Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation was done us ing Musculoskeletal Tumor Society (MSTS) Score six months postoperatively and after one year. Schatzker and Lambert Score was used in the last visit to assess the functional outcome Results: The mean MSTS Score was 27.13±3.030 (range, 20-30) and the mean functional arc of motion around the knee was 123.13±12.230 degrees (range, 90–135). According to Schatzker and Lambert Score 75% had excellent results, 12.5% had good results and 12.5% had fair results. Two patients (12.5%) had a recurrence of the tumor, and one (6.25%) developed postoperative fracture in the distal femur. Conclusion: Sandwich reconstruction for giant cell tumor is a good option for definite management and there is improvement in the quality of the patient's life. (Rawal Med J 202;45:637-640).
The research aims to present a proposed strategy for the North Oil Company, and the proposed strategy took into account the surrounding environmental conditions and adopted in its formulation on the basis and scientific steps that are comprehensive and realistic, as it covered the main activities of the company (production and exploration activities, refining and refining activities, export and transport of oil, research and development activity, financial activity, information technology, human resources) and the (David) model has been adopted in the environmental analysis of the factors that have been diagnosed according to a
... Show Moreيهدف البحث الى تقديم استراتيجية مقترحة لشركة نفط الشمال ، وأخذت الاستراتيجية المقترحة بنظر الاعتبار الظروف البيئية المحيطة واعتمدت في صياغتها على اسس وخطوات علمية تتسم بالشمولية والواقعية ، اذ انها غطت الانشطة الرئيسية في الشركة (نشاط الانتاج والاستكشاف , نشاط التكرير والتصفية , التصدير ونقل النفط , نشاط البحث والتطوير , النشاط المالي , تقنية المعلومات , الموارد البشرية ) وقد اعتمد نموذج (David) في التحليل البيئي
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... Show MoreIn this paper, the effective computational method (ECM) based on the standard monomial polynomial has been implemented to solve the nonlinear Jeffery-Hamel flow problem. Moreover, novel effective computational methods have been developed and suggested in this study by suitable base functions, namely Chebyshev, Bernstein, Legendre, and Hermite polynomials. The utilization of the base functions converts the nonlinear problem to a nonlinear algebraic system of equations, which is then resolved using the Mathematica®12 program. The development of effective computational methods (D-ECM) has been applied to solve the nonlinear Jeffery-Hamel flow problem, then a comparison between the methods has been shown. Furthermore, the maximum
... Show MoreThe graphic privacy feature is one of the most important specifications for the existence of any type of design achievements alike, which is one of the graphic products with its multiple data, and from here the current research investigates the graphic privacy of vector graphics design with all its technical descriptions and concepts associated with it and the possibility of achieving it to the best that it should be from Where its formal structure in children's publications, where the structural structure of the current research came from the first chapter, which contained the research problem, which came according to the following question: What is the graphic privacy in the design of vector graphics in children's publ
... Show MoreSamples (4th) reviewed are deposited and stored in the Iraqi Natural History Museum (INHM), and there are 4th of them. Sciurus anomalous (Güldenstädt, 1785) species are preserved and mummified. It is a Caucasian squirrel (S. anomalus) that was medium in size, with a grayish-to-chestnut color, a golden gray back, and a golden tail. It is found in the forests of East and Southeast Asia. The variety possessed for the study was previously registered in the vertebrate literature by several authors and was stored by scientific methods in the museum. As a result of the multiplication and growth of these species, and to know the environmental changes that occurred in them, they were compared with models and samples found throughout Iraq
... Show MoreIn this paper, the finite element method is used to study the dynamic behavior of the damaged rotating composite blade. Three dimensional, finite element programs were developed using a nine node laminated shell as a discretization element for the blade structure (the same element type is used for damaged and non-damaged structure). In this analysis the initial stress effect (geometric stiffness) and other rotational effects except the carioles acceleration effect are included. The investigation covers the effect speed of rotation, aspect ratio, skew angle, pre-twist angle, radius to length, layer lamination and fiber orientation of composite blade. After modeling a non-damaged rotating composite blade, the work procedure was to ap
... Show MoreDemography or population studies or demography is the science that is based on the different characteristics of the population scientific study, and represent a population studies principled way to understand the population of society, in addition to verification of the population in a given area determine the reason for the increase or decrease this number from the previous statistical As these studies estimate future trends for the occurrence of demographic change in terms of birth, death and migration That the registration of deaths of paramount importance narrated that way can the demographic reality of the population analysis, and coverage of the health authorities' needs and enable government institutions of decision-making
... Show MoreWilla Cather (1873-1947) sought to capture the gradation of human emotion through carefully selected descriptive and narrative touches and firmly controlled management of dramatic scenes, situations, dialogue, and point of view. Cather’s novels and stories drew increasingly upon her personal experiences and memories.
The old settlement of Virginia and the new lands of Nebraska formed the bedding ground for Willa Cather’s talents; so did the layers of memory she found across the North American continent, from New Mexico to Canada. She saw the full-blooded European immigrants, Czechs and Swedes, plowing the unbroken land, on the way up from peasants to proprietors.
 
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