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42 U.S. Code § 6372 - Definitions
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For purposes of this part—
(1) The terms "hospital", "State", "school", "Governor", "State energy agency", "energy conservation measure", "energy conservation maintenance and operating procedure", "preliminary energy audit", "technical assistance costs", "energy audit" and "Secretary" have the meanings provided in section 6371 of this title.
(2) The term "unit of local government" means the government of a county, municipality, or township, which is a unit of general purpose government below the State (determined on the basis of the same principles as are used by the Bureau of the Census for general statistical purposes) and the District of Columbia. Such term also means the recognized governing body of an Indian tribe (as defined in section 6862 of this title) which governing body performs substantial governmental functions.
(3) The term "building" has the meaning provided in section 6371 of this title except that for purposes of this part such term includes only buildings which are owned and primarily occupied by offices or agencies of a unit of local government or by a public care institution and does not include any building intended for seasonal use or any building utilized primarily by a school or hospital.
(4) The term "public care institution" means a public or nonprofit institution which owns—
(A) a facility for long term care, a rehabilitation facility, or a public health center, as described in section 300s–3 of this title, or
(5) The term "public or nonprofit institution" means an institution owned and operated by—
(6) The term "technical assistance program costs" means the costs of carrying out a technical assistance program.
(7) The term "technical assistance" means assistance under rules, promulgated by the Secretary, to States, units of local government and public care institutions—
(A) to conduct specialized studies identifying and specifying energy savings and related cost savings that are likely to be realized as a result of
(ii) the acquisition and installation of one or more specified energy conservation measures in such building or
Source(Pub. L. 94–163, title III, § 400A, as added Pub. L. 95–619, title III, § 311(a),Nov. 9, 1978, 92 Stat. 3248; amended Pub. L. 99–514, § 2,Oct. 22, 1986, 100 Stat. 2095.)
1986—Par. (5)(B). Pub. L. 99–514substituted "Internal Revenue Code of 1986" for "Internal Revenue Code of 1954", which for purposes of codification was translated as "title 26" thus requiring no change in text.
For separability of provisions of title III of Pub. L. 95–619, see section 302(c) ofPub. L. 95–619, set out as a note under section 6371 of this title.
Congressional Statement of Findings and Purposes
Pub. L. 95–619, title III, § 310,Nov. 9, 1978, 92 Stat. 3248, provided that:
"(a) Findings.—The Congress finds that—
"(1) the Nation's nonrenewable energy resources are being rapidly depleted;
"(2) buildings owned by units of local government and public care institutions are major consumers of energy, and such units and institutions have been especially burdened by rising energy prices and fuel shortages;
"(3) substantial energy conservation can be achieved in buildings owned by units of local government and public care institutions through the implementation of energy conservation maintenance and operating procedures; and
"(4) units of local government and public care institutions in many instances need financial assistance in order to conduct energy audits and to identify energy conservation maintenance and operating procedures and to evaluate the potential benefits of acquiring and installing energy conservation measures.
"(b) Purpose.—It is the purpose of this part [part 2 (§§ 310–312) of title III of Pub. L. 95–619, enacting sections 6371j and 6372 to 6372i of this title] to authorize grants to States and units of local government and public care institutions to assist them in conducting preliminary energy audits and energy audits in identifying and implementing energy conservation maintenance and operating procedures and in evaluating energy conservation measures to reduce the energy use and anticipated energy costs of buildings owned by units of local government and public care institutions."
Application of Davis-Bacon Act
For application of the Davis-Bacon Act to grants made by the Secretary under this part, see section 6371j of this title.
LII has no control over and does not endorse any external Internet site that contains links to or references LII.


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Arsene Wenger believes Arsenal's Capital One Cup fourth-round tie with Chelsea is an opportunity for the Gunners to prove their Barclays Premier League title ambitions are serious.
Arsenal are searching to end their eight-year trophy drought and hold a two-point lead over second-placed Chelsea in the Premier League standings ahead of Tuesday night's League Cup contest at the Emirates Stadium.
Some have attributed the Gunners' lead to a favourable fixture list, with the opening day loss to Aston Villa followed by seven wins in an eight-match unbeaten run in the Premier League.
"We haven't won the title for a few years and people question that now," Wenger said.
"At the end of the day, the Premier League will reflect the quality of the performances of the team throughout the season and how well you do in the big games.
"This is a good opportunity for us to show we are ready."
Wenger is uncertain if the League Cup clash will have an impact on the Premier League and is unconcerned by the opinion of those who believe his side will be overhauled at the top of the standings.
"I'm not sure it will affect the Premier League at all, but you know people will look at you, how you behave and whether you can win the big games like that," Wenger said.
"What is for sure is you that you want to win these sort of games.
"That has a certain psychological influence on the team.
"What we want to do is to show that we want to be considered as a very strong team and that comes only with the way we play and with the results, so let's just focus on that.
"We will absolutely go for this game."
The match pits Wenger against old adversary Jose Mourinho for the first time since the Portuguese returned to English football.
Wenger endured a difficult relationship with Mourinho during his first spell.
"It was not a big surprise because there was talk about it many times," the Frenchman said.
"When he left Madrid, it looked to be one of his best opportunities to come back."
The last time the pair crossed swords in the League Cup was in the 2007 final, which Mourinho's Chelsea won 2-1 with two goals from Didier Drogba.
Wenger added: "We scored first but after that - we had decided to go with a very young team - Chelsea's experience took over and made the difference.
"Chelsea had a fantastic team but the quality of our performance on the day was fantastic too.
"Overall, we went to the final with the young players, it was a completely young team and that shows how the competition has changed because nowadays that would not be possible anymore.
"It is impossible today, because all the teams in the Premier League are too strong to do that."
Mourinho has promised wholesale changes for a fixture which comes with just 24 hours rest following Sunday's defeat of Manchester City.
Wenger also plans to make changes and utilise his squad.
"The team will be a mixture, with some players who are at the moment not getting the games they need and deserve, and also one or two young players," Wenger said.
"I have to get that mixture right and I will leave myself until tomorrow to decide how I do that."
Denmark striker Nicklas Bendtner could make his first Arsenal start since March 2011 following loan spells at Sunderland and Juventus. Bendtner was close to exiting Arsenal in the summer.
"Nicklas has been away for a lot of time and he was half - when I say half I mean 80 per cent - out of the club," Wenger said.
"In the end he decided to stay and I stopped him from going.
"I must say, he responded in a positive way and that is what we want from him now.
"I believe he is physically ready, a very good player and if his concentration is 100 per cent to commit himself to the cause he will be a great asset for us. But that is what you want from him in this game."
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subset: commoncrawl


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These antique finds will have you at "hello."
8 Stylish Rugs Under $500
Pay bills, write grocery lists, and jot down notes in style. Colorblock Pen, $5 each. poketo.com.
In classic black-and-white, these oversize paper clips stylishly organize your desktop. Large Black & White Paper Clips, $8. paper-source.com.
6 World Map Wallpaper Designs


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The two brown poppy ones were different sizes widths. Don't you just love the colors and details? There were so many pretty ones to choose from it was hard to narrow them down.
Can't wait to show you what I'm working on!
They are wonderful. I can't imagine what you're making so I'm excited to see. Show soon! Please?ReplyDelete
I am so glad you like them!ReplyDelete
Love the ribbon!ReplyDelete
Oh, I love the chunky wrap bracelet you made. It's beautiful great job!ReplyDelete
Lovely ribbons! I really like the colours and patterns in no 2 and, even more, no 4. It'd feels like a fab ribbon for a summer bracelet.ReplyDelete


text: Great Western Auction Realty, 133 N. Sixth St., announced Kevin Davis has joined their firm. Davis is employed at The Daily Jeffersonian, Cambridge. He is a graduate of Cambridge High School and attended Muskingum Area Technical College, where he earned an associate degree in business management. He is a member of Phi Theda Kappa, coached a girls softball league, referees Biddy League football and is a notary public. He is an avid collector of Michael Jordan memorabilia. Davis said he looks forward to serving residents of Guernsey and surrounding counties for all their real estate needs. Rick Moore, office manager of Great Western Auction Realty, said he is excited about the addition of Davis to their professional staff. Call Davis today at 432-7368, ext. 105, or at his residence, 432-2587, for real estate needs.


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Take a look at the entire new and used automobile stock of Midland Saab dealers at Autobytel.com Search for new or used cars in a variety of different ways including by: year, make, fuel economy, price, or location. Find Saab dealers in Midland with ease. Purchasing a vehicle is quite a large investment. Do some legwork by studying all the various options to get the most out of your investment. Discover which Midland Saab dealers have the car you are interested in
With the resources available on the web; the majority of consumers begin their search online. Driving around to each Saab dealer Midland can be a real hassle. A better way to browse automobile listings from Saab dealers in Midland is to visit Autobytel; which has hundreds of autos listed in your area. We are a top resource for all things automotive. You can compare multiple vehicles at once. And see the MSRP of a new or preowned car. This is just the tip of the iceberg. The Autobytel website is packed with additional information. See a vehicle's safety rating, fuel economy, performance figures, standard equipment and more. Browse online for Midland Saab dealers from the comfort of your own home.
Any great Saab dealer Midland has much more to offer than new and used sales. Midland Saab dealerships should have a leasing branch too. Stop by the parts and accessories area of a Midland Saab dealer if you need a replacement part. Free maintenance is offered on some new car purchases. And most Saab dealers in Midland will service your automobile for free if covered. Own a past-production vehicle and need some major repairs? Then most Midland Saab dealers will have a repair center on the premises. These repair centers employ only factory trained professionals. A Saab dealer Midland can provide so much more including service coupons, special maintenance offers, incentives, and rebates.
There is an area to rate Midland Saab dealerships based on your experience. Knowing the reputation of a business may save you heartache down the road. A Midland Saab dealer definitely wants to make a good impression on any car shopper. Exploring all that Saab dealers in Midland have to offer is a solid game plan. Use the online resources at Autobytel.com to locate the perfect vehicle. You may even save hundreds if not thousands by looking at incentives and rebates before going out to buy a vehicle.


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On this episode of Chat with the Experts, we talk with Chef Suzanne about difference between catering services and private chefs and how both can serve you.
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Light that spark in your romantic life with some couples' activities like dance, photography, cooking classes and fitness.
Pastry chefs cater both weddings and private parties. Choosing the right chef for either one can be difficult, but with a little time and effort you can find the perfect pastry artist for your event.
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Gym memberships, cooking classes, car washes and handyman service are just a few unexpected ideas for dad.
Personal Chef reviews in Raleigh
My wife is in chronic pain and partially disabled, and I am to old to do everything anymore. We used to eat out a lot, or bring food in, but I was not satisfied that we were getting a healthy diet. I found single but has an eighteen year old son she still raises. For the five years previous to moving to Albuquerque,
I couldn't have asked for a better event. My husband was completely surprised and the menu included all of his favorites. Passed hors d'oeuvres: , etc.), and cheese plate. The dinner menu started with a great arugula salad with
I got an estimate and made an appointment. I was impressed with the professionalism of this young lady from the start. Every single aspect of the service far exceeded my expectations. She went to work and stayed focused during her work. She cleaned very thoroughly and was very pleasant. She had quoted a very fair price and I was totally surprised at all the cleaning she did for the price. I could not be more pleased with the job she did. I give her a 10 out of 10 score."
He was prompt and courteous and professional on the day of the party and required very little guidance/assistance in setting up the serving areas.
The food was elegant, delicious and made the entire event feel special. The setup was was pleasing to the eye and fit right in with my decor. Everyone commented on the how delicious everything was. At the end of the event everything was whisked away as
The next day the catering rental people picked up the rental items. I didn't have to wash a THING!
There were absolutely no surprises with
Chef we enjoyed a delicious meal complete with a dessert of Banana's Foster that everyone loved! The portions were huge, and some were bringing leftovers home to enjoy later. Chef
Chef "
Our evening of dining was delightful! Chef
I'd highly recommend Mercury212 and Chef "
I'd highly recommend Mercury212 and Chef "
.At 4Pm residents set up tables for dinner. At 4:30 caterer was contacted and resident was informed that they were stuck in traffic due to accident. The caterer was contacted again againat 5,5:30,6:30,7:30 and 8PM. At this point many of the residents left and went to their apartments to make dinner. Residents who had snack foods brought them out to community room to share with those of us waiting. At 8:30 PM caterer finally showed up. He served Meridian court I then our bldg Meridian court II. Food was cold. Many residents were afraid to neat Turkey due to it sitting in tray for over 4 hrs. Residents took food out of supposed warming containers and arranged on tables. The only thing the caterer was worried about was getting paid. Even though their are many people from different cultures and regions of country here it was in full agreement that the food was bland and tasteless. Our building s committee have tabled a motion to never use him again. We were so disappointed in the level of service that was provided for us at that price.
Personal Chefs in Raleigh
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Amara Catering
Bali-Hai - Raleigh
2414 Wake Forest Rd
blu seafood and bar
2002 Hillsborough Rd
Candyland Buffets
100 Main st
Chatham Street Cafe & Catering
PO Box 4433
Chef For Me Personal Chefs
Chapel Hill
Chef Ken's Catering
19031 11th Ave NW
Chrisabethella Catering
Hwy 40/42
CORE Catering, Inc.
4206 S. Alston Avenue
Crepe Culture
140 West Franklin Street, Suite 120
Chapel Hill
Chapel Hill
Executive Chef Services
Food Simply Fresh
8108 Lakeshore Dr
Helping Hands Wait Staff
O'Kelly Chapel Rd
Kansas Crown Discount Liquor
1215 W 6th St
1241 Horsham Way
My Personal Chef
Stephens Catering Inc
203 CapCom Ave
Wake Forest
Wake Forest
Supreme Cakes
2057 Rowland Pond Dr
Willow Spring
Willow Spring
Taste' PCS
8007 Satillo Lane
PO Box 366351
yaggsitenn african catering and services
2417 gazebo dr
Zacki's Culinary Creations
3537 Sugartree Place
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Send us your interest if this course is currently not offered or the current schedule does not accomodate your schedule. It is often necessary to understand interest a semester in advance for planning and scheduling. Companies and organizations can often request a course if the group is large enough. This doesn't mean that we can make accommodations in every case. However, we will utilize and maximize our available resources as best as we can. Thanks for letting us know your interests and we will respond as soon as we can.
Project Execution Planning (PEP) for Qualification
A Project Execution Plan is a document describing how, when and by whom a specific target or set of targets is to be achieved. These targets will include the project's scope, timescales, coasts, quality and benefits by showing the activities and resources required for the project. Learn the concepts utilized in the development of sound plans for the implementation of Risk-Based and Lifecycle Integrated Commissioning and Qualification Campaigns. Students will review facility design and regulatory issues in the US and Europe the reflect industry trends and changing regulatory policy, and determine best methodologies for obtaining compliance. In-class utilization of case studies, templates, and guidance documents provide a strong foundation in C & Q methodologies for those who enroll.
Each college has their own registration process.
We make every attempt to make it seamless.


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~by Nikki
When having weight loss surgery, many of us are concerned about how our kids will react to our new lifestyles. We tend to indulge children with cookies, cake, candy and snacks - things we won't be able to eat anymore. Will we be able to handle it? Will our kids resent us if we try to change their eating too?
I understand. I have two girls, as you all probably know, and when I decided to have weight loss surgery, in a way, they decided to do it too. I can't afford to make several different meals a night, so they eat what I eat. We have one default dinner choice - grilled chicken Caesar salad (only because it takes like 5 minutes to make and I ALWAYS have the ingredients on hand).
But most of the time it isn't necessary to do a huge overhaul of what your kids eat. More often you just need to take a look at how you make the things they already like.
Yowsa. It's kind of scary when you think about it. Read Fast Food Nation, people. It's eye opening.
This is a stand-by kid and weight loss surgery friendly meal that my kids like a lot. The good thing about this is that you can play with the recipe to get the way YOUR kids like it. And you can get creative! We've made these using cookie cutters (not in the above...but we've done it) to make shaped nuggets, we've experimented with dipping sauces, the whole nine. Get funky with it!
Nik's Kid and WLS Friendly Chicken Nuggets
1 lb. chicken breasts
1/3 c. unflavored Greek yogurt
2 eggs, beaten
1 canister whole wheat panko bread crumbs (when making just for me, I usually use 2 cups of my beloved Fiber One crumbs -just Fiber One whizzed through the blender - but I've heard back that they give a slightly "sweet" taste...I still love them!)
1/2 c. grated Parmesan cheese
1/4 tsp onion powder
1/4 tsp garlic powder
Salt and pepper to taste
Step One (the night before you are to make the nuggets): Place your chicken in a zip-top bag with the Greek yogurt. Make sure to get the chicken nice and coated. Leave it in the fridge overnight. ("But why Nik?") Those same cultures that are so good for your guts are also good for tenderizing meat. I marinate nearly all my chicken in Greek yogurt before cooking. It comes out tender and juicy and I cannot taste the yogurt in the finished product.
Step Two: Pre-heat your oven to 350. Remove chicken from baggie and wrap in plastic wrap. Pound down to an even 1/4 inch thickness (in the below my meat mallet broke so I didn't get it down to where I wanted it. If you like yours thicker, that's fine. Adjust your cooking time up accordingly.)
Step Three: Slice chicken into long strips.
Step Four: Then, cut it into bite-sized pieces (whatever that means for your kids, your mileage may vary).
(By the way...the hand in the purple sleeve is La Petite Diva...get your kids in the kitchen peeps!)
Step Five: In a bowl, mix about a cup of your panko crumbs (keep them handy...you may have to re-load, which is why I didn't specify an amount. I use a different amount each time I make these!) with parmesan cheese and spices. Then set up a dredging station with your chicken on one end, followed by your egg, your crumb mixture and, finally, a cookie sheet.
Step Six: Dredge your chicken pieces in the egg and the crumb mixture. For extra crispy nuggets, re-dredge. Line them up on a cookie sheet as you go.
Step Seven: Bake at 350 for about 15 minutes. Flip them over and bake another 10-15 minutes. Cool before serving!
Now for the fun part...dip! You can make really cool dips based on what your kids like. Here are some combos we've tried and liked:
Dijon mustard + a bit of honey = honey mustard
Ranch dressing + a bit of BBQ sauce = BBQ ranch
Ranch dressing + juice from adobo peppers = Chipotle ranch
Greek yogurt + dry ranch dressing mix = protein ranch dip


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New Canaan Library Kindergarten to 2nd Grade Story and Craft Time
Tuesday, Jan 29, 2013 at 4:15pm
151 Main St., New Canaan, CT
Each week, this class listens to a book and makes a related art project. For kids in Kindergarten through grade 2 who enjoy working with their hands & getting creative. Please register.


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It's been a while, Crash Pad.
For a while, my breakup turned me into a sleeps-at-8, never-dates-never-masturbates, prudish hermit-spinster. Nay, those words are too nice. Perhaps a sex-negative curmudgeon would be a better descriptor. I didn't even touch a vibrator for months on end. And I'm a sex blogger. For shame.
I did watch one episode to review during that time, the one featuring Nic Switch and Iona Grace. I did okay, I think. But as hot as they were and as much as I tried, I don't think I was yet ready to jump back into the insatiable desires I once had.
I saw the signs that I was on the come-back. I am currently sleeping with my nubby-g vibrator in bed with me every night, because that's just about how often I use it. I am once again the sex-toy guru for friends and co-workers. I bought the Daily Candy deal to use at Babeland. And I participated in two readings for Best Lesbian Erotica 2012. I've been ready.
I didn't watch the newest episode to ease back into the Crash Pad swing of things. I wanted a familiar face. Someone who I'd watched before, someone who I'd chatted with (even if just on Twitter.) Someone with a smile like pure liquid sunshine–
And there they were! J-Bird is back and better than ever with their new episode and they've brought a new face into the mix, Rose Waters (adorbs!) And as I'm getting off (multiple times) to this amazing queerness, this wonderful pleasure that I'm seeing before me, it hits me.
This shit is fucking subversive.
Well duh, it's queer porn. It's Crash Pad. Subversive is kinda their thing. But having really been divorced from porn, Crash Pad, and even this part of me for a while, it really gave me a renewed appreciation for exactly how "dangerous" it is. In those readings I mentioned earlier, Kathleen Warnock said in her MCing something to the effect of "these stories are important–they are activism" and hearing it said aloud gets me every time. This is activism. Sinclair Sexsmith writes in their intro to that very same book "These books of lesbian erotica are not fluff. They are not nothing. They are not frivolous or useless. For queers coming out, they are a path." This is creating a whole new system in which new and different things are valued. This is instruction. And I feel the same way about the work that Crash Pad does. Let's talk about why.
I am coming (coming!) at this particular episode having just taken a trip down memory lane to visit the L Word, in which lesbians are given permission to be shallow human beings. Lesbians are given permission to be just as neurotic and terrible to each other as every other human being in television shows is. While that's all well and good, it hit me this time, as it has multiple times in the past, how Crash Pad gives queers permission to be deep and nuanced instead of being over-sexualized or stereotyped due to race or gender expression. It just hit me harder this time, perhaps because of the clear juxtaposition between two types of queer. And I am so glad to have had both examples in my life.
These particular Crash Pad wonders, J-Bird and Rose Waters, give female-bodied queers permission to enjoy themselves, to tell their sexy-time-partners to wait to take their underwear off, to have a goofy, sunshiny smile after being fucked, and to enjoy themselves without cisgender men in the picture. Holy shit! And in 1960 McCalls printed in large print because they thought women were about as complex as first graders! In some parts of the world, these two could be put to death for expressing outside the norm! The very existence of this punches holes in mainstream white male culture's idea that every woman needs the right biological penis! Holy shit this is subversive! This is threatening to mainstream everything and yet, with a smile like J-Bird's, it's not. You look at these two people, clearly buzzing with caring and respect for each other, clearly electrified by orgasm, and it's not threatening. It's relatable. It's hot. You want it for yourself and, if you're searching for a path–a path to queerness you may not have figured out yet, it's here. Crash Pad subverts, yes, but it also instructs. It blazes that path Sinclair Sexsmith was talking about. It makes people think about identity and also about how best to touch their clit.
The premise of this episode is that J-Bird has a surprise for Rose Waters, and they bring a blindfold into the works and say "your surprise is coming in a minute." My surprise came in a couple of ways. As I bit down on my sheets to keep the entire apartment complex from hearing me come, hearing my pleasure spill from my lips, I was surprised that porn can make me think this much. I was surprised that I had gone this long without watching it. And I was surprised that I had reaccessed this part of myself that can both analyze and enjoy at once. And mostly I was surprised by how subversive this thing is that these wonderful queers made. And I was surprised that I was surprised, because thinking outside the box (even when filming one) is par for the course when it comes to the Crash Pad Series.
Thank you to everyone involved in this episode. It changed me back.


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The Department of Athletics established the Substance Abuse Education and Screening Program for the benefit of its student-athletes. The purpose of the program is education: to inform student-athletes of the dangers of substance abuse, to bring to their attention the best health-care advice concerning drug usage, and to assist any student-athlete with a substance abuse problem in order to identify and correct the problem.
It is not the purpose of these policies and procedures to ensure or punish any student-athlete who in good faith participates in this program.
1. To educate the student-athlete regarding the dangers of substance misuse and abuse.
2. To prevent through education the misuse and abuse of chemical substances.
3. To identify through periodic screening those student-athletes who may be involved in substance misuse and abuse.
4. To recommend and provide confidential counseling for those individuals with substance abuse or substance abuse-related problems. It is the express purpose of the program to provide assistance to the student-athlete in solving any substance abuse problems encountered while at the University of Missouri.
Procedural Guidelines
1. Each year a substance abuse education presentation will be made to educate all student-athletes about the dangers of substance misuse and abuse. The purpose of the program and the procedures to be followed will be explained in detail.
2. MU student-athletes will be required to sign a consent form (pages SA-40) once each academic year. This form gives the sports medicine staff permission to collect and test his/her urine, saliva or breath samples for the presence of certain drugs and alcohol at such times as testing is required under this program during the academic year. At the recommendation of the team physician, blood samples may also be collected for the purpose of substance screening.
3. An approved independent collection team, under the direction of the sports medicine staff, will conduct collections of samples. Appropriate steps will be taken to ensure proper collection, identification and confidentiality during the testing of samples. Each individual sample will be coded to provide anonymity and to avoid any possibility of identification error. An appropriate accredited laboratory will conduct the testing. Drug screening tests will be for selected substances included in the current year's NCAA "Banned Drug List."
4. Under separate cover, the director of the laboratory outlined in #3 (above) will provide written test results to the Director of Athletics, and Director of Sports Medicine, who are required under this program to preserve the confidentiality of all test findings. Under certain circumstances, the student-athlete's parent(s) or legal guardian(s) or spouse will be informed of positive test results.
5. The head coach, Director of Sports Medicine, and Director of Athletics will have a confidential meeting with any student-athlete testing positive. Appropriate steps will be taken at this time to recommend and provide the student-athlete with the proper counseling, treatment and rehabilitation program necessary to assist the student in solving the problem. No information will be released at any time regarding any student-athlete's participation in counseling, treatment, or rehabilitation program.
6. If the Director of Sports Medicine and/or team physician determine that the student-athlete is not complying with the recommendation of the team physician, the student-athlete's name will be referred to the head coach and the Director of Athletics who will decide what further action, if any, shall be appropriate. The head coach and the Director of Athletics shall not disclose their action or information leading to their action except as required by University policy, NCAA or Conference rules or other legal requirements.
7. The Department of Athletics realizes that the abuse of alcohol, as well as drugs, is a potential problem for student-athletes. For this reason, testing procedures that entail use of an alcohol Breathalyzer device will accompany collection of urine for drug screening purposes. Breathalyzer findings that indicate alcohol blood levels equal to or in excess of 0.1% (weight by volume) will be treated as positive findings (see "Effective Positive Test Results"). Breathalyzer results below 0.1% will not count as positive findings but may, at the discretion of the team physicians, lead to more frequent follow-up testing of the student-athlete in question.
8. All student-athletes will receive at least one drug and alcohol screening per academic year. On the recommendation of the team physicians, certain student-athletes may be selected for more frequent screening. In particular, student-athletes with a history of positive test results will be singled out for more frequent screening, with timing and frequency determined by the team physician. More frequent testing of various teams may be done based on the wishes of head coaches, with the consent of the Director of Athletics.
9. The Director of Sports Medicine will keep confidential records of all test findings, as well as the actions taken based on these findings. When substance abuse counseling is involved, written notification that such counseling was received will be a part of these records. This data will be summarized on a yearly basis, with a report submitted to the Substance Abuse Committee that maintains confidentiality of the names of individual student-athletes, but includes detailed information regarding the number and nature of test findings and the incidence and nature of substance abuse counseling. All members of the Substance Abuse Committee will consider results of these reports strictly confidential. Release of these findings to other parties will occur only with the express permission of the Director of Athletics.
10.Copies of this policy will be made available to all members of the Department of Athletics staff, Substance Abuse committee and other persons at the discretion of the Director of Athletics staff, Substance Abuse Committee and other persons at the discretion of the Director of Athletics. Members of the Substance Abuse Committee will undertake periodic review of these policies.
Effect of Positive Drug/Alcohol Test Results
1. First Positive Test: The Director of Athletics, head coach, Director of Sports Medicine, and the team physician will be notified of the positive test result. If circumstances warrant, the Director of Athletics (or designee) and the head coach, along with the Director of Sports Medicine and team physician, will have a confidential meeting with any student- athlete who tests positive. The student-athlete has the option to request that one person of his or her choosing may accompany him/her to this meeting, the student-athlete and Director of Sports Medicine will contact the parent(s), legal guardian(s) or spouse to inform them of the nature of the positive test. The student-athlete may be required to participate in a substance abuse treatment program, which has been reviewed and approved by the team physician and the Director of Athletics. The student-athlete will be subject to unannounced follow-up drug testing for one year after the date of the first violation. Refusal to participate in the substance abuse treatment program, (if required), as set forth in this paragraph may be treated as a second positive test result.
2. Second Positive Test: The Director of Athletics, head coach, Director of Sports Medicine, and the team physician will be notified of the second positive test result. The Director of Athletics (or designee) and the head coach, along with the Director of Sports Medicine and team physician will have a confidential meeting with any student-athlete who tests positive. The student-athlete has the option to request that one person of his or her choosing may accompany him/her to this meeting. The student-athlete will be required to notify his/ her parent(s) and/or legal guardian(s) or spouse of the second positive test result in the presence of the Director of Sports Medicine. The student-athlete may be required to participate in a substance abuse treatment program, which has been reviewed and approved by the team physician and the Director of Athletics and will be suspended from any play and practice for a minimum of seven days. The student-athlete must provide proof that the treatment pro-gram was successfully completed. Refusal to participate in the substance abuse treatment program, (if required), as set forth in this paragraph may be treated as a third positive test result.
3. Third Positive Test: Any student-athlete who tests positive for a third time will immediately be dropped from the athletics program. Any existing athletic financial aid will be terminated at the end of the time for which it was initially committed and will not be renewed the following year.
Any student-athlete legally charged with the sale, purchase, transfer or possession of illegal drugs may be suspended from practice and play until he/she is cleared of those charges. Conviction of a student- athlete of sale, purchase, transfer or possession charges will result in automatic and immediate dismissal for his/ her team and in the loss of all athletically related financial aid. No punitive action will be taken by the department of athletics in those cases where a student-athlete spontaneously self reports his/her own personal misuse or abuse of chemical substances and seeks professional help to correct the behavior prior to an initial positive drug test result. Such a self-disclosure may be made to the director of athletics (or designee), to an athletic trainer or a team physician. In all cases, coaches will not be informed if a student- athlete voluntarily seeks professional assistance for the purpose of rectifying a substance misuse or abuse problem, unless in the opinion of the team physician, a clear and imminent health risk exists for the student-athlete or others as a result of said student-athlete's current drug usage. However, all student-athletes who self-report substance abuse will not be exempted from standard drug and alcohol screening procedures as outlined in #8 (above), nor will they be exempted from procedures outlined in steps 1, 2 and 3 (above) if the results of the future test are positive.
Chemical Substance Screening Procedures
1. The student-athlete will enter the testing site and will provide proof of identity. A number will have been assigned to each student-athlete at a prearranged time prior to his/her testing.
2. A student-athlete will be given an implied consent form, or he/she may have been given one previously to read, sign, date and have witnessed; if not, he/she will read and complete as mentioned above.
3. Upon completion of above procedure, the student-athlete will be given two assigned specimen bottles with numbers on campus and sides of the sealed specimen bottles. The student-athlete will be asked to verify the validity of his/her number. A professional observer will accompany the student-athlete to the voiding station for the spilling of urine into the specimen bottle. The door must remain open, and the observer must be in attendance at all times during the voiding. The specimen bottle will be returned to the pick-up station for validation of name and number and placed in properly supervised storage area.
4. If the student-athlete is unable to void, he/she is instructed to drink water or other fluids that are available. The fluids must be caffeine-free and alcohol-free. At the appropriate time, the student-athlete will inform the testing supervisor that he/she is capable of voiding and the observer will accompany him/her to the voiding station.
5. Upon completion of the voiding process, the observer will sign the student-athlete's implied consent form certifying that there were no irregularities. Any perceived irregularities in the process must be characterized and recorded on the implied consent form.
6. If the student-athlete refuses to provide urine or fails to appear, the student-athlete will thereby render himself/herself ineligible.
7. After the last student-athlete has been processed, the samples will be picked up by the laboratory and analyzed accordingly. If a positive result occurs, an alternative test is administered. If the alternative test is also positive, the original positive result stands. If the alternative test is negative, the result is negative.
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text:
Nueces elects first GOP county judge in 140 years
Loyd Neal's victory over Larry Olivarez represents an historic turning point in Nueces County, a longtime Democratic stronghold.
Every election records some upset or unexpected result, but few fall into the historic category like that of Loyd Neal's victory over Larry Olivarez. Neal will become Nueces County's first Republican county judge since John J. Dix following the Civil War.
Neal ran as a Republican, but his campaign was essentially non-partisan. That was smart, given the county's Democratic tradition. Now, Neal must govern as he campaigned, in a non-partisan way. Being a Republican county judge in a Democratic stronghold will have its problems; almost all the elected office-holders are Democrats and three of the four county commissioners are Democrats. But Neal, as a Republican filling the position of county judge, will change the power equation in Nueces County. The position has far-reaching influence when you consider the county's appointments to the Port of Corpus Christi and the Regional Transportation Authority. It also will change the nature of how the county and city do business together.
Neal will be a newcomer to the courthouse, but he is no newcomer to government. As a former major of Corpus Christi and former president of the Texas Municipal League, he has a lot of experience and knowledge about how government works. He is committed to consolidating county and city services where practical. And he is committed to operating the county judge's office with greater transparency. Neal will take over a changed operation. The county judge's main staffers have been shifted to a new department. This shift, if it stands, reduces the power of the county judge and increases the power of the four commissioners. This gives the commissioners an opportunity to begin to earn those inflated salaries.
The county faces critical issues. The loss of federal prisoners at the jail will cost the county some $2 million in lost revenue. There is a need for a countywide medical assessment on indigent care. Drainage improvements will be costly. Neal wants the county, Corpus Christi, and the port authority to work together on a drainage master plan. He wants the county, Port Aransas, and Corpus Christi to work together to address beach erosion.
In electing the first Republican county judge in 140 years, the voters decided a major change is needed in the direction of county government. The voters clearly recognized that Loyd Neal has the ability and experience to oversee that change.
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19th Century Concept of Irish-Catholic 'Spiritual Empire' is Topic of Nov. 6 Lecture at St. Thomas
The speaker, historian Irene Whelan, is associate professor of history and director of Irish studies at Manhattanville College.
ST. PAUL, Minn. -- Historian Irene Whelan of Manhattanville College in Purchase, New York, will discuss the concept of an Irish-Catholic "spiritual empire" in a lecture at 7 p.m. Thursday, Nov. 6, in the O'Shaughnessy Room of the O'Shaughnessy-Frey Library Center on the St. Paul campus of the University of St. Thomas.
The lecture, free and open to the public, is sponsored by the university's Center for Irish Studies and the Center for Catholic Studies.
This concept of an Irish-Catholic "spiritual empire" -- a belief that the Irish were destined to lead the world back to the Catholic faith -- gained huge popularity in the latter part of the 19th century. Though the idea seems preposterous to present-day Catholics, Whelan says, it once was embraced by historians, politicians and churchmen. They looked to both the ancient and the more recent past to justify a view of the Irish as a chosen people.
One on the most enthusiastic supporters of the notion was Archbishop John Ireland, the Irish-born founder of St. Thomas, who made it a feature of many of his St Patrick's Day sermons. In 1869, for instance, he declared that "Nations, no less than individuals, receive from Heaven a vocation." According to the archbishop, Judea held this position in the past but "in modern times this high office has been assigned to Ireland."
This thesis, Whelan says, provided a sense of purpose to a people dispersed throughout the world by forces over which they had little control. Whelan argues that the view allowed for the creation of a virtual "empire of the spirit" to parallel the great mercantile and land empires being carved out by the great powers during the heyday of imperialism.
In the years immediately following the Easter Rising, the notion of the Irish as a people of destiny and a "martyr nation" gained wide currency among those seeking a new identity for an independent country; chief among them were Archbishop Daniel Mannix of Melbourne and Irish president Eamon de Valéra. Mannix termed de Valéra "Ireland's man of destiny" -- an idea that would have profound consequences for the new state, particularly in church-state relations and the anti-modern culture that became a feature of the new Ireland from the 1930s onward.
A native of Clifden, County Galway, Whelan is associate professor of history and director of Irish studies at Manhattanville College. Her research and publications focus on popular religion in Ireland. She is the author of the 2005 book The Bible War in Ireland: The 'Second Reformation' and the Polarization of Protestant-Catholic Relations 1800-1840, an account of the evangelical movement and the sources of modern religious and political polarization in Ireland.
For more information, contact the Center for Irish Studies at 651-962-5662 or email firstname.lastname@example.com .
The Center for Irish Studies at the University of St. Thomas advances teaching and scholarship in Irish Studies for Students, faculty
and friends of the university through publications, instruction and public programs; enriches the international dimensions of education at St. Thomas; and affirms the many historic and contemporary bonds between the university, Ireland and the Irish-American community.
The Irish Family at Home and Abroad
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An evening of stories and food at Tennessee Tech University Oct. 30 will bring experiences from all corners of the globe to the Roaden University Center.
TTU student organization One World will host its multicultural evening from 6 to 8 p.m. in the RUC second floor multipurpose room.
A survivor of terrorist attacks and a former child soldier will discuss their experiences, along with several others.
Linda Ragsdale survived the 2008 terrorist attack in Mumbai and carries a nearly three-foot scar from a machine gun bullet. After the attacks, she became a motivational and inspirational speaker.
Gatluak Ter Thach was a child soldier in South Sudan and came to the U.S. in the late 1990s as a refugee. Here, he founded the Nashville International Center for Empowerment, dedicated to working with refugees and immigrants in Middle Tennessee through social services and educational programs.
International foods will be provided, and attendees are encouraged to bring non-perishable food items, hygiene products or children's school supplies to support various service projects at the university's Service Center, including the campus food pantry and Blessings in a Backpack, which gives weekend food supplies to needy Jackson County students.
One World is a student organization that works to introduce people to different cultures from around the world to achieve understanding and harmony.
The event is free and open to the public. It is funded by Center Stage, which is made possible by the TTU general education fund.


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A knee joint prosthesis includes tibial and femoral components and a bearing insert designed for unicompartmental prosthetic total knee replacement and can be implanted using arthroscopic surgical techiques. The tibial and femoral prosthesis components have channels or portals therethrough allowing supply of cement to the prosthesis-bone interface after the prosthesis has been positioned for implant. Recesses communicate with the channels and cooperate with the bone surfaces to form cement receiving chambers, and rims at least partially surround the recesses to penetrate the bone surfaces to stabilize the positions of the prostheses and form seals preventing cement from escaping from the prosthesis-bone interfaces.
1. A prosthesis for implant in the body comprising
a body having a periphery and a fixation surface extending substantially continuously along said periphery to be placed against a tissue surface in the body to which said prosthesis is to be affixed, recess means in said body for forming a cement receiving chamber defining a space closed by the tissue surface and said body when said fixation surface is placed against the tissue surface; and
means in said body disposed along said fixation surface establishing communication with said recess means from externally of said body after fixation surface is placed against the tissue surface whereby cement can be supplied to the cement receiving chamber to fill said space after said prosthesis is placed against the tissue surface, said fixation surface confining the cement within the bounds of said periphery as said space is filled.
2. A prosthesis as recited in claim 1 wherein said communication means includes a channel formed in said body in communication with said recess means.
3. A prosthesis as recited in claim 1 further comprising seal means for retaining cement between said body and the tissue surface.
4. A prosthesis as recited in claim 3 wherein said seal means includes a rim extending substantially around said recess means.
5. A prosthesis as recited in claim 4 wherein said rim has a sharp edge to penetrate the tissue.
6. A prosthesis as recited in claim 1 further comprising means protruding from said fixation surface for securing said body to the tissue.
7. A prosthesis as recited in claim 6 wherein said protruding means includes a screw passing through a hole in said body.
8. A prosthesis for implant on a resected bone surface in the body comprising
a body having a periphery and a fixation surface including a peripheral portion extending substantially continuously along said periphery to be placed against a resected bone surface in the body to which said prosthesis is to be affixed, recess means in said fixation surface for forming a cement receiving chamber within the confines of said peripheral portion, said cement receiving chamber being closed by the resected bone surface when said fixation surface is placed against the resected bone surface;
a rim projecting from said peripheral portion and having a sharp edge extending along said peripheral portion substantially around said recess means for penetrating the resected bone surface; and
means in said body establishing communication with said recess means from externally of said body after said fixation surface is placed against the tissue surface whereby cement can be supplied to the cement receiving chamber after said prosthesis is placed against the resected bone surface.
9. A prosthesis for implant in the body comprising
a body having an upper wall, a lower wall with a periphery and a fixation surface extending along said periphery to be placed against a tissue surface in the body to which said prosthesis is to be affixed, an end wall disposed between said lower wall and said upper wall within the confines of said fixation surface, said end wall covering substantially the entire area of said body bounded by said fixation surface and having a planar surface spaced from said lower wall for defining a space closed by the tissue surface when said fixation surface is placed against the tissue surface; and
means in said body establishing communication with said end wall from externally of said body after said fixation surface is placed against the tissue surface for supplying cement between said end wall and the tissue surface after said prosthesis is placed against the tissue surface.
1. Field of the Invention
The present invention relates broadly to prosthetic implants, and more particularly, to prostheses for human joints, such as the knee, implantable by means of arthroscopic as well as open surgical techniques.
2. Discussion of the Prior Art
Previous proposals for artificial knee prostheses including components for surgical implantation into a patient's knee are known in the art. The complexity of normal knee movement, however, has rendered the attainment of natural knee action quite difficult. More specifically, the natural knee joint includes the bottom part of the femur, constituted by the two condyles, the lower parts of which bear upon the complementary shaped upper surface plateaus of the tibia through the intermediary of cartilage or meniscus. Connection through the knee is provided by means of ligaments which also provide joint stability and assist in absorbing stresses applied to the knee. The femur, cartilage and tibia are normally subjected to significant compression loading in supporting the weight of the body.
Movement of the normal knee is not a true hinged joint about a single center but, rather, is a complex action including rocking, gliding and axial rotation. During the first part of the knee movement from full extension of the leg towards flexion, there is pivotal rotation of the tibia about the femur, which is then converted to a rocking movement wherein the femoral condyles roll posteriorly on the tibial plateaus. The rocking movement then changes to a combined sliding and pivoting movement wherein successive points on the femoral condyles slide forward on the tibial plateaus until full flexion is obtained. In other words, the flexion movement is polycentric, that is, about different centers which are not fixed in one position but lie in a somewhat spiral or polycentric pathway.
A variety of total knee prostheses have been proposed, essentially being of two broad types, hinged and non-hinged. Knee prostheses of the first category possess significant disadvantages in that they generally involve the removal of natural ligaments and only permit motion about a single axis as opposed to the controlled rotation and translation characteristic of a natural, healthy knee.
Knee prostheses of the second type generally include femoral components secured to the condylar surfaces of the femur, typically having cylindrical bearing surfaces, and tibial components fixed to the tibial plateaus, the femoral components bearing against the upper surfaces of corresponding tibial components. Examples of prostheses of the latter type are shown in U.S. Pat. No. 4,470,158 to Pappas et al; U.S. Pat. No. 4,211,228 to Cloutier; U.S. Pat. No. 4,207,627 to Cloutier; and U.S. Pat. No. 3,953,899 to Charnley.
In addition to total knee replacement, unicompartmental knee replacement is known wherein a single compartment of the knee is surgically restored. Typically, the medial or lateral portion of the tibio-femoral joint is replaced without sacrificing normal remaining structure in the knee. For instance, U.S. Pat. No. 4,340,978 to Buechel et al discloses a unicompartmental knee replacement device including a tibial platform secured to the tibia and having a track for receiving a bearing insert. A femoral component is attached to one of the condylar surfaces of the femur and is provided with a generally convex spherical inferior surface for engaging the superior surface of the bearing insert. Similar unicompartmental knee implants are shown in U.S. Pat. No. 4,743,261 to Epinette; U.S. Pat. No. 4,309,778 to Buechel et al; U.S. Pat. No. 4,193,140 to Treace; U.S. Pat. No. 4,034,418 to Jackson et al; and U.S. Pat. No. 3,852,830 to Marmor.
The non-hinged knee implants previously discussed, while possessing advantages over the hinged devices, nonetheless are characterized by numerous drawbacks. Many of the prior art prostheses require the removal of a great deal of bone from the femur and tibia in order to accommodate the implant, thus complicating and prolonging the surgical procedure and reducing the amount of bone available in reserve should subsequent restorative measures be required. Additionally, alignment of the prosthesis components is extremely difficult, and even small misalignments lead to an imbalance of the forces transmitted from the femoral component to the tibial component. The asymmetric distribution of load on the plateaus of the tibial component can result in tibial loosening and failure of the prosthesis. Moreover, inadequate fixation of the prosthesis can occur, possibly resulting in the prosthesis twisting loose from the implanted position.
The misalignment and anchoring problems associated with conventional prostheses are due in part to the fact that the prosthesis is secured in place by means of cement applied to the prosthesis after a trial fit and prior to actual fixation. Although the joint may have been precisely prepared to accept the prosthesis, and although the femoral and tibial components may have been accurately aligned during trial fitting, deviation from the desired location is apt to occur when the prosthesis is removed to place cement on the prepared bone surface and then replaced on the bone surface.
The prior art prosthetic devices have another disadvantage in that excess cement tends to escape from between the bone and the implant around the edges of the implant. The excess cement, if not removed, may deteriorate and crumble, thereby becoming a source of possible irritation. Additionally, cracking and breakage of the cement may lead to loosening of the cement bond, thus jeopardizing the integrity of the cemented parts. Therefore, additional steps are typically undertaken to remove the excess cement squeezed out during the surgical procedure.
Several of the prior art prosthetic devices previously referred to are illustrative of the foregoing deficiency. For example, Buechel et al ('978) is directed to a unicompartmental knee prosthesis wherein the prosthesis components must be removed after a satisfactory trial fit to allow cement to be placed on the bone surfaces. The components are then reintroduced into the surgical site, located in the pre-established position and firmly held in compression with the bone until complete polymerization has been obtained. Excess cement is removed from the edges of the prosthetic component by a scalpel and curette. Similarly, Charnley teaches inserting cement through a hole cut into the head of the tibia. The anterior end of the tibial component is then elevated to cause the posterior end to press into the tibia bone so as to close the posterior route of escape for the cement. Treace discloses a knee prosthesis for fixation to the femur including a curved body provided with a plurality of cement holding rings fixedly attached to and extending upwardly from the upper surface of the body. The femur must be prepared by drilling slots therein for receiving the cement holding rings subsequent to cement being injected into the slots.
Accordingly, it is a primary object of the present invention to overcome the above mentioned disadvantages of the prior art.
Another object of the present invention is to provide a prosthesis permitting cement to be supplied between the prosthesis and the prepared tissue surface after the prosthesis has been positioned on the tissue surface.
A further object of the present invention is to provide a prosthesis which can be implanted utilizing arthroscopic surgical techniques.
An additional object of the invention is to utilize a rim to control rotation of a femoral prosthesis during fixation by cement.
The present invention has another object in that unicompartmental prosthetic total knee replacement can be performed with the use of modular tibial components, bearing inserts and femoral components.
Another object of the invention is to provide a tibial prosthesis receiving bearing inserts of varying thicknesses to provide accurate alignment.
According to the present invention, therefore, a prosthesis includes a body having a fixation surface for placement adjacent the surface of the tissue, such as bone, to which the prosthesis is to be affixed. A recess is formed in the fixation surface of the body such that, when the fixation surface is positioned adjacent the bone surface, the recess is substantially closed off by the bone surface to define a cement receiving chamber. Securing means such as a screw or post member secures the body member in position on the bone surface. A channel formed in the prosthetic body establishes communication between the cement receiving chamber and the exterior of the body member, and cement is introduced into the cement receiving chamber via the channel. Thus, the prosthesis may be cemented in place while in the desired position and secured against movement. The invention further contemplates a wall or rim extending from the fixation surface for penetrating the bone surface when the prosthesis is in position thereon so as to provide additional stability. The rim extends along and at least partially surrounds the recess to serve as a seal or trap for preventing release of cement from the cement receiving chamber thereby augmenting cement pressurization.
Some of the advantages of the present invention over the prior art are that the prostheses can be placed using arthroscopic surgical techniques, textured surfaces enhance the prosthesis-cement interface, the asymmetrical shape of the tibial prosthesis component provides optimal coverage of the tibial plateau, the modular design allows variation of final tibial thickness, the femoral prosthesis component does not interfere with the patella, two spaced tapered posts on the femoral prosthesis component provide rotational stability, a rim extending along a recess in the fixation surface of the femoral prosthesis component resists rotation of the implant and augments cement pressurization, a rim extending along a recess in the fixation surface of the tibial prosthesis component holds the implant in place and augments cement pressurization, and a portal or channel through the tibial and femoral prosthesis components allows placement of bone cement between the implant and the prepared bone surface after the implant has been accurately positioned on the bone surface without moving the implant.
Other objects and advantages of the present invention will become apparent from the following description of the preferred embodiments taken in conjunction with the accompanying drawings.
FIG. 1 is a side view of the knee joint prosthesis of the present invention with the femur and tibia shown in phantom.
FIG. 2 is a top plan view of the tibial prosthesis component of the present invention.
FIG. 3 is a bottom plan view of the tibial prosthesis component of FIG. 2.
FIG. 4 is a cross-section of the tibial prosthesis component taken along line 4--4 of FIG. 2.
FIG. 5 is an enlarged fragmentary view taken along line 5--5 of FIG. 4.
FIG. 6 is a broken side view of the tibial prosthesis component with a bearing insert shown in phantom.
FIG. 7 is a top view of a bearing insert of the present invention.
FIG. 8 is a section of the bearing insert taken along line 8--8 of FIG. 7.
FIG. 9 is a bottom plan view of another embodiment of the tibial prosthesis component of the present invention.
FIG. 10 is a side view of a further embodiment of the tibial prosthesis component of the present invention.
FIG. 11 is a side view of the femoral prosthesis component of the present invention.
FIG. 12 is a top view of the femoral prosthesis component of FIG. 11.
FIG. 13 is an anterior view of the femoral prosthesis component of FIG. 11.
FIG. 14 is an enlarged fragmentary view in section taken along line 14--14 of FIG. 11.
The present invention relates to prostheses for implant in the body and is particularly described in connection with a prosthesis or implant for the knee joint. A preferred embodiment for a knee joint prosthesis implant according to the present invention is shown in FIG. 1 and includes a tibial prosthesis component 12, a femoral prosthesis component 14 and a bearing insert 60. The tibial component 12 is affixed to a suitably prepared site on the upper plateau 16 of the tibia 18, shown in phantom. The femoral component 14 is affixed to a suitably prepared site on a condyle 20 of a femur 22, shown in phantom.
FIGS. 2-6 show a preferred embodiment of the tibial component 12 including a body 24 which, viewed from the top, has a generally asymmetrical, D-shaped configuration with an arcuate side wall 26 joined to a generally planar side wall 28 via curved side wall sections 29. The body 24 has a top or upper surface 30 connecting the upper edges of the planar side wall 28, the arcuate side wall 26 and the curved side wall sections 29. As best shown in FIG. 3, the body has a bottom or fixation surface 32 connecting the lower edges of the planar side wall 28, the arcuate side wall 26 and the curved side wall sections 29.
A cavity 34 is formed in the top surface 30 of the body 24 defined by a planar cavity side wall 36 joined to an arcuate cavity side wall 38 by curved cavity wall end sections 40 and a cavity bottom wall 42 joining the lower edges of cavity side walls 36, 38 and 40. An inwardly tapered through hole 44 is formed in the cavity bottom wall 42 and extends substantially perpendicularly through the body 24.
With particular reference to FIGS. 2 and 4, each curved cavity wall end section 40 has a lip 46 projecting from the curved cavity wall section into the interior of the cavity 34. As shown in detail in FIG. 5, the lip 46 has a chamfered surface 48 extending downwardly from the top surface 30 of the body at an angle of approximately 45�. The surface 48 terminates in a vertical cavity facing surface 50 which joins curved cavity wall section 40 via a horizontal surface 52. Curved cavity wall sections 40 extend downwardly from horizontal surface 52 to cavity bottom wall 42 at an angle of approximately 20� toward the interior of the cavity 34 such that lips 46 form grooves in the side wall curved end sections 40.
With reference to FIG. 6, it can be seen that the top surface 30 of the body 24 is generally flat except for a sloping surface 54 at an anterior portion extending from a straight edge 56 located on the top surface downwardly at an angle of approximately 30� with respect to the parallel top and bottom surfaces to meet the side walls of the body. A through hole 58 is formed in the anterior portion to extend through the body from sloping surface 54 to bottom surface 32 at an angle of approximately 60� with respect to the bottom surface 32 and perpendicular to surface 54.
A bearing insert 60 closely configured to the peripheral dimensions of the cavity 34, as defined by cavity side wall sections 36, 38 and 40, includes a body defined by a planar insert side wall 62 joined to an arcuate insert side wall 64 by curved insert wall end sections 66. The body has an upper surface 68 joining the upper ends of the insert side walls 62, 64 and 66, while the lower ends of the side walls are joined by a lower surface 70.
Upper surface 68 is slightly concave when viewed from the side, as shown in FIGS. 6 and 8. Each curved end section 66 is provided with a flexible protruding lip 72 extending upwardly and outwardly from the lower surface 70 toward the upper surface 68 at an angle of approximately 20� with respect to the end section 66, as best illustrated in FIG. 8, to terminate in an upper edge 73 spaced from the side wall curved end section 66. The insert 60 has a configuration mating with the configuration of cavity 34 and is received in the cavity 34, as shown in phantom in FIG. 6, with the insert bottom surface 70 resting on the cavity bottom wall 42, insert side walls 62, 64 and 66 in close abutment with the respective cavity side walls 36, 38 and 40 and the lips 72 engaged in the grooves beneath lips 46 to securely retain the insert in position within the cavity. A range of inserts ranging in thickness, for example, from approximately 8 mm to 15 mm as measured from the insert upper surface 68 to the insert lower surface 70, is provided so that the proper fit can be attained. The upper surface 68 of the insert will be elevated with respect to the top surface 30 of the tibial component body by varying amounts depending upon the thickness of the particular insert. Preferably, the bearing insert is integrally fabricated in a unitary manner of ultrahigh molecular weight polyethylene.
As particularly shown in FIG. 3, the fixation surface 32 of the body 24 has a recess 74 therein defined within the confines of the side walls 26, 28 and 29 of the body. A channel or portal 76 connects the recess 74 to the exterior of the body and extends from the recess 74 through the arcuate side wall 26 at the anterior portion of the body. The recess 74 and the channel 76 share a common end wall 78 which defines the depth to which the recess and channel extend above the bottom surface 32 into the interior of the body. A land 80 along the fixation surface 32 isolates the through hole 44 from the recess 74, while a land 82 along the fixation surface 32 isolates the through hole 58 from the recess 74. A rim 84 projects from the bottom surface 32 spaced from but following the curve of arcuate side wall 26 with an interruption at the location of channel 76. As is most clearly depicted in FIGS. 4 and 5, the rim 84 is triangular in cross-sectional configuration, with the apex of the triangle forming a sharp bottommost edge 86 for the body. The rim 84 defines a wall extending along the recess 74 and at least partially surrounding the recess.
The tibial component 12 is provided in a range of sizes, for example, with the dimension A of the body ranging from approximately 37.5 mm to approximately 54 mm and the dimension B ranging from approximately 21 mm to approximately 33 mm, as shown in FIG. 2, to accommodate a range of sizes for optimal coverage of the tibial plateau. The asymmetrical "D" configuration of the body further contributes to optimal tibial plateau coverage in order to present a contact area for the femoral component coinciding with that of a normal knee.
The tibial component 12 is particularly designed to be affixed to a suitably prepared tibial plateau through arthroscopic surgical techniques; however, the tibial component can be used in normal open surgery procedures for prosthetic knee replacement. In use, the body can be grasped by an appropriate surgical instrument and placed in position on the tibial plateau with the bottommost edge 86 resting upon the tibial plateau. Once the desired position for the body on the tibial plateau has been established, the body is affixed by a cancellous bone screw 88 inserted at an angle through hole 58 and into the anterior portion of the tibia as illustrated in FIG. 1. A second cancellous bone screw 90 can be inserted through the body into the tibia via through hole 44 if desired. The recess 74 formed in the bottom surface 32 of the body define, together with the tibial plateau, an enclosed cement receiving chamber which communicates with the exterior of the body through channel 76. A bone cement, preferably low viscosity methyl-methacrylate, is injected into the chamber through channel 76 to form a physical bond between the body and the tibial plateau. It can be seen, therefore, that the tibial component can properly be positioned prior to the application of cement and need not be moved or disturbed in any manner thereby assuring precise and accurate positioning. The cement can be inserted in the cement receiving chamber by means of a needle or syringe to be compatible with arthroscopic techniques. The rim 84 forms a seal around the cement receiving chamber with respect to the tibial plateau to augment filling of the cement receiving chamber, and the rim 84 penetrates the tibial surface to establish a seal preventing escape of cement from the chamber while the bottom surface 32 engages the tibial plateau. Additionally, the rim 84 stabilizes the position of the tibial component on the tibial plateau. The lands 80 and 82 along the bottom surface 32 isolate the respective fixation screws from the cement so that the screws can be removed, if necessary. The bottom surface 32 and the wall 78 of recess 74 are textured to enhance the interface between the body and the cement. The invention contemplates a right medial/left lateral orientation for the tibial component in addition to the left medial/right lateral illustrated herein. A suitable bearing insert 60 can be inserted after the body has been implanted, or the insert 60 can be mounted in the body prior to implanting the body.
Another embodiment of a tibial component according to the present invention is shown in FIG. 9 wherein a body 88 is essentially the same as body 24 except that through hole 44 has been eliminated and the recess 90 follows the arcuate wall 26, as does end wall 92. The body 88 thus accommodates only a single screw which, due to its position at the anterior portion of the implant, provides sufficient fixation.
A further embodiment of the present invention is shown in FIG. 10 and is essentially the same as the tibial component of FIG. 9 except that a post 96 depends from the end wall 92 of the recess 90 at substantially the same position as through hole 44 shown in FIG. 3. The post 96 is intended to be inserted into a corresponding drilled hole in the tibial plateau. Preferably, the post 96 is tapered to allow a press fit into the corresponding hole.
The femoral component 14 of the prosthesis of the present invention is illustrated in FIGS. 11-15 and includes a body 100 having a curved configuration defining an arcuate outer bearing surface 102 with an anterior or distal end 104 and a posterior end 106. The bearing surface 102 is generally polycentric, that is, the surface lies on arcs of circles having more than one center and more than one radius to approximate the natural articulating surface of a femoral condyle. The posterior end 106 curves somewhat sharply while the anterior end 104 curves somewhat gradually. In other words, the radius cf an imaginary circle in which the anterior end 104 lies is greater than the radius of an imaginary circle in which the posterior end 106 lies. Body 100 further includes an inner fixation surface which joins the bearing surface 102 at side and end edges. The fixation surface includes a planar posterior section 118, a planar chamfer section 120 and a planar distal section 122. The posterior and distal sections 118 and 122 are oriented substantially perpendicular with respect to each other, while chamfer section 120 is oriented at an angle of substantially 45� with respect to the posterior and distal sections.
As shown in the top view of the femoral component 14 in FIG. 12, the body 100 has a generally straight medial side edge 110 and a generally straight lateral side edge 112 parallel to edge 110 but about one half the length of the edge 110. The side edge 112 is joined to side edge 110 via a generally polycentric curved edge 114. An arcuate posterior edge 116 joins the opposite ends of the side edges 110 and 112. Side edge 110 extends along the sides of the posterior, chamfer and distal sections of the fixation surface. Side edge 112 extends along the sides of the posterior and chamfer sections and along a portion of the side of the distal section, the curved edge 114 extending along the remaining portion of the side of the distal section.
As shown in FIGS. 11 and 12, a recess 124 is formed in the chamfer section 120 and the distal section 122 of the fixation surface. A side wall 126 of the recess 124 generally follows the side edges 110, 112 and 114 of the body 100, running generally parallel thereto but separated therefrom by a portion of the fixation surface. The recess is provided with a bottom surface 128 and terminates along a bottom edge 130 of the posterior section 118. A channel 132 is formed in the bottom surface 128 of the recess 124 extending generally parallel to the side edge 110 of the body 100 in the distal section 122 and through the curved side edge 114 of the body to establish communication with the exterior.
Posts 136 and 138 project upwardly substantially perpendicular to bottom surface 128, preferably at an inclination of 5� from the plane of the posterior section 118. The posts 136 and 138 are generally cone-shaped and have respective tapered top ends 140 and 142. As depicted in FIG. 11, the post 136 is longer than the post 138, the post 138 being around two-thirds the length of post 136. A rim 144 projects from the fixation surface, spaced from but lying generally parallel to side edges 110, 112 and 114 of the body 100. As can be seen in FIG. 12, the rim 144 also lies generally parallel to the side wall 126 of the recess 124 so as to at least partially surround the recess 124 along the chamfer section 120 and the distal section 122. The rim 144 is preferably triangular in cross-sectional configuration to provide a relatively sharp edge 148 as was discussed in connection with rim 84 for the tibial component 12 and as shown in FIG. 14. A semi-circular indentation 150 is provided on each side of the body 100 in distal section 122 proximate side edges 110 and 112 as shown in FIGS. 11, 12 and 13.
The femoral component 14 is adapted to be positioned on a condylar surface of the femur after the surface has been suitably cut and shaped to conform to the fixation surface of the body 100. The femoral component may be positioned by means of open or arthroscopic surgical techniques with the indentations 150 engaged by a surgical tool for placement of the femoral component on the prepared femoral condyle. The posts 136 and 138 are fitted into drilled holes in the cut distal end of the femoral condyle, the tapered upper ends 140 and 142 of the posts allowing for a press fit. With the femoral component in the proper position on the femoral condyle, the rim 144 penetrates the bone to enhance securement and forms a seal with respect to the bone around the cement receiving chamber formed by the recess 124 and the surface of the bone. Cement is introduced into the chamber through the channel 132 by means of a syringe, a needle or the like as discussed in connection with the tibial component. The rim 144 inhibits rotation of the femoral component as do the posts 136 and 138. Preferably, the fixation surface and the recess bottom surface 128 are textured to enhance the interface between the femoral component and the cement. The tibial and femoral components are preferably fabricated of metal, the preferred material for the tibial component being implant grade titanium, and for the femoral component cobalt-chromium.
The surface 102 of the femoral component cooperates with the concave surface 68 of bearing insert 60 to allow the same freedom of movement afforded by a healthy knee. The nonmetallic insert 60 provides a bearing surface for the metallic femoral component similar to the cartilage in a natural knee joint. The plastic material from which the insert is fabricated provides a low coefficient of friction between the contacting surfaces and minimizes the rate of wear of the contacting surfaces of the components. As discussed in connection with the tibial component, it is contemplated that the femoral component be available in a number of sizes, and in right medial/left lateral and left medial/right lateral versions to prevent interference with the patella.
The knee joint prosthesis of the present invention can be used in conventional open, total knee replacement surgical procedures but is particularly useful for implant using arthroscopic surgical techniques due to the simplified cementing procedures and the stability permitted by the tibial and femoral prosthesis components coupled with the modular nature thereof and the use of bearing inserts of varying sizes to produce desired tibial thicknesses or heights. Method and apparatus for implant of the knee joint prosthesis of the present invention are disclosed in an application filed concurrently herewith by the same inventors, entitled "Methods and Apparatus for Arthroscopic Prosthetic Knee Replacement", the disclosure of which is incorporated herein by reference.
Inasmuch as the present invention is subject to many variations, modifications and changes in detail, it is intended that all subject matter discussed above or shown in the accompanying drawings be interpreted as illustrative only and not be taken in a limiting sense.
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Attending KahBang
WTF is a Music Flex Day Pass? | Warren The Intern Explains
For the past few years, we have received a lot of emails from fans saying that they would like to buy a Music Day Pass for KAHBANG, but they are unsure what day they will be able to attend or if they can get the time off from work. Additionally, a lot of people would like to
Warren The Intern
March 7th, 2014


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Stor-Drawer Frame Crossbars - Series 12 (Set of 4)
Item #: 046964941218 Stock Status: In Stock
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Stor-Drawer Series 12
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A set of Series 12 Frame Crossbars are necessary for building a compact Series 12 or Series 12 Mini Stor-Drawer Basket System to organize a narrow space. These crossbars are used when assembling a storage drawer system that holds series 12 size wire baskets, which will fit in spaces at least 14" wide. A properly assembled Stor-Drawer system provides an overall weight capacity of 100 pounds.
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Product Dimensions Additional Product Info
- Stor-Drawer Series 12 Crossbars Features
- Durable steel construction with a baked on white epoxy finish.
- Series 12 size creates a storage drawer system that fits in spaces at least 14" wide.
- Works with any size frame uprights to build a Stor-Drawer system that then holds coordinating Series 12 or Series 12 Mini baskets.
- Set of four support crossbars coordinate with a pair of frame uprights to create a single Stor-Drawer unit.
- Crossbars attach at the top and bottom of the frames on both the front and back to maintain superior strength and stability.
- Essential for building a space-saving Stor-Drawer basket system to organize a narrow space in the laundry room, kitchen pantry, craft workspace, or linen closet.
- Assembled Stor-Drawer unit offers a weight capacity of 100 pounds.
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our Kiffle buns this year, we're trying something new: making sweet roll dough in the bread machine using this recipe, and then shaping them and adding jam "pokes" as we usually do. (More on Kiffle here.)
"I could eat a hundred grilled cheese sandwiches. And a hundred macaroni and cheese. And a hundred kiffle. And a hundred of my favourite beans."--Crayons, April 2006
(That's an old photo--this year's are still in the dough-rising stage.)
Linked from Four Moms Bake Bread (March 2011)
Friday, April 10, 2009
Bread and Jam for Easter
Posted by Mama Squirrel at 9:25 a.m.
Labels: bread, Easter, Good Friday, Kiffle, Resurrection
1 comment:
- Headmistress, zookeeper said...
Those look YUMMY!
- 11:47 a.m.
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The Owls are said to be exploring midfield transfer options, with Seyi Olofinjana in their thoughts.
The 33-year-old has spent time training with Wednesday and is available as a free agent following his release by Hull City.
Jones admits to being an admirer of the Nigeria international, but says there is no room in his ranks for additions at present.
He said in the Sheffield Star: "Things are tight, and until I can move people out I can't bring people in."
Jones is not overly concerned at the thought of working with those already at his disposal, with injuries having opened the door to those on the fringes of the squad to prove their worth.
He added: "It always gives somebody else an opportunity. At the moment there are a lot of opportunities for people to show 'I'm ready and I can do it'.
"We need to strengthen and move players out when they're surplus to requirements. But players have been given opportunities in the past and taken them. The door is never closed."


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It's my birthday today, I turned 46 and for the first time in my life I'm feeling a little blue about my age. Don't get me wrong I'm still gorgeous and everything, but I feel the big 50 coming and it's making me depressed. I don't know if it's my imagination but my teeth are starting to feel loose and I feel they might start to drop onto my lap as I type. Yesterday I went to smack my husband with my slipper and I barely leaped one foot off the ground, usually I can jump 3 ft. off the ground, smack him, and simultaneouly pulvarize the spider perched on the ceiling with one swoop!! Well, I have to go to work now where everyone will pat me on the shoulder and then rub Ben Gay on it. Boo hoo hoo Wah!!!!
White gold and yellow gold hoops intertwined.
I have my eye on a pair of earings at Costco that will do very nicely thank you!!! I love you guys, thanks for all of your good wishes. Constance, my mom says I've closed 46 and going on 47. You know all Greeks say this!!! They're such rays of hope and sunshine sometimes.
for the first time I had coffee coming out of my nose. Luckily I saved it with holding my cup underneath it. Wouldn't want to spill the precious coffee beans.
You still look very young and beautiful to me! (Even with a few teeth missing).
I hope you have a great day! :)
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Hans Bathelt
Anybody like this band and drummer from the 70s?
They were Germany's answer to ELP.
I liked this type of prog rock and found Hans Bathelt's drumming to be precise,
tasteful and reserved. I also like the sound of his drums.
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By now I'm sure your copy of the July Anthropologie catalog is tattered, dog-eared, and chocolate stained. Maybe even spotted with drool? Mine is for sure, so I had to take to the InterWeb and swipe some images for these Outfit to Room pairings. It simply doesn't get better than this, folks.
At this stage I'm beyond matching only the outfit to the room. Because Anthropologie does such a brilliant job creating an environmental mood, I'm drawing inspiration from the image as a whole. My challenge? Create a seamless pairing that segues flawlessly from one shot to the next.
I'm utterly captivated by the dreamy, Atonement-esque sensibility here. It's unexpected to see deep hues, shadowy light, and velvets and paisleys in a July catalog, yet the effect is a complete success. I feel like I've been transported to a crumbling English estate on a lazy, hazy summer afternoon.
I wasn't kidding yesterday about papering my bedroom walls with a glorious pattern, so there's some major ideas to sink my teeth into here. I adore the impact of stripes paired with traditional florals, and I have some vintage French ticking pillows waiting for the perfect wallpaper mate!
This soft blue pairing has me longing for an airy retreat from my busy schedule. With everything on my to-do list lately, I'm trying to cultivate peaceful moments throughout the day--a walk around the block, coffee with a friend--and the soft mood here provides perfect inspiration for us all! Just two days 'til the weekend, everyone!
All fashion images courtesy of Anthropologie. Interiors Images: 1. French Country Style at Home 2, 4, 5. Homes and Gardens 3. World of Interiors


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Arizona Cardinals
All-Access with Arians: Cardinals are a healthy team
GLENDALE, Ariz. -- Head coach Bruce Arians, now in his second year with the Arizona Cardinals, meets the media each day during training camp.
Here, in this space, we'll highlight many of the key topics and personnel conversations he has with reporters following the morning walkthrough:
"Only person not practicing still is Lyle Sendlein (calf). Everybody else is good to go; might be a first after six or seven days of training camp to have everybody available. With that in mind, I'm going to give Darnell Dockett the day off."
What he hopes to see out of his players in first preseason game against the Houston Texans
"Can you play smart, fast and physical? If you can do those three things, I'll like you a lot."
Is tight end Troy Niklas OK to play with that cast on his hand?
"He's going to have a much smaller one starting today. He's about 99 percent healed so we don't want to re-injure it. He's going to have a smaller one and he'll have some use of some fingers."
Why are some players are better in practice than in games, and vice versa?
"I never like that guy they call a gamer. I like to see it every day, but there are guys that just shine in games, when the lights come on. The other guys it's normally nerves. It's like, why are there good putters and bad putters? They can all make them on the practice green, but they get it out there (on the course) and all of a sudden just you can't make a putt. That's the same thing with playing. If you just get a little bit tight, you're not going to play fast enough and you're not going to play confidently enough to do your job."
Have you seen a carryover in the defense from last season?
"Oh, there's no doubt. Every day we go on the field, it's an unbelievable challenge for this offense. First of all, (the defense) has seen us practice now for about 25 days. They recognize things very well, they know all the audibles and they're very talented. So, when the offense wins a few matches in practice, I'm very proud that our offense is getting better. But our defense has a great swagger about it. We've got some good depth in the d-line rotation right now. I think there's no doubt that there's a ton of confidence left over from last year."
Asked about the difficulty ahead when it comes to roster decisions
"We're going to cut some really good players this year, and that's a testament to (general manager) Steve (Keim) and (vice president player personnel) Terry (McDonough) and the guys that built the roster. It's a very nice problem to have."
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Cardinals Audio
- Jen Welter, Cardinals assistant coach - Tuesday July 28Welter talks about the historical significance of her hire, and how she'll approach the job
- Bickley Blast - Tuesday July 28The Cardinals made a ground breaking coaching hire
- Former Arizona Cardinals Pro Bowler Bertrand Berry - Tuesday July 28Bertrand Berry talks about the Cardinals hiring Jen Welter as the first woman coach in NFL history.
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- Hardware - Monday July 27The Sign of Our Times award, the 2nd Place Isn't So Bad award and more