opposed to case study evidence) on the effects of the nature and scope of human capital on career success (measured by appointments to top management). First, we confirm the beneficial effect of acquiring general human...... capital formally through schooling for career success, as well as the gender gap in career success rates. Second, broadening the scope of human capital by experiencing various occupations (becoming a generalist) is found to be advantageous for career success. Third, initial human capital earned through...

  16. From Information Capitalism to Information Socialism

    Institute of Scientific and Technical Information of China (English)

    XiaoFeng

    2005-01-01

    Information technology and information capital are both neutral in character and can serve socialism as well as capitalism. As Karst pointed out, the information society is culturally and institutionally diverse. If in their transformation into social morphology information technology and capital may both end in socialism as well as capitalism, then what is the essential distinction between information capitalism and information socialism?

  17. Human capital and optimal positive taxation of capital income

    NARCIS (Netherlands)

    B. Jacobs (Bas); A.L. Bovenberg (Lans)

    2010-01-01

    textabstractThis paper analyzes optimal linear and non-linear taxes on capital and labor incomes in a life-cycle model of human capital investment, financial savings, and labor supply with heterogenous individuals. A dual income tax with a positive marginal tax rate on not only labor income but also

  18. Treatment of osteonecrosis of the femoral head using autologous cultured osteoblasts: a case report

    Directory of Open Access Journals (Sweden)

    Kim Seok-Jung

    2008-02-01

    Full Text Available Abstract Introduction Osteonecrosis of the femoral head is a progressive disease that leads to femoral head collapse and osteoarthritis. Our goal in treating osteonecrosis is to preserve, not to replace, the femoral head. Case presentation We present the case of a patient with bilateral osteonecrosis of the femoral head treated with autologous cultured osteoblast injection. Conclusion Although our experience is limited to one patient, autologous cultured osteoblast transplantation appears to be effective for treating the osteonecrosis of femoral head.

  19. Estudio radiológico de anteversión femoral

    OpenAIRE

    Oller Asensio, Antonio; Oller Arcas, Javier

    2005-01-01

    La deformidad torso rotacional de las extremidades inferiores es un desorden esquelético frecuente, de gran importancia y es causa de alteración de la marcha. La anteversión femoral corresponde a la inclinación anterior de la cabeza femoral con respecto al eje bicondíleo femoral. El cuello femoral está normalmente en anteversión con respecto al plano bicondilar femoral.

  20. Cell therapy for avascular osteonecrosis of femoral head

    Directory of Open Access Journals (Sweden)

    Tomoki Aoyama

    2009-04-01

    Full Text Available Avascular osteonecrosis of femoral head causes severe musculoskeletal disability. There is not standard treatment to cure avascular osteonecrosis.? Recently, cell therapy using bone marrow stromal cells has begun for this disease.

  1. Acute femoral neuropathy secondary to an iliacus muscle hematoma.

    Science.gov (United States)

    Seijo-Martínez, M; Castro del Río, M; Fontoira, E; Fontoira, M

    2003-05-15

    We present a patient with a spontaneous iliacus muscle hematoma, appearing immediately after a minor physical maneuver, presenting with pain and femoral neuropathy initially evidenced by massive quadriceps muscle fasciculations. A magnetic resonance imaging (MRI) study of the pelvic area confirmed the diagnosis, showing a hematoma secondary to a partial muscle tear. The patient was managed conservatively, and the continuous muscle activity ceased in 3 days, with progressive improvement of the pain and weakness. The recovery was complete. Femoral neuropathy is uncommon and usually due to compression from psoas muscle mass lesions of diverse nature, including hematomas. Usually subacute, femoral neuropathy may present acutely in cases of large or strategically placed compressive femoral nerve lesions, and may require surgical evacuation. The case presented herein is remarkable since the muscle hematoma appeared after a nonviolent maneuver, fasciculations were present at onset, and conservative management was sufficient for a full recovery.

  2. Periprosthetic subtrochanteric femoral fracture in a megaprosthesis of the knee

    Directory of Open Access Journals (Sweden)

    Vaishya Raju

    2013-10-01

    Full Text Available 【Abstract】We report a rare case of periprosthetic posttraumatic fracture of subtrochanteric region of femur after a megaprosthesis of the knee, done for resistant nonunion of distal femur with secondary osteoarthrosis in a 51 years old man. Treatment with a locking femoral plate was able to achieve primary union with a good result. Key words: Periprosthetic fractures; Femur; Femoral fractures; Knee

  3. Brodie's abscess of the femoral neck simulating osteoid osteoma.

    Science.gov (United States)

    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

    Subacute osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Though reported in the metaphyseal region of the femur, Brodie's abscess is rarer in the femoral neck. The authors present a case of Brodie's abscess in the femoral neck, which clinico-radiologically simulated an osteoid osteoma. Retrospectively, the presence of a cortical sinus tract should have aroused suspicion.

  4. 12 CFR 565.4 - Capital measures and capital category definitions.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Capital measures and capital category... PROMPT CORRECTIVE ACTION § 565.4 Capital measures and capital category definitions. (a) Capital measures. For purposes of section 38 and this part, the relevant capital measures shall be: (1) The total...

  5. 12 CFR 325.103 - Capital measures and capital category definitions.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Capital measures and capital category... STATEMENTS OF GENERAL POLICY CAPITAL MAINTENANCE Prompt Corrective Action § 325.103 Capital measures and capital category definitions. (a) Capital measures. For purposes of section 38 and this subpart,...

  6. Social Capital and Savings Behavior

    DEFF Research Database (Denmark)

    Newman, Carol; Tarp, Finn; Khai, Luu Duc

    In this paper, we analyze household savings in rural Vietnam paying particular attention to the factors that determine the proportion of savings held as formal deposits. Our aim is to explore the extent to which social capital can play a role in promoting formal savings behavior. Social capital...

  7. Capital loss in China's agriculture

    Institute of Scientific and Technical Information of China (English)

    Cheng Peng

    2004-01-01

    China's agriculture has contributed a lot to industrialization but it has suffered a long-run and severe capital loss.This paper provides an estimation model of capital loss in agriculture and gives some explanation in marginal approach.With an eye to a balanced and sustainable economy development, it is high time for government to do something for it.

  8. Venture Capital and Innovation Strategies

    NARCIS (Netherlands)

    Da Rin, M.; Penas, M.F.

    2015-01-01

    Venture capital is a specialized form of financial intermediation that often provides funding for costly technological innovation. Venture capital firms need to exit portfolio companies within about five years from the investment to generate returns for institutional investors. This paper is the fir

  9. Universities Venture into Venture Capitalism.

    Science.gov (United States)

    Desruisseaux, Paul

    2000-01-01

    Reports that some universities are starting their own venture-capital funds to develop campus companies, or are investing endowment funds with established venture-capital firms inclined to finance potential spinoffs from campus research. Examples cited are from the University of Alabama, Vanderbilt University (Tennessee), University of…

  10. Innovation and venture capital exits

    NARCIS (Netherlands)

    Schwienbacher, A.

    2008-01-01

    This article analyses how start-ups financed by venture capital choose their innovation strategy based on the investor's exit preferences and thereby form different outcomes in the product market. It considers innovation choices and venture capital exits (IPO vs trade sale) in a setting in which ent

  11. Business model and Intellectual Capital

    DEFF Research Database (Denmark)

    Lindgren, Peter; Saghaug, Kristin Margrethe

    2012-01-01

    When practicing business model (BM) innovation releasing intellectual capital (IC) strategically from SME´s BMs through the innovation process can be extremely difficult and complex to carry out especially to small and medium size enterprises (SME). There are so many opportunities and resources...... in SME´s Intellectual Capital – but how to release them?...

  12. A Capital Adequacy Buffer Model

    NARCIS (Netherlands)

    D.E. Allen (David); M.J. McAleer (Michael); R.J. Powell (Robert); A.K. Singh (Abhay)

    2013-01-01

    markdownabstract__Abstract__ In this paper, we develop a new capital adequacy buffer model (CABM) which is sensitive to dynamic economic circumstances. The model, which measures additional bank capital required to compensate for fluctuating credit risk, is a novel combination of the Merton structur

  13. Capital flight and political risk

    NARCIS (Netherlands)

    Lensink, R; Hermes, N; Murinde, [No Value

    2000-01-01

    This paper provides the first serious attempt to examine the relationship between political risk and capital flight for a large set of developing countries. The outcomes of the analysis show that in most cases political risk variables do have a statistically robust relationship to capital flight onc

  14. Schools, Social Capital and Space

    Science.gov (United States)

    Allan, Julie; Catts, Ralph

    2014-01-01

    This paper reports on the significance of social capital in relation to education, exploring its relevance to teachers and other professionals as well as among young people. It draws on aspects of five case studies undertaken by the Schools and Social Capital Network, within the Applied Educational Research Scheme in Scotland. These case studies…

  15. San Diego's Capital Planning Process

    Science.gov (United States)

    Lytton, Michael

    2009-01-01

    This article describes San Diego's capital planning process. As part of its capital planning process, the San Diego Unified School District has developed a systematic analysis of functional quality at each of its school sites. The advantage of this approach is that it seeks to develop and apply quantifiable metrics and standards for the more…

  16. Avascular Necrosis of the Capitate

    OpenAIRE

    Bekele, Wosen; Escobedo, Eva; Allen, Robert

    2011-01-01

    Avascular necrosis of the capitate is a rare entity. The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma.

  17. 76 FR 74631 - Capital Plans

    Science.gov (United States)

    2011-12-01

    ... business or activities on the bank holding company's capital adequacy or liquidity, including revenue and... bank holding companies to submit capital plans to the Federal Reserve on an annual basis and to require such bank holding companies to obtain approval from the Federal Reserve under certain...

  18. Exploring the social capital grid

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Patulny, Roger

    2007-01-01

    catch-all social capital concept, rather than classifying it according to the bonding/bridging distinction. Furthermore, most studies make little distinction on the basis of methodology, between qualitative and quantitative approaches to investigating social capital. These omissions need to be addressed....

  19. Cultural capital as a measurand

    Science.gov (United States)

    Taymanov, R.; Sapozhnikova, K.

    2016-11-01

    The necessity for developing metrology due to extension of its application sphere is noted. The efficiency of the metrological approach to measurement of multidimensional quantities in the field of humanities is shown using the development of cultural capital interpreted by L. Harrison. The cultural capital is defined as a measure of the society structure complexity and adaptive capacity.

  20. Performance systems and social capital

    DEFF Research Database (Denmark)

    Rasmussen, Grane Mikael Gregaard; Edwards, Kasper

    2014-01-01

    from a study on implementation of a performance system in Danish construction. The results show causalities between implementing the performance system and the emergence of social capital in construction projects. Results indicate that performance systems and social capital is not mutually exclusive...

  1. Sand in the Wheels of Capitalism

    DEFF Research Database (Denmark)

    Bersem, Mario; Perotti, Enrico; von Thadden, Ernst-Ludwig

    We present a positive theory of capital market frictions that raise the cost of capital for new firms and lower the cost of capital for incumbent firms. Capital market frictions arise from a political conflict across voters who differ in two dimensions: (i) a fraction of voters owns capital......, the rest receives only lab or income; and (ii) voters have different vintages of human capital. We identify young workers as the decisive voter group, with preferences in between capitalists who favor a free capital market, and old workers, who favor restricted capital mobility. We show that capital market...... frictions do not naturally arise in a static framework, or even in a dynamic framework if capital market frictions are reversible. But if capital market frictions can be made to p ersist over time, we show that young workers favor capital market frictions as a way to smo oth income, especially if wealth...

  2. Social capital and localised learning

    DEFF Research Database (Denmark)

    Lorenzen, Mark

    2007-01-01

      This conceptual paper analyses why social capital is important for learning and economic development, how it is created and its geography. It argues that with the rise of globalisation and learning-based competition, social capital is becoming valuable because it organises markets, lowering...... business firms' costs of co-ordinating and allowing them flexibly to connect and reconnect. The paper defines social capital as a matrix of various social relations, combined with particular normative and cognitive social institutions that facilitate co-operation and reciprocity, and suggests that social...... capital is formed at spatial scales lower than the national or international, because the density of matrices of social relations increases with proximity. The paper also offers a discussion of how national and regional policies may be suited for promoting social capital....

  3. Individual social capital and survival

    DEFF Research Database (Denmark)

    Ejlskov, Linda; Mortensen, Rikke Nørmark; Overgaard, Charlotte;

    2014-01-01

    Background The concept of social capital has received increasing attention as a determinant of population survival, but its significance is uncertain. We examined the importance of social capital on survival in a population study while focusing on gender differences. Methods We used data from...... a Danish regional health survey with a five-year follow-up period, 2007?2012 (n=9288, 53.5% men, 46.5% women). We investigated the association between social capital and all-cause mortality, performing separate analyses on a composite measure as well as four specific dimensions of social capital while...... controlling for covariates. Analyses were performed with Cox proportional hazard models by which hazard ratios and 95% confidence intervals were calculated. Results For women, higher levels of social capital were associated with lower all-cause mortality regardless of age, socioeconomic status, health...

  4. Human capital strategy: talent management.

    Science.gov (United States)

    Nagra, Michael

    2011-01-01

    Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

  5. Osteoid Osteoma of the Femoral Neck in Athletes: Two Case Reports Differentiating From Femoral Neck Stress Injuries.

    Science.gov (United States)

    Cordova, Christopher B; Dembowski, Scott C; Johnson, Michael R; Combs, John J; Svoboda, Steven J

    2016-01-01

    The diagnosis of an intra-articular osteoid osteoma can be a challenging and lengthy process, with reports of delayed diagnosis of greater than 2 years. In the young, athletic patient with an atraumatic onset of groin pain, an overuse injury or muscle strain is the most likely etiology. However, an overuse injury of femoral neck stress fracture must be identified because of the potentially disastrous outcome of fracture completion. The similar clinical presentation of a femoral neck stress fracture and intra-articular osteoid osteoma of the femoral neck can further delay the diagnosis of the osteoid osteoma. In a patient with these differential diagnoses that do not improve with a period of nonweightbearing activity, a more intensive workup must ensue. The purpose of this case report is to describe the initial presentations, subsequent follow-up, and imaging findings leading to the diagnosis of osteoid osteoma as well as to differentiate an osteoid osteoma from femoral neck stress injuries.

  6. Prevascular femoral hernia and its relation with inferior epigastric vessels: a rare presentation of the femoral hernia sac.

    Science.gov (United States)

    Boshnaq, Mohamed; Phan, Yih Chyn; Akhtar, Mansoor; Hamade, Ayman

    2016-04-18

    A 61-year-old man presented to the emergency department, with a 2-week history of a painful lump on his right groin. A diagnosis of an irreducible right femoral hernia was made. As such, an urgent operation was carried out on the same day, and the patient was found to have a rare prevascular femoral hernia in which the sac was lying over the femoral vessels and split by the inferior epigastric vessels into 2 components resembling 2 trouser limbs. The hernia sac presented in a different and challenging way that necessitated meticulous dissection and full orientation of the anatomy of the femoral triangle. Complete dissection and control of the inferior epigastric vessels, and complete reduction of the sac followed by repair with a prosthetic mesh plug were performed successfully. The patient was discharged home the next day.

  7. Culture as Capital

    DEFF Research Database (Denmark)

    Kacunko, Slavko

    A collection of essays 2011-2014 By following, and reproducing, the cultural turn, the rhetoric of cultural mix and hybridism is disseminated today primarily in its crossing of trade barriers. Cultures reduced to their exchange value function as capital - an accumulative, speculative and...... essays, Slavko Kacunko discusses the process art by crossing the disciplines of art history and comparative media-, visual- and -cultural studies. As a first approximation, several historiographical remarks on closed-circuit video installations underline their importance as a core category of process art....... In the second part, the problems of process art, seen as a threshold of art history, are further examined in another retroanalytical step, in which concepts and objects related to `mirror', `frame' and `immediacy' are analyzed as the triple delimitation of visual culture studies. In the third part, previously...

  8. 78 FR 76973 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy...

    Science.gov (United States)

    2013-12-20

    ... #0; Federal Register #0; #0; #0;This section of the FEDERAL REGISTER contains regulatory documents #0..., and 225 Regulations H, Q, and Y RIN 7100-AD 87 Regulatory Capital Rules: Regulatory Capital... Approach for Risk-Weighted Assets, Market Discipline and Disclosure Requirements, Advanced Approaches...

  9. Reconstruction of femoral length from fragmentary femora

    Science.gov (United States)

    Offei, Eric Bekoe; Osabutey, Casmiel Kwabena

    2016-01-01

    The reconstruction of femoral length (FL) from fragmentary femora is an essential step in estimating stature from fragmentary skeletal remains in forensic investigations. While regression formulae for doing this have been suggested for several populations, such formulae have not been established for Ghanaian skeletal remains. This study, therefore, seeks to derive regression formulae for reconstruction of FL from fragmentary femora of skeletal samples obtained from Ghana. Six measurements (vertical head diameter, transverse head diameter, bicondylar breadth, epicondylar breadth, sub-trochanteric anterior-posterior diameter, and sub-trochanteric transverse diameter) were acquired from different anatomical portions of the femur and the relationship between each acquired measurement and FL was analyzed using linear regression. The results indicated significantly moderate-to-high correlations (r=0.580–0.818) between FL and each acquired measurement. The error estimates of the regression formulae were relatively low (i.e., standard error of estimate, 13.66–19.28 mm), suggesting that the discrepancies between actual and estimated stature were relatively low. Compared with other measurements, sub-trochanteric transverse diameter was the best estimate of FL. In the absence of a complete femur, the regression formulae based on the assessed measurements may be used to infer FL, from which stature can be estimated in forensic investigations. PMID:27722014

  10. THE ENDO-EXO-FEMORAL PROSTHESIS

    Directory of Open Access Journals (Sweden)

    H. Aschoff

    2011-01-01

    Full Text Available Patients with above knee amputation (AKA face many challenges to mobility including difficulty with socket fit and fatigue due to high energy consumption. The aim of the Endo-Exo-Femur Prosthesis (EEFP is to avoid problems at the interface between the sleeve of the socket-prosthesis and the soft tissue coat of the femur stump which often impedes an inconspicuous and harmonic gait. In 1999 we began using a transcutaneous, press-fit distal femoral intramedullary device whose most distal external aspect serves as a hard point for AKA prosthesis attachment. The bone guided prosthesis enables an advanced gait via osseoperception and leads to a decreased oxygen consumption of the patient. Thirty two patients underwent the procedure between 1999 and 2008. Their indication for surgery was persistent AKA prosthesis difficulties with a history of AKA for trauma. The paper presents the patient data regarding the design of the implant, the operative procedure, patient satisfaction, gait analysis and oxygen consumption.

  11. Aneurisma da veia femoral simulando uma hérnia inguinal Femoral vein aneurysm simulating an inguinal hernia

    Directory of Open Access Journals (Sweden)

    Victor Assad Buffara-Jr

    2009-12-01

    Full Text Available INTRODUÇÃO: Somente seis casos de aneurismas da veia femoral simulando hérnia inguinal foram descritos na literatura. RELATO DO CASO: Um caso de aneurisma da veia femoral comum direita que simulava uma hérnia inguinal é descrito em jovem de 19 anos de idade com uma massa dolorosa de consistência mole na região inguinal direita de seis meses de duração. Durante a consulta médica, o paciente morreu durante em episódio de convulsão generalizada. Na necropsia, tromboembolismo pulmonar maciço e um aneurisma da veia femoral comum de 8x8x7 cm com trombos foram diagnosticados.BACKGROUND: Only six cases of femoral vein aneurysm are related on medical literature. CASE REPORT: A case of a right common femoral vein aneurysm simulating an inguinal hernia in a 19 year-old male. He had a soft and painful mass in the right inguinal area of six months of duration. At medical consultation, the patient died during a generalized convulsive episode. At necropsy, massive pulmonary thromboembolism and an 8x8x7 cm common femoral vein aneurysm with thrombus were recognized.

  12. National Capital Planning Commission Meeting Transcripts

    Data.gov (United States)

    National Capital Planning Commission — Transcripts of the monthly (with the exception of August) National Capital Planning Commission meeting transcripts are provided for research to confirm actions taken...

  13. A CADAVERIC STUDY OF VARIATIONS IN THE ORIGIN OF LATERAL CIRCUMFLEX FEMORAL ARTERY

    Directory of Open Access Journals (Sweden)

    Apurva Pradipkumar Darji

    2015-12-01

    Full Text Available Introduction: The lateral circumflex femoral artery is a branch of the profunda femoris artery, which is the largest branch of femoral artery. The knowledge of origin and branching patterns of the lateral circumflex femoral artery is valuable for various surgeries and clinical procedures. Objectives: To determine mode of origin of lateral circumflex femoral artery and to determine the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery and from mid-inguinal point. Materials and Method: 130 femoral triangles were studied and various measurements were noted and analysed from the department of anatomy of various Medical colleges of Gujarat. Result and conclusion: The lateral circumflex femoral artery originated from profunda femoris artery in 119 cases and from femoral artery in 11 cases. In most of the cases, the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery was ranging from 11 to 40 mm on both the sides.

  14. Surgical outcome of proximal femoral fractures using proximal femoral - locking compression plate

    Directory of Open Access Journals (Sweden)

    Prakash A. Sasnur

    2015-07-01

    Full Text Available Introduction: Proximal femoral fractures are complex fractures following devastating injuries in young and elderly population. Despite marked improvement in implant design, surgical technique and patient care these fractures are associated with high incidence of implant failure, refracture and varus collapse. Intramedullary nails are technically demanding and associated with high re-operation rates. The study was done to evaluate the outcome of proximal femoral fractures treated with proximal femur locking compression plate (PF-LCP. Methods: This study is conducted at Al Ameen Medical College and Hospital, Bijapur during the period Jan 2012 to March 2014.Pertrochanteric fractures especially unstable intertrochanteric & subtrochanteric fractures were included. Technical difficulties with the implant and operating time were quantified. Union of fracture site and implant related complications were followed up clinically and radiological. The Harris Hip Score was used to evaluate the functional outcome. Results: Thirty-two patients were available for final evaluation with average age of 55.4 years. The average operation time was 1 hour and 35 minutes with mean blood loss of 180ml. Union was achieved in all the cases with an average time of 17 weeks. Complications included one case of delayed union and three cases of varus collapse. Conclusion: PF-LCP achieves anatomical reduction and stable fixation with higher union rate and fewer complications.

  15. Immigrant Capital and Entrepreneurial Opportunities

    Directory of Open Access Journals (Sweden)

    Malavika Sundararajan

    2016-01-01

    Full Text Available Objective: The main objective of this study is to define and operationalize the concept of immigrant capital, a key factor that differentiates immigrant from host country entrepreneurs in how they recognize and start new ventures. Research Design & Methods: A detailed analysis of contemporary immigrant entrepreneurship and opportunity recognition literature was carried out. Using grounded theory, we synthesized the outcomes from the analysis of eight Canadian and U.S. case studies of successful immigrant entrepreneurs with the key findings from the literature to define and develop a model of immigrant capital. Findings: Based on our grounded theory development process we show that the concept of immigrant capital as a distillate of human, cultural, economic and social capital that goes beyond expected opportunity recognition (OR drivers like prior knowledge and prior experience to differentiate and enhance the immigrant entrepreneur’s ability to recognize business opportunities compared to host country entrepreneurs. We found immigrant capital to be a consequence of being boundary spanners in host and home country networks. Implications & Recommendations: Understanding a unique resource like immigrant capital, will help immigrant as well as host country entrepreneurs further develop their opportunity recognition ability by bridging gaps and fulfilling the needs for both, immigrant and host country consumers. Contribution & Value Added: The main contribution is the theoretical development, identification and definition of the immigrant capital model and propositions that will articulate the factors that lead to the conceptualization and operationalization of immigrant capital. Furthermore, the immigrant capital model can serve host country entrepreneurs to develop cross-cultural networks and jump-start entrepreneurial activities in their home countries as well as learn how to expand their operations into global markets.

  16. Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Selahattin Ozyurek

    2015-07-01

    Full Text Available Dear Editor,We have greatly enjoyed reading the case report entitled “‘Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature in the issue of Arch Bone Jt Surg. 2015;3(2 with great interest. We would like to commend the authors for their detailed and valuable work. Although various case reports have described postoperative distal femur fracture at a range of time intervals (1,2 intraoperative intra-articular distal femur fracture is a unique entity.However, we believe that some important additional observations seem necessary to be contributed through this study. In this article, the authors stated that, to the best of their knowledge, there is no other case report in the literature introducing a femoral condyle fracture during arthroscopic ACL reconstruction or revision reconstruction. Nevertheless, we would like to call the attention of the readers to the fact that that the literature contains one additional case report re‌porting on intraoperative distal femoral coronal plane (Hoffa fracture during primary ACL reconstruction (2. Werner BC and Miller MD presented of case report of an intraoperative distal femoral coronal plane (Hoffa fracture that occurred during independent femoral tunnel drilling and dilation in a primary ACL reconstruction. As in the their case, this type of fracture can occur with appropriately placed femoral tunnels, but the risk can increase with larger graft diameters in patients with smaller lateral femoral condyles The patient was treated with open reduction and internal fixation, without compromise of graft stability and with good recovery of function. We believe that tailoring graft size to the size of the patient is important to prevent similar adverse events.

  17. Femoral neck radiography: effect of flexion on visualization

    Energy Technology Data Exchange (ETDEWEB)

    Garry, S.C. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada); Jhangri, G.S. [Univ. of Alberta, Dept. Public Health Sciences, Edmonton, Alberta (Canada); Lambert, R.G.W. [Univ. of Alberta, Dept.of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada)]. E-mail: rglamber@cha.ab.ca

    2005-06-15

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15{sup o} and flexion in 10{sup o} increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0{sup o} and 20{sup o} flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation ({rho} < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15{sup o} internal rotation to 30{sup o} external rotation ({rho} <0.01). However, when 20{sup o} flexion was applied to bones in external rotation, visualization significantly improved at 15{sup o} ({rho} <0.05) and 30{sup o} ({rho} <0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20{sup o}) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  18. Structural and functional studies of bioobjects prepared from femoral heads

    Energy Technology Data Exchange (ETDEWEB)

    Kirilova, I. A., E-mail: IKirilova@niito.ru; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru [Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, 17, Frunze, Novosibirsk, 630091 (Russian Federation); Sharkeev, Yu. P., E-mail: sharkeev@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Popova, K. S., E-mail: kseniya@ispms.tsc.ru; Uvarkin, P. V., E-mail: uvarkin@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation)

    2015-11-17

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  19. Solow Residuals Without Capital Stocks

    DEFF Research Database (Denmark)

    Burda, Michael C.; Severgnini, Battista

    2014-01-01

    investment expenditures: one eliminates the capital stock by direct substitution, while the other employs generalized differences of detrended data and the Malmquist index. In short samples, these measures can exhibit consistently lower root mean squared errors than the Solow–Törnqvist counterpart. Capital......We use synthetic data generated by a prototypical stochastic growth model to assess the accuracy of the Solow residual (Solow, 1957) as a measure of total factor productivity (TFP) growth when the capital stock in use is measured with error. We propose two alternative measurements based on current...

  20. Capital-imperialismo e neoliberalismo

    OpenAIRE

    Campagnaro, Yuri Gabriel

    2014-01-01

    Resumo: O marxismo interpreta o imperialismo desde Hilferding, com sua análise do capital financeiro em 1910. Lenin sintetizou o primeiro debate, caracterizando o imperialismo como uma nova fase do capitalismo, com monopólios e maior centralização do capital. O debate se estende à década de 1970 com Mandel, que identificou uma alteração na morfologia do capital de então. Os autores contemporâneos debatem o período do capitalismo após os anos 1970, entre eles David Harvey e Virgínia Fontes. Ch...

  1. Avascular necrosis of the femoral head in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2007-02-01

    Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

  2. Reconstruction plate fixation of subtrochanteric femoral fractures in children.

    Science.gov (United States)

    El-Sayed, Moustafa; Abulsaad, Mazen; El-Hadidi, Mahmoud; El-Adl, Wael; El-Batouty, Magdy

    2007-08-01

    Pediatric subtrochanteric femoral fractures are rare and have received limited attention in the literature Treatment is controversial. Different treatment options are used: skin traction, 90/90 skeletal traction, spica casting, cast bracing, internal fixation and external fixation. The aim of this study is to present our results with internal fixation of subtrochanteric femoral fractures in children using a reconstruction plate. Between 2000 and 2004, eighteen patients with closed subtrochanteric femoral fractures were treated in the Mansoura Emergency Hospital. The average age at the time of injury was 8.2 years (range 5.3 years to 11.5 years). Pathological fractures and fractures associated with neuromuscular diseases were excluded from this study. Eight patients had head injuries and/or multiple injuries. In all cases a single 4.5 mm contoured reconstruction plate was used and a 6.5 mm cancellous screw was inserted through the plate into the femoral neck. Average follow-up was 38 months (range, 12 to 47 months). All fractures united with anatomical alignment within an average of 8 weeks (range 6 to 12 weeks). There were no deep infections and no significant limb length discrepancies. At the latest follow-up, no patient had any restriction of activities. Internal fixation with a reconstruction plate appears as a good treatment option for children with subtrochanteric femoral fractures.

  3. Analysis of Femoral Components of Cemented Total Hip- Arthroplasty

    CERN Document Server

    Singh, Shantanu

    2014-01-01

    In cemented Total Hip Arthroplasty (THA), material chosen for femoral stem and cross section of stem itself, proved to be critical parameters for, stress distribution in the femoral components, interfacial stresses and micro movements. Titanium alloy (Ti6Al4V), when used as a material for femoral stem, recorded large displacement as compared to Chromium alloy (CoCrMo) stems. This large displacement in case of Ti6Al4V caused the stem to bend inside the cement mantle, thus destroying it. Thus, CoCrMo proved to be a better in cemented THA. Failure in THA may occur at cement-stem or cement-bone interface, thus interfacial stresses and micro movements were analysed in the present study. Comparison between trapezium and circular cross section showed that, femoral stem with trapezium cross section underwent lesser amount of sliding and debonding, at both interfaces, as compared to circular cross section. Moreover, trapezium cross section also generated lower peak stresses in femoral stem and cortical femur. The pres...

  4. Emerging Forms of Cultural Capital

    DEFF Research Database (Denmark)

    Prieur, Annick; Savage, Mike

    – and hence are highly appropriate for direct comparisons with that study. This paper will begin by raising general issues regarding the meaning of the concept, and about how one may make assessments and claims about cultural capital. Here we consider how the legitimacy of certain cultural competencies...... assessment of the arguments made, including those made in the studies we have been involved in ourselves (the study of cultural capital and social exclusion in the UK, and the study of the Danish city Aalborg). Secondly, the paper looks into the different claims that are made in empirical studies after......This paper reviews recent European studies to assess whether cultural capital now has the same characteristics – or may be rather the same functions - as when Distinction was written. The paper will examine empirical applications of the concept of cultural capital in leading European studies...

  5. The Valuation of Organizational Capital

    Directory of Open Access Journals (Sweden)

    Fiala Roman, Borůvková Jana

    2012-12-01

    Full Text Available The authors’ aim was to create a model suitable for measuring organization capital. This model was produced by means of the Forward and Backward Stepwise methods, on the basis of company information. Low p-levels (approaching 0 show the statistical significance of all regression coefficients, including the intercept. Organizational capital of 2,796 companies in the Czech Republic was quantified. A statistically significant correlation between organizational capital and return on equity (ROE, as well as between organizational capital and return on assets (ROA, has been established. This article is a part of the results of the project No. 402/09/2057 ‘‘Measurement and Management of Intangible Assets Impact on Firm Performance’’ financed by Czech Science Foundation.

  6. Corporate governance and intellectual capital

    Directory of Open Access Journals (Sweden)

    Rahmat Alizadeh

    2014-01-01

    Full Text Available The purpose of this paper is to examine the association between corporate governance and Intellectual capital in the pharmaceutical companies accepted in Tehran Stock Exchange over the period 2004-2009 using a regression based model. The study investigates the impacts of three some independent variables of the corporate governance (i.e. the number of board members, the relative extent of nonexecutive to executive directors, the auditing committee. The results suggest that corporate governance had no special effect on intellectual capital in the pharmaceutical companies. Furthermore among corporate governance's variables, the first one (i.e. board size had negative impact on firms' intellectual capital and the second and the third variables had no effects on intellectual capital.

  7. Bridges in social capital: a review of the definitions and the social capital of social capital researchers

    OpenAIRE

    Akcomak, S.

    2009-01-01

    There has been a recent surge of interest in social economics and social capital. Articles on social capital that are published in the last five years constitute more than 60 percent of all articles on social capital. Research on social capital is now massive and spans sociology, economics, management, political science and health sciences. Despite this interest there is still not a consensus on the definition and the measurement of social capital. This paper argues that this is due to lack o...

  8. ORGANIZATIONAL CAPITAL IN ENTERPRISE ARCHITECTURE

    Directory of Open Access Journals (Sweden)

    Kirill G. Skripkin

    2016-01-01

    Full Text Available The paper describes a new approach to the description of organizational capital in enterprise architecture. This approach is focused on internal consistency of organizational mechanisms and their fit to the requirements of technologies in use and key employees. The description rests on Henry Mintzberg organizational design theory. The value of this description is demonstrated for the case of influence of Ministry of Education and Science policy on the organizational capital of the Russian university.

  9. The Era of Super Capitalism

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The world has entered the "super capitalism" era when one third of its economic activities are controlled by less than 3 percent of global financial capital. This year,a global economic recession,triggered by the U.S. subprime mortgage crisis,seems unavoidable. To tackle international financial problems,Tao Dong,Chief Economist for Asia at Credit Suisse First Boston in Hong Kong,shared his insights with China Business Journal. Excerpts follow.

  10. Splendid Arts Fram Ancient Capitals

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    IT was in the golden autumn in Beijing, when the sky was high and the air clear, that I hurried to Zhongshan Park to witness the display of the songs and dances of the seven Chinese ancient capitals. The flower beds arranged for the celebration of National Day were still there and the colorful blooms looked especially bright in the sunshine. The seven cities which have served as capitals in Chinese history are Beijing,

  11. Do European capital flows comove?

    OpenAIRE

    Silvio Contessi; Pierangelo DePace

    2008-01-01

    We study the cross-sectional correlations of net, total, and disaggregated capital flows for the major source and recipient European Union countries. We seek evidence of changes in these correlations since the introduction of the euro to understand whether the European Union can be considered a unique entity with regard to its international capital flows. We first use Ng's (2006) "uniform spacing" methodology to rank cross-sectional correlations (i.e., which flows comove more) and to shed lig...

  12. Organizational Capital of the Enterprise

    Directory of Open Access Journals (Sweden)

    Vladimir Nikiforovich Belkin

    2016-09-01

    Full Text Available In the article, the main theoretical questions of the organizational capital of the enterprise are considered. The concept of «organizational capital of the enterprise» as a system consisting of three subsystems (organization of production, labour organization and management is introduced. It is shown that the organizational capital forms the labour relations system at the enterprise consisting of the cooperation, technological, economic, moral labour relations and the relations of workers’ responsibility. The model of cyclic evolution of crisis at the enterprise caused by shortcomings of the organizational capital is revealed. It is shown that the organizational capital is a basis for the realization of the human capital, which creates value added. A considerable attention is paid to the experience of the creation and functioning of the organizational capital at the enterprises of the Japanese corporation «Toyota». The Russian economic literature on crisis management quite often considers only the financial aspects of diagnostics, proposing the optimization of cash flows, elimination of excess stocks, transition to the medium-term budgeting and others. However, the deep reasons of crisis need to be found not only in financial streams, but also in the system of the work relationships. The shortcomings in the development of technological, cooperation, economic, moral labour relations and the relations of responsibility directly reflects the shortcomings in the development of the elements of the organizational capital as they «are adjusted» by these elements. In turn, organizational problems affect the product quality leading to the customer attrition and decrease in the enterprise’s financial performance. The lack of financial resources cause the need to save costs (first of all, on personnel, that was brightly shown by the economic crisis of 2009 that even more weakens the enterprise and system of labour relations. Finally, the

  13. Mengukur Kontribusi Human Capital terhadap Tujuan Perusahaan

    Directory of Open Access Journals (Sweden)

    Brata Wibawa Djojo

    2010-10-01

    Human Capital Cost Factor, (iv Human Capital Value Added, and (v Human Capital Return on Investment. Results of research can provide guidelines for the management, especially for management of JLI in view of Human Capital contribution to corporate objectives, namely in terms of staffing and agency.

  14. 47 CFR 65.304 - Capital structure.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Capital structure. 65.304 Section 65.304... OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Exchange Carriers § 65.304 Capital structure. The proportion of each cost of capital component in the capital structure is equal to: Proportion in the...

  15. 12 CFR 208.4 - Capital adequacy.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Capital adequacy. 208.4 Section 208.4 Banks and... Requirements § 208.4 Capital adequacy. (a) Adequacy. A member bank's capital, as defined in appendix A to this...) Standards for evaluating capital adequacy. Standards and guidelines by which the Board evaluates the...

  16. 47 CFR 32.4540 - Other capital.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Other capital. 32.4540 Section 32.4540... FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts § 32.4540 Other capital. This... capital stock, capital recorded upon the reorganization or recapitalization of the company and...

  17. STATISTICAL MODELS OF REPRESENTING INTELLECTUAL CAPITAL

    Directory of Open Access Journals (Sweden)

    Andreea Feraru

    2016-07-01

    Full Text Available This article entitled Statistical Models of Representing Intellectual Capital approaches and analyses the concept of intellectual capital, as well as the main models which can support enterprisers/managers in evaluating and quantifying the advantages of intellectual capital. Most authors examine intellectual capital from a static perspective and focus on the development of its various evaluation models. In this chapter we surveyed the classical static models: Sveiby, Edvisson, Balanced Scorecard, as well as the canonical model of intellectual capital. Among the group of static models for evaluating organisational intellectual capital the canonical model stands out. This model enables the structuring of organisational intellectual capital in: human capital, structural capital and relational capital. Although the model is widely spread, it is a static one and can thus create a series of errors in the process of evaluation, because all the three entities mentioned above are not independent from the viewpoint of their contents, as any logic of structuring complex entities requires.

  18. 76 FR 40407 - Sterling Capital Funds and Sterling Capital Management LLC; Notice of Application

    Science.gov (United States)

    2011-07-08

    ... COMMISSION Sterling Capital Funds and Sterling Capital Management LLC; Notice of Application July 1, 2011.... Applicants: Sterling Capital Funds (the ``Trust'') and Sterling Capital Management LLC (``Sterling'' and... serves as a Sub-Adviser of Sterling Capital International Fund; and Federated Investment...

  19. 12 CFR 6.4 - Capital measures and capital category definitions.

    Science.gov (United States)

    2010-01-01

    ... categories of asset quality, management, earnings, or liquidity. ... risk-based capital ratio; (2) The Tier 1 risk-based capital ratio; (3) The leverage ratio. (b) Capital...) Well capitalized if the bank: (i) Has a total risk-based capital ratio of 10.0 percent or greater;...

  20. A case report of missed femoral neck stress fracture

    Directory of Open Access Journals (Sweden)

    Onibere Oruaro Adebayo

    2015-01-01

    Full Text Available Femoral neck stress fracture (FNSF is an uncommon but potentially serious orthopaedic problem. This is a case report on missed femoral neck stress fracture in a 62-year-old female who was initially treated as early-onset coxarthrosis. She later presented to us with a displaced intra-capsular neck of left femur fracture and underwent total hip replacement. This case illustrates that causes other than osteoarthritis should be taken into consideration in patients presenting with anterior hip pain where symptoms are disproportionate to clinical and radiological findings. More advanced investigations such as MRI scan or regular follow up with plain radiographs should be performed. A delay in diagnosis can lead to secondary displacement of the femoral neck stress fracture.

  1. Femoral arteriographic finding in acute ergotism: Report of A Case

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, H. S.; Lee, K. N.; Cha, S. B. [St. Mary' s Hospital, Catholic Medical College, Seoul (Korea, Republic of)

    1971-10-15

    A case of acute ergotism with angiographic demonstration of bilateral femoral artery involvement is reported. A 27-year-old married woman was admitted because of sudden onset of severe pain in both flanks and lower legs, followed by numbness and coldness of the skin on both legs. The attack occurred after the administration of ergot tartrate as postpartum care. Femoral arteriography was performed on 10th day of illness with the Seldinger technic. The femoral arteries were generally smaller in caliber than normal. There was no definite evidence of occlusive disease. Findings were more or less symmetrical and extended to lower legs where only fine branches were visualized. The final diagnosis was diffuse vasospasm due to acute ergotism with secondary occlusion of the arteries of lower leg bilaterally.

  2. An Economic Viewpoint on Capitalism Bashing

    OpenAIRE

    Burnete Sorin

    2016-01-01

    In this paper I discuss two long disputed notions: that capitalism without crises is a fallacy respectively that capitalism bashing, however severe, will not endanger the system itself. Yet proving both is not an easy task since the capitalism issue has always been a cupellation of theory, ideology and political precepts, which are controversial and hard to disentangle. That capitalism detractors are numberless is a truism. Yet criticism against capitalism, however fierce, has always been cle...

  3. Human Capital, Fertility, and Economic Growth

    OpenAIRE

    Gary S. Becker; Murphy, Kevin M.; Robert F. Tamura

    1990-01-01

    Our model of growth departs from both the Malthusian and neoclassical approaches by including investments in human capital. We assume, crucially, that rates of return on human capital investments rise, rather than, decline, as the stock of human capital increases, until the stock becomes large. This arises because the education sector uses human capital note intensively than either the capital producing sector of the goods producing sector. This produces multiple steady scares: an undeveloped...

  4. Application of Epiphysis Retained Limb Salvage in Knee Osteosarcoma in Children and Adolescent%保留骨骺保肢术在儿童及青少年膝关节骨肉瘤中的应用

    Institute of Scientific and Technical Information of China (English)

    姜源涛; 朱立娟; 姜源波; 焦建宝

    2014-01-01

    目的:探讨保留骨骺保肢术在儿童及青少年膝关节骨肉瘤中的应用价值。方法:选择49例患者,随机分为两组,观察组24例实施保留骨骺保肢术,非保留组25例实施切除骨骺结合同种异体半关节移植术,比较两组手术时间、术中出血和双下肢长度差距,并对所有患者随访1年,观察组其复发情况和生存情况。结果:保留组手术时间显著短于非保留组(P0.05)。结论:保留骨骺的保肢手术对提高手术安全性,减少术后肢体不等长等不良反应效果显著。%To explore the application of epiphysis retained limb salvage in the knee osteosarcoma with children and adolescent.Methods:49 cases were randomly divided into two groups,the retention group (24 cases)were used implementation of epiphysis limb salvage surgery,unretention group(25 cases)were used implementation of excision epiphysis with allogeneic bone transplantation,then the operation time,bleeding during operation and limb length gap were compared between two groups,and all patients were followed up for 1 years,recurrence and survival were compared also.Results:The retention group operation time was shorter than unretention group(P0.05).Conclusion:Epiphyseal preservation can improve the operation safety and reduce the effect of limb length inequality and other adverse reactions after operation.

  5. Retrograde femoral nailing in elderly patients: outcome and functional results.

    Science.gov (United States)

    Neubauer, Thomas; Krawany, Manfred; Leitner, Lukas; Karlbauer, Alois; Wagner, Michael; Plecko, Michael

    2012-06-01

    Functional outcome after retrograde femoral intramedullary nailing was investigated in 35 patients older than 60 years (mean, 86 years) with 36 fractures, comprising 15 (41.7%) shaft and 21 (58.3%) distal fractures; overall, 7 (19.4%) periprosthetic fractures occured. Twenty-two (62.9%) of 35 patients were evaluated at a mean 16.5-month follow-up with the Lyshom-Gillquist score and the SF-8 questionaire. Primary union rate was 97.8%, with no significant differences in duration of surgery, bone healing, mobilization, and weight bearing among different fracture types; periprosthetic fractures revealed a significantly delayed mobilization (P=.03). Complications occured significantly more often among distal femoral fractures (P=.009), including all revision surgeries. The most frequently encountered complication was loosening of distal locking bolts (n=3). Lysholm score results were mainly influenced by age-related entities and revealed fair results in all fractures (mean in the femoral shaft fracture group, 78.1 vs mean in the distal femoral fracture group, 74.9; P=.69), except in the periprosthetic subgroup, which had good results (mean, 84.8; P=.23). This group also had increased physical parameters according to SF-8 score (P=.026). No correlation existed between SF-8 physical parameters and patient age or surgery delay, whereas a negative correlation existed between patient age and SF-8 mental parameters (P=.012). Retrograde femoral intramedullary nailing is commonly used in elderly patients due to reliable bone healing, minimal soft tissue damage, and immediate full weight bearing. It also offers a valid alternative to antegrade nailing in femoral shaft fractures.

  6. Open femoral hernia repair: one skin incision for all

    Directory of Open Access Journals (Sweden)

    El-Masry Nabil S

    2009-11-01

    Full Text Available Abstract Background Femoral hernias are relatively uncommon, however they are the most common incarcerated abdominal hernia, with strangulation of a viscus carrying significant mortality. Classically three approaches are described to open femoral hernia repair: Lockwood's infra-inguinal, Lotheissen's trans-inguinal and McEvedy's high approach. Each approach describes a separate skin incision and dissection to access the femoral sac. The decision as to which approach to adopt, predominantly dependent on the suspicion of finding strangulated bowel, is often a difficult one and in our opinion an unnecessary one. Methods We propose a technique for open femoral hernia repair that involves a single skin incision 1 cm above the medial half of the inguinal ligament that allows all of the above approaches to the hernia sac depending on the operative findings. Thus the repair of simple femoral hernias can be performed from below the inguinal ligament. If found, inguinal hernias can be repaired. More importantly, resection of compromised bowel can be achieved by accessing the peritoneal cavity with division of the linea semilunaris 4 cm above the inguinal ligament. This avoids compromise of the inguinal canal, and with medial retraction of the rectus abdominis muscle enables access to the peritoneal cavity and compromised bowel. Discussion This simple technique minimises the preoperative debate as to which incision will allow the best approach to the femoral hernia sac, allow for alteration to a simple inguinal hernia repair if necessary, and more importantly obviate the need for further skin incisions if compromised bowel is encountered that requires resection.

  7. Risk of pelvic injury from femoral neck guidewires.

    Science.gov (United States)

    Feeney, M; Masterson, E; Keogh, P; Quinlan, W

    1997-01-01

    Many of the devices used in the internal fixation of femoral neck fractures are cannulated and require the initial placement of one or more guidewires for accurate positioning. These wires are occasionally advanced inadvertently through the hip joint and the acetabulum. Pelvic visceral damage may follow. To assess this risk, we inserted three guidewires to a depth of 16 cm into each femoral neck of ten cadavers and explored the pelvis during autopsy. Thirty-two of the 60 guidewires had penetrated a pelvic organ. The literature on intrapelvic injuries associated with hip surgery is reviewed, and suggestions are offered on the avoidance of pelvic penetration during hip fracture fixation.

  8. Can femoral dialysis catheter insertion cause a life threatening complication?

    Directory of Open Access Journals (Sweden)

    Nurkay Katrancıoğlu

    2014-09-01

    Full Text Available Venous catheter (VC insertion may be necessary for the patients with renal failure facing vascular access problem. Femoral VCs are commonly used for their lower complication rates especially in emergency clinics. The incidence of bleeding associated with VC is reported 0.5-1.6%, however, life threatening hemorrhage and complications requiring surgical intervention are very rare. In this manuscript, we aimed to present a case with hemolytic uremic syndrome complicated with retroperitoneal hematoma after femoral VC insertion. J Clin Exp Invest 2014; 5 (3: 472-474

  9. [Femoral head chondroblastoma and reconstruction with osteochondral allograft. Case report].

    Science.gov (United States)

    Orlando-Díaz, C; Guzmán-Vargas, R; Rincon-Cardozo, D F; Mantilla-León, N; Camacho-Casas, J A

    2014-01-01

    Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure.

  10. Desenvolvimento de um novo conceito de implante patelo-femoral

    OpenAIRE

    Vieira, Eugénio Vítor Caldeira

    2012-01-01

    O joelho é uma das articulações mais importantes do corpo humano, permite a mobilidade e a estabilidade em simultâneo. Algumas patologias como a síndrome patelo-femoral podem conduzir à necessidade da realização da artroplastia patelo-femoral. Vários efeitos comprometem a longevidade desta artroplastia, sendo os mais frequentes o efeito de stress shielding, responsável pela reabsorção óssea localizada, o efeito de fadiga por sobrecarga associado à geração de microfissuras e ...

  11. [Angioscopy and angioplasty of the iliac and femoral arteries].

    Science.gov (United States)

    Baudrillard, J C; Cécile, J P; Foucart, H; Carlier, C; Baidj, Z

    1990-01-01

    Angioscopy is a technique of endoscopic investigation of the vascular lumen and its contents, which we have coupled with iliac and femoral angioplasty. The material comprises 3 main elements: the angioscope, the TV-monitoring assembly and the infusion system. No complication was recorded in a series of 94 angioscopies (47 iliac, 44 distal femoral and 3 grafts) performed over a period of 18 months. The technical quality of the images obtained was good in 90% of cases (85/94). Angioscopy revealed lesions that had either been nonvisualized or underrated by angiography, and played a determinant role in 16% of cases (15/94), whereby the therapeutical procedure could be modified accordingly.

  12. Automatic quantification of tibio-femoral contact area and congruity

    DEFF Research Database (Denmark)

    Tummala, Sudhakar; Nielsen, Mads; Lillholm, Martin;

    2012-01-01

    We present methods to quantify the medial tibio- femoral (MTF) joint contact area (CA) and congruity index (CI) from low-field magnetic resonance imaging (MRI). Firstly, based on the segmented MTF cartilage compartments, we computed the contact area using the Euclidian distance transformation....... The CA was defined as the area of the tibial superior surface and the femoral inferior surface that are less than a voxel width apart. Furthermore, the CI is computed point-by-point by assessing the first- and second-order general surface features over the contact area. Mathematically, it is the inverse...

  13. Amputated limb by cerclage wire of femoral diaphyseal fracture: a case report.

    Science.gov (United States)

    Won, Yougun; Yang, Kyu-Hyun; Kim, Kwang-Kyoun; Weaver, M J; Allen, Elizabeth M

    2016-12-01

    An entrapment of the femoral artery by cerclage wiring is a rare complication after spiral diaphyseal femoral fractures. We report the case of an 82-year-old female treated by an antegrade intramedullary nailing and multiple cable augmentation, which was then complicated by injury to the femoral artery that resulted in ipsilateral leg necrosis and amputation. The entrapment was caused by direct belting by the cable and resulted in a total obstruction of the femoral artery.

  14. Significance of nitric oxide on the pathogenesis of steroid-induced femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@Steroid-induced femoral head necrosis is claimed to be an ischemic femoral head disease. But there is no discussion on the role of nitric oxide (NO) in the idiopathic disease. The concentration of NO indirectly in serum with steroid induced avascular necrosis of femoral head (ANFH) and in controls are studied in this article.

  15. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral...

  16. Common femoral vein reconstruction using internal jugular vein after blast injury.

    Science.gov (United States)

    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  17. The Pro-Cyclical Impact of Basel III Regulatory Capital on Bank Capital Risk

    OpenAIRE

    Song, Guoxiang

    2014-01-01

    To raise the quality of regulatory capital, Basel III capital rules recognize unrealized gains and losses on all available-for-sale (AFS) securities in Common Equity Tier 1 Capital (CET1). However, by examining the correlations between U.S. GDP growth rate, interest rates and regulatory capital ratios computed using Basel III regulatory capital definition for six U.S. global systemically important banks (G-SIBs) since 2007, this chapter finds that Basel III regulatory capital will enhance the...

  18. Intellectual Capital Management in Transport Sector

    Directory of Open Access Journals (Sweden)

    Asta Znakovaitė

    2011-03-01

    Full Text Available This article presents an analysis of intellectual capital; its management, features and processes by which intellectual capital of a company can be evaluated. The main elements of intellectual capital (human, structural and relationship capital are presented and used in research. After surveying bibliography, intellectual capital evaluation model, which applies to Lithuanian and Latvian companies operating in the transport sector, is created. The research is based on the value-added intellectual capital factor model, the relationship between indicators, multi-asset return correlation and regression analysis and generation of alternatives to intellectual capital performance-enhancing. Following an assessment of intellectual capital of Lithuanian and Latvian transport sectors, on the basis of the results, it was found that the intellectual capital is a key factor in corporation management to increase revenue. Article in Lithuanian

  19. 股骨头软骨母细胞瘤的诊断与治疗%Diagnosis and treatment of chondroblastoma of the femoral head

    Institute of Scientific and Technical Information of China (English)

    李远; 邓志平; 杨发军; 王涛; 牛晓辉

    2009-01-01

    diagnoses were confirmed by pathological examination. All the patients underwent surgery through Smith-Peterson approach. During the operatin, The tumor tissue was thoroughly curetted via fovea of femoral head. Bone grafting was performed in all patients, including autogenous bone grafts in 7 cases , allografts in 5 cases and the mixture of autogenous and allografts in 1 case. Results All the patients were followed up. The median time was 26 months (range, 6-84 months). There was no local recurrence in this group .No operative complications were found during follow-up. One patient who underwent autogenous bone graft had suffered femoral head necrosis after partial weight bearing 2 months after operation.The further intervention included femoral head resection and total hip arthroplasty 6 months after operation in this patient. The remaining patients presented with good function. The mean Harris Score was 89 (range, 69-98 ) after surgery, 21 points increasing from preoperative scores. The mean healing time was 5.3 months, 6.8 months, and 4 months in patents received autogenous bone grafts, allografts and the mixture of autogenous and allografts, respectvely. Conclusion Chondroblastoma of the femoral head, which is uncommon has its specific clinical and radiological characteristics. The curettage can been carried out via fovea of femoral head followed by bone grafting through anterior Smith-Peterson approach. This procedure proved to be a useful surgical approach for the treatment of chodroblastoma in the epiphysis of the femoral head. Weight bearing must be avoided before bone healing. Hip joint exercise without weight bearing can improve the outcome.

  20. Periprosthetic subtrochanteric femoral fracture in a megaprosthesis of the knee

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya; Ajay Pal Singh; Abhishek Vaish

    2013-01-01

    We report a rare case of periprosthetic posttraumatic fracture of subtrochanteric region of femur after a megaprosthesis of the knee,done for resistant nonunion of distal femur with secondary osteoarthrosis in a 51 years old man.Treatment with a locking femoral plate was able to achieve primary union with a good result.

  1. Postmortem Femoral Blood Reference Concentrations of Aripiprazole, Chlorprothixene, and Quetiapine

    DEFF Research Database (Denmark)

    Skov, Louise; Johansen, Sys Stybe; Linnet, Kristian

    2015-01-01

    Postmortem femoral blood concentrations of the antipsychotic drugs aripiprazole, chlorprothixene and its metabolite, and quetiapine were determined by LC-MS-MS in 25 cases for aripiprazole and 60 cases each for chlorprothixene and quetiapine. For cases where the cause of death was not related to ...

  2. Quadratus lumborum block for femoral–femoral bypass graft placement

    Science.gov (United States)

    Watanabe, Kunitaro; Mitsuda, Shingo; Tokumine, Joho; Lefor, Alan Kawarai; Moriyama, Kumi; Yorozu, Tomoko

    2016-01-01

    Abstract Introduction: Atherosclerosis has a complex etiology that leads to arterial obstruction and often results in inadequate perfusion of the distal limbs. Patients with atherosclerosis can have severe complications of this condition, with widespread systemic manifestations, and the operations undertaken are often challenging for anesthesiologists. Case report: A 79-year-old woman with chronic heart failure and respiratory dysfunction presented with bilateral gangrene of the distal lower extremities with obstruction of the left common iliac artery due to atherosclerosis. Femoral–femoral bypass graft and bilateral foot amputations were planned. Spinal anesthesia failed due to severe scoliosis and deformed vertebrae. General anesthesia was induced after performing multiple nerve blocks including quadratus lumborum, sciatic nerve, femoral nerve, lateral femoral cutaneous nerve, and obturator nerve blocks. However, general anesthesia was abandoned because of deterioration in systemic perfusion. The surgery was completed; the patient remained comfortable and awake without the need for further analgesics. Conclusion: Quadratus lumborum block may be a useful anesthetic technique to perform femoral–femoral bypass. PMID:27583851

  3. The Femoral Hernia-a rare hernia and its treatment

    Institute of Scientific and Technical Information of China (English)

    Andreas Hoeferlin

    2009-01-01

    @@ Introduction Hernias age protrusions through weak areas of our abdominal wall.The most common hernia is Inguinal Hernia in men.A rather rare hernia is the Femoral Hernia,a protrusion into the femotal canal next to the blood vessels in our groin (Picl).

  4. Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion II

    Science.gov (United States)

    Lee, Scott

    2015-01-01

    In the second paper of this series, the effect of transverse femoral stresses due to locomotion in theropod dinosaurs of different sizes was examined for the case of an unchanging leg geometry. Students are invariably thrilled to learn about theropod dinosaurs, and this activity applies the concepts of torque and stress to the issue of theropod…

  5. Low-energy trauma-induced intercondylar femoral fracture

    Science.gov (United States)

    Aeby, Mathias; Wyss, Tobias; Mentrup, Birgit; Kunstmann, Erdmute; Jakob, Franz; Aeberli, Daniel

    2016-01-01

    Summary We present a 44-year-old female patient with recurrent fragility fractures including an intercondylar femoral fracture and with normal planar bone densitometry. Diagnosis of hypophosphatasia was suggested by low volumetric cortical bone mineral density and laboratory findings. DNA sequencing revealed heterozygous mutations in the exons 5, 6 and 9 of the ALPL gene, thus confirming the suspected diagnosis. PMID:27920814

  6. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    Science.gov (United States)

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions. PMID:24400191

  7. Adductor Canal Block versus Femoral Nerve Block and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia Therese; Nielsen, Zbigniew Jerzy Koscielniak; Henningsen, Lene Marianne;

    2013-01-01

    : The authors hypothesized that the adductor canal block (ACB), a predominant sensory blockade, reduces quadriceps strength compared with placebo (primary endpoint, area under the curve, 0.5-6 h), but less than the femoral nerve block (FNB; secondary endpoint). Other secondary endpoints were...

  8. MR imaging findings of the femoral marrow in myelodysplastic syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Osamu; Takagi, Shojiro; Matsuura, Katsuhiko; Ichikawa, Tamaki; Kobayashi, Yasuyuki; Nagai, Jun [Jichi Medical School, Minamikawachi, Tochigi (Japan)

    1995-10-01

    MR imaging of the femoral marrow was performed in 30 patients with myelodysplastic syndrome (MDS), 11 cases of which evolved to acute myeloid leukemia (AML). The MRI appearance was classified into five patterns: fatty marrow; faint signal; nodular pattern; heterogeneous infiltration; and diffuse infiltration. For each type of MDS, MRI patterns of the femoral marrow were evaluated and compared with those in normal subjects as well as in patients with aplastic anemia. Signal intensity alteration, a low signal on T1-weighted SE image and a high signal on STIR image, began in the proximal femoral marrow almost symmetrically in patients with MDS. The area of abnormal signal intensity tended to gradually extend towards the distal portion of the femur as the disease progressed. MRI patterns of the femoral marrow correlated with marrow cellularity, and diffuse marrow infiltration was noted in patients with a more advanced type of MDS or with severe anemia. There were limitations to making an accurate diagnosis of the MDS type on the basis of the MRI pattern. Progression of the MRI appearance in the course of MDS was thought to be a sign suggesting evolution to AML. It was difficult to differentiate hypoplastic MDS from aplastic anemia, although the nodular pattern was commonly seen in the latter disease. (author).

  9. Femoral head-neck junction reconstruction, after iatrogenic bone resection.

    Science.gov (United States)

    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin

    2015-07-01

    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

  10. Retained portion of latex glove during femoral nailing. Case report.

    Science.gov (United States)

    Sadat-Ali, M; Marwah, S; al-Habdan, I

    1996-11-01

    A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication.

  11. Femoral nailing in adults : doctor and patient reported outcomes

    NARCIS (Netherlands)

    El Moumni, Mostafa

    2016-01-01

    The treatment of traumatic femoral shaft fractures using an unreamed nail is associated with good results. Both antegrade and retrograde unreamed nailing techniques result in high union rates and low rates of complications, such as non-union, deep infection and septic arthritis. These results are co

  12. A De Garengeot Hernia masquerading as a strangulated femoral hernia

    Directory of Open Access Journals (Sweden)

    A. Hussain

    2014-01-01

    CONCLUSION: A De Garengeot's hernia should be considered as a differential diagnosis in patients presenting with clinical signs of a strangulated femoral hernia. It is often an incidental finding during an emergency operation. Although mesh repairs in the presence of appendicitis have been reported, the safest approach remains a primary suture repair.

  13. Inflamed appendix in a femoral hernial sac: de Garengeot's hernia.

    Science.gov (United States)

    Rajan, S S; Girn, H R S; Ainslie, W G

    2009-10-01

    Croissant de Garengeot's hernia is defined as the presence of an appendix in the femoral hernial sac. It is rare and occurs mostly in females. We report this hernia in a male patient along with the surgical management and review of literature.

  14. Early micromovement of the Articular Surface Replacement (ASR) femoral component

    DEFF Research Database (Denmark)

    Penny, J O; Ding, M; Varmarken, J E;

    2012-01-01

    Radiostereometric analysis (RSA) can detect early micromovement in unstable implant designs which are likely subsequently to have a high failure rate. In 2010, the Articular Surface Replacement (ASR) was withdrawn because of a high failure rate. In 19 ASR femoral components, the mean micromovemen...

  15. [Spontaneous disappearance of herniation pit on the femoral neck].

    Science.gov (United States)

    Lerais, J M; Jacob, D; Thibaud, J C; Fourrer, C; Cercueil, J P; Krause, D; Laredo, J D; Baudrillard, J C

    1995-09-01

    The authors present a case of a 39 years old patient who had a herniation pit of the left femoral neck, 5 years ago. This lesion disappeared spontaneously. To our knowledge, no report of healing of a herniation pit has been previously described.

  16. Unusual Foreign Bone Fragment in Femoral Open Fracture

    Science.gov (United States)

    Sadoni, Hanon; Arti, Hamidreza

    2016-01-01

    Introduction: Femoral shaft fracture is one of the typical bone fractures due to high energy trauma and may occur as an open fracture. Some foreign materials may enter the fracture site such as sand, cloth particles and so on. Case Presentation: A 28-year-old motorcycle riding military member and his collaborator were received in the hospital because of multiple traumas due to a fall in a hollow during a surveillance mission. His collaborator died because of head trauma and multiple severe open fractures. When fixing the patients femoral fracture, a large femoral butterfly fragment was removed from the patient’s thigh as a foreign segment. The patient’s femur was fixed with a plate and screws. No femoral defect was detected during surgery or post-operative X-rays and CT scan. The removed segment was not a part of the patient’s femur. Conclusions: Surgical and post-surgical findings showed that this segment was not related to the patient’s femur. The foreign segment may have belonged to the other victim of this trauma. PMID:27218050

  17. Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly

    Directory of Open Access Journals (Sweden)

    SKS Marya

    2011-01-01

    Conclusion: Cementless bipolar hemiarthroplasty for femoral neck fractures in the very elderly permits early return to premorbid life and is not associated with any untoward cardiac event in the perioperative period. It can be considered a treatment option in this select group.

  18. The measurement of social capital

    Directory of Open Access Journals (Sweden)

    Ester Villalonga-Olives

    2015-01-01

    Full Text Available Social capital has been defined as the resources available to individuals and groups through membership in social networks. The definition is consistent with either an individualistic approach, i.e. resources (such as information or instrumental assistance that are accessed by individuals through their network connections; or a collective approach, e.g. the benefits accruing to members of a group – such as the ability of a community to engage in collective action – as a consequence of the existence of cohesive relationships. While research often restricts itself to a single level of analysis, the benefits (and downsides of social capital accrue to both the individual as well as to the network to which he belongs. In the Dictionary of Epidemiology both the individual and collective levels of analysis were recognized in the definition of social capital.

  19. Health, Human Capital, and Development.

    Science.gov (United States)

    Bleakley, Hoyt

    2010-09-01

    How much does disease depress development in human capital and income around the world? I discuss a range of micro evidence, which finds that health is both human capital itself and an input to producing other forms of human capital. I use a standard model to integrate these results, and suggest a re-interpretation of much of the micro literature. I then discuss the aggregate implications of micro estimates, but note the complications in extrapolating to general equilibrium, especially because of health's effect on population size. I also review the macro evidence on this topic, which consists of either cross-country comparisons or measuring responses to health shocks. Micro estimates are 1-2 orders of magnitude smaller than the cross-country relationship, but nevertheless imply high benefit-to-cost ratios from improving certain forms of health.

  20. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  1. Human capital, schooling and health.

    Science.gov (United States)

    Schultz, T Paul

    2003-06-01

    A consensus has been forged in the last decade that recent periods of sustained growth in total factor productivity and reduced poverty are closely associated with improvements in a population's child nutrition, adult health, and schooling, particularly in low-income countries. Estimates of the productive returns from these three forms of human capital investment are nonetheless qualified by a number of limitations in our data and analytical methods. This paper reviews the problems that occupy researchers in this field and summarizes accumulating evidence of empirical regularities. Social experiments must be designed to assess how randomized policy interventions motivate families and individuals to invest in human capital, and then measure the changed wage opportunities of those who have been induced to make these investments. Statistical estimation of wage functions that seek to represent the relationship between wage rates and a variety of human capital stocks may yield biased estimates of private rates of return from these investments for a variety of reasons. The paper summarizes several of these problems and illustrates how data and statistical methods can be used to deal with some of them. The measures of labor productivity and the proxies specified for schooling and adult health are first discussed, and then the functional relationships between human capital and wages are described. Three types of estimation problem are discussed: (1) bias due to omitted variables, such as ability or frailty; (2) bias due to the measurement of an aggregation of multiple sources of human capital, e.g. genetic and socially reproducible variation, which may contribute to different gains in worker productivity; and (3) errors in measurement of the human capital stocks. Empirical examples and illustrative estimates are surveyed.

  2. Financing Human Capital: Families & Society

    Directory of Open Access Journals (Sweden)

    Neantro Saavedra-Rivano

    2016-10-01

    Full Text Available The Organization for Economic Cooperation and Development (OECD describes human capital as “knowledge, skills, competencies and attributes embodied in individuals that facilitate the creation of personal, social and economic wellbeing.”* It follows from this interpretation that investment in human capital includes the sum of all costs that allow a new being to reach economic autonomy. In this paper we analyze the family and social dimensions of human capital and discuss how decisions on human capital formation are taken and how its associated costs are shared. The discussion leads us to identify an important paradox underlying human capital formation, namely the fact that while families are its main contributors the benefits of such investment go primarily to society as a whole. This paradox and its consequences are central to two very important current issues. The first issue, one that is common to many developed countries, is low female fertility which is the source, in particular, of population aging. The second issue, affecting chiefly developing countries, is the inequality of opportunities, a problem lying at the root of underdevelopment. Two options are discussed to respond to this dilemma, one based on redistributive programs and another on market solutions. The paper discusses the limits inherent to redistributive programs and goes on to present at length the alternative market solution. In a nutshell this consists of securitizing the human capital of individuals so as to finance the expenses leading to their upbringing, from birth to adulthood. In addition to describing this scheme the paper analyzes its advantages as well as the difficulties associated with its implementation. It concludes by exploring possible interpretations of the scheme and feasible routes for its adoption.

  3. Mechanical properties of femoral trabecular bone in dogs

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2005-03-01

    Full Text Available Abstract Background Studying mechanical properties of canine trabecular bone is important for a better understanding of fracture mechanics or bone disorders and is also needed for numerical simulation of canine femora. No detailed data about elastic moduli and degrees of anisotropy of canine femoral trabecular bone has been published so far, hence the purpose of this study was to measure the elastic modulus of trabecular bone in canine femoral heads by ultrasound testing and to assess whether assuming isotropy of the cancellous bone in femoral heads in dogs is a valid simplification. Methods From 8 euthanized dogs, both femora were obtained and cubic specimens were cut from the centre of the femoral head which were oriented along the main pressure and tension trajectories. The specimens were tested using a 100 MHz ultrasound transducer in all three orthogonal directions. The directional elastic moduli of trabecular bone tissue and degrees of anisotropy were calculated. Results The elastic modulus along principal bone trajectories was found to be 11.2 GPa ± 0.4, 10.5 ± 2.1 GPa and 10.5 ± 1.8 GPa, respectively. The mean density of the specimens was 1.40 ± 0.09 g/cm3. The degrees of anisotropy revealed a significant inverse relationship with specimen densities. No significant differences were found between the elastic moduli in x, y and z directions, suggesting an effective isotropy of trabecular bone tissue in canine femoral heads. Discussion This study presents detailed data about elastic moduli of trabecular bone tissue obtained from canine femoral heads. Limitations of the study are the relatively small number of animals investigated and the measurement of whole specimen densities instead of trabecular bone densities which might lead to an underestimation of Young's moduli. Publications on elastic moduli of trabecular bone tissue present results that are similar to our data. Conclusion This study provides data about directional elastic

  4. Coxa vara with proximal femoral growth arrest in patients who had neonatal extracorporeal membrane oxygenation.

    Science.gov (United States)

    DiFazio, Rachel L; Kocher, Minider S; Berven, Sigurd; Kasser, James

    2003-01-01

    This is a retrospective review of four patients in whom a pattern of coxa vara with proximal femoral growth arrest and metaphyseal irregularities developed. These patients were all treated with neonatal extracorporeal membrane oxygenation and presented with a progressive gait disturbance and pain, leg-length discrepancy, and limited abduction. Imaging revealed coxa vara with proximal femoral growth arrest. Two patients (three hips) underwent proximal femoral valgus osteotomy, one patient underwent fixation of a femoral neck fracture with subsequent greater trochanter transfer, and one patient is being observed. This case series suggests an association between neonatal extracorporeal membrane oxygenation and this unusual pattern of coxa vara with proximal femoral growth arrest.

  5. Effect of surgeon experience on femoral component size selection during total knee arthroplasty.

    Science.gov (United States)

    Nandi, Sumon; Bono, James V; Froimson, Mark; Jones, Morgan; Bershadsky, Boris

    2013-01-01

    Femoral component size selection during total knee arthroplasty should not vary from surgeon to surgeon for patients with the same bone size. This study explored if systematic variations in femoral component size selection exist. Thirteen surgeons' choices of femoral component size (Duracon, n = 1388; Triathlon, n = 740) were analyzed using a generalized linear model with femoral component size as the dependent variable and surgeon identification, years in practice, and adult reconstruction fellowship training as the independent variables. The model adjusted for differences in bone size. It was found that more experienced surgeons implant larger femoral components. New instruments and training protocols may be necessary to adjust for surgeon experience.

  6. El capital intelectual en Confamdi

    OpenAIRE

    Marulanda Lórez, Paulo César

    2012-01-01

    El “capital intelectual” es uno de los conceptos más difíciles de medir en economía. Por ello, existe un escaso consenso en la doctrina alrededor de cómo han de tratarse conceptualmente los activos intangibles y qué es lo que constituye una medición satisfactoria de los mismos. La abundante literatura acerca del capital intelectual en los últimos años, propone diversos modelos y estudios efectuados sobre esta medición, pero la falta de consenso para abordar el tema y la carencia en l...

  7. CAPITAL SOCIAL, DEMOCRACIA E DESENVOLVIMENTO

    Directory of Open Access Journals (Sweden)

    Luciene Dal Ri

    2011-12-01

    Full Text Available Este artigo apresenta uma revisão critica da literatura sobre a relação entre Capital Social, Democracia e o Desenvolvimento. É relevante refletirmos sobre estes três temas, pois não se consegue ver um distanciamento entre ambos. Todavia, como meio para promover o capital social, o desenvolvimento e a democracia, é necessária que haja uma melhoria do bem-estar social, devendo ser associada com liberdades econômicas e abertura de mercado de modo a viabilizar o crescimento econômico e a melhoria na qualidade de vida da população.

  8. LABOR AND CAPITAL: OPPOSING SYSTEMS

    Directory of Open Access Journals (Sweden)

    Adrián Sotelo Valencia

    2014-12-01

    Full Text Available During the second half of the twentieth century, and so far this century, there have been major changes such as the disintegration of the Soviet Union, the destruction of the Twin Towers or the current economic crisis sweeping the world from 2008-2009 – to be evaluated in the sense that if they have altered the essence of the capitalist system or only its form, which would rather reaffirmed their basic laws, including the world of work. We favor the latter assessment, since today the social metabolism capital is entirely universal and becomes effective, more than ever, the contradiction between her antogonica eo trabalho capital.

  9. Capital humano y capacidad humana Human capital and human capacity

    Directory of Open Access Journals (Sweden)

    Sen Amartya Kumar

    1998-12-01

    Full Text Available En este articulo se examinan las relaciones y diferencias entre el concepto de 'capital humano' y el concepto de 'capacidad humana'. El concepto de capital humano es mas limitado puesto que solo concibe las cualidades humanas en su relación con el crecimiento económico mientras que el concepto de capacidades da énfasis a la expansión de libertad humana para vivir el tipo de vida que la gente considera valedera. Cuando se adopta esa visión mas amplia, el proceso de desarrollo no puede verse simplemente como un incremento del PIB sino como la expansión de la capacidad humana para llevar una vida mas libre y mas digna.In this article the relationships and the differences between the concept of 'human capital' and the concept of 'human capability' are examined. The concept of human capital is more limited since it only conceives human qualities in relation to economic growth, whereas the concept of capabili ties puts emphasis on the expansion of human freedom to live the kind of life that people judge valuable. Whenthis broader vision is adopted, the process of development cannot be seen as simply an increase in the GNP, but rather as the expansion of the human capability to live a more free and worthy life.

  10. Pentosan reduces osteonecrosis of femoral head in SHRSP.

    Science.gov (United States)

    Miyata, Noriaki; Kumagai, Kenji; Osaki, Makoto; Murata, Masakazu; Tomita, Masato; Hozumi, Akira; Nozaki, Yoshihiro; Niwa, Masami

    2010-01-01

    Increased oxidative stress is considered one of the main causes of steroid-induced osteonecrosis of the femoral head (ONFH). The aim of this study was to evaluate the effects of a steroid hormone and pentosan polysulfate sodium (pentosan), a heparin analog, in stroke-prone spontaneously hypertensive rats (SHRSP) as a model of ONFH. One hundred twenty-three 13-week-old male SHRSP/Izm rats were divided into four groups: a control group (group C), pentosan-administered group (group P), steroid-administered group (group S), and group administered pentosan plus steroid (group PS). Methylprednisolone acetate, as the steroid hormone, at a dose of 4 mg (15 mg/kg) was administered at 15 weeks of age. Pentosan at a dose of 3 mg/day/kg was continuously administered intraperitoneally from 13 weeks of age for 4 weeks. Rats were sacrificed at 17 weeks of age, and heart blood and both femora were collected. Triglyceride levels were significantly lower in group PS than in group S, indicating that pentosan improves lipid metabolism. The incidence of histologic ONFH was significantly lower in group P, at 14.8% (10/71 femoral heads), than in group C, at 30.4% (17/56 femoral heads), and significantly lower in group PS, at 40.8% (29/71 femoral heads), than in group S, at 91.3% (42/46 femoral heads), indicating that pentosan markedly inhibits ONFH. Immunohistochemical staining for oxidative stress showed that the stainability was significantly lower in group PS than in group S. Pentosan seems to reduce the incidence of ONFH in SHRSP by improving lipid metabolism and decreasing oxidative stress.

  11. Groove model of tibia-femoral osteoarthritis in the rat.

    Science.gov (United States)

    de Visser, Huub M; Weinans, Harrie; Coeleveld, Katja; van Rijen, Mattie H P; Lafeber, Floris P J G; Mastbergen, Simon C

    2017-03-01

    Several experimental models of osteoarthritis in rats are used to study the pathophysiology of osteoarthritis. Many mechanically induced models have the limitation that permanent joint instability is induced by, for example, ligament transection or meniscal damage. This permanent instability will counteract the potential beneficial effects of therapy. The groove model of osteoarthritis uses a one-time trigger, surgically induced cartilage damage on the femoral condyles, and has been validated for the canine tibia-femoral compartment. The present study evaluates this model for the rat knee joint. The articular cartilage of the weight bearing surface of both femoral condyles and trochlea were damaged (grooved) without damaging the underlying subchondral bone. Severity of joint degeneration was histologically assessed, in addition to patella cartilage damage, and subchondral bone characteristics by means of (contrast-enhanced) micro-CT. Mild histological degeneration of the surgically untouched tibial plateau cartilage was observed in addition to damage of the femoral condyles, without clear synovial tissue inflammation. Contrast enhanced micro-CT demonstrated proteoglycan loss of the surgically untouched patella cartilage. Besides, a more sclerotic structure of the subchondral bone was observed. The tibia-femoral groove model in a rat results in mild knee joint degeneration, without permanent joint instability and joint inflammation. This makes the rat groove model a useful model to study the onset and progression of post-traumatic non-inflammatory osteoarthritis, creating a relatively sensitive model to study disease modifying osteoarthritic drugs. © 2016 The Authors. Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 35:496-505, 2017.

  12. Current concepts on osteonecrosis of the femoral head.

    Science.gov (United States)

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-09-18

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated.

  13. MULTICENTRIC GIANT CELL TUMOR OF IPSILATERAL ACETABULUM AND FEMORAL HEAD WITH PATHOLOGICAL FRACTURE OF FEMORAL NECK: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayant

    2015-02-01

    Full Text Available INTRODUCTION: Multicentric Giant Cell Tumor is extremely rare; here we are presenting a case of pathological neck femur fracture in case of multicentric giant cell tumor involving ipsilateral acetabulum along with femoral head and neck. CASE PRESENTATION: 24 years old male presented with pain in groin region and inability to walk after he fell down while walking. He had pain in left groin on weight bearing for last six months. Radiological examination shows pathological trans - cervical femoral neck fracture with sub - articular lytic lesion in femoral head and neck suggestive of Giant cell tumor. MRI has been done to define the extent of involvement and to rule out soft tissue infiltration. Fine needle aspiration cytology which was done through anterior route was inconclusive. After review of literature, patient has been planned for excisional biopsy and un - cemented total hip arthroplasty. Intra - operatively, frozen section confirms the giant cell tumor and surprisingly acetabulum was found to be involved which was curetted and hydrogen - peroxide treated. Post - operatively, patient was pain - free with good range of movements at hip. CONCLUSION: Giant cell tumor involving femoral head and neck with pathological fracture though uncommon, but may present as multicentric with acetabular involvement.

  14. National Capital Planning Commission Library contents

    Data.gov (United States)

    National Capital Planning Commission — The National Capital Planning Commission library catalog is a compilation of titles, authors, years of publication and topics of books, reports and NCPC publications.

  15. 12 CFR 615.5220 - Capitalization bylaws.

    Science.gov (United States)

    2010-01-01

    ... retirable at the sole discretion of the board, provided minimum permanent capital adequacy standards... association's funding bank in conjunction with any agreement for a transfer of capital between the...

  16. Employee Capital:Resource or Reoccurring Nightmare

    OpenAIRE

    Murphy, James Peter

    2005-01-01

    Employee capital need not be a reoccurring nightmare for bar owners if they create a system for managing their employee capital which deals with recruitment, placement, training and development for all hospitality staff members.

  17. Social Capital. Trust and Ideology

    Directory of Open Access Journals (Sweden)

    Jacek TITTENBRUN

    2013-06-01

    Full Text Available The paper offers a critical analysis of the central concept around which the popular construct of social capital is organised, i.e. trust. To this end the views of Fukuyama, the leading exponent of the said concept are considered. As a result, the concept in question is found to be ideologically charged and substantively weak in many respects.

  18. Impression management as symbolic capital

    DEFF Research Database (Denmark)

    Lueg, Klarissa; Nielsen, Camilla

    2015-01-01

    Social Network Sites (SNS) play an increasingly important role in the European business world, especially with respect to cross-cultural impression management. Departing from the Bourdieusian concept of “capital,” this paper analyzes the differences in the use of two popular business SNS: XING...

  19. Building Social Capital for Internationalization

    Directory of Open Access Journals (Sweden)

    Suzana Braga Rodrigues

    2012-01-01

    Full Text Available Social capital may be defined as social relationships that confer actual or potential benefits. It can therefore beunderstood as a particular type of resource. Recent research has drawn attention to how connections andrelationships (networking both at home and abroad can be crucially important for small and medium-sizedenterprises (SMEs seeking to export or invest abroad. However, relatively little is known about how SMEsinitiate, develop and maintain network relationships. This paper reports a study of 32 British SMEs exporting, orattempting to export, to Brazil and of domestic institutional agencies whose role was to facilitate businessconducted between British and Brazilian SMEs. The study explored both the functions of social capital for theSMEs and the process whereby it was developed. Its findings confirm the value of social capital in internationalentrepreneurship. It can provide information, interpretation, market opportunities, and some degree of protectionagainst the risks associated with foreignness, newness and smallness. The study also confirms the vitalimportance of personal trust in sustaining social capital between small firms.

  20. Social Capital and Community Heterogeneity

    Science.gov (United States)

    Coffe, Hilde

    2009-01-01

    Recent findings indicate that more pronounced community heterogeneity is associated with lower levels of social capital. These studies, however, concentrate on specific aspects in which people differ (such as income inequality or ethnic diversity). In the present paper, we introduce the number of parties in the local party system as a more…

  1. THE INTELLECTUAL CAPITAL OF UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    Bratianu Constantin

    2009-05-01

    Full Text Available The purpose of this paper is to present some of our research results concerning the intellectual capital of universities. This is an important topic of the intellectual research area since universities are knowledge intensive organizations. They contain b

  2. Capital Punishment: An International Perspective.

    Science.gov (United States)

    Kaufman, Edy

    1983-01-01

    The debate over the death penalty in the United States has implications beyond our borders. Because of the lack of universal standards governing its use, only those countries which have abolished capital punishment may, with any moral authority, denounce its exploitation as an instrument of political expediency. (IS)

  3. School Cheating and Social Capital

    Science.gov (United States)

    Paccagnella, Marco; Sestito, Paolo

    2014-01-01

    In this paper we investigate the relationship between social capital and cheating behaviour in standardized tests. Given the low-stakes nature of these tests, we interpret the widespread presence of cheating as a signal of low trust towards central education authorities and as lack of respect for the rule of law. We find that cheating is…

  4. Real Assets and Capital Structure

    NARCIS (Netherlands)

    Campello, M.; Giambona, E.

    2013-01-01

    We characterize the relation between asset structure and capital structure by exploiting variation in the salability of corporate assets. To establish this link, we distinguish across different assets in firms’ balance sheets (machinery, land, and buildings) and use an instrumental approach that inc

  5. Varieties of capitalism in crisis?

    DEFF Research Database (Denmark)

    Bruff, Ian; Horn, Laura

    2012-01-01

    In this introduction to the special issue, we provide a brief overview of the two distinct but connected meanings of the phrase ‘varieties of capitalism in crisis’: (1) the crisis of empirical political economies under conditions of capitalist diversity; and (2) the crisis of the institutionalist...

  6. Capital productivity and the nature of competition

    OpenAIRE

    Börsch-Supan, Axel

    1997-01-01

    This paper measures capital productivity in West Germany, Japan and the United States and links capital productivity to financial performance. We show that West Germany and Japan have significantly lower levels of capital productivity than the United States, mainly due to lower capital utilization but also because less productive capacity was created per unit of physical assets. On a higher level of causality, we show that this mainly comes from less pressure from product market competition a...

  7. CRISIS FOCUS:Alert Over Capital Inflow

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ Emerging Asia's capital markets have posted rapid gains as the pace of economic recovery in the region has increased,drawing massive investment from overseas.Governments in emerging Asia should remain vigilant and be ready to act if volatile capital inflows threaten to destabilize the region's financial markets,said the Asia Capital Markets Monitor,Asian Development Bank's annual assessment of the performance and outlook for the region's capital markets released on May18.Edited excerpts follow:

  8. Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: A longitudinal study by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vande Berg, Bruno C. [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium)]. E-mail: vandeberg@rdgn.ucl.ac.be; Gilon, Raphael [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Malghem, Jacques [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Lecouvet, Frederic [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Depresseux, Genevieve [Rheumatology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Houssiau, Frederic A. [Rheumatology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium)

    2006-06-15

    Objective: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. Patients and methods: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. Results: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p = 0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p = 0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p = 0.0298). Conclusion: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy.

  9. The effect of human capital, social capital, and perceptual values on nascent entrepreneurs' export intentions

    DEFF Research Database (Denmark)

    Christensen, Poul Rind; Evald, Majbritt Rostgaard; Klyver, Kim

    2011-01-01

    This study investigates the influence of human capital, social capital, and cognition on nascent entrepreneurs' export intentions. The results indicate that while human capital and social capital influence the level of intended export, cognitive characteristics, such as self-efficacy and risk...

  10. 77 FR 52791 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Minimum Regulatory...

    Science.gov (United States)

    2012-08-30

    ... incorporating aspects of the BCBS's Basel II standardized framework in the ``International Convergence of... references to credit ratings. \\5\\ See BCBS, ``International Convergence of Capital Measurement and Capital...'' of common equity tier 1 capital in excess of the new minimum capital requirements. \\11\\...

  11. Psychological Capital, Career Identity and Graduate Employability in Uganda: The Mediating Role of Social Capital

    Science.gov (United States)

    Ngoma, Muhammad; Dithan Ntale, Peter

    2016-01-01

    This paper seeks to evaluate the relationship between psychological capital, career identity, social capital and graduate employability. We also seek to evaluate the mediating role of social capital on the relationships between psychological capital, career identity and graduate employability in Uganda. A population of 480 unemployed young people…

  12. Building Social Capital through Outdoor Education

    Science.gov (United States)

    Beames, Simon; Atencio, Matthew

    2008-01-01

    Over the last 15 years, the body of literature surrounding the subject of social capital has witnessed steady growth. While sociologists have extensively discussed how social capital can be created and sustained within local communities and national contexts, there is little evidence of the social capital discourse within the outdoor education…

  13. 12 CFR 615.5200 - Capital planning.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Capital planning. 615.5200 Section 615.5200 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FUNDING AND FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Capital Adequacy § 615.5200 Capital planning. (a) The...

  14. The Maastricht gigantomachy capital and its models

    NARCIS (Netherlands)

    T.A.S.M. Panhuysen

    2009-01-01

    In this article a figured pillar capital with gigantomachy scenes will be discussed. This unique capital represents an iconographic curiosity with its gigantomachy representations on two opposite sides of the square block. Apollo and Moira are represented. The capital must date from the second quart

  15. Cognitive Capitalism, Education and Digital Labor

    Science.gov (United States)

    Peters, Michael A., Ed.; Bulut, Ergin, Ed.

    2011-01-01

    Cognitive capitalism--sometimes referred to as "third capitalism," after mercantilism and industrial capitalism--is an increasingly significant theory, given its focus on the socio-economic changes caused by Internet and Web 2.0 technologies that have transformed the mode of production and the nature of labor. The theory of cognitive capitalism…

  16. Venture Capital Initiative: Ohio's School Improvement Effort.

    Science.gov (United States)

    Yoo, Soonhwa; Loadman, William E.

    In 1994 the Ohio State Legislature established Venture Capital to support school restructuring. The Venture Capital school initiative is a concept borrowed from the business community in which the corporate entity provides risk capital to parts of the organization to stimulate creative ideas and to provide opportunities for local entities to try…

  17. Regulatory capital requirements and bail in mechanisms

    NARCIS (Netherlands)

    Joosen, B.P.M.; Haentjens, M.; Wessels, B.

    2015-01-01

    With the introduction of the Capital Requirements Regulation (CRR) in the European Union, the qualitative requirements for bank regulatory capital have changed. These changes aim at implementing in Europe the Basel III principles for better bank capital that is able to absorb losses of banks, withou

  18. 78 FR 1991 - Major Capital Investment Projects

    Science.gov (United States)

    2013-01-09

    ... Capital Investment Projects; Notice of Availability of Proposed New Starts and Small Starts Policy... Part 611 RIN 2132-AB02 Major Capital Investment Projects AGENCY: Federal Transit Administration (FTA... implementation of the major capital investment program, primarily by giving the project justification...

  19. Cognitive Capitalism, Education and Digital Labor

    Science.gov (United States)

    Peters, Michael A., Ed.; Bulut, Ergin, Ed.

    2011-01-01

    Cognitive capitalism--sometimes referred to as "third capitalism," after mercantilism and industrial capitalism--is an increasingly significant theory, given its focus on the socio-economic changes caused by Internet and Web 2.0 technologies that have transformed the mode of production and the nature of labor. The theory of cognitive…

  20. Social capital in involuntary displacement and resettlement

    NARCIS (Netherlands)

    Navarra, M.Q.; Niehof, A.; Vaart, van der W.

    2013-01-01

    Social capital is often seen as a substitute for lack of other types of capital among poor people. Because of the recognized applicability of the social capital concept and its correlation with the different dimensions of poverty, it has been used in evaluating the adaptation and integration of invo

  1. The Political Economy of Capital Reallocation

    NARCIS (Netherlands)

    M. Bersem; E. Perotti; E.L. von Thadden

    2013-01-01

    In this paper we develop a positive theory of capital market frictions. We focus on a political conflict that arises between citizens with different vintages of human capital. Once human capital is sunk in a firm- or sector specific technology, stakeholders will resist the emergence of newer sectors

  2. 47 CFR 69.310 - Capital leases.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Capital leases. 69.310 Section 69.310 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Net Investment § 69.310 Capital leases. Capital Leases in Account 2680 shall be...

  3. 47 CFR 32.4510 - Capital stock.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Capital stock. 32.4510 Section 32.4510... FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts § 32.4510 Capital stock. (a... received for capital stock issued and outstanding. (b) Subsidiary records shall be maintained so as to...

  4. Measuring Social Capital Accumulation in Rural Development

    Science.gov (United States)

    Teilmann, Kasper

    2012-01-01

    Using a theoretical framework, the study proposes an index that can measure the social capital of local action group (LAG) projects. The index is founded on four indicators: number of ties, bridging social capital, recognition, and diversity, which are aggregated into one social capital index. The index has been tested in LAG-Djursland, Denmark,…

  5. Measuring Social Capital in Hamilton, Ontario

    Science.gov (United States)

    Kitchen, Peter; Williams, Allison; Simone, Dylan

    2012-01-01

    Social capital has been studied by academics for more than 20 years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and…

  6. Human Capital Development: A Family Objective.

    Science.gov (United States)

    Hildebrand, Verna

    1995-01-01

    Examines the concept of human capital as an economic construct. Suggests that human capital contributes to economic development, as do physical capital or natural resources, in that its development reinforces individuals' future economic output. Suggests that this perspective may prove useful for human service professionals because funding…

  7. Heterogeneity of Human Capital and the Return

    DEFF Research Database (Denmark)

    Madsen, Erik Strøjer

    2015-01-01

    Human capital is an important growth factor for developing and developed countries and measuring the return to education is essential in evaluating the growth impact from human capital. Most studies use the length of education measured by the years of schooling as an indicator of human capital...

  8. INSURANCE AND THE CORPORATE COST OF CAPITAL

    Directory of Open Access Journals (Sweden)

    Monika Wieczorek-Kosmala

    2012-04-01

    Full Text Available The purpose of the paper is to provide some support to the thesis that insurance may reduce the cost of capital in a company by influencing both the cost of capital components and the need for rising capital. The problem is here perceived from two perspectives – the classical concept related to the weighted average cost of capital (WACC and a novel concept related to the risk-based capital structure model with the total average cost of capital (TACC. The paper explains the idea of insurance as a retrospective (post-loss risk financing tool and the risk transfer mechanism upon it. As the risk financing tool insurance reduces the need for the balance-sheet capital in a company and thus the financial distress costs. Also, insurance may reduce the level of operating risk and thus influences the required returns of the capital providers. These observations allow emphasising the impact of insurance on the WACC. However, according to the novel concept of the risk-based capital structure, insurance (as a risk financing tool represents an off-balance sheet capital component. As a consequence, it extends the volume of total capital. The presented conceptual model, based on the TACC concept, indicates that large volume of insurance (the insurance sum and its relatively low cost (the insurance premium gives the possibility to the significant reduction of the cost of capital on average. The concluding remarks discuss some dilemmas over the utility of the TACC concept.

  9. 12 CFR 725.5 - Capital stock.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Capital stock. 725.5 Section 725.5 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS NATIONAL CREDIT UNION ADMINISTRATION CENTRAL LIQUIDITY FACILITY § 725.5 Capital stock. (a) The capital stock of the Facility is...

  10. 78 FR 62017 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy...

    Science.gov (United States)

    2013-10-11

    ... 1 Capital a. Goodwill and Other Intangibles (Other Than Mortgage Servicing Assets) b. Gain-on-sale...(a) of the Final Rule 2. Deductions for Intangibles Other Than Goodwill and Mortgage Servicing Assets...-Weighted Assets--Modifications to the Advanced Approaches A. Counterparty Credit Risk 1. Recognition...

  11. A Model of Optimal Allocations of Physical Capital and Human Capital in Three Sectors

    Institute of Scientific and Technical Information of China (English)

    ZHOU Shaobo; XUE Minggao

    2007-01-01

    The paper develops an endogenous economic growth model about allcation of physical and human capital in three sectors. Optimal allocation of physical capital and human capital in three sectors is derived, the fraction of physical and human capital in each sector is positively related. The balanced values and the growth rates at steady state are given under certain conditions.Finally relations between the fractions of human capital and parameters are analyzed elaborately.

  12. Importance of sagittal MR imaging in nontraumatic femoral head osteonecrosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Alice S. [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Wells, Lawrence [Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Jaramillo, Diego [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2008-11-15

    In nontraumatic femoral head osteonecrosis, characterization of femoral head collapse is important in staging disease progression and planning treatment. Few prior studies have quantitatively compared the ability of sagittal and coronal MR images to detect femoral head collapse. We hypothesized that sagittal MR images show a greater degree and angular span of femoral head collapse than coronal images. We reviewed 38 hip MRI scans of nontraumatic femoral head osteonecrosis from 34 pediatric patients. In both sagittal and coronal images, the maximal extent and angular location along with the angular span of the femoral head collapse were measured. Differences were evaluated using a paired t-test. The extent of bone and cartilage loss from the femoral head was evaluated. Sagittal MR images showed 29% maximal femoral head radius collapse, whereas coronal images showed 16% collapse (P<0.001). Sagittal images showed a larger angular span of collapse (115 ) than coronal images (55 , P<0.001). Sagittal images showed greater epiphyseal bone loss in the anterior than in the posterior portion (P<0.001), whereas coronal images did not show a significant difference in bone loss between the medial and lateral portion (P=0.32). Sagittal images show greater femoral head collapse than coronal images in nontraumatic femoral head osteonecrosis. (orig.)

  13. VARIATIONS IN ORIGIN OF FEMORAL NERVE FROM THE LUMBER PLEXUS (A CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    Dr. Gurbachan Singh Gindha

    2015-04-01

    Full Text Available The variations in origin of femoral nerve from lumbar plexuses is very much common. The normal root value of origin of femoral nerve is L2, L2 and L4. It can be prefixed or postfixed. Mostly the femoral nerve is used for the nerve block in several surgeries and is vulnerable to compression in tight ilio-psoas compartment. The knowledge of origin and variations of femoral nerve in iliac fossa is important for anatomists, anaesthetists and surgeons to prevent iatrogenic femoral nerve injuries.3 0 embalmed with 10% formal in and fixed cadavers were dissecte donboth sides and 60 lumbar plexuses with their branches formed the mat e r i a l f o r t h e study. The p s oas major muscle was dissected to see the formation of femoral nerve from theroots and to observe the variations in the formation of femoral nerve. The aim of this study was to look for the variations in origin and branching pattern of the femoral nerve in the iliac fossa and proper exposure of the femoral nerve in the femoral triangle.

  14. Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study

    Directory of Open Access Journals (Sweden)

    Xiu-yun Su

    2015-01-01

    Full Text Available Purpose. To establish a new approach for measuring and locating the femoral intramedullary canal isthmus in 3-dimensional (3D space. Methods. Based on the computed tomography data from 204 Chinese patients, 3D models of the whole femur and the corresponding femoral isthmus tube were reconstructed using Mimics software (Materialise, Haasrode, Belgium. The anatomical parameters of the femur and the isthmus, including the femur length and radius, and the isthmus diameter and height, were measured accordingly. Results. The mean ratio of the isthmus height versus the femoral height was 55 ± 4.8%. The mean diameter of the isthmus was 10.49 ± 1.52 mm. The femoral length, the isthmus diameter, and the isthmus tube length were significantly larger in the male group. Significant correlations were observed between the femoral length and the isthmus diameter (r=0.24, p<0.01 and between the femoral length and the isthmus height (r=0.6, p<0.01. Stepwise linear regression analyses demonstrated that the femoral length and radius were the most important factors influencing the location and dimension of the femoral canal isthmus. Conclusion. The current study developed a new approach for measuring the femoral canal and for optimization of customer-specific femoral implants.

  15. 13 CFR 108.230 - Private Capital for NMVC Companies.

    Science.gov (United States)

    2010-01-01

    ... VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.230 Private Capital for NMVC Companies. (a) General. Private Capital means the contributed capital of a NMVC... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Private Capital for NMVC...

  16. Femoral lengthening during hip resurfacing arthroplasty: a new surgical procedure.

    Science.gov (United States)

    Vasseur, L; Ayoub, B; Mesnil, P; Pasquier, G; Migaud, H; Girard, J

    2015-04-01

    Correction of leg length discrepancy during hip arthroplasty is a technical challenge. Although resurfacing proposed to young subjects presents a number of advantages (stability, bone stock, etc.), it does not correct leg length discrepancy. We propose an original femoral lengthening technique concomitant to resurfacing performed through the same approach, consisting in a Z-shaped subtrochanteric osteotomy. Resurfacing was performed first and the femoral and acetabular reaming material was used for autografting. The series comprised five cases followed for a mean 42.2 months (range, 33-64 months). The mean surgical time was 100 min (range, 76-124 min). Weightbearing was authorized in all cases at the 8th week. The mean lengthening was 32 mm (range, 25-40 mm). Healing was observed in all cases. This surgical technique, reserved for very young subjects who accept an 8-week postoperative period without weightbearing, can be proposed in cases with substantial preoperative leg length discrepancy.

  17. Subchondral insufficiency fracture of the femoral head after liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, Kenyu; Yamamoto, Takuaki; Nakashima, Yasuharu; Mawatari, Taro; Motomura, Goro; Ikemura, Satoshi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)

    2009-09-15

    A 53-year-old woman developed a subchondral insufficiency fracture of the right femoral head after undergoing a liver transplantation. Radiographs obtained at her first visit demonstrated a slight subchondral collapse in the superolateral portion of the femoral head. Magnetic resonance imaging (MRI) disclosed an irregular, discontinuous, low-intensity band on the T1-weighted image. After 7 months of conservative treatment, the hip pain and the radiograph abnormalities had both disappeared. On the follow-up T1-weighted MR image obtained 17 months after the onset, the band of low signal intensity was not obvious. A subchondral insufficiency fracture is one of the diagnoses to be considered in patients presenting with hip pain after a liver transplantation. (orig.)

  18. Computer assisted measurement of femoral cortex thickening on radiographs

    Science.gov (United States)

    Yao, Jianhua; Liu, Yixun; Chen, Foster; Summers, Ronald M.; Bhattacharyya, Timothy

    2013-03-01

    Radiographic features such as femoral cortex thickening have been frequently observed with atypical subtrochanteric fractures. These features may be a valuable finding to help prevent fractures before they happen. The current practice of manual measurement is often subjective and inconsistent. We developed a semi-automatic tool to consistently measure and monitor the progress of femoral cortex thickening on radiographs. By placing two seed points on each side of the femur, the program automatically extracts the periosteal and endosteal layers of the cortical shell by active contour models and B-spline fitting. Several measurements are taken along the femur shaft, including shaft diameter, cortical thickness, and integral area for medial and lateral cortex. The experiment was conducted on 52 patient datasets. The semi-automatic measurements were validated against manual measurements on 52 patients and demonstrated great improvement in consistency and accuracy (p<0.001).

  19. Quality of life in old patients with proximal femoral fractures

    Directory of Open Access Journals (Sweden)

    T A Raskina

    2012-01-01

    Full Text Available Objective: to study quality of life in Kemerovo old patients with proximal femoral fractures. Patients and methods. Quality of life in osteoporotic fractures was analyzed in 219 patients (173 women and 46 men who had sustained the injury in January 2004 to December 2008. Results. In the patients with hip fractures, the lowest (41.94+31.16 scores values were recorded by the physical functioning scale reflecting the degree to which their health limited the performance of physical exercises (self-service, walking, going upstairs, weight carriage, etc.. The role functioning and life activity scales showed the highest values (50.96+19.04 and 51.44+26.51 scores, respectively. The mean value of the physical component scale was 46.42+28.26 scores. That of the psychological component scale was 49.56+19.55 scores. Conclusion. The patients with proximal femoral fractures were found to have lower scores on all SF-36 dimensions.

  20. Nonunion of coronal shear fracture of femoral condyle

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2011-06-01

    Full Text Available 【Abstract】Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union was achieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed. Key words: Femoral fracture; Fracture fixation, internal; Retrospective studies

  1. Confronting hip resurfacing and big femoral head replacement gait analysis

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2014-03-01

    Full Text Available Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS. On the other hand, hip kinematics with standard total hip replacement (THR is optimized with large diameter femoral heads (BFH-THR. The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.

  2. Femoral anatomy of Aegyptopithecus zeuxis, an early oligocene anthropoid.

    Science.gov (United States)

    Ankel-Simons, F; Fleagle, J G; Chatrath, P S

    1998-08-01

    Three partial femora from Quarries I and M of the early Oligocene Jebel Qatrani Formation in the Fayum of Egypt are attributed to Aegyptopithecus zeuxis on the basis of their appropriate size and anthropoid morphology. Compared with extant catarrhines, Aegyptopithecus is unusual in having a distinct gluteal tuberosity (third trochanter) and a relatively deep distal femoral articulation. In the estimated neck angle, Aegyptopithecus resembles arboreal quadrupeds rather than either leaping or suspensory primates. It seems likely that the femur of this species was relatively robust and short for its body mass. In aspects of its femoral anatomy, Aegyptopithecus is quite different from the parapithecid Apidium and more similar to Catopithecus from late Eocene deposits of the Fayum, and also to small hominoids from the Miocene of East Africa.

  3. A Case of Femoral Fracture in Klippel Trenaunay Syndrome

    Directory of Open Access Journals (Sweden)

    Sam Nahas

    2014-01-01

    Full Text Available We present a case of Klippel Trenaunay syndrome (KTS who presented with severe bilateral knee osteoarthritis (OA. Preoperative planning was commenced for a total knee replacement (TKR. Whilst on the waiting list the patient suffered a fall and sustained a complete femoral diaphysis fracture. Conservative management in the form of skin traction was initially chosen as significant extra- and intramedullary vascular malformations posed an increased risk of perioperative bleeding. This failed to progress to union, and so open reduction and internal fixation was performed. This subsequently resulted in on-going delayed union, which was subsequently managed with low intensity pulsed ultrasound (LIPUS, otherwise known as Exogen (Bioventus. exogen. Secondary exogen, 2012. There are only two previous documented cases of femoral fracture in KTS. This is the first report of a patient with this rare syndrome receiving this treatment. We discuss the management of fracture in this challenging group of patients.

  4. Tibial tubercle osteotomy for patello-femoral joint disorders.

    Science.gov (United States)

    Hall, Matthew J; Mandalia, Vipul I

    2016-03-01

    Tibial tubercle osteotomy has a long history in the management of patella instability and patello-femoral arthritis. This review aims to provide a comprehensive review of the literature describing the biomechanics of the patello-femoral joint and the rationale behind the use of the tibial tubercle osteotomy in modern day practice. Several different tibial tubercle osteotomies are available and we aim to detail the concepts behind their use and the subsequent clinical results. With continued developments of chondrocyte implantation techniques, the potential to fill defects on the chondral surface of either the patella or trochlea in conjunction with a tibial tubercle osteotomy may well become more commonplace in a group that is commonly young and difficult to manage. Level of evidence III.

  5. Coexisting ipsilateral right femoral hernia and incarcerated obturator hernia.

    Science.gov (United States)

    Seppälä, Toni T; Tuuliranta, Mikko

    2015-02-25

    Obturator hernia (OH) is an uncommon cause of bowel obstruction and described in elderly females in the literature. The treatment has traditionally been laparotomy because of an acute nature of the condition. However, because of old age and comorbidities that OH is associated with, general anaesthesia may need to be avoided. In the current case, a transinguinal preperitoneal approach and management are presented after delayed preoperative diagnosis of bowel obstruction caused by a coexisting right incarcerated OH and ipsilateral non-reducible femoral hernia. A 91-year-old woman had a 6-day history of nausea and vomiting. She was referred to surgery because of persisting vomiting, but without any abdominal pain. A CT scan showed a hernia in the right groin area but the diagnosis was delayed. The hernias were repaired using a preperitoneal transinguinal approach. Bowel resection was not needed. The obturator canal and the femoral ring were both covered by a Bard Polysoft patch.

  6. Malformação ílio-femoral

    OpenAIRE

    2006-01-01

    Durante uma dissecção de rotina realizada em um cadáver do sexo masculino com 65 anos de idade foi constatada malformação arterial iliofemoral. A aorta abdominal estava consideravelmente deslocada lateralmente e também bifurcava em nível mais alto. A artéria ilíaca comum dividia-se uma vértebra acima do nível normal e a artéria femoral dava origem à artéria femoral profunda aproximadamente l,2 cm abaixo do ligamento inguinal, o que é consideravelmente proximal ao seu nível normal. Aqui nós ap...

  7. Blood flow and microdialysis in the human femoral head

    DEFF Research Database (Denmark)

    Bøgehøj, Morten; Emmeluth, Claus; Overgaard, Søren

    2007-01-01

    BACKGROUND: If it would be possible to detect lack of flow and/or the development of ischemia in bone, we might have a way of predicting whether a broken bone will heal. We established microdialysis (MD) and laser Doppler (LD) flow measurement in the human femoral head in order to be able to detect...... ischemia and measure changes in blood flow. MATERIAL AND METHODS: In 9 patients undergoing total hip arthroplasty for primary osteoarthrosis, two MD catheters were inserted into the femoral head through two drill holes after the blood flow had been visualized by LD. Then primary samples were collected...... detected within 2 h of cessation of blood flow in most patients....

  8. International working capital practices of Ghanaian firms

    Directory of Open Access Journals (Sweden)

    J. Abor

    2005-12-01

    Full Text Available International working capital management is important to firms frequently operating in the international market. This article investigates the international working capital practices of top Ghanaian firms involved in international trade. The objective of the study is to ascertain the extent to which Ghanaian firms use international working capital management vehicles. The article focuses on two main areas of international working capital management; international cash management and international sales and accounts receivables management. The results of this study reveal low level of use of international working capital vehicles among Ghanaian firms. Recommendations are made in this regard.

  9. Social Capital, Economic Growth and Transition Economies

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard

    1998-01-01

    transactions to take place without third-party enforcement. Theory and lessons from empirical evidence lead to three general recommendations for building social capital in the future: First, the state must withdraw and minimize its role in the economy so to leave room for voluntary organization and free......Summary: What does social capital mean and how can it be built? Social capital is considered as a new production factor which must be added to the conventional concepts of human and physical capital. Social capital is productive because it increases the level of trust in a society and allows more...

  10. Social capital: its constructs and survey development.

    Science.gov (United States)

    Enfield, Richard P; Nathaniel, Keith C

    2013-06-01

    This article reports on experiences and methods of adapting a valid adult social capital assessment to youth audiences in order to measure social capital and sense of place. The authors outline the process of adapting, revising, prepiloting, piloting, and administering a youth survey exploring young people's sense of community, involvement in the community, and the development of social capital. They then discuss the trade-offs of defining the often amorphous concepts included in social capital as they select measurement scales. The constructs used in the survey are agency, belonging, engagement, and trust for bonding, bridging, and linking forms of social capital.

  11. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases

    OpenAIRE

    Bush, Lisabeth A.; Chew, Felix S.

    2015-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was foc...

  12. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  13. Titanium elastic nailing in pediatric femoral diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Singh Roop

    2006-01-01

    Full Text Available Background: The need for operative fixation of pediatric femoral fractures is increasingly being recognised in the present decade. The conventional traction and casting method for management of pediatric femoral fractures is giving way for the operative stabilisation of the fracture. Methods : Thirty five pediatric patients in age group 6-14 years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for two years. The final results were evaluated using the criteria of Flynn et al. Technical problems and complications associated with the procedure were also analysed. Results : Overall results observed were excellent in 25, satisfactory in 8 and poor in 2 patients. Hospital time averaged 12.30 days in the series. All the fractures healed with an average time to union of 9.6 (6-14.4 weeks. Return to school was early with an average of 7.8 weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in three cases and restriction of knee flexion in 5 patients. There was no delayed union, infection or refractures. Per operative technical problems included failure of closed reduction in 2 cases and cork screwing of nails in one case. Conclusion : We believe that with proper operative technique and aftercare TENs may prove to be an ideal implant for pediatric femoral fracture fixation. The most of the complication associated with the procedure are infact features of inexact technique and can be eliminated by strictly adhering to the basic principles and technical aspects.

  14. Residual stress around the cortical surface in bovine femoral diaphysis.

    Science.gov (United States)

    Yamada, Satoshi; Tadano, Shigeru

    2010-04-01

    Residual stress in living tissue plays an important role in mechanical strength. We have reported that residual stress exists in the bone tissue of a rabbit's tibiofibula. The purpose of this study is to measure the residual stress around the outer cortical region of bovine femoral diaphysis and to discuss the distribution of the stress. This work proposed the sin(2) psi method of X-ray diffraction to the measurement of residual stresses in bone tissue. In this method, residual stress can be estimated from the variation in the interplanar spacings orientated to a number of directions without the lattice strain in the stress direction. Four-point bending tests of strip specimens taken from bovine femoral diaphysis were carried out during X-ray irradiation in advance. In the proximal, middle, and distal sections of bovine femoral diaphyses, the residual stresses at the cortical surface were measured using characteristic Mo-Kalpha X-rays. The bending tests of strip specimens with X-ray irradiation showed that the method could reliably estimate residual stresses in the bone tissue. The residual stress of the bone axial direction was larger than that of the circumferential direction. The stresses in the middle part of five diaphyses along the bone axial direction were tensile. The maximum stress was 162 MPa at the lateral position and the minimum was 78 MPa at the posterior position. The residual stress in the bone axial direction varies around the circumferential region. In addition, the bone axial distributions of residual stresses were different in the proximal, middle, and distal sections of the individual femur. Furthermore, it was confirmed that residual stress in the bone tissue was released by the cutting out of the specimen. The residual stresses in bone tissue could be measured by this method. The results show that residual stress in the bone axial direction at the cortical surface in bovine femoral diaphysis is tensile and varies around the circumferential

  15. Postmortem retrieved canine THR: femoral and acetabular component interaction.

    Science.gov (United States)

    Skurla, Carolyn P; James, Susan P

    2004-01-01

    Dogs are the preferred animal model for testing of human total hip replacements (THRs). A postmortem retrieval program for clinical, cemented, canine THR was established to analyze the long-term performance of THRs in dogs and to compare that performance to postmortem retrievals of human THRs. The purpose of the present study was to analyze the interaction between the femoral and acetabular components. Thirty-eight postmortem retrievals from 29 dogs were donated and analyzed. The acetabular components (ACs) were measured for volumetric wear and graded for articulating surface damage. Femoral and acetabular components were mechanically tested for implant stability. Digital image analysis was performed on contact radiographs of transverse femoral slices. Of 14 cases with a firmly implanted femoral component (FC). 6 articulated against loose ACs. Of 24 cases with a loose FC, 16 articulated against loose ACs. Only 4 specimens had both components firmly implanted, and 14 specimens had both components loose. There was a significant positive correlation between AC volumetric wear and FC loosening; however, there was no evidence of osteolysis or wear debris induced osteolysis as seen in human postmortem retrieval studies. There was a significant but weak negative correlation between FC loosening at the cement/bone interface and AC scores reflecting damage to the rim and creep across the entire AC. Although implant-on-implant damage to the AC was expected to positively correlate with FC loosening, this was not found. Researchers need to look at interactions between AC and FC to understand how the failure of one component affects performance of the other.

  16. Subchondral insufficiency fracture of the femoral head in younger adults

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki; Nakashima, Yasuharu; Shuto, Toshihide; Jingushi, Seiya; Iwamoto, Yukihide [Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)

    2007-06-15

    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  17. Magnetic resonance imaging of idiopathic osteonecrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Yamazoe, Shoichi [Kyoto Prefectural Univ. of Medicine (Japan)

    1995-02-01

    Idiopathic osteonecrosis of the femoral head (IONF) can result in disability due to bone collapse and destruction. Therefore, early diagnosis of IONF and prognosis assessment are essential for treatment planning. This study investigated the early characteristic pattern of IONF on magnetic resonance imaging (MRI) and its correlation to the prognosis of the femoral head. MRI was performed repeatedly on fifty-one patients who had undergone renal transplantation. Three abnormal patterns were found in the T{sub 1}-weighted images: a band-like low-signal pattern (band pattern), an irregular low-signal pattern (mottled pattern), and a homogeneous low-signal area localized in the subchondral region (homogeneous pattern). Abnormal changes were detected in thirteen patients; twenty-three hips (25.5%). Most changes were evident within six months after transplantation. The earliest was found six weeks after transplantation. A band pattern was the initial finding in all hips showing abnormal changes. The band pattern did not spread peripherally as time passed. There was no progression from a mottled or homogeneous pattern to a band pattern either. Band-like patterns were subclassified into four types: MR-A, MR-B, MR-C and MR-D. Each of types according to the size and location of the band in relation to the weight bearing portion of the acetabulum was correlated to the prognosis of the femoral head. Three fourths of femoral heads with MR-C resulted in collapse on roentgenographs. These results show that MRI is useful for the diagnosis and evaluation of prognosis in IONF. (author).

  18. Pediatric femoral shaft fractures treated by flexible intramedullary nailing

    Institute of Scientific and Technical Information of China (English)

    K.C.Kapil Mani; R.C.Dirgha Raj; Acharya Parimal

    2015-01-01

    Background:Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization.Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail,or external fixators in the case of open fractures.The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age.Methods:There were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy.Long leg cast was applied at the time of fixation.Partial weight bearing was started 2 weeks after surgery.Patients were evaluated in follow-up study to observe the alignment of fracture,infection,delayed union,nonunion,limb length discrepancy,motion of knee joint,and time to unite the fracture.Results:We were able to follow up 28 out of 32 patients.The patients were 8.14 years of age on average.The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks.There were 3 cases of varus angulation,2 cases of anterior angulation,and 4 cases of limb lengthening.Conclusion:Patients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery,short rehabilitation period,less immobilization and psychological impact,and cost-effective.

  19. Genetic predisposition for femoral neck stress fractures in military conscripts

    OpenAIRE

    Barral Sandra; Sahi Timo; Ruohola Juha-Petri; Solovieva Svetlana; Pihlajamäki Harri; Hartikka Heini; Korvala Johanna; Ott Jürg; Ala-Kokko Leena; Männikkö Minna

    2010-01-01

    Abstract Background Stress fractures are a significant problem among athletes and soldiers and may result in devastating complications or even permanent handicap. Genetic factors may increase the risk, but no major susceptibility genes have been identified. The purpose of this study was to search for possible genetic factors predisposing military conscripts to femoral neck stress fractures. Results Eight genes involved in bone metabolism or pathology (COL1A1, COL1A2, OPG, ESR1, VDR, CTR, LRP5...

  20. Successful Return to Sport Following Distal Femoral Varus Osteotomy

    Science.gov (United States)

    Voleti, Pramod Babu; Degen, Ryan; Tetreault, Danielle; Krych, Aaron John; Williams, Riley J.

    2016-01-01

    Objectives: Distal femoral varus osteotomy is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and return to sport for athletic patients that underwent distal femoral varus osteotomy. Methods: A consecutive series of athletic patients that had undergone distal femoral varus osteotomy for symptomatic lateral compartment overload and valgus knee malalignment were prospectively reviewed. All patients had a minimum of 2-year follow-up. Radiographs were assessed to determine pre-operative and post-operative alignment. Details regarding sport of interest, ability to return to sport, and timing of return were obtained from the patients. Prospective institutional registries were utilized to collect pre-operative and post-operative Marx Activity Scale and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) scores; these values were compared using paired t-tests with p allografts, 2 partial lateral meniscectomies, 1 lateral meniscus allograft transplantation, and 1 revision anterior cruciate ligament reconstruction. All patients were able to successfully return to their sport of choice (4 soccer, 2 softball, 2 running, 1 football, 1 basketball, 1 ice hockey, 1 volleyball, 1 rowing) at a mean of 11 months (range: 9-13). Furthermore, all 13 patients demonstrated an improvement in both Marx Activity Scale and IKDC scores after surgery. The mean improvement in Marx Activity Scale was 7 (mean pre-op: 4, mean post-op: 11, p ligamentous pathology is addressed. Therefore, distal femoral varus osteotomy should be considered in the athletic population for correction of symptomatic valgus knee malalignment.

  1. A low morbidity surgical approach to the sheep femoral trochlea

    Directory of Open Access Journals (Sweden)

    Orth Patrick

    2013-01-01

    Full Text Available Abstract Background The ovine stifle joint is an important location for investigations on the repair of articular cartilage defects in preclinical large animals. The classical medial parapatellar approach to the femoral trochlea is hazardous because of the high risk of postoperative patellar luxation. Here, we describe a low morbidity surgical exposure of the ovine trochlea without the necessity for intraoperative patellar luxation. Methods Bilateral surgical exposure of the femoral trochlea of the sheep stifle joint was performed using the classical medial parapatellar approach with intraoperative lateral patellar luxation and transection of the medial patellar retinaculum in 28 ovine stifle joints. A low morbidity approach was performed bilaterally in 116 joints through a mini-arthrotomy without the need to transect the medial patellar retinaculum or the oblique medial vastus muscle nor surgical patellar luxation. Postoperatively, all 72 animals were monitored to exclude patellar luxations and deep wound infections. Results The novel approach could be performed easily in all joints and safely exposed the distal two-thirds of the medial and lateral trochlear facet. No postoperative patellar luxations were observed compared to a postoperative patellar luxation rate of 25% experienced with the classical medial parapatellar approach and a re-luxation rate of 80% following revision surgery. No signs of lameness, wound infections, or empyema were observed for both approaches. Conclusions The mini-arthrotomy presented here yields good exposure of the distal ovine femoral trochlea with a lower postoperative morbidity than the classical medial parapatellar approach. It is therefore suitable to create articular cartilage defects on the femoral trochlea without the risk of postoperative patellar luxation.

  2. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases.

    Science.gov (United States)

    Bush, Lisabeth A; Chew, Felix S

    2008-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was focally increased T2 signal on MRI and a small, triangular ridge or cortical beak on radiographs. The lesion was initially thought to represent a metastasis, but after the patient returned with a transverse femoral shaft fracture through the ridge following minimal trauma, MRI and biopsy of the lesion failed to show any evidence of tumor. We suggest that this fracture is similar to the low-energy proximal femoral shaft fractures recently reported in postmenopausal women who have received oral bisphosphonates for osteoporosis. Suppression of bone turnover may play a role in the development of these fractures.

  3. Osteonecrosis of the femoral head after bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Mi; Jun, Jeong Su; Park, Chang Suk; Kim, Yong Sik; Kwon, Soon Yong; Kim, Yoo Jin; Kim, Chun Choo [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2003-07-01

    To retrospectively review findings of osteonecrosis of the femoral head after bone marrow transplantation. We reviewed the clinical and MR findings of osteonecrosis of the femoral head in 23 of 1112 patients who underwent marrow transplantation during a five-year follow-up period lasting from 1996 to 2000. Mean age at the time of diagnosis was 31 (range, 20-47) years, and the mean time from transplant to diagnosis was 17 months. All patients developed variable graft-versus-host disease and seventeen were treated with high-dose prednisolone and/or cysclosporin for severe acute or extensive chronic graft versus host disease. Osteonecrosis was diagnosed by magnetic resonance (MR) imaging, which allowed early detection of disease assessment of its stage. At the time of diagnosis, 15 hips were at stage I, 28 at stage II, two at stage III, and none at stage IV, according to the international ARCO classification system. Osteonecrosis of femoral diaphyses, the lower lumbar spine, or pelvic bones in the MR field was also found to have occurred in 11 patients. Initial treatment was conservative: 21 hips underwent surgery [core decompression (n=10), vascularized fibular bone graft (n=5), and joint replacement (n=6)]. In patients receiving high-dose steroids for the treatment of graft-versus-host disease, MR screening might help detect osteonecrosis at an early stage.

  4. Unstable femoral neck fractures in children - A new treatment option

    Directory of Open Access Journals (Sweden)

    Pruthi K

    2006-01-01

    Full Text Available Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.

  5. Custom Knee Device for Knee Contractures After Internal Femoral Lengthening.

    Science.gov (United States)

    Bhave, Anil; Shabtai, Lior; Ong, Peck-Hoon; Standard, Shawn C; Paley, Dror; Herzenberg, John E

    2015-07-01

    The development of knee flexion contractures is among the most common problems and complications associated with lengthening the femur with an internal device or external fixator. Conservative treatment strategies include physical therapy, serial casting, and low-load prolonged stretching with commercially available splinting systems. The authors developed an individually molded, low-cost custom knee device with polyester synthetic conformable casting material to treat knee flexion contractures. The goal of this study was to evaluate the results of treatment with a custom knee device and specialized physical therapy in patients who had knee flexion contracture during femoral lengthening with an intramedullary lengthening femoral nail. This retrospective study included 23 patients (27 limbs) who underwent femoral lengthening with an internal device for the treatment of limb length discrepancy. All patients had a knee flexion contracture raging from 10° to 90° during the lengthening process and were treated with a custom knee device and specialized physical therapy. The average flexion contracture before treatment was 36°. The mean amount of lengthening was 5.4 cm. After an average of 3.8 weeks of use of the custom knee device, only 2 of 27 limbs (7.5%) had not achieved complete resolution of the flexion contracture. The average final extension was 1.4°. Only 7 of 27 limbs (26%) required additional soft tissue release. The custom knee device is an inexpensive and effective method for treating knee flexion contracture after lengthening with an internal device.

  6. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry.

    Science.gov (United States)

    Casciaro, Sergio; Peccarisi, Marco; Pisani, Paola; Franchini, Roberto; Greco, Antonio; De Marco, Tommaso; Grimaldi, Antonella; Quarta, Laura; Quarta, Eugenio; Muratore, Maruizio; Conversano, Francesco

    2016-06-01

    The aim of this paper was to investigate the clinical feasibility and the accuracy in femoral neck densitometry of the Osteoporosis Score (O.S.), an ultrasound (US) parameter for osteoporosis diagnosis that has been recently introduced for lumbar spine applications. A total of 377 female patients (aged 61-70 y) underwent both a femoral dual X-ray absorptiometry (DXA) and an echographic scan of the proximal femur. Recruited patients were sub-divided into a reference database used for ultrasound spectral model construction and a study population for repeatability assessments and accuracy evaluations. Echographic images and radiofrequency signals were analyzed through a fully automatic algorithm that performed a series of combined spectral and statistical analyses, providing as a final output the O.S. value of the femoral neck. Assuming DXA as a gold standard reference, the accuracy of O.S.-based diagnoses resulted 94.7%, with k = 0.898 (p < 0.0001). Significant correlations were also found between O.S.-estimated bone mineral density and corresponding DXA values, with r(2) up to 0.79 and root mean square error = 5.9-7.4%. The reported accuracy levels, combined with the proven ease of use and very good measurement repeatability, provide the adopted method with a potential for clinical routine application in osteoporosis diagnosis.

  7. Radiographic features of teriparatide-induced healing of femoral fractures

    Directory of Open Access Journals (Sweden)

    Youngwoo Kim

    2015-12-01

    Full Text Available Teriparatide is a drug that is used to increase bone remodeling, formation, and density for the treatment of osteoporosis. We present three cases of patients with a femoral insufficiency fracture. The patients were administered teripatatide in an attempt to treat severe osteoporosis and to enhance fracture healing. We found several radiographic features around the femoral fractures during the healing period. 1 Callus formation was found at a very early stage in the treatment. Teriparatide substantially increased the unusually abundant callus formation around the fracture site at 2 weeks. Moreover, this callus formation continued for 8 weeks and led to healing of the fracture. 2 Abundant callus formation was found circumferentially around the cortex with a ‘cloud-like’ appearance. 3 Remodeling of the teriparatide-induced callus formation was found to be part of the normal fracture healing process. After 1 year, normal remodeling was observed on plain radiographs. These findings indicate that teriparatide can be used as an adjuvant therapy in the management of femoral insufficiency fractures.

  8. Magnetic Resonance Imaging of the Femoral Neck Cortex

    Energy Technology Data Exchange (ETDEWEB)

    Sievaenen, H.; Karstila, T.; Apuli, P.; Kannus, P. [Bone Research Group, UKK Inst., Tampere (Finland)

    2007-04-15

    Purpose: To determine the in vivo precision and accuracy of magnetic resonance imaging (MRI) in evaluating the thin (emm) femoral neck cortex. Material and Methods: Hip regions of 30 volunteers were scanned with standard 1.5T MRI twice with repositioning, and the images of the narrow-neck cross-sections were obtained. Two radiologists independently delineated periosteal and endosteal cortical boundaries, and several structural variables were determined. For precision, 95% limits of agreement and coefficients of variation were calculated. Accuracy was determined with phantoms. Results: In vivo precision of the directly delineated measurements varied from 0.9% (periosteal circumference) to 1.6% (total area), while the precision of the calculated variables remained poorer, from 7.3% (cortical to total area ratio) to 15.1% (torsional rigidity). The root-mean-square error of the cortical thickness measurement was 0.15 mm. Conclusion: Thin cortical bone at the narrowest location of the femoral neck can be delineated precisely and accurately with a standard clinical 1.5T MRI device. MRI provides a feasible tool for the assessment of mechanically important cortical bone at the femoral neck and may be of clinical utility in assessing hip fragility. Keywords Bone densitometry, bone fragility, bone strength, osteoporosis, precision.

  9. A Case of Bilateral Aseptic Necrosis of the Femoral Head

    Science.gov (United States)

    KAMAL, DIANA; TRĂISTARU, RODICA; KAMAL, C.K.; ALEXANDRU, D.O.; MOGOANTĂ, L.; GRECU, D.C.

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment. PMID:26788359

  10. A Case of Bilateral Aseptic Necrosis of the Femoral Head.

    Science.gov (United States)

    Kamal, Diana; Trăistaru, Rodica; Kamal, C K; Alexandru, D O; Mogoantă, L; Grecu, D C

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment.

  11. Developing a sensation information message for femoral arteriography.

    Science.gov (United States)

    Clark, C R; Gregor, F M

    1988-03-01

    Sensation information is proposed as a way of decreasing the patient's distress during a threatening health care event. A first step in developing a sensation information message is to determine the content of the message. This study, using a systematic theory-based methodology, was conducted to describe and validate the common physical sensations experienced by patients undergoing the diagnostic procedure of femoral arteriography. (A conceptual framework based on how an individual perceives or senses a situation was used.) A three-stage survey design was used including: (1) tool development following observation of the procedure and pilot-testing of the interview schedule, (2) interview of patients who had undergone femoral arteriography about the sensations experienced during the procedure, and (3) validation of the responses. Twenty-one steps in the femoral arteriography procedure of which patients were aware were identified. Nine 'feeling' sensations commonly experienced during the procedure and the sights and sounds associated with the procedure were determined. The sequencing and duration of procedure steps were observed and the environment in which the procedure was performed was described.

  12. Strangulated Femoral Hernia Turned to Be Peritoneal Cyst

    Directory of Open Access Journals (Sweden)

    Dionysios Dellaportas

    2012-01-01

    Full Text Available Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia’s contents.

  13. Redox Status in Patients with Femoral Neck Fractures

    Directory of Open Access Journals (Sweden)

    Pesic Goran

    2016-09-01

    Full Text Available The femur transfers the body weight from the pelvic bone to the shinbone. Femur fractures are a significant cause of morbidity and mortality among the group of locomotor apparatus injuries, especially in the elderly population. Considering that oxidative stress occurs as a result of increased production of free radicals that damage cell function and cause numerous pathological conditions and diseases, the aim of this study was to investigate oxidative stress parameters in older patients with femoral neck fractures. This clinical study included 70 patients, of which 35 had femoral neck fractures (26 males and 9 females, while the other half of the patients formed the matched control group. Markers of oxidative stress (NO2−, TBARS, H2O2 and O2- and anti-oxidative enzymes (SOD, CAT, and GSH were measured. Results showed that the levels of O2- increased, while levels of NO2-, H2O2 and all the antioxidative enzymes decreased in patients with femoral neck fractures. These findings indicate that fractures cause oxidative stress, probably because of the reduced activity of osteoblasts and the increased activity of osteoclasts.

  14. Hip replacement in femoral head osteonecrosis: current concepts.

    Science.gov (United States)

    Scaglione, Michelangelo; Fabbri, Luca; Celli, Fabio; Casella, Francesco; Guido, Giulio

    2015-01-01

    Osteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient's factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome. There is not a gold standard treatment and frequently it is necessary a multidisciplinary approach. Preservation procedures of the femoral head are the first choice and can be attempted in younger patients without head collapse. Replacement procedure remains the main treatment after failure of preserving procedures and in the late-stage ONFH, involving collapse of the femoral head and degenerative changes to the acetabulum. Resurfacing procedure still has good results but the patient selection is a critical factor. Total hip arthroplasties had historically poor results in patients with osteonecrosis. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems.

  15. [Femoral venous catheterization. Does it really need to be avoided?].

    Science.gov (United States)

    Lorente, L; León, C

    2009-12-01

    The guidelines to prevent central venous catheter related bloodstream infections (CVCBSI) of the Centers for Disease Control and Prevention (CDC) of 2002, Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEMICYUC/SEIMC) of 2004, and the recently published guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA(IDSA) of 2008 have recommended using the subclavian vein and avoiding the use of the femoral vein. They also recommend considering the use of antiseptic- or antimicrobial-impregnated CVCs for hospital units or groups of patients with a high incidence of CVCBSI. When implementing these guidelines, two questions could be asked: 1) Could the abuse of the subclavian vein and avoiding the use of the femoral vein imply a decrease in the incidence of CVCBSI, but an increase in the rate of mechanical complications as pneumothorax and/or hemothorax? 2) Couldn't antimicrobial-impregnated CVCs be used to prevent CVCBSI when the femoral venous access is used?

  16. Is Social Capital an Effective Smoke Condenser?

    DEFF Research Database (Denmark)

    Paldam, M.; Svendsen, Gert Tinggaard

    1999-01-01

    be added to human and physical capital, or it might enter as a reduction in either transaction or monitoring costs. A direct and an indirect way to measure social capital are discussed. The crucial question is if social capital can be changed. That is, if self enforcement can replace third party......Social capital is defined as mutual trust. It is related to production by a key hypothesis: social capital determines how easily people work together. An easy-to-use proxy (Putnam's Instrument) is the density of voluntary organizations. Social capital might be a new production factor which must...... enforcement, and it is discussed how much harm totalitarian regimes do to social capital, when they expand their area of central control....

  17. MAPPING EUROPEAN CAPITAL MARKETS TENDENCIES

    Directory of Open Access Journals (Sweden)

    Andreea Avadanei

    2011-01-01

    Full Text Available The scope of this paper is to analyze the main tendencies influencing European capitalmarkets development. In order to point out their implications, we structured our study onfour chapters. The first one illustrates the consolidation of stock exchanges at the Europeanlevel; the seconds presents some considerations about the deregulation/re-regulation of EUcapital markets; the third section highlights the globalization implications on their evolutionand the fourth one indicates the effects of financial innovation. The progressive integrationof European capital markets over the past decade contributed to the lowering of capital costas a result of increased risk diversification opportunities and reduced transaction costs dueto the specialization of financial system provisions. Moreover, the expansion of thesemarkets improved firms financing decisions, leading to an increased share of non-bankfunding sources.

  18. Academic Words and Academic Capitalism

    Directory of Open Access Journals (Sweden)

    Michael Billig

    2013-03-01

    Full Text Available This paper suggests that it is the best and worst of times for academic work. It is the best of times because there are more academics publishing than ever before. It is the worst of times because there is much unnecessary publication. Working in the competitive conditions of academic capitalism, academics feel impelled to keep publishing, whether or not they have anything to say. The pressures to publish continually and to promote one’s own approach are reflected in the way that social scientists are writing. Academics use a noun-based technical language, which is less precise than ordinary language. Postgraduates are taught this way of writing as a precondition for entering the social sciences. In this way, the nature of academic capitalism not only determines the conditions under which academics are working but it affects the way that they are writing.

  19. Human Capital and Organizational Effectiveness

    Directory of Open Access Journals (Sweden)

    Ioana Julieta Josan

    2013-05-01

    Full Text Available The new organizational changes caused by social, economic and politic reforms led to a shift in the strategic management of the companies. The growing need for professionals, who know how to generate profits, is growing and increase confidence of partners and clients, find new ideas and adapt to a dynamic market. Therefore, internally, we need an efficient management of human resources to find and retain the most suitable and efficient people which will increase productivity and face the increased acting globally competition. Currently, companies that succeed are the ones that integrate in their business strategy, an important component of development and valuation human capital. The paper aims to analyze and highlight the importance of human capital in the new organizational strategies, focused on achieving a high level of competitiveness, innovation and excellence.

  20. Capital Markets Union for Europe

    DEFF Research Database (Denmark)

    Ringe, Georg

    2015-01-01

    The merits of the “Capital Markets Union” project lie with its political importance, rather than its legal coherence or significance. Despite a number of substantial flaws, the initiation of this project comes at the right time. The Commission first and foremost sends a political message to the U...... and other non-Euro Member States, as well as a commitment to the Single Market.......The merits of the “Capital Markets Union” project lie with its political importance, rather than its legal coherence or significance. Despite a number of substantial flaws, the initiation of this project comes at the right time. The Commission first and foremost sends a political message to the UK...

  1. From Finance Capitalism to Financialization

    DEFF Research Database (Denmark)

    Hansen, Per H.

    2014-01-01

    In this article I interpret 150 years of financial history with a focus on shifts in the role of finance in society. I argue that over time the role of finance has shifted twice from that of servant to that of master of society, and that this process has been driven by sense making through narrat...... narratives that legitimized and shaped these changes. When finance became a master rent seeking, cultural capture and out-of control financial innovation resulted in financial and social instability. Finance as a master was the characteristic of finance capitalism from around 1900......–1931 and of financialization from around 1980 to today. Finance capitalism and financialization were enabled by a dominant narrative that legitimized the power of finance. The shifts in the role of finance happened when crises undermined the meaning of the existing narrative and created for a new narrative able to make sense...

  2. Do Central Banks Need Capital?

    OpenAIRE

    Peter Stella

    1997-01-01

    Central banks may operate perfectly well without capital as conventionally defined. A large negative net worth, however, is likely to compromise central bank independence and interfere with its ability to attain policy objectives. If society values an independent central bank capable of effectively implementing monetary policy, recapitalization may become essential. Proper accounting practice in determining central bank profit or loss and rules governing the transfer of the central bank’s ope...

  3. Capitalizing R&D Expenditures

    OpenAIRE

    Diewert, Erwin; Huang, Ning

    2008-01-01

    The next international version of the System of National Accounts will recommend that R&D (Research and Development) expenditures be capitalized instead of being immediately expensed as in the present System of National Accounts 1993. An R&D project creates a new technology, which in principle does not depreciate like a reproducible asset. A new technology is however subject to obsolescence, which acts in a manner that is somewhat similar to depreciation. The paper looks at the net benefits o...

  4. Human Capital, Fertility and Growth

    OpenAIRE

    Galor, Oded

    2006-01-01

    The demographic transition that swept the world in the past 140 years has been identified as one of the prime forces in the transition from stagnation to growth. The unprecedented increase in population growth during the early stages of industrialization was ultimately reversed. The rise in the demand for human capital in the second phase of industrialization brought about a significant reduction in fertility rates and population growth in various regions of the world, enabling economies to c...

  5. Capital social en empresas familiares

    Directory of Open Access Journals (Sweden)

    Magda Jiménez

    2011-01-01

    Full Text Available Este artículo está dirigido a caracterizar la dinámica de la gestión del capital social en empresas familiares ubicadas en Santa Ana de Coro, municipio Miranda del estado Falcón. Para ello se llevó a cabo un estudio de campo de tipo descriptivo, mediante el uso de la técnica de la encuesta, siendo la modalidad utilizada el cuestionario, con el interés de obtener datos e información directamente de las 08 empresas familiares que funcionan en este municipio. De esta manera se conoció que en las empresas familiares del municipio Miranda, el capital social representa significativamente una de las características conducentes a la sociabilidad y confianza entre los miembros de las familias conductoras de las organizaciones y los empleados no miembros de familia; y es precisamente esta dinámica la razón por la cual el capital social se convierte en un trascendental recurso para las empresas, permitiendo el acceso a otros recursos e impulsando la participación de todos los que hacen vida en la organización, y por ende el crecimiento y desarrollo económico se hace evidente, estimulando en los empleados el sentido de pertenencia, confianza, compromiso y reciprocidad, generando beneficios para la red de demandantes y consumidores.

  6. The Opportunity Cost of Capital

    Directory of Open Access Journals (Sweden)

    Ayman Chit PhD

    2015-04-01

    Full Text Available The opportunity cost of the capital invested in pharmaceutical research and development (R&D to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D.

  7. Multiple Small Diameter Drillings Increase Femoral Neck Stability Compared with Single Large Diameter Femoral Head Core Decompression Technique for Avascular Necrosis of the Femoral Head.

    Science.gov (United States)

    Brown, Philip J; Mannava, Sandeep; Seyler, Thorsten M; Plate, Johannes F; Van Sikes, Charles; Stitzel, Joel D; Lang, Jason E

    2016-10-26

    Femoral head core decompression is an efficacious joint-preserving procedure for treatment of early stage avascular necrosis. However, postoperative fractures have been described which may be related to the decompression technique used. Femoral head decompressions were performed on 12 matched human cadaveric femora comparing large 8mm single bore versus multiple 3mm small drilling techniques. Ultimate failure strength of the femora was tested using a servo-hydraulic material testing system. Ultimate load to failure was compared between the different decompression techniques using two paired ANCOVA linear regression models. Prior to biomechanical testing and after the intervention, volumetric bone mineral density was determined using quantitative computed tomography to account for variation between cadaveric samples and to assess the amount of bone disruption by the core decompression. Core decompression, using the small diameter bore and multiple drilling technique, withstood significantly greater load prior to failure compared with the single large bore technique after adjustment for bone mineral density (pcore decompression techniques. When considering core decompression for the treatment of early stage avascular necrosis, the multiple small bore technique removed less bone volume, thereby potentially leading to higher load to failure.

  8. Medial opening wedge distal femoral osteotomy for post-traumatic secondary knee osteoarthritis.

    Science.gov (United States)

    Matsui, Gen; Akiyama, Takenori; Ikemura, Satoshi; Mawatari, Taro

    2014-04-30

    Osteoarthritis of the knee secondary to femoral fracture is difficult to treat. There are some surgical options, such as total knee arthroplasty or correction osteotomy. Opening wedge high tibial osteotomy is an established treatment of gonarthrosis. However, few reports are available on the effectiveness of a medial opening wedge distal femoral osteotomy. We present a case of a medial opening wedge distal femoral osteotomy on gonarthrosis secondary to a malunited femoral fracture with varus deformity and leg length discrepancy. This osteotomy was performed at the deformed femur, with locking plate fixation and autologous bone graft. Six months after the surgery, the osteotomy site was filled with bridging callus. Two years later, the Knee Society Score improved from 45 to 90 points. Medial opening wedge distal femoral osteotomy can be a useful method to treat knee osteoarthritis associated with distal femoral deformity.

  9. Diagnostic methods in ischemic necrosis of the femoral head. Metodos de diagnostico en la necrosis isquemica de la cabeza femoral

    Energy Technology Data Exchange (ETDEWEB)

    Parra Blanco, J.A.; Pagola Serrano, M.A.; Delgado Macias, M.T. (Hospital Universitario Marques de Valdecilla, Santander (Spain))

    1994-01-01

    Ischemic necrosis of the femoral head (INFH) must be diagnosed at an early stage of development, when therapeutic approaches such as forage biopsy or osteotomy can prevent or slow the normal progression of the disease to arthrosis. In this article, on the basis of the pathological changes that characterize process, we review the advantages and limitations of the principal diagnostic techniques (table I) currently employed in the study of INFH. (Author)

  10. MR evaluation of the articular cartilage of the femoral head during traction. Correlation with resected femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, K. [Osaka Seamens Insurance Hospital (Japan). Dept. of Radiology; Tanaka, H.; Narumi, Y.; Nakamura, H. [Osaka Univ. Medical School (Japan). Dept. of Radiology; Nishii, T.; Masuhara, K. [Osaka Univ. Medical School (Japan). Dept. of Orthopedic Surgery

    1999-01-01

    Objective: The purpose was to evaluate the articular cartilage of the hip joint with MR during traction and compare the findings with the resected specimen or arthroscopic findings. Material and Methods: Eight healthy volunteers, 5 patients with osteonecrosis, 5 with acetabular dysplasia, and 5 with advanced osteoarthrosis underwent MR imaging to evaluate the articular cartilage of the hip joint. Coronal fat-suppressed 3D spoiled gradient-echo (SPGR) images were obtained during traction. Identical imaging was performed of all the resected femoral heads of the osteonecrosis and advanced osteoarthrosis patients, and was correlated with the macroscopic pathological findings. Results: The traction was effective and the femoral articular cartilage was clearly identified in all 8 control subjects, and in all cases of osteonecrosis and acetabular dysplasia. In 4 cases of osteonecrosis, chondral fracture was identified in the boundary between the necrosis and the normal area. In all cases of advanced osteoarthrosis, cartilage was identified only at the medial side. The MR images of osteonecrosis and advanced osteoarthrosis corresponded well with the MR images of the resected femoral heads and the macroscopic findings. (orig.)

  11. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail.

    Science.gov (United States)

    Gomes, Pedro Luciano Teixeira; Castelo, Luís Sá; Lopes, António Lemos; Maio, Marta; Miranda, Adélia; Dias, António Marques

    2016-01-01

    Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  12. Atypical femoral fractures bilaterally in a patient receiving bisphosphonate: a case report

    Science.gov (United States)

    Moghnie, Alessandro; Scamacca, Veronica; De Fabrizio, Giovanni; Valentini, Roberto

    2016-01-01

    Summary Atypical femoral fractures are often associated with prolonged bisphosphonate use. The American Society for Bone and Mineral Research (ASBMR) has set the diagnosis criteria for atypical subtrochanteric and diaphyseal femoral fractures by classifying them according to their major and minor criteria. Prolonged bisphosphonate use is correlated with AFF, but the pathogenetic mechanism that causes this kind of fracture has not been defined yet. We describe simultaneous bilaterally femoral fractures in a 76-year-old woman. PMID:27252749

  13. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail

    Directory of Open Access Journals (Sweden)

    Pedro Luciano Teixeira Gomes

    2016-08-01

    Full Text Available ABSTRACT Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  14. Current Concepts of Using Large Femoral Heads in Total Hip Arthroplasty

    OpenAIRE

    Cho, Myung-Rae; Choi, Won Kee; Kim, Jae Jung

    2016-01-01

    Instability and dislocation after total hip arthroplasty are the most common causes of revisions and major complications for failure of inserted prostheses, leading to a reduction in quality of life. Because the use of artificial femoral head sizes smaller than patient's own size is the important cause for dislocation, the use of large femoral head have increased. Femoral head sizes greater than 32 mm offer multiple advantages in physical function and activity levels of patients by improving ...

  15. Social capital, economics, and health: new evidence.

    Science.gov (United States)

    Scheffler, Richard M; Brown, Timothy T

    2008-10-01

    In introducing this Special Issue on Social Capital and Health, this article tracks the popularization of the term and sheds light on the controversy surrounding the term and its definitions. It sets out four mechanisms that link social capital with health: making information available to community members, impacting social norms, enhancing the health care services and their accessibility in a community, and offering psychosocial support networks. Approaches to the measurement of social capital include the Social Capital Community Benchmark Survey (SCCBS) developed by Robert Putnam, and the Petris Social Capital Index (PSCI), which looks at community voluntary organizations using public data available for the entire United States. The article defines community social capital (CSC) as the extent and density of trust, cooperation, and associational links and activity within a given population. Four articles on CSC are introduced in two categories: those that address behaviors -- particularly utilization of health services and use of tobacco, alcohol, and drugs; and those that look at links between social capital and physical or mental health. Policy implications include: funding and/or tax subsidies that would support the creation of social capital; laws and regulations; and generation of enthusiasm among communities and leaders to develop social capital. The next steps in the research programme are to continue testing the mechanisms; to look for natural experiments; and to find better public policies to foster social capital.

  16. Social Capital Impact On Service Supply Chains

    Directory of Open Access Journals (Sweden)

    Sherry L. Avery

    2011-05-01

    Full Text Available Purpose – This study explores the impact of social capital on service firm supply chains.Design/methodology/approach – The theoretical underpinnings of social capital is reviewed from various disciplines, including sociology, management, and operations management.  This is used to develop a conceptual model of the use of social capital in a service supply chain setting.Findings - Social capital is proposed to improve the operational performance of service firms as a source of both physical and information resources.    The impact of social capital is projected to vary by firm size and service type.  Small firms have limited resources and thus a need for resources obtained through social capital.  Service firms that have high customization and customer contact are subject to process variations which can be mitigated by social capital.  A conceptual model is presented to test several propositions related to social capital.Originality/value – The impact of social capital has not been widely studied in an operational setting.  This is the first known study to specifically analyze the impact of social capital in service supply chains.

  17. Where's the capital? A geographical essay.

    Science.gov (United States)

    Jones, Gareth A

    2014-12-01

    This paper is inspired by Thomas Piketty's book Capital in the Twenty-First Century. Piketty does a wonderful job of tracing income and wealth over time, and relating changes to trends of economic and population growth, and drawing out the implications for inequality, inheritance and even democracy. But, he says relatively little about where capital is located, how capital accumulation in one place relies on activities elsewhere, how capital is urbanized with advanced capitalism and what life is like in spaces without capital. This paper asks 'where is the geography in Capital' or 'where is the geography of capital in Capital'? Following Piketty's lead, the paper develops its analysis through a number of important novels. It examines, first, the debate that Jane Austen ignored colonialism and slavery in her treatment of nineteenth century Britain, second, how Balzac and then Zola provide insight to the urban political economy of capital later in the century, and third, how Katherine Boo attends to inequality as the everyday suffering of the poor.

  18. Intramedullary fixation of a femoral shaft fracture with preservation of an existing hip resurfacing prosthesis.

    Science.gov (United States)

    Bilkhu, A; Sisodia, G; Chakrabarty, G; Muralikuttan, K P

    2015-04-01

    Femoral neck fractures have been reported as a cause for failure in patients with a hip resurfacing arthroplasty. However, the incidence and management of fractures of the femoral shaft with an ipsilateral hip resurfacing arthroplasty is relatively absent in current literature. Although, the gold standard for the fixation of a closed femoral shaft fracture is with the use of an intramedullary nail, this can be a challenge in the presence of a hip resurfacing arthroplasty. We describe the case of anterograde intramedullary nail fixation for a femoral shaft fracture in a patient with an ipsilateral hip resurfacing arthroplasty in situ.

  19. Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Denise M.D. Özdemir-van Brunschot

    2016-09-01

    Full Text Available Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion.

  20. A histomorphometric study of necrotic femoral head in rabbits treated with extracorporeal shock waves

    Science.gov (United States)

    Ma, Huan-Zhi; Zhou, Dong-Sheng; Li, Dong; Zhang, Wei; Zeng, Bing-Fang

    2017-01-01

    [Purpose] This study aimed to determine the effectiveness and mechanisms of extracorporeal shock wave therapy in the treatment of femoral head osteonecrosis. [Subjects and Methods] Histomorphometric analysis of necrotic femoral head in rabbits treated with shock waves was performed. Bilateral osteonecrosis of femoral heads was induced with methylprednisolone and lipopolysaccharide in eight rabbits. The left limb (study side) received shock waves to the femoral head. The right limb (control side) received no shock waves. Biopsies of the femoral heads were performed at 12 weeks after shock wave therapy. [Results] Necrotic femoral heads treated with shock waves, compared with controls, had higher bone volume per tissue volume, trabecular thickness, trabecular number, osteoblast surface/bone surface, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineralizing apposition rate, and bone formation rate. However, trabecular separation was lower in shock wave-treated femoral heads than in controls. Eroded surface/bone surface and osteoclast surface/bone surface did not differ significantly between groups. [Conclusion] The bone mass of necrotic femoral heads treated with shock waves increases. Extracorporeal shock wave may promote bone repair in necrotic femoral heads through the proliferation and activation of osteoblasts. PMID:28210032

  1. Iatrogenic Femoral Pseudoaneurysm and Secondary Ipsilateral Deep Vein Thrombosis: An Indication for Early Surgical Exploration.

    Science.gov (United States)

    Papadakis, Marios; Zirngibl, Hubert; Floros, Nikolaos

    2016-07-01

    Pseudoaneurysm formation often complicates transfemoral interventional procedures. Nonsurgical treatment consists of femoral compression and thrombin injection under ultrasound guidance. We report a 74-year-old man who was diagnosed with a pseudoaneurysm, following coronary angiography. Duplex ultrasound revealed deep vein thrombosis of the ipsilateral common femoral vein. Ultrasound-guided thrombin injection was unsuccessfully performed, and the patient subsequently underwent surgical exploration for repair of the pseudoaneurysm and release of the venous compression. The increased local inflammation, because of the thrombosis, added in surgical difficulties. We conclude that early surgical intervention should be considered as a primary strategy in patients with femoral pseudoaneurysms and deep vein thrombosis secondary to femoral compression.

  2. Subtrochanteric femur fracture after removal of screws for femoral neck fracture in a child.

    Science.gov (United States)

    Song, Kwang Soon; Lee, Si Wook

    2015-01-01

    Displaced femoral neck fractures are rare in children and are associated with a high rate of complications. Subtrochanteric fractures after cannulated screw fixation of femoral neck fractures in adults are well recognized, and there are several reports on the topic. However, there are no reports on complications related to hardware or subtrochanteric fractures after removal of the screws in the treatment of femoral neck fractures in children. Here we report the case of a 10-year-old boy who sustained a subtrochanteric fracture after the screw removal and healing that followed a femoral neck fracture.

  3. Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction. A new surgical technique.

    Science.gov (United States)

    Koulouvaris, Panagiotis; Stafylas, Kosmas; Sculco, Thomas; Xenakis, Theodore

    2008-10-01

    Successful total hip arthroplasty (THA) in congenital dislocated hips demands anatomical reduction in the normal center of rotation without overstretching the sciatic nerve and without excessive compression or abnormal forces across the joint. Proximal femoral and subtrochanteric shortening osteotomy has been described for THA for the treatment of dislocated hips. However, these osteotomies are demanding, associated with deformation of femoral canal and nonunion, and may increase the femoral stem stress. This study reports excellent results in 24 patients with a new surgical technique that combines THA with a distal femoral shortening in severely deformed hips using customized components.

  4. Glucocorticoids Significantly Influence the Transcriptome of Bone Microvascular Endothelial Cells of Human Femoral Head

    Institute of Scientific and Technical Information of China (English)

    Qing-Sheng Yu; Wan-Shou Guo; Li-Ming Cheng; Yu-Feng Lu; Jian-Ying Shen; Ping Li

    2015-01-01

    Background:Appropriate expression and regulation of the transcriptome,which mainly comprise ofmRNAs and lncRNAs,are important for all biological and cellular processes including the physiological activities of bone microvascular endothelial cells (BMECs).Through an intricate intracellular signaling systems,the transcriptome regulates the pharmacological response of the cells.Although studies have elucidated the impact of glucocorticoids (GCs) cell-specific gene expression signatures,it remains necessary to comprehensively characterize the impact of lncRNAs to transcriptional changes.Methods:BMECs were divided into two groups.One was treated with GCs and the other left untreated as a paired control.Differential expression was analyzed with GeneSpring software V12.0 (Agilent,Santa Clara,CA,USA) and hierarchical clustering was conducted using Cluster 3.0 software.The Gene Ontology (GO) analysis was performed with Molecular Annotation System provided by CapitalBio Corporation.Results:Our results highlight the involvement of genes implicated in development,differentiation and apoptosis following GC stimulation.Elucidation of differential gene expression emphasizes the importance of regulatory gene networks induced by GCs.We identified 73 up-regulated and 166 down-regulated long noncoding RNAs,the expression of 107 of which significantly correlated with 172 mRNAs induced by hydrocortisone.Conclusions:Transcriptome analysis of BMECs from human samples was performed to identify specific gene networks induced by GCs.Our results identified complex RNA crosstalk underlying the pathogenesis of steroid-induced necrosis of femoral head.

  5. 股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的诊治%Analysis of misdiagnoses for femoral shaft fracture with ipsilateral femoral neck or femoral fractures

    Institute of Scientific and Technical Information of China (English)

    李守民; 朱晨; 孔荣; 夏睿; 方诗元; 张光平

    2010-01-01

    Objective To analyze the misdiagnoses of femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures.Methods Over the past six years,eight misdiagnosed cases of ipsilateral femoral neck or femoral fractures missed patients,aged 25 to 59 years old(mean:41.7),were treated at our department.An initial diagnosis of femoral shaft fracture was later revised as ipsilateral femoral shaft with supra-condylar fracture of femoral neck or femur.Femoral shaft fracture was fixed with armor plate,3-screw hollow compression fixation of femoral neck;two cases of femoral condylar fractures of distal femoral condyle with anatomical plate fixation and 1 case of intraoperative change into the retrograde femoral intramedullary nail fixation.Results The mean post-operative follow-up was 3.5 years.All fractures healed with excellent hip and knee functions.Conclusion For those with a strong reverse and torsional violence,femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures may be easily misdiagnosed.A preoperative conventional hip-knee X-ray film is an effective way to avoid a misdiagnosis.%目的 对股骨干骨折合并同侧股骨颈或股骨髁上骨折漏诊的治疗进行分析.方法 2002年12月至2008年12月安徽医科大学附属省立医院骨科收治8例股骨干合并同侧股骨颈或股骨髁上骨折漏诊患者,年龄25~59岁,平均41.7岁,初步诊断为股骨干骨折,后修正为股骨干合并同侧股骨颈或股骨髁上骨折.股骨干骨折行钢板内固定.股骨颈骨折行3枚空心加压螺丝钉内固定;股骨髁上骨折2例行股骨远端外髁解剖钢板的内固定,1例术中更改行逆行股骨交锁髓内钉内固定.结果 术后平均随访3.5年,骨折均愈合,髋膝关节功能良好.结论 凡强大暴力及有扭转暴力者股骨干合并同侧股骨颈或股骨髁上骨折易漏诊,术前常规髋膝摄片是避免漏诊的有效方法.

  6. Mengukur Kontribusi Human Capital terhadap Tujuan Perusahaan

    Directory of Open Access Journals (Sweden)

    Brata Wibawa Djojo

    2010-11-01

    Full Text Available Human capital is a valuable asset of any company, especially for competent human resources and contributes both to the company. The performance evaluation given to employees annually can be defined and standardized by the company. However, the question is how big the contribution of human resources to sales and profit contribution is. Case studies take data from one branch of a general insurance company in Indonesia, Jakarta branch. Measurement is done by taking samples of data from 2007, 2008, and 2009. The study measures the risk of several components: (i Human Capital Revenue Factor, (ii Human Economic Value Added, (iii Human Capital Cost Factor, (iv Human Capital Value Added, and (v Human Capital Return on Investment. Results of research can provide guidelines for the management, especially for management of JLI in view of Human Capital contribution to corporate objectives, namely in terms of staffing and agency. 

  7. Cultural Capital and Teaching Ability Rating

    DEFF Research Database (Denmark)

    Jæger, Mads Meier

    , health impairments, social behaviour, antenatal influences, and many family background characteristics. My analysis shows, first, that both children and parents’ cultural capital have independent effects on teacher ability ratings. Second, for oral ability I find that parents’ cultural capital ‘protects......This paper studies the effect of cultural capital on teachers’ ratings of children’s oral and math ability. Cultural reproduction theory hypothesises that, holding everything else constant, children who possess cultural capital are more likely to be perceived by teachers as gifted than children who...... do not possess cultural capital. This paper uses extremely rich longitudinal data that provides a better basis than previous studies for holding ‘everything else’ constant. In addition to children and parents’ cultural capital, I control for children’s actual academic ability, physical appearance...

  8. Global capital markets: An updated profile

    Directory of Open Access Journals (Sweden)

    Filipović Miroslava

    2007-01-01

    Full Text Available More than two decades after the beginning of the financial revolution globalization of capital flows still attracts considerable attention, from both practitioners and academics. The aim of this paper is to contribute to understanding of some aspects of the global capital scene, as well as to emphasize certain developments which might illustrate its changing profile. Several fundamental perspectives profile the global capital market. A quantitative review provides a sense of sheer volumes, trends, origins and destinations of capital flows; an assessment of the global capital market’s degree of integration follows. The emergence of new (types of actors is another important aspect of the global processes, while illustrations of new market products and emerging segments may add new perspectives on the profile of the global capital market. Finally, the paper concludes with a brief overview of digitalization of the financial supply chain.

  9. Changing Endogenous Development: the Territorial Capital

    Directory of Open Access Journals (Sweden)

    Balázs István Tóth

    2011-12-01

    Full Text Available The aim of this research is to analyze territorial capital as a new paradigm to make best use of endogenous assets. The study is dealing with the preconditions, meaning and possible theoretical taxonomies of territorial capital. In this study I emphasize that the cumulative effects of regional potentials are more important than economies of scale and location factors. I present different approaches and interpretations of territorial capital, then make an attempt to create an own model. I try to find answers for questions, such as why territorial capital shows a new perspective of urban and regional development; how cognitive elements of territorial capital provide increasing return; how territorial capital influences competitiveness and what kind of relation it has with cohesion.

  10. An Economic Viewpoint on Capitalism Bashing

    Directory of Open Access Journals (Sweden)

    Burnete Sorin

    2016-12-01

    Full Text Available In this paper I discuss two long disputed notions: that capitalism without crises is a fallacy respectively that capitalism bashing, however severe, will not endanger the system itself. Yet proving both is not an easy task since the capitalism issue has always been a cupellation of theory, ideology and political precepts, which are controversial and hard to disentangle. That capitalism detractors are numberless is a truism. Yet criticism against capitalism, however fierce, has always been clearly delineated. Not any more: globalization has rendered the picture dangerously fuzzy. It is now hard to ascertain whether someone who will harangue about the ostensible evils of globalization is also a declared anti-capitalist. The blend of capitalism and globalization seems to be pure dynamite.

  11. Measuring Social Capital Accumulation in Rural Development

    DEFF Research Database (Denmark)

    Teilmann, Kasper

    2012-01-01

    for pursuing development projects similar to those implemented previously and the degree of social capital. The paper concludes that there are indications that projects hosted by municipalities tend to show the most social capital, there is no connection between the amount of project financing and social......Using a theoretical framework, the study proposes an index that can measure the social capital of local action group (LAG) projects. The index is founded on four indicators: number of ties, bridging social capital, recognition, and diversity, which are aggregated into one social capital index....... The index has been tested in LAG-Djursland, Denmark, and the study further investigates whether the organisational affiliation, project financing, and LAG co-financing can explain the degree of social capital accumulation. Furthermore, the author has tested if there are connections between motivation...

  12. ANALYSIS OF THE CAPITAL MARKET IN CROATIA

    Directory of Open Access Journals (Sweden)

    Maja Buljat

    2015-12-01

    Full Text Available The financial crisis that began in 2008 in the USA turned into a global economic crisis in a short time. As such, it had a big impact on the financial stability of Croatia, primarily on capital market. Capital market includes securities trading, primarily stocks and bonds, whose market value is influenced by the market capitalization of capital market and vice versa. Macro economically, market capitalization had an influence on the fall in the value of the entire capital market, and micro economically, it had an influence on the fall of the prices of stocks, bonds and other financial instruments of companies. The volume of trade decreased, but there was an increase in the number of transactions. In other words, people traded more and in smaller quantities. Therefore, the risk increased, and investors became more cautious.

  13. Capital intelectual: verdades e mitos

    Directory of Open Access Journals (Sweden)

    Maria Thereza Pompa Antunes

    2002-08-01

    Full Text Available Muito se tem comentado que os relatórios fornecidos pela Contabilidade Financeira não retratam certas realidades das empresas atualmente, tendo em vista o fato de o valor contábil das ações estar muitas vezes abaixo do seu valor de mercado. Esse contraste entre os dois valores vem sendo identificado como Capital Intelectual e apresentado como um novo conceito de administração de empresas que conduz à necessidade de aplicação de novas estratégias, de nova filosofia de gestão e novas formas de avaliação do valor da empresa. Este trabalho evidencia a verdadeira relação existente entre a Contabilidade e o Capital Intelectual. Desmistifica-se a novidade do conceito, pois comprova-se que o capital Intelectual é parte integrante do Goodwill, conceito secularmente conhecido e estudado pela Contabilidade. Os elementos intangíveis sempre foram abordados pela Contabilidade e, da mesma forma, como nunca se desprezou a sua importância, nunca se subestimou a sua complexidade. Portanto, a Contabilidade não é falha na divulgação das informações por ela registradas. Deve-se entender a finalidade de cada uma das Demonstrações Contábeis, bem como os Princípios subjacentes a elas. A falta de conhecimento, por vezes, conduz a conclusões precipitadas e errôneas. Por outro lado, qualquer que seja o rótulo atribuído aos elementos intangíveis, que sempre fizeram parte das organizações, entende-se e aceita-se que hoje, cada vez mais, o conhecimento e o gerenciamento desses elementos são relevantes para a gestão das empresas, pois o momento atual é caracterizado pela ampla aplicação do recurso do conhecimento pelo homem, que se materializa em novas tecnologias, sistemas e serviços (entendidos como ativos intangíveis que agregam valor às organizações.It has been said many times that the statements provided by Financial Accounting do not give a picture of certain realities of companies nowadays, considering the fact that, often

  14. One-Stage Femoral Osteotomy and Computer-Assisted Navigation Total Knee Arthroplasty for Osteoarthritis in a Patient with Femoral Subtrochanteric Fracture Malunion

    Directory of Open Access Journals (Sweden)

    C. H. Jason Fan

    2014-01-01

    Full Text Available Extra-articular femoral deformity in total knee arthroplasty (TKA is realigned by either intra-articular correction or extra-articular osteotomy. The more distant the deformity is away from knee joint, the more likely it is corrected by the former method. No report described the use of antegrade cephalomedullary femoral nail to fix the osteotomy followed by computer-assisted navigation TKA. This report described the unusual use of this method to manage a 64-year-old man with femoral subtrochanteric fracture malunion and osteoarthritis of knee. He demonstrated a satisfactory functional outcome and good lower limb alignment.

  15. Piketty's capital and social policy.

    Science.gov (United States)

    Piachaud, David

    2014-12-01

    Piketty's Capital (2014) primarily describes and analyses changes in the distribution of wealth and annual incomes. This paper focuses on his policy proposals that make up Part Four of the book. Piketty defends the 'social state' but he discusses it largely in terms of distribution and redistribution between tax units. This neglects the important role of social policy in promoting recognition and redistribution of income and opportunities that is related to gender, race, disability and sexual orientation. Nor does Piketty consider inequalities in health which effect life-time incomes, nor the impact of housing policies on house prices and the distribution of wealth. It is argued that Piketty's approach to social security is simplistic and plays down the complexity of competing policy goals. On taxation, Piketty defends progressive taxation and proposes a global capital levy. The latter proposal runs into formidable problems in seeking global taxation in a world of nation states. Rather than seeking a policy that is, for the foreseeable future, wholly politically impractical, a case is made for less idealistic but more practical and urgent tax coordination between nations to address the widespread avoidance of taxation that large corporations and the very wealthy are now permitted - taxation on which the future of the social state depends. The importance of human and social capital, which are largely set aside by Piketty, are discussed. Finally,it is argued that his approach to policy is to describe trends and propose amelioration of growing inequality rather than to identify causes of the trends and propose policies that might address the causes. Nevertheless, the importance of his work in bringing issues of inequality to the fore, especially among economists, is recognized and applauded.

  16. Venture Capital Contracting Under Asymmetric Information

    OpenAIRE

    Jeffrey Trester

    1993-01-01

    The author develops a model of venture capital contracting in which the entrepreneur and venture capitalist contract under symmetric information. A condition of asymmetric information may arise subsequent to the first contract. The author shows that this condition makes debt contracts infeasible and leads to the use of preferred equity contracts. The author notes that discussions of the relation between venture capital and capital structure are rare. This paper expands the literature by addre...

  17. The Positive and Negative Social Capital

    OpenAIRE

    Rohman, Arif

    2014-01-01

    Social capital can be useful when cooperation for mutual benefit can be facilitated by social network and norms of reciprocity (Putnam, 2000:21). In this context, both individuals and organisations agree to mobilise joint resources to achieve common outcomes which are more efficient and productive. However, the concept of social capital is not always positive.This article will discuss positive and negative social capital.

  18. Rawlsian justice and welfare-state capitalism

    OpenAIRE

    Yuen, Ho-yin; 袁浩然

    2014-01-01

    Rawls emphasizes in his later writings that his theory of justice as fairness is not a defense of welfare-state capitalism. He argues that welfare-state capitalism cannot be an acceptable regime for justice as fairness because its ideal institutional description fails to satisfy the two principles of justice in various ways. Against Rawls, I argue in this thesis that his rejection of welfare-state capitalism is not justified. I begin by clarifying an ambiguity regarding what arrangements...

  19. Capitalizing Central Banks: A Net Worth Approach

    OpenAIRE

    Alain Ize

    2005-01-01

    This paper provides a simple, quantitative, net worth-based, approach to assessing the need for central bank capital. It derives a concept of "core capital" (a function of the central bank's operating expenditures and the carrying cost of its international reserves) as the minimum capital needed by a central bank to ensure the credibility of its inflation target. The approach is illustrated with the published accounts of three loss-making central banks and selected accounting entries for a br...

  20. EMERGING CAPITAL MARKETS: OPPORTUNITIES AND LIMITS

    Directory of Open Access Journals (Sweden)

    FELICIA RAMONA BIRAU

    2012-05-01

    Full Text Available This theoretical study examines the concept of emerging capital markets in Europe from the border between certain opportunities and limits. The financial architecture of emerging capital markets has certain characteristics such as a high degree of instability and a sharp level of illiquidity which exposed the vulnerability of this particular type of market. Emerging capital market represents a main characteristic of developing countries and they are less efficient than the developed market given their deep functional, structural and institutional dysfunctions.