text:
|Número de publicación
|Tipo de publicación
|Número de solicitud
|Fecha de publicación
|5 Jun 1984
|Fecha de presentación
|2 Jul 1982
|Fecha de prioridad
|2 Jul 1982
|Número de publicación
|Leonard W. Russum
|Cesionario original
|Standard Oil Company (Indiana), Gulf Oil Corporation
|Exportar cita
|BiBTeX, EndNote, RefMan
|Citas de patentes (2), Citada por (24), Clasificaciones (11), Eventos legales (9)
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet
This invention relates to a process for retorting of oil shale.
Researchers have now renewed their efforts to find alternative sources of energy and hydrocarbons in view of recent rapid increases in the price of crude oil and natural gas. Much research has been focused on recovering hydrocarbons from solid hyrdocarbon-containing material such as oil shale, coal and tar sands by pryolysis or upon gasification to convert the solid hydrocarbon-containing material into more readily usable gaseous and liquid hydrocarbons.
Vast natural deposits of oil shale found in the United States and elsewhere contain appreciable quantities of organic matter known as "kerogen" which decomposes upon pyrolysis or distillation to yield oil, gases and residual carbon. It has been estimated that an equivalent of 7 trillion barrels of oil is contained in oil shale deposits in the United States with almost sixty percent located in the rich Green River oil shale deposits of Colorado, Utah, and Wyoming. The remainder is contained in the leaner Devonian-Mississippian black shale deposits which underlie most of the eastern part of the United States.
As a result of dwindling supplies of petroleum and natural gas, extensive efforts have been directed to develop retorting processes which will economically produce shale oil on a commercial basis from these vast resources.
Generally, oil shale is a fine-grained sedimentary rock stratified in horizontal layers with a variable richness of kerogen content. Kerogen has limited solubility in ordinary solvents and therefore cannot be recovered by extraction. Upon heating oil shale to a sufficient temperature, the kerogen is thermally decomposed to liberate vapors, mist, and liquid droplets of shale oil, water, and light hydrocarbon gases, such as methane, ethane, ethene, propane and propene, as well as other products, such as hydrogen, nitrogen, carbon dioxide, carbon monoxide, ammonia, steam and hydrogen sulfide. A carbon residue typically remains on the retorted shale.
In order to obtain high thermal efficiency in retorting, carbonate decomposition should be minimized. Carbonate decomposition consumes heat, lowers thermal efficiency and decreases the heating value of off gases. Colorado Mahogany zone oil shale contains several carbonate minerals which decompose at or near the usual temperature attained when retorting oil shale. Typically, a 28 gallon per ton oil shale will contain about 23% dolomite (a calcium/magnesium carbonate) and about 16% calcite (calcium carbonate), or about 780 pounds of mixed carbonate minerals per ton. Dolomite requires about 500 BTU per pound and calcite about 700 BTU per pound for decomposition, a requirement that would consume about 8% of the combustible matter of the shale if all these minerals were allowed to decompose during retorting. Saline sodium carbonate minerals also occur in the Green River formation in certain areas and at certain stratigraphic zones.
Shale oil is not a naturally occurring product, but is formed by the pyrolysis of kerogen in the oil shale. Crude shale oil, sometimes referred to as "retort oil," is the liquid oil product recovered from the liberated effluent of an oil shale retort. Synthetic crude oil (syncrude) is the upgraded oil product resulting from the hydrogenation of crude shale oil.
The process of pyrolyzing the kerogen in oil shale, known as retorting, to form liberated hydrocarbons, can be done in surface retorts in aboveground vessels or in situ retorts under ground. In situ retorts require less mining and handling than surface retorts.
In in situ retorts, a flame front or an inert feed gas is passed downward through a bed of rubblized oil shale to liberate shale oil, off gases and residual water. There are two types of in situ retorts: true in situ retorts and modified in situ retorts. In true in situ retorts, the oil shale is explosively fractured and then retorted. In modified in situ retorts, some of the oil shale is removed before explosive rubblization to create a cavity or void space in the retorting area. The cavity provides extra space for rubblized oil shale. The oil shale which has been removed is conveyed to the surface and retorted above ground.
Air is typically injected into in situ retorts to support the flame front. Air contains appreciable quantities of nitrogen, however, which contaminate the retort gases.
Different sized oil shale fragments, channeling, irregular packing and imperfect distribution of oil shale fragments in underground retorts can cause tilted (nonhorizontal) and irregular, high temperature flame fronts in close proximity to the retorting zone and fingering, that is, flame front projections of high temperature which extend downward into the raw oil shale and advance far ahead of other portions of the flame front. High temperature flame fronts and fingering can cause carbonate decomposition, coking and thermal cracking of the liberated shale oil. Irregular, tilted flame fronts can lead to flame front breakthrough, incomplete retorting and burning of the product shale oil.
In the case of severe channeling, horizontal pathways may permit oxygen to flow underneath the raw unretorted shale. If this happens, all of the oil flowing downward in that zone may burn. It has been estimated that losses from burning in in situ retorting are as high as 40% of the product shale oil.
Typifying the many methods of in situ retorting are those found in U.S. Pat. Nos. 1,913,395; 1,191,636; 2,481,051; 3,001,776; 3,586,377; 3,434,757; 3,586,377; 3,661,423; 3,951,456; 4,005,752; 4,007,963; 4,105,072; 4,117,886; 4,119,349; 4,126,180; 4,133,380; 4,149,752; 4,158,467; 4,169,506; 4,194,788; 4,241,547; 4,241,952 and 4,285,547. These prior art processes have met with varying degrees of success.
It is therefore desirable to provide an improved process for retorting of oil shale.
A huff and puff process is provided for retorting oil shale. The huff and puff process can be advantageously used in underground in situ retorts or in aboveground surface retorts.
In the process, retort off gases are cycled through and heated in a spent shale retort, to at least the retorting temperature of raw oil shale, before being fed into an active, raw oil shale retort for use as a gaseous heat carrier material. In the active retort, the heated off gases heat the raw oil shale to a sufficient temperature to liberate an effluent product stream of shale oil and light hydrocarbon gases from the raw oil shale. Air and molecular oxygen are substantially prevented from entering the retort to prevent burning of the effluent product stream and nitrogen contamination of the retort off gases, as well as to minimize chances of explosion. Desirably, the off gases are also deoiled in a gas plant and optionally scrubbed of carbon dioxide and hydrogen sulfide before being heated in the spent shale retort.
In the preferred form, retort off gases, most preferably derived from the active retort, and air are alternately injected into the spent shale retort to cyclically heat the retort off gases and combust the coked shale. In the illustrative embodiments, the retort off gases and air are alternately passed upwardly through the spent shale retort, although they could be passed downwardly through the spent shale retort, if desired.
For in situ and surface retorts, the heated off gases are preferably passed downwardly through the active retort. Other gas flow directions can also be used.
The huff and puff process for retorting oil shale has many advantages. Off gases recovered from the huff and puff process have a high heating value (BTU) in comparison to high nitrogen level, off gases recovered from conventional retorting processes. Furthermore, retorting temperatures in the active retort will be maintained for a longer period of time in the huff and puff process, permitting the heat the penetrate large oil shale boulders and less permeable shale zones, so as to minimize the detrimental effects of imperfect rubblization and increase product yield and quality. In conventional in situ processes, a recovery of 65% of the Fischer Assay oil is considered good. In the novel huff and puff process, almost 100% of the Fischer Assay oil can be recovered.
Desirably, much of the carbon dioxide and hydrogen sulfide that is produced in the active retort is reabsorbed in the cooler zone at the bottom of the spent shale retort. Such absorption simplifies off gas scrubbing and recovery and heats the spent retort.
As used throughout this application, the term "retorted shale" refers to oil shale which has been retorted to liberate hydrocarbons leaving an organic material containing carbon residue.
The terms "spent shale" and "spent oil shale" as used herein mean retorted shale from which most of the carbon residue has been removed by combustion.
The terms "spent retort," "spent shale retort" and "spent oil shale retort" as used herein mean a retort containing retorted shale or spent shale.
A more detailed explanation of the invention is provided in the following description and appended claims taken in conjunction with the accompanying drawings.
FIG. 1 is a schematic flow diagram of a huff and puff in situ process for retorting oil shale underground in accordance with principles of the present invention;
FIG. 2 is a schematic flow diagram of a modification of FIG. 1; and
FIG. 3 is a schematic flow diagram of a huff and puff process for retorting oil shale above ground in accordance with principles of the present invention.
Referring now to FIG. 1 of the drawings, a pair of underground modified in situ, oil shale retorts 10 and 12 are located in a subterranean formation of oil shale. Retorts 10 and 12 are covered with an overburden and are each elongated, upright and generally box-shaped, with a top or dome-shaped roof.
Retorts 10 and 12 are filled with irregularly packed, fluid permeable, fragmented, rubblized masses of oil shale spaced below the roofs. The rubblized masses are formed by first mining an access tunnel or drift extending horizontally into the bottom of each retort and removing from 2 per cent to 40 per cent and preferably from 15 per cent to 25 per cent by volume of the oil shale from a central region of each retort to form a cavity or void space in the retort. The removed oil shale is conveyed to the surface and retorted in an aboveground surface retort. The mass of oil shale surrounding the cavity is then fragmented and expanded by detonation or explosives to form the rubblized mass in the retort.
Feed gas lines 14 and 16 extend from above ground through the overburden into the top of retorts 10 and 12, respectively. The extent and rate of gas flow through the feed gas lines are regulated and controlled by feed gas valves 18, 20 and 22. Air and recycled off gases are injected into the bottom of retort 10, through a common line 24 and are regulated and controlled by air valve 26 and recycle gas valve 28, respectively. Preferably, the line 24 is purged with an inert gas, such as a stack gas, between the air and recycle gas injections, to avoid explosions.
Heated off gases and combustion gases are discharged from the top of retort 10 through a common overhead line 30 and are regulated by on-off valves 20 and 32, respectively.
In order to retort retort 10, feed gas valve 18 is opened and hot inert feed gas, such as fresh hot retort off gases, steam or carbon dioxide is fed into retort 10 through feed lines 14 and 34. The feed gas passes downwardly through the retort to liberate an effluent product stream of shale oil, retort water and off gases from the raw oil shale. Off gases emitted during retorting include various amounts of hydrogen, carbon monoxide, carbon dioxide, hydrogen sulfide, carbonyl sulfide, oxides of sulfur, and low molecular weight hydrocarbons. The effluent product stream flows downward through the retort and is discharged into a collection basin and separator, such as a sump 36 in the bottom of access tunnel 38. Concrete wall 40 prevents leakage of off gas into the mine. The liquid shale oil, water and gases are separated in collection basin 36 by gravity and conveyed to the surface by pumps 41 and 42 and compressor 43, respectively, through inlet and return lines 44-49 for further processing. The pumps and/or compressor can be located above ground if desired.
Retorted oil shale contains carbon residue or coke which has useful heating value. After the raw oil shale in retort 10 has been retorted, valve 18 is closed, air valve 26 is opened and air from a compressor, pneumatic pump or blower 50 is injected upwardly into the bottom of spent shale retort 10 through lines 51, 52 and 24, respectively, to ignite a flame front which combusts the carbon residue (coke) and heats the retorted shale. Combustion gases emitted during combustion are withdrawn from the top of spent retort 10 through overhead lines 30, 53 and 54 and passed through an optional heat recovery boiler (not shown) before being substantially depleted of SO2 in SO2 removal equipment 55, by opening combustion gas valve 32 and closing recycle gas valve 20. The combustion off gases are then passed through line 56 to a stack and flared or to a cyclone or electrostatic precipitator where the gas is dedusted before being discharged into the atmosphere.
Air being fed into spent shale retort 10 is intermittently and cyclically stopped by repetitively closing and opening valve 26 to alternately quench and reignite the flame front in the spent retort for selected intervals of time. When air is not being fed into spent shale retort 10, i.e., between pulses of air, valve 28 is opened, and valve 26 is closed, to allow recycle gas blower 58 to feed retort off gases from an active, fresh oil shale retort 12, through lines 60, 62, 64 and 24, respectively, into the bottom of spent shale retort 10. The retort off gases from the active retort 12 flow upwardly through the spent shale retort 10 and are heated to at least the retorting temperature of the raw oil shale in spent shale retort 10 and preferably to a temperature ranging from about 900° F. to about 1300° F.
The heated off gases are withdrawn from the top of spent shale retort 10 through overhead line 30 and fed downwardly into the active shale retort 12 via lines 65 and 66, by opening recycle gas valve 20 and closing combustion gas valve 32, to liberate an effluent product stream of shale oil, retort water and off gases from the raw oil shale contained in the active shale retort. The effluent product stream of shale oil, retort water and off gases flows downwardly through active retort 12 and is discharged into a collection basin and separator, such as sump 68 in the bottom of access tunnel 70, where it is separated by gravity. Concrete wall 72 prevents leakage of gas into the mine. Retort water is pumped to water purification and recovery equipment 72 by pump 74 through lines 75 and 76. Shale oil is pumped to oil recovery equipment 78 by pump 80 through lines 81 and 82. Off gases emitted from active retort 12 have a composition similar to the off gases emitted from retort 10 and are pumped to gas plant 84 through lines 85 and 86 by pump 87 or a compressor in gas plant 84. Oil recovery equipment dedusts the shale oil, separates the shale oil into fractions and hydrotreats or otherwise upgrades the shale oil. Gas plant 84 includes a scrubber or other deoiling equipment to remove a substantial portion of any entrained shale oil in the effluent off gases and feeds the removed oil to oil recovery equipment 70 through oil return line 88. In the preferred mode, the gas plant and oil recovery equipment are integrated.
When air is being fed into spent shale retort 10, off gas valve 22 is opened and recycle gas valve 28 is closed to allow recycle blower 58 to feed retort off gases from gas plant 84 back into the top of retort 12 through lines 89, 90, 60, 91, 92 and 16, respectively, to assure continuous retorting of active retort 12.
The net make of the off gases from active retort 12 can be scrubbed or otherwise purified of carbon dioxide and hydrogen sulfide by passing the off gases through lines 89 and 94 into CO2 and H2 S scrubber 93. The low-in-nitrogen-content scrubbed gases are discharged through outlet line 95 for further use downstream.
If desired, the off gases from active retort 12 can be scrubbed or otherwise purified of carbon dioxide and hydrogen sulfide in CO2 and H2 S scrubber 93, via line 96 (FIG. 2), and passed through lines 97 and 98 into recycle blower 58, before the off gases are injected and heated in the spent shale retort and fed into the active shale retort. Some of the purified off gases can be conveyed through outlet line 99 (FIG. 2) for further use downstream.
Horizontal- and irregular-shaped underground retorts can also be retorted by the above huff and puff processes.
The huff and puff process shown in FIG. 3 is substantially similar to the huff and puff process shown in FIG. 1, except that the retorts 110 and 112 are above ground surface, batch sequential retorts and raw oil shale is dumped or otherwise fed downwardly into the retorts during retorting by raw shale feed lines 111 and 113, respectively. In the huff and puff process of FIG. 3, the influent retort off gases are injected upwardly into the retorts and the effluent product streams are separated in aboveground separators 137 and 169, such as API oil/water separators. Spent shale is dumped from each retort, alternately, through outlets 171 and 173. The retort off gases can also be scrubbed of carbon dioxide and hydrogen sulfide before being recycled into the retorts. For ease of understanding and for clarity, the parts and components of the huff and puff process of FIG. 3 have been given part numbers similar to the parts and components of the huff and puff process of FIG. 1, except in the 100 series, such as air blower 150, recycle gas blower 158, etc.
In the illustrative huff and puff processes, the spent shale retorts are operated cyclically, alternating between an air blow cycle during which residual carbon on the retorted shale is burned, and a recycle gas flow cycle during which recycle off gases from the active retorts are heated in the spent retorts.
In a commercial operation, it is preferred to have numerous huff and puff retorts, such as 100 or so retorts over the course of a year arranged in a time sequence with each other so that the retort gases from a hot spent retort provide the gaseous heat carrier for an active retort.
Among the many advantages of the above in situ and surface huff and puff processes are:
1. Improved product yield and recovery.
2. Less loss of product oil.
3. Better retorting efficiency.
4. More simplified gas recovery.
5. Recovery of high BTU gas with low nitrogen content.
Although embodiments of this invention have been shown and described, it is to be understood that various modifications and substitutions, as well as rearrangements and combinations of process steps, can be made by those skilled in the art without departing from the novel spirit and scope of this invention.
|Patente citada
|Fecha de presentación
|Fecha de publicación
|4 Mar 1974
|30 Nov 1976
|Occidental Petroleum Corporation
|Process for in situ oil shale retorting with off gas recycling
|20 Oct 1980
|12 Oct 1982
|Standard Oil Company (Indiana)
|In situ retorting of oil shale
|Patente citante
|Fecha de presentación
|Fecha de publicación
|22 Mar 1984
|12 Nov 1985
|Standard Oil Company (Indiana)
|Pulsed in situ retorting in an array of oil shale retorts
|8 Feb 2008
|4 Ene 2011
|Red Leaf Resources, Inc.
|Methods of recovering hydrocarbons from hydrocarbonaceous material using a constructed infrastructure and associated systems
|8 Feb 2008
|4 Ene 2011
|Red Leaf Resources, Inc.
|Methods of recovering hydrocarbons from water-containing hydrocarbonaceous material using a constructed infrastructure and associated systems
|8 Feb 2008
|15 Mar 2011
|Red Leaf Resources, Inc.
|Methods of recovering hydrocarbons from hydrocarbonaceous material with reduced non-carbonaceous leachate and CO2 and associated systems
|8 Feb 2008
|28 Jun 2011
|Red Leaf Resources, Inc.
|Methods of recovering hydrocarbons from hydrocarbonaceous material using a constructed infrastructure having permeable walls and associated systems
|6 Feb 2009
|23 Ago 2011
|Red Leaf Resources, Inc.
|Methods of transporting heavy hydrocarbons
|4 Ene 2011
|7 Feb 2012
|Red Leaf Resources, Inc.
|System for recovering hydrocarbons from water-containing hydrocarbonaceous material using a constructed infrastructure
|12 Feb 2010
|18 Sep 2012
|Red Leaf Resources, Inc.
|Convective heat systems for recovery of hydrocarbons from encapsulated permeability control infrastructures
|5 Feb 2010
|4 Dic 2012
|Red Leaf Resources, Inc.
|Carbon management and sequestration from encapsulated control infrastructures
|10 Feb 2010
|8 Ene 2013
|Red Leaf Resources, Inc.
|Methods of recovering hydrocarbons from hydrocarbonaceous material using a constructed infrastructure and associated systems maintained under positive pressure
|5 Feb 2010
|5 Feb 2013
|Red Leaf Resources, Inc.
|Intermediate vapor collection within encapsulated control infrastructures
|9 Feb 2010
|5 Feb 2013
|Red Leaf Resources, Inc
|Methods of recovering minerals from hydrocarbonaceous material using a constructed infrastructure and associated systems
|5 Feb 2010
|5 Feb 2013
|Red Leaf Resources, Inc.
|Vapor collection and barrier systems for encapsulated control infrastructures
|10 Feb 2010
|23 Jul 2013
|Red Leaf Resources, Inc
|Corrugated heating conduit and method of using in thermal expansion and subsidence mitigation
|22 Dic 2011
|22 Abr 2014
|Chevron U.S.A. Inc.
|Preconditioning a subsurface shale formation by removing extractible organics
|22 Dic 2011
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|In-situ Kerogen conversion and product isolation
|22 Dic 2011
|7 Oct 2014
|Chevron U.S.A. Inc.
|In-situ kerogen conversion and oxidant regeneration
|11 Feb 2010
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|Articulated conduit linkage system
|22 Dic 2011
|20 Ene 2015
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|In-situ kerogen conversion and recovery
|16 Dic 2010
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|Red Leaf Resources, Inc.
|Method for the removal and condensation of vapors
|25 May 2012
|31 Mar 2015
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|Isolating lubricating oils from subsurface shale formations
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|In-situ kerogen conversion and product upgrading
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|In-situ kerogen conversion and recycling
|Clasificación de EE.UU.
|208/407, 208/410, 166/261, 166/266
|Clasificación internacional
|Clasificación cooperativa
|Clasificación europea
|20 Sep 1982
Owner name: STANDARD OIL COMPANY, CHICAGO, IL A CORP. OF IN
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:RUSSUM, LEONARD W.;REEL/FRAME:004037/0977
Effective date: 19820630
Owner name: GULF OIL CORPORATION, PITTSBURGH, PA A CORP. OF PA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:RUSSUM, LEONARD W.;REEL/FRAME:004037/0977
Effective date: 19820630
|16 Jul 1985
|Certificate of correction
|7 Nov 1986
Owner name: CHEVRON RESEARCH COMPANY, SAN FRANCISCO, CA. A COR
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:CHEVRON U.S.A. INC.;REEL/FRAME:004688/0451
Effective date: 19860721
Owner name: CHEVRON RESEARCH COMPANY,CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:CHEVRON U.S.A. INC.;REEL/FRAME:004688/0451
Effective date: 19860721
|19 Jun 1987
Owner name: CHEVRON U.S.A. INC.
Free format text: MERGER;ASSIGNOR:GULF OIL CORPORATION;REEL/FRAME:004748/0945
Effective date: 19850701
|9 Nov 1987
|Fee payment
Year of fee payment: 4
|2 Oct 1991
|Fee payment
Year of fee payment: 8
|9 Ene 1996
|Maintenance fee reminder mailed
|2 Jun 1996
|Lapse for failure to pay maintenance fees
|13 Ago 1996
|Expired due to failure to pay maintenance fee
Effective date: 19960605


text:
Hands down, John McCain is the buzz in New Hampshire. After a political freefall in the summer, the man who swept Granite State Republicans and independents in 2000 has gone and done a Lazarus, resurrecting his presidential candidacy.
He did it the old-fashioned way: He earned it.
"Townhall meeting by townhall meeting, bus ride by bus ride, and endless phone calls to local talk show hosts, are what have put McCain back on the map in New Hampshire," says David Carney, a GOP political strategist not affiliated with any campaign.
One of those local radio talk show hosts, former Democrat candidate for governor Arnie Arnesen, agrees. "(D)espite many voters' disappointment with his dismal campaign ... the charisma, smarts and straight talk of McCain did not evaporate with voters over the last eight years."
More important, Arnesen says, no negative news has come out about McCain: "No illegals cutting his lawn, no clemency cases in Arkansas, no trophy wife, no Bernie Kerik or curious housemates who happen to be gay ... we know who he is, and with the war in Iraq taking second place to the new gorilla in the room, the economy, suddenly McCain becomes attractive again."
"Death spiral" and "death-watch" were all the talk of McCain in July. Fresh off an ugly and losing illegal-immigration battle, McCain's campaign imploded. Longtime adviser John Weaver exited, causing a domino effect that left McCain's campaign bare-boned and broke.
Most political soothsayers predicted he would never make the next filing deadline. Yet Weaver, who gave his first post-McCain interview in September, bucked conventional wisdom by predicting McCain would re-emerge in late December.
And he has, according to New Hampshire's polling average as of Friday. He's climbed to within 5.6 percentage points and is in second place behind Mitt Romney, who's been taking it on the chin in the Granite State's leading editorial pages.
Weaver's prediction was considered foolish. Today, he is a political Nostradamus.
"John has done a phenomenal job on his own," says Weaver. "You have to give him credit for it. He has run his campaign in New Hampshire on his back.
"John's re-emergence also has a lot to do with the times that we live in. Remember, we are a nation at war against an enemy that does not wear a uniform. You have to ask yourself, who has been prepared to lead us in this global struggle that we are in?"
"Experience in foreign policy and (the) military matters," says Sen. Lindsey Graham, R-S.C.
Pew poll: Trump leads GOP field by nine as Jeb Bush crashes into sixth place with … four percent | Allahpundit

subset: commoncrawl


text:
After a session spent dueling with Gov. Bill Walker over his plan to spend $85 million in state funds to increase the size of a state-led natural gas pipeline, and Walker's veto of a bill stopping him from spending the money, the Legislature may have gotten the final word.
In their final budget action before adjourning April 27, lawmakers took the money away from the governor.
Two consultants to the state Legislature have warned that Gov. Bill Walker's quest for an expanded state-led natural gas pipeline could undermine the larger industry-led gas project in which the state is also a partner.
"The state and its commitment has become a major risk factor for the Alaska LNG Project," Nikos Tsafos, of the consulting firm Enalytica, told the Senate Resources Committee April 16. "A process where the state is appearing to pursue two projects at the same time could undermine both."
Tsafos and his partner Janak Mayer appeared before the committee.
Gov. Bill Walker has ordered a 45-day review of the state's participation in the Alaska LNG Project with an eye toward possible changes in the partnership with North Slope producing companies and TransCanada Corp.
In a speech April 1 to Commonwealth North, an Anchorage business group, Walker said he had received the consent of the industry partners for the review, which would be done under terms of confidentiality.
The governor acknowledged he did get some pushback, however.
Alaska's current budget crisis can easily be blamed on the plunge in oil prices, which are less than half what they were nine months ago, but some responsibility should be laid at the door of the state's citizens, who are largely disconnected from state spending decisions — except to spend more.
The disconnect is because Alaskans are largely insulated from having to pay taxes. In fact, the state sends every citizen a big Permanent Fund Dividend check every year.
Just as things seemed to be going reasonably well for the large Alaska LNG Project, the $45 billion to $65 billion gas pipeline and liquefied natural gas initiative in which the state is a partner, Gov. Bill Walker may be throwing a wrench into the works.
State legislators, and the state's industry partners in the big project, are now worried about the governor's Feb. 18 announcement that he will pursue a larger version of a small state-backed pipeline intended now to supply gas to Alaskans.
JUNEAU — Finance subcommittees in the state House were closing out budgets for state agencies this week, while other legislative committees heard updates on the Alaska LNG Project and worked on energy legislation.
A bill dealing with regulation of now-legal marijuana is also being worked on in House and Senate committees.
State geologists have now increased the amount of natural gas they believe can be economically produced from known fields in Cook Inlet.
The state Division of Oil and Gas concluded, in a recent study, that there may be 440 billion cubic feet more gas in the Inlet's gas fields than previously estimated.
About 1.1 trillion cubic feet of recoverable gas reserves were estimated in a 2009 resource assessment by the division, and the new figure is about 1.54 trillion cubic feet of gas, according to Paul Decker, acting director of the state Division of Oil and Gas.
State officials are "fully engaged" in negotiations over commercial agreements needed in 2015 for the large North Slope natural gas pipeline and liquefied natural gas project, but declining to give specifics.
"We are in commercial negotiations with all Alaska LNG parties and are making every effort to maintain timelines. However, commercial negotiations can only occur as quickly as all parties come to agreement," Marty Rutherford, Deputy Commissioner of Natural Resources, said in a statement released to reporters.
The turnaround in Cook Inlet oil and gas production in recent years is one of the big success stories for Alaska. It has come at a hefty expense, however, to the state treasury.
It turns out that Inlet producers are being heavily subsidized by the state of Alaska, consultants to the state Legislature say in a report.
Since the state budget is 90 percent dependent on North Slope oil production revenues, this also means that, in effect, the big producing companies on the Slope are paying for the Cook Inlet producers.
Senior managers of CH2M Hill were in Alaska Feb. 4 meeting with the company's employees.
Their message: The company's oil and gas business is no longer for sale and it's business as usual.
CH2M Hill Senior Vice President for Corporate Development Matt McGowan and Senior Vice President and Regional Managing Director Patrick O'Keefe said the company wanted to test the market's reception on a possible sale when it was announced last October.
Peninsula Clarion ©2015. All Rights Reserved.


text:
Comments about 'Why wearing high heels might make you a better shopper'
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If nothing else, I'd be able to reach stuff on the top shelf better.
- 9:21 a.m. Aug. 27, 2013
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I'll skip the suggestion to wear high heels. Best advice I ever got for sensible shopping: shop alone, don't shop if you're hungry or emotionally upset, and buy only things on a shopping list that you prepared long before you enter a store.
- 10:03 a.m. Aug. 27, 2013
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Shopping is an expensive entertainment. I can see how the discomfort can keep your mind from desire. So lesson learned, If she has high heels nothing or no one is desirable more than taking off those shoes.
- 11:50 a.m. Aug. 27, 2013
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Wearing high heels seems to indicate little experience, maturity or common sense, without which shopping could be disastrous.
- 11:55 a.m. Aug. 27, 2013
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Well, I've never worn them, but they look painful. Maybe the pain will make you hurry up and not spend money on things you don't need.
- 1:47 p.m. Aug. 27, 2013
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Date: 1921
Description: Three-quarter view of front and side of the Methodist Evangelical Church, a wooden building with arched windows on the side and an arched entrance in the f...
Date: 1893
Description: View of the Columbian Exposition grounds from Lake Michigan.
Date: 1893 ca.
Description: Group portrait of the Northern Hospital for the Insane's institutional fire fighting department posed outside the building. Horse-drawn transport cart and...
Date: 1934 ca.
Description: View down road of overhead lighting equipment of the T.M.E.R. and L. Company, which, at the time had a proposal to be replaced by more modern lighting. Th...
Date: 1908
Description: The Yahara River from Williamson Street with Lake Monona in the background.
Date: date unknown
Description: Exterior of the People's Co-operative Hospital. The view shows a porch and a sign above it. Stairs lead to the main entrance.
Date: 1954 ca.
Description: A young girl stands in the foreground holding a puppy in her arms. Behind her bordering the yard are trees and buildings.
Date: 1912
Description: Exterior of two-story city hall in Library Park. It features a bell tower and mansard roof. There is a plaque mounted over the doorway just below the roof....
Date: 2004
Description: The Wendling barn was built in 1929 for $10,000. In 1991, cows were milked for the last time.
Date: 1987 ca.
Description: Open house at the Gordon Berg farm where the Bergs show off their Holsteins.
Description: Exterior of Saint Peter's Catholic Church, dedicated in 1897 and constructed by Joseph Hutter. The church is located on Fourth Avenue and features a centra...
Date: 1920 ca.
Description: A building on the Milton College campus.
Description: View of Flores Avenue, a commercial section of downtown. The city hall, built in 1884, stands on the left near Laredo National Bank, founded in 1892. On...
Date: 1948
Description: John Jenkins, museum director, and Ruth K. Harris, museum curator, of the (then) State Historical Society of Wisconsin museum prepare a display case for an...
Date: 1934-10-24
Description: Friends Homer Graber and Gilbert May of Mineral Point, show their baby beef calves that won the grand champion and reserve champion titles at the Livestock...
Description: View of Wisconsin State College.
Date: 1939 ca.
Description: The David Atwood house, located at 204 Monona Avenue on the corner of Doty Street.
Date: 1870
Description: Baraboo was first settled around 1838, and by 1870 it had become the county seat and the thriving village illustrated here. This birds eye drawing depicts...
Description: Side view of a two-story brick building with rectangular windows, chimney, cupola, and pointed roof. A sidewalk runs in front of the building.
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Lamar Odom
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It was a homecoming of sorts when Jordan Hamilton joined the Clippers here. Hamilton is from Los Angeles and grew up going to Clippers games at Staples Center because he played on Lamar Odom's summer club team. "When he was with the Clippers,...
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In a recent interview with GQ, Kobe Bryant couldn't help but imagine what could have been if Chris Paul had come to the Lakers instead of the Clippers. In December 2011, the Lakers and the New Orleans Hornets agreed to a deal that would have sent...
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Bad record. Passive defense. Hot-and-cold offense. The Lakers and Boston Celtics have a lot in common, two teams muddling through downtrodden days after meeting in the NBA Finals just 4½ years ago. Kobe Bryant will be the only Lakers player...
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If players voted, Bulls forward Taj Gibson already would have one first-place nod for this season's Sixth Man of the Year award. "To win big, sacrifices must be made, and I think Taj is a proven winner and someone who will sacrifice for this...
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Khloe Kardashian has revealed that she knew her soon-to-be-ex-husband Lamar Odom was cheating on her. So what did the Kardashian know and when did she know it? The emotional revelation comes in a clip from this Sunday's episode of her reality series,...
Lamar Odom hopes divorce from Khloe Kardashian won't happen
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Lamar Odom had some sweet words for his lady love Khloe Kardashian despite their split in December. And that whole divorce thing? Call him an eternal optimist, because he doesn't seem to think it's going to happen. Odom, 34, who has been embroiled...
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Kris Jenner and Bruce talk separation, have no plans to divorce
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Bruce Jenner and wife Kris Jenner, the Kardashian momager, have separated but don't plan to file for divorce. "I'm doing great," the former Olympian, 63, told People. "Kris is happy, I'm happy. Nobody is filing for divorce." The...
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Lamar Odom has been charged with driving under the influence, the Los Angeles City Attorney's office said Friday. The NBA free agent was arrested Aug. 30 after he was spotted allegedly driving erratically on the 101 Freeway in the San Fernando...
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Social Selling: How to use Social Networks to get Sales Leads & Influence Buyers
Growing your business using social networks can be a great success or a big waste of time. Would you like to know how to monitor your competitors, learn what types of... Learn more
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A few posts ago we made the point that we should all count our lucky stars that we were not some newly middle class guy in China who leveraged his home to play the stock market.
If however you are that guy and you are reading this know that at the very least you have our sincerest sympathies. Though that doesn't pay the margin call we understand.


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text:
Big D Finds Bottles of Tequila In The Hot Studio [VIDEO]
Earlier this week I found Big D, the custodian of all seven radio stations, in our studio with two bottles of tequila!!!
Earlier this week I found Big D, the custodian of all seven radio stations, in our studio with two bottles of tequila!!!
Monday morning we were LIVE from the campus of UL as we said "Welcome Back" to all of the students for the 2014 Fall Semester.
Last week while on vacation, I packed too quickly and actually left my radio back home as we headed to the beach. Thanks to modern technology and a little innovation on my part, I was still able to enjoy the radio while my feet were in the sand.
As I continue my "Eat Lafayette" tour this year, I made a stop at Nash's in Broussard and boy was this a treat!!!
This morning I walked out of the studio for a second and I saw Big D's truck parked out back. If you think your vehicle is dirty, wait until you see the truck of our custodian!!!
A few weeks ago I was fortunate enough to visit Rochetto's Pizzeria in Scott, La. for "Eat Lafayette." This is one of my favorite places to visit when it comes to getting pizza!!!
I was fortunate enough to have the pleasure to visit one of my favorite restaurants in Acadiana for one of my "Eat Lafayette" assignments, "Fezzo's Seafood, Steakhouse, and Oyster Bar" in Scott, La.
WWE Monday Night RAW is coming back to the Cajundome on Monday September, 15th and we have FIRST LEVEL tickets to giveaway all week on the morning show with Chris Reed On-Air!!!
Friday morning our custodian here at Townsquare Media, Big-D, was admiring a plaque in our front lobby. But what he did not know is that it's an old plaque---from 2011.
Last weekend I was introduced to a wonderful organization that I never knew existed, Icing Smiles. It's a non-profit organization that gets custom designed theme cakes to kids that are critically ill.


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Michelin rolling out tire-art contest
Michelin North America is asking folks to reinvent the wheel.
The tire maker announced this week that it will host a tire-art contest as part of Upstate International, a monthlong series of community events and activities that celebrate the cultural diversity of this region of South Carolina.
The annual Upstate International series began last year when Michelin partnered with Clemson University to offer more than two dozen events, from foreign language lessons for children to concerts by international musicians. The International Center of the Upstate is also part of the collaborative efforts to make the series flourish.
This year, Michelin's "In-TIRE-National Art Contest" challenges participants to create a piece of art with an international theme. The winning contestant or team will receive $5,000 to donate to an Upstate-area school or registered nonprofit organization.
Submissions will be judged on overall design and execution, global theme and tire use, Michelin officials said.
Michelin will be accepting online registrations for the contest Monday. Registrants must go to upstateinternational.org to enter. Registration will be open through Feb. 28. Once they have entered the contest, budding artists will be given four scrap tires from Michelin. Contestants will have from March 3 until March 21 to complete their artwork.
"It's an honor to participate in and support Upstate International," said Leesa Owens, director of community relations for Michelin North America. "Last year's inaugural showing was a great success, and as we considered ways to enhance the initiative this year, an art contest that highlights the cultural fabric of our community seemed like a winning idea. We look forward to seeing the creativity that goes into these entries."
The tire-art contest is open to all legal residents of South Carolina who live in the Upstate. Contestants can participate as individuals or as teams from schools, universities, businesses and nonprofit organizations.
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text: POPSUGAR Tech Shopping Urban Outfitters Bumps Up Its Retro Gadget Stock — Are You Buying In? Urban Outfitters Ups the Retro Ante, I'm All In by Tech 9/09/09 0 Shares Like us on Facebook Sign up for our daily newsletter > Follow us on Pinterest I'm the kind of girl that can appreciate the early days of technology and rock a vinyl record player next to a high-quality sound system. Urban Outfitters isn't the first place you'd think to get your tech fix, but it has been raising the bar when it comes to offering up retro gadgets like record players and old-school typewriters. Two of my favorites, natch. Check out a few of Urban Outfitters' latest offerings in the retro gadget arena below and tell me — do you ever buy your vintage gadgets from the chain store? 4637733 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Read More Record PlayerVinylTypewriterRetroVintage GeekUrban OutfittersShopping Urban Outfitters The 7 Biggest Denim Trends For Fall Lily Aldridge Just Wore the Sexiest Airport Outfit, Possibly Ever These Are the Worst Colors to Wear to an Interview The T-Shirt Fashion Bloggers Can't Get Enough Of POPSUGAR, the #1 independent media and technology company for women. Where more than 75 million women go for original, inspirational content that feeds their passions and interests. Get Inspired With Our Living Newsletter Personalize Tech Home Vegetarian DIY Food Love and Sex Sign up with facebook or By signing up, I agree to the Terms and to receive emails from POPSUGAR.


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What's the deal with LTC?
Bruce Williams discusses long-term care insurance and tenants with rights of survivorship.
It sounds to me that you would like the property to go to two or more tenants. This may be your children or something of that nature. Anytime you are leaving property to more than one person, undivided interest in property can lead to very contentious situations. I was always more comfortable in having the property left in a will whereby the executor of that will is directed in the will to dispose of the property and divide the proceeds rather than have the property put in the names of two or more people however related. Oftentimes, one wants to sell and the other one doesn't. Many times one would like to keep it in the family but doesn't have the assets to buy out the others. I am far more comfortable in leaving it in the will with specific directions to your personal representative or executor as to your thoughts on the matter. It could be you want to leave it in their names, but then there are better ways to do that. One of them could be a trust. Interested in buying or selling a house? Let Bruce Williams' "House Smart" be your guide. Price: $14.95, plus shipping and handling. Call: (800) 337-2346. Send your questions to: Smart Money, P.O. Box 2095, Elfers, FL 34680. E-mail to: email@example.com. Questions of general interest will be answered in future columns. Owing to the volume of mail, personal replies cannot be provided. Copyright 2010, United Feature Syndicate, Inc.


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Welcome to Interpreting in Healthcare Settings
Our mission is to provide resources and learning opportunities in American Sign Language & English for Interpreters and Educators related to healthcare settings
Featured Resources
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National Symposium on Healthcare Interpreting - June 3-6 2015
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Gallery Folders
Digital Experiments
You're incredible. I especially love your Avatar series - Do you have any plans to continue it? If so, is there any chance you're going to paint Azula?
Aw thank you so much~
I plan to continue it when I have more time in the fall (summer time is just way busy for me at my home.. hehe ^^)
Your gallery is Mega Amazing! Your drawing style is very unique. Keep up the awesome work!
The shinsengumi from Hakuoki would look amazing in your style =3
Your gallery has to be one of the most awesome galleries on deviantart I love this art style keep it up.
This and your style is AMAZING


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Malmaison Birmingham3
1 Wharfside, Birmingham, B1 2JR
Price FromView Rooms
- Very Good
- 62 guest reviews
"Love the hotel, excellent value for money and great customer service. Thank you for a quality stay...."
"Great value suite upgrade. The rooms were huge and very comfortable. Charming reception staff, slightly frosty service in the bar and at br..."
"Chic hotel, ideal location, well appointed rooms rounded off by a sumptuous breakfast...."
"The Malmaison Birmingham was a brilliant stay. This was the 3rd time we have stayed here and there has never been a problem. The spa is amaz..."
"Generally a good stay, but was charged for mini bar items I did not use, especially after I said I had had nothing from the mini bar...."
About the hotel
Property Location With a stay at Malmaison Birmingham, you'll be centrally located in Birmingham, steps from The Mailbox and minutes from International Convention Centre. This 4-star hotel is within close proximity of Alexandra Theatre and Adrian Boult Hall. Rooms Make yourself at home in one of the 189 air-conditioned rooms featuring minibars and LCD televisions.
Complimentary wireless Internet access keeps you connected, and digital programming is available for your entertainment. Private bathrooms with shower/tub combinations feature complimentary toiletries and hair dryers. Conveniences include phones, as well as safes and desks. Amenities Relax at the full-service spa, where you can enjoy massages, body treatments, and facials. You're sure to appreciate the recreational amenities, including a spa tub, a steam room, and a fitness center. Additional features include complimentary wireless Internet access, concierge services, and wedding services. Dining Satisfy your appetite at the hotel's restaurant, which serves breakfast, lunch, and dinner, or stay in and take advantage of 24-hour room service. Quench your thirst with your favorite drink at a bar/lounge. Business, Other Amenities Featured amenities include dry cleaning/laundry services, a 24-hour front desk, and luggage storage. Planning an event in Birmingham? This hotel has facilities measuring 3034 square feet (282 square meters), including conference space.
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Showing Wednesday 7 October 2015 to Thursday 8 October 2015Change Search
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- 24 Hour Reception , Concierge , Laundry/Valet Service
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- Wedding Licence , Lift to all floors
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- 01/01/2015 to 31/12/2024 - You must present a photo ID when checking in. Your credit card is charged at the time you book. Bed type and smoking preferences are not guaranteed.Your reservation is prepaid and is guaranteed fo ... The price shown is based on the occupancy and dates you have searched for. Prices and availability are subject to change based on the arrival date, number of nights and occupancy searched for. All prices are inclusive of all local taxes.
- Pets are not allowed
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Great room,
Great value suite upgrade.
The rooms were huge and very comfortable.
Charming reception staff, slightly frosty service in the bar and at breakfast, delivering cold scrambled eggs.... Summary, good hotel, nip to Starbucks for breakfast.
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Providing Quality Signs, Banners, Labels, Vehicle Signage, Printed Clothing & Digital Printing to Herefordshire & beyond since 1953. The Sign Makers and Printers of Hereford.
Nothing is too much trouble... even when it is!!
Done a big job for us at the Hereford Military Club and what an amazing job it was, a highly recommended and reputable company.
A always ready to offer a first class service nothing too much trouble. Fully endorse them for your signage!


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Femoral tunnel placement in anterior cruciate ligament reconstruction: rationale of the two incision technique
© Garofalo et al. 2007
Received: 20 October 2006
Accepted: 21 May 2007
Published: 21 May 2007
Endoscopic anterior cruciate ligament (ACL) reconstruction can be performed through one-incision or two-incision technique. The current one-incision endoscopic ACL single bundle reconstruction techniques attempt to perform an isometric repair placing the graft along the roof of the intercondylar notch, anterior and superior to the native ACL insertion. However the ACL isometry is a theoretical condition, and has not stood up to detailed testing and investigation. Moreover this type of reconstruction results in a vertically oriented non-anatomic graft, which is able to control anterior tibial translation but not the rotational component of the instability. Femoral tunnel obliquity has a great effect on rotational stability. To improve the obliquity of graft, an anatomical ACL reconstruction should be attempt. Anatomical insertion of ACL on the femur lies very low in the notch, spreading between 11 and 9–8 o'clock position and the center lies lower than at 11 o'clock position. Femoral aiming devices through the tibial tunnel aim at an isometric placement, and they do not aim at an anatomic position of the graft. Also, a placement of tunnel in a position of 11 o'clock is unable to restore rotational stability. The two-incision technique, with the possibility to position femoral tunnel independently by tibial tunnel, allows us to place femoral tunnel entrance in a position of 10 'clock that can most accurately reproduce the anatomic behaviour of the ACL and can potentially improve the response of the graft to rotatory loads. This positioning results in a more oblique graft placement, avoiding problem related to PCL impingement during knee flexion. Further studies are required to understand if this kind of reconstruction can ameliorate proprioception as well as clinical outcome at a long-term follow-up.
Endoscopic anterior cruciate ligament (ACL) reconstruction is a surgery that allows most subjects to resume activity at preinjury level. However the estimated failure rate after this surgery remains approximately 10% [1]. For many years the two-incision technique has represented the gold standard operation for ACL reconstruction [2, 3]. In the last years, however, the single incision tibial endoscopic technique has been developed to obviate the necessity of the lateral incision and to, potentially, reduce operative time and surgical morbidity.
Many published reports have concluded that there is no difference in subjective, objective, functional, or radiographic mid-terms follow-up outcomes between one or two incision technique [4, 5]. However, these studies have not compared the obliquity of femoral tunnels, but nowadays we know that placement of femoral tunnel has a great influence on knee kinematics [6, 7]. Transtibial ACL reconstruction has shown some disadvantages in the femoral tunnel placement with respect to the two incision techniques. With transtibial technique, in particular, femoral tunnel can not be placed freely, so this technique dictates a relatively vertical and central non anatomical graft placement compared to the more horizontal and lateral course of the native ACL. This physiometric "central cruciate" cannot control rotational stability and places abnormal force on the knee joint, which could lead to degenerative osteoarthritis in long term [6–8]. To obviate the above problems, drilling femoral tunnel through anteromedial portal has been proposed. With the knee in a maximally flexed position, it seems to be possible to perform a femoral tunnel 5 mm anterior to the posterior capsular insertion through this portal at the 11 o'clock (right) or 1 o'clock position with respect to the apex of the notch [9]. Also the graft placed in this position failed to control rotatotial stability [7]. Recently, a great number of surgeons sustaining the one-incision transtibial reconstruction technique has focused the attention on the double bundle (DB) anatomical reconstruction of the ACL to ameliorate the rotational control on the reconstructed knee [10].
Moreover there are other recognized potential pitfalls of the endoscopic technique, including graft tunnel mismatch [11], interference screw fixation divergence [12] or screw laceration of the graft, posterior cruciate ligament (PCL) impingement [13] and possible violation of posterior cortical wall [5]. The purpose of this paper is first, to describe anatomical single bundle ACL reconstruction with a two-incision technique and second, to discuss the rationale of this technique by reviewing anatomy and biomechanics on femoral tunnel position in ACL reconstruction.
Surgical technique
Setup and graft harvesting
The patient is placed in the supine position with a lateral post just proximal to the knee. In our mind graft choices in primary ACL reconstruction for young persons and sports people is the bone-patellar tendon-bone (BPTB) graft, whereas semitendinosus and gracilis tendons (ST-GR) is reserved for older subjects, women, and those devoted to recreational sports or for patients with some patellar problems.
BPTB is harvested via an incision of 7 cm in average, extending from the inferior pole of patella to the tibial tubercle. The paratenon is divided longitudinally. A central third bone-patella tendon-bone (BPTB) graft is harvested 10 mm wide with 10 or 11-mm × 25-mm tibial bone block and 9 or 10-mm × 20-mm patellar bone block. The block is cut in a trapezoidal fashion at the tibial level and in a triangular fashion at the level of patella to reduce bone stress and anterior knee pain. A small rongeur and a graft shaper are used to trim the graft to the appropriate size. One hole is drilled in each bone block to be used for leading threads. Normally, tibial bone plug is positioned into femoral tunnel and patellar bone plug into the tibial tunnel. A number 2 reabsorbable suture is passed through these holes and used as pulling suture. The tibial bone-tendon junction is marked with a sterile pen to aid in appropriate placement within the femoral tunnel.
Before starting arthroscopic step of reconstruction, patellar tendon defect is closed with a 3.0 reabsorbable suture. We prefer to include the Hoffa tissue in the first proximal stitch. Paratenon is closed with a running suture.
In case in whom we use hamstring tendon the ST-GR tendons are harvested through a 2–3 cm oblique incision made directly over the pes anserinus in line with the hamstring tendons course. Once the sartorius fascia is identified, it is opened and an angled clamp is then used to localize the ST-GR tendon, which is harvested with an open tendon stripper with the limb held in the so-called figure-of-four position. Retained muscle belly is scraped from the tendons and the end of each graft is then sutured for approximately 4 cm with a "Chinese" finger trap stitch of a number 2 nonabsorbable suture. The quadrupled tendon graft is sutured at the looped end using one stitch of a number 1 absorbable suture. The graft is sized and a mark is made at 30 mm from the looped end.
Arthroscopic reconstruction
We use a high anterolateral and low anteromedial portal for arthroscopy. A outflow portal is made through the suprapatellar pouch to end in the medial gutter. Articular and meniscal injury are addressed at first. Any remaining fibres of the ruptured ACL are debrided using scissor and motorized 5.5 mm full radius resector. A 10 mm curved rugine is used to debride the medial wall of the lateral condyle just to the posterior capsule so as to identify the site of insertion of native ACL. The same instrument is used to verify that the distance between PCL (posterior cruciate ligament) and medial wall of lateral condyle is at least 10 mm. If it not the case a lateral trochleoplasty is performed.
With a suture passer, the graft can be passed into the knee by passing a nylon loop-shuttle suture through the joint. The suture at the end of graft is passed in the loop suture, so the surgeon pulling on the loop suture out of tibial or femoral tunnel, allowing the suture of the graft to go out the tunnel.
Hamstring tendon graft is positioned such that the mark at 30 mm is flushed with the femoral tunnel, whether BPTB is positioned such that the marked tendon-bone junction is flushed with the intra-articular entrance of the femoral tunnel. BPTB is passed with the cortical surface posterior to keep the tendinous portion of the graft as posterior as possible. Different systems of fixation can be used. Anyway femoral fixation is performed at first. A maximal manual tension is applied to the distal sutures of the graft and the knee is cycled through full flexion extension several times for graft pretensioning and settling. The knee is placed in approximately 30 degree of flexion, with one arm of assistant put under the proximal femur, and tibial fixation is carried-out under arthroscopic control. At the end of procedure, the scope is inserted retrograde in the tibial tunnel to verify that during passive knee motion there is no graft motion.
Rationale of the two incision ACL reconstruction
The native ACL lies in an oblique position with a complex attachment to the femur [14]. This attachment is smaller than tibial, and is semicircular (18 × 10 mm) with a straight anterior border and a convex posterior border. It lies at level of posteromedial wall of the lateral femoral condyle, at the transition between the notch roof a bone cartilage boundary of the posterior part of the lateral femoral condyle. The attachment extends anteriorly 6 to 8 mm from the posterior border which gives the footprint a rounded triangular shape [15, 16]. The ACL has a complex anatomy. Many investigators [16, 17] have described anatomically separated fibre bundles of the ACL. Based on their tibial attachments, the bundles are called anteromedial (AM) and posterolateral (PL) bundles, some also includes an intermediate bundle [18]. At level of femur, the attachment of AM bundle is anterior and proximal, just behind the top of the intercondylar notch roof. This point is corresponding to the most isometric point [19, 20]. Consequently, the most anterior fibers of AM bundle are the most isometric [21, 22]. The reason of placing femoral bone tunnel at 11:00 o'clock position for a right knee and 1:00 o'clock for a left knee is related to an attempt to reconstruct the anteromedial bundle. The PL bundle of the ACL represents the bulk of ligament and its fibres are the most posterior and distal and provide stability when the knee is near extension. The femoral attachment site is more important than the tibial attachment because it has a greater effect on the graft length changes as the knee flexes and extends, [21]. In fact, the center of rotation is closer to the femoral attachment than the tibial attachment side, so there is little room for error when placing the femoral tunnel. Clinical results correlate positively with femoral tunnels placed at least 60% posterior to the anterior origin of Blumensaat line in a deep and superior (proximal) position [23].
A cadaveric study, performed by Arnold et al., has confirmed that the anatomical insertion of ACL on the femur lies very low in the notch spreading between 11 and 9–8 o'clock and the center lies lower than at 11 o'clock position [14]. The major part of these fibres lies posteriorly to the isometric point on the medial wall of the femoral condyle [24]. These fibres located behind the most isometric point, are lax during flexion and tight in extension. Chambat has defined the behaviour of these fibres as "favourable non isometry" [25]. During knee extension we can observe a progressive recruitment of the fibres from front (the most isometric) to backward. The "favourable non isometry" is very interesting because knee loading during daily activities occurs at flexion angles of less than 60 degrees, and to reproduce it, an anatomical placement of the graft should be performed during surgery.
The major part of current endoscopic transtibial ACL reconstruction techniques place the graft along the roof of the intercondylar notch, anterior and superior to the native ACL insertion, exposing some of fibers of the non-anatomically placed graft to higher strain rates and risk of failure. Some authors sustaining that a nearly isometric behaviour of the ACL substitute is desirable, with a maximum of 2–3 mm lengthening of the graft towards extension [18, 26]. The isometry is widely influenced by femoral tunnel placement. Studies evaluating isometric placement of graft have suggested that the 12-o'clock position with a 2 mm of posterior wall was the most isometric [27], but this position results in a vertically oriented non-anatomic graft [28]. In such situation the anterior stability of the knee is partially controlled, but rotational stability remained uncontrolled, resulting in a persistent pivot shift with consequent pathologic knee kinematics that can be associated with a poorer outcome and long-term arthritis [6, 8, 29]. Hefzy et al. [21] noted a larger isometric (2 mm) zone superiorly and proximally, so most authors are recommending an entry point high in the notch, at the 11 o'clock position for a right knee with 1 to 2 mm posterior cortical shell, and often this requires the use of a more inferior anteromedial portal resulting in a more demanding technique [30]. However, the current method used to place the femoral tunnel in the 11 o'clock position seems to be inaccurate and moreover analysis of literature shows that the ACL isometry is a theoretical condition, and has not stood up to detailed testing and investigation [22, 26, 27].
According to cadaveric dissection [14], we create a 25 to 30 mm long femoral tunnel at anatomical insertion site of all, at 10 o'clock position. This positioning is impossible to obtain through a transtibial endoscopic technique [14]. To reach a better femoral tunnel placement the anteromedial portal instead of the transtibial portal with a knee flexed at 130 degrees has been proposed [9]. Moreover, problem about PCL impingement when using transtibial technique should not be ignored. Simmons et al. [13] have showed that placing the femoral tunnel in the coronal plane at 60 degree lowers graft tension in flexion. This minimize PCL impingement of graft. To obtain this positioning with the transtibial technique, a special tibial guide should be used and drilling through the superficial fibers of the medial collateral ligament should be performed [13].
The rationale to perform an anatomical ACL reconstruction is also related to concept of rotational stability. Recent study has shown that placing ACL graft at the 11 o'clock is unable to restore rotational stability [31]. Loh et al [6] in a laboratory robotic study reproduced a single bundle ACL reconstruction positioning the femoral tunnel at 10 and 11 o'clock. They found that the 10 o'clock femoral position restored anterior tibial translation and in situ forces towards knee extension significantly better than the 11 o'clock position, and although the resulting knee kinematics was not normal, however, the rotational knee stability was improved. Scopp [7], using a biomechanical model, has shown that reconstructing the femoral tunnel at the oblique anatomic origin of the native ACL, oriented 60 degrees from vertical, more closely restored knee rotational stability than the standard tunnel reconstruction oriented at 30 degrees from vertical [7]. This positioning corresponds to our proposed technique of ACL reconstruction with a "favourable non isometry" [25] and to place the graft in this area, a femoral tunnel at 10 o'clock position on the right lateral femoral condyle should be drilled, with the knee at 90 degrees of flexion.
Recently, the group of surgeon sustaining the one-incision reconstruction technique has shift the attention on the DB ACL reconstruction in attempt to ameliorate the rotational control on the reconstructed knee [32].
Nevertheless, it should be underlined that rotational control of knee is not completely related to ACL. Other peripheral restraints are also responsible for this control, otherwise we could not explain why different people with a complete, subacute ACL disruption show different grades of pivot shift phenomenon. Probably a certain number of ACL disruption are not isolated. However, the evaluation and diagnosis of peripheral associated instability, such as anterolateral rotatory instability is demanding and difficult to assess objectively, so the associated lesions often are not addressed with a consequent persistence of a some rotational instability, that probably could remain using a DB ACL reconstruction.
In our opinion DB ACL reconstruction is a shift of emphasis to an anatomic procedure. Nevertheless, creation of three or four tunnels is technically challenging and some concerns such as theoretical risks of avascular necrosis of the lateral femoral condyle, fracture, graft impingement and difficulty in revision cases should be taken in account. Moreover further clinical trials will be necessary to determine whether these theoretical advantages will translate into superior clinical outcomes.
For instance, according to other authors [28, 33, 34], anatomical single bundle reconstruction using a two-incision technique seems to be a good technique to position femoral tunnel entrance in a position that most accurately reproduces an anatomic behaviour of the ACL and potentially can improve the response of the graft to rotational loads.
Further biomechanical studies in "vivo" are needed to verify if this positioning of femoral tunnel have some positive effects on long-terms clinical outcome in terms of reduction of pivot shift phenomenon and improved proprioception.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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Presidents Day Weekend
9:30-4:00 Sat, Feb 16 - Mon, Feb 18, 2013
Venue: Old Sturbridge Village
1 Old Sturbridge Village Road, Sturbridge, MA 01566Contact:
Laura Chilson
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George Washington, the first U.S. president, was honored with balls and toasts in the 1830s. Take part in the celebration and embrace the joys of an old fashioned winter with ice skating, sledding on vintage 1830s sleds, and horse-drawn sleigh rides. Indoor hands-on crafts, activities, and entertainment for children are also available.
Lowell Celebrates Kerouac
Massachusetts is proud of its literary icons – from Henry James and Emily Dickinson to...
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I'm planning my third Key West trip May 31-June 11, 2013. I haven't been to the Island since November 2011 (I know, no excuse in that).
So, who's planning (or even thinking of going) in June 2013?
I see that Gay Pride is June 5-June 9 (this will be my first Gay Pride anywhere...I know, again, no excuse in that).


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Heart attack victim: 'ALS saved my life'
It was a familiar scenario in Naples – a doting grandfather, watching his grandson play around his pool.
"He was going to the slide, saying, 'Papa look, papa look,' and that's the last thing I remember for three days," says North Naples resident Doug Learn.
According to North Naples Fire Chief Mike Brown, Learn suffered "sudden cardiac death," and needed to be revived several times in a dramatic rescue that followed.
First on the scene were North Naples Lt. Erik Espineta, engineer Nick Stolts and Firefighter Chris Perry. The three continued defibrillation and resuscitation that subsequently returned a pulse, said Brown.
Last month, the three fire district professionals were honored with a Lifesaving Award. Looking on was a grateful Learn, with wife Nancy.
"I'm usually a pretty stoic guy," Learn said, in a heartfelt thank-you to the fire professionals present. "I could never thank you enough, mainly for the careers you chose and being there when I needed you."
After the presentation, Learn said he did not personally recall the actions of the fire professionals.
"My wife and my daughter told me what a tremendous job they did to keep me alive," he said. "I was dead by the time transport got there, I know that. I have doctors in my family."
Today, the 57-year-old is back to what he describes as a "crazy, insane schedule."
"My wife and I started a business in May and the stress is what got me," he surmises about his wholesale pool supplies distribution company. "I've been in good health and good shape; it caught me and the whole family off guard."
On the day of the awards, Learn couldn't say enough about the fire and rescue district.
"They care about people like me, and for that I could never repay them," he said.
Commission Chairman Christopher Lombardo said he was touched by Learn's emotional outpouring.
"It's so important that these firefighters get recognition for what they do, and it was in such a heartfelt way," he said.
At a time when county EMS is questioning the need for fire districts to provide advanced life support, Learn urged the board to ensure the district has all the life-sustaining equipment and certification necessary to treat residents like him in the future.
He said he had shared his story with Collier County Commissioners and asked them to make sure local fire districts have whatever permission they need to save lives like his.
NNFD public information officer, Jerry Sanford, said honoring local life-saving professionals is one of the district's greatest joys.
"We like to honor our firefighters for their heroic efforts," he said. "When you bring somebody like that back, it's remarkable."


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How to Start a Small BusinessThis course explores the various options, considerations, and legal requirements involved in starting up a small business in B.C., including business structures, business types, business planning, and other essential steps. The session covers the ins and outs of start-up costs, break-even analysis, financing, market share, and marketing strategy.
Hope Centre(80140 BISC BS01 H5A) 1 session, Sat, 9 am–3:30 pm, $110 Oct 24
updated Sept 18, 2015
Get fully equipped to attend hearings, conduct legal research, interview clients or witnesses, manage evidence and draft legal documents.


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