Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences, and Woods Hole Oceanographic Institution, 1990. / GRSN 589503 / Includes bibliographical references (p. 299-301). / by Martin Eugene Dougherty. / Ph.D.

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences, and Woods Hole Oceanographic Institution, 1996. / Includes bibliographic references (leaves 63-66). Includes bibliographical references (leaves 63-66). / by Carolyn Louise Harris. / M.S.

Master of Science / Most studies of condylar movement are based on the movement of an arbitrary condylar point. As the condyle is a 3-dimensional body which undergoes complex rotations and translations in function, the movement of one point in the vicinity of the condyle may not accurately represent condylar movement. The aims of this investigation were to determine in human subjects, during open-close and excursive jaw movements, the movement patterns of arbitrary and anatomical condylar points; and whether the trajectory of a single selected point can accurately reflect the movement of the condyle. In 44 subjects, condylar point movements were recorded with an opto-electronic tracking system (JAWS3D), which recoded the position of three light-emitting diodes attached to each dental arch. The primary point, selected to represent movement of the condyle, was 15 mm medial to the palpated lateral condylar pole, parallel to the Frankfort horizontal plane. Additionally, four points were selected along orthogonal axes in the sagittal plane, and four in the horizontal plane: each was 5 mm from the primary point. In two subjects, the mandibular condyles were imaged by computerised tomography (CT) and the lateral and medial poles, most superior, anterior and posterior points of their condyles were selected. The trajectories of each point were compared for each subject for the mandibular movements listed above. Variability in both path form and dimension was noted between the subjects for all mandibular movements. For example, in an open-close mandibular movement the condylar point translation varied in the antero-posterior direction between 1.8-22.8 mm, and in the supero-inferior direction between 4.5-12.1 mm. For each subject, the pathway of each point was different in form and dimension from that subject’s other condylar points for the open-close, and ipsilateral lateral mandibular movements. For the open-close movement, in only four of the 44 subjects were the arbitrary point traces similar in form within a subject; and the tracings of each subject’s condylar points showed, on average, a 3.2 mm difference in maximal horizontal (i.e. antero-posterior) translation and 2.9 mm in maximal vertical (i.e. supereo-inferior) translation. For contralateral lateral mandibular movements, the path form and dimension in the sagittal plane of the condylar points were similar within a subject; however the lateral component showed variability in path length for the different points within a subject. The pathways of the condylar points for a protrusive movement displayed the most similarity within a subject, with an average of 0.4 mm variation in maximal horizontal or vertical displacement between each subject’s arbitrary condylar points’ tracings. The anatomical condylar points of the two subjects showed variability between and within each subject. For these two subjects the trajectories of the arbitrary condylar points moved in directions similar to the anatomical points of all movements except for the ipsilateral lateral mandibular movement, where in one subject, the arbitrary condylar points moved posteriorly, inferiorly and laterally whereas the anatomical points moved anteriorly, inferiorly and laterally. There is much variability in both form and dimension for mandibular condylar movement between human subjects. There is also considerable variability within subjects in the form and dimension of condylar point movement, whether arbitrary or anatomical, depending on the point selected. By inference therefore, a single condylar point cannot accurately reflect the movement of the mandibular condyle, except perhaps for a protrusive mandibular movement. Multiple mandibular points are therefore required to describe the motion of the condyle. In an ipsilateral lateral mandibular movement, for example, an arbitrary point may move in a completely different direction to the mandibular condyle, and so anatomically derived condylar points should be utilised to assess accurately condylar movement.

Doctor of Philosophy / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Master of Dental Surgery / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Lateral hip pain (LHP), characterised by non-specific symptoms in the region of the greater trochanter, is a condition frequently encountered by physiotherapists and other health professionals. However, the pathogenesis of LHP is not well understood. Although pathology of the gluteal tendons and their associated bursae have long been implicated in the cause of this problem, trochanteric bursitis has emerged as the primary clinical diagnosis. In order to determine a differential diagnosis, clinicians are reliant on information collated from the patient history and physical examination, yet the validity of many of the tests used to diagnose LHP has not been established. Abnormalities of the gluteal bursae may give rise to LHP and therefore to ensure precision of clinical assessment and treatment techniques, knowledge of bursal morphology is essential. However, a review of the literature revealed that there are no complete morphological accounts of all the bursae in this area. Therefore, the main purposes of this study were (a) to determine the morphology of the bursae associated with the greater trochanter and (b) to examine the physiotherapy and radiological diagnoses of LHP, and the validity of selected tests used in the diagnosis of LHP. In the anatomical study, the bursae deep to each of the layered gluteal tendons were examined in 21 embalmed human hips (9 male, 12 female; mean age 79 years, SD 9.4 years) using macro-dissection and histological techniques. Morphological associations, size, positions and histological characteristics of the bursae were recorded. A total of 121 bursae were identified in ten different locations, with an average of six bursae per hip. Variation was evident, but it was typical that at least two bursae were found deep to gluteus maximus (GMax) and the fascia lata, and gluteus medius (GMed). In approximately two-thirds of specimens a single bursa was situated deep to the tendon of gluteus minimus (GMin). All of these bursae demonstrated a synovial lining, which was predominantly areolar in type. This study revealed that numerous bursae are intimately associated with the greater trochanter, and provides new morphological detail which is of significance when considering clinical and biomechanical models of LHP. A clinical study was undertaken whereby 40 consecutive patients (37 female, 3 male; mean age 54.4 years, SD 9.5 years) with unilateral LHP were recruited prospectively. Each eligible participant underwent a standardised physiotherapy assessment followed by a magnetic resonance (MR) imaging study of the pelvis and both hips. The MR images were analysed in random order by three radiologists blinded to clinical findings and symptomatic side, and the intra-and inter-observer reliability for image analysis was examined using the kappa statistic. To determine the validity of selected clinical tests as evaluated against MR imaging, sensitivity, specificity, and positive and negative likelihood ratios (LRs) were calculated, and the chi-squared test was used to determine association. As demonstrated by MR imaging, GMed tendon pathology, bursitis, osteoarthritis (OA) and gluteal muscle atrophy are all associated with the report of LHP. Interestingly, these various pathologies were identified in asymptomatic as well as symptomatic limbs. However, while bursitis was equally prevalent in symptomatic and asymptomatic hips, GMed tendon pathology and OA were observed more frequently on the symptomatic side. Furthermore, muscle atrophy which predominantly affected GMin, was specific to symptomatic hips. Large variation was evident in the strength of agreement between radiologists and there was little agreement between physiotherapy and radiological diagnoses of pathology. Physiotherapists frequently diagnosed trochanteric bursitis as a cause of LHP and while palpation was identified as the most provocative test for reproducing patients complaint of LHP, it was not shown to be a valid technique. Instead, the outcomes pertaining to the validity of the clinical tests indicate that attention should be focused towards the assessment and treatment of gluteal tendon pathology. The two tests that appeared to be most useful for diagnosing gluteal tendon pathology were pain reproduction with passive hip abduction and resisted testing of GMed and GMin. While these findings demonstrate that various pathologies are associated with the report of LHP, they also highlight some problems associated with the use of MR imaging as a reference standard. Before further clinical validation studies of LHP are undertaken in larger populations, it is recommended that verification of MR imaging outcomes are performed against surgical and histological findings.

The burden of non-specific low back pain in the population is substantial. Putative sacroiliac joint pain or 'sacroiliac syndrome' is a significant subset of this condition. Localisable pain over the long posterior sacroiliac ligament (LPSL) is often described as both a clinical sign and symptom of this syndrome. The aim of this qualitative morphological investigation was to investigate a potential basis for a patho-anatomic relationship between the long posterior sacroiliac ligament (LPSL) and the posterior sacrococcygeal plexus (PSP). Twenty-two cadavers were available for study. Three methods were utilised: macro-dissection (n = 22 sides), small wax block histology (n = 3 sides), large wax block histology (n = 1 side), giant wax block histology (n = 4 sides) and a review of E12 sheet plastinated transverse and sagittal sections (n = 4 sides). The LPSL was demonstrated to have a layered structure that was penetrated by the lateral branches of the dorsal sacral rami. A segmental relationship was observed between the lateral branches of the dorsal sacral rami and the LPSL. The posterior layer of the thoracolumbar fascia was not continuous with the superficial layer of the LPSL, deep to the fibres of gluteus maximus. The LPSL was shown to have three morphologically distinct regions, the proximal, mid and distal LPSL. A confluence of three layers was observed at the mid LPSL posterior to the sacroiliac joint (SIJ) namely the erectores spinae aponeurosis (ESA), the gluteal aponeurosis (GA) and the deep fascial layer from the second and third medial dorsal sacral foramina. A region of adipose and loose connective tissue was evident deep to the deep fascial layer in which lateral branches of the dorsal sacral rami were observed. In the region of the mid LPSL between the inferior PSIS and the third sacral transverse tubercle (ST), the attachment of the ESA to sacral bone was absent. This space was occupied by the continuous underlying region of adipose and loose connective tissue. At its greatest extent, this region was observed between the central sacral canal medially and the gluteal aponeurosis laterally. This study suggests that the LPSL may be better described as a retinaculum for the lateral branches of the dorsal sacral rami. These morphological findings provide a basis for the existence of a potential patho-anatomical mechanism that may explain localised pain in the posterior sacroiliac region, usually interpreted as referred pain from the sacroiliac joint. The lateral branches of the dorsal sacral rami may have a potential vulnerability to trauma or ischaemic challenge in this region, which may account for SIJ related 'non-specific' low back pain or for pregnancy related peripartum pelvic pain. Furthermore, a morphological basis for the anatomical confounding of SIJ tests is shown.

Thesis (Ph. D.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

<p>China has become one of the most attractive destinations for foreign direct investment (FDI) in the world. The Chinese government is still imposing regulations on certain industries in which foreign firms have to establish through a joint venture. Joint ventures with a Chinese partner are considered to be a great risk due to the environment they operate in and also due to cultural aspects and many joint ventures end with a buyout.</p><p>The aim of this study is to analyze what factors firms need to be aware of when entering into a joint venture and how to avoid or overcome the problems that arise.</p><p>The essay is written using a qualitative method. The study is partly based on a literature study, partly on primary sources. The primary sources consist of five interviews with representatives from companies who are either currently in a joint venture or have previously been in one. Six interviews with experts within the field have also been carried out.  </p><p>The essay is strongly influenced by the contingency theory which argues that the performance of a company depends on the environment the company is operating in. The problem has therefore been tackled through describing the specific conditions that a foreign firm will meet in China.</p><p>Joint ventures with a partner from another country involve risks but can also be of great advantage if they are run in a good way. How to run the joint venture might differ between firms but some factors seem to be common for most firms.</p><p>It is important to be careful which partner to choose and to do a due diligence in the beginning as well as having a letter of intent written down in the initial stages. Operating in China might bring unusual challenges so it is important for the foreign firm to have knowledge about the Chinese culture and the Chinese laws and regulations before establishing in China.</p>

The purpose of this study was to characterize glenohumeral joint laxity and stiffness using instrumented arthrometry. To evaluate the validity of an instrumented measurement system we compared cutaneous and bone-pinned measures of laxity and stiffness that replicate previously reported in vivo methodology. Characterization of capsular laxity was achieved through determination of the sagittal plane translational area at increasing levels of quantified force. Finally, a method for increasing the objectivity of the standard manual laxity examination was developed for the orthopaedic clinician to quantify humeral head translation and capsular volume in vivo. We hypothesized that: 1) cutaneous measures could accurately predict bone-pinned measures, 2) capsular laxity would increase with increasing levels of applied force, and 3) manual cutaneous, manual bone-pinned, and force-displacement bone-pinned measures of translation would be equal. Thirty fresh frozen cadaveric shoulder specimens (mean age=70��14 years) were tested. The shoulders were thawed and mounted to a custom-made shoulder-testing apparatus. Displacement was measured using an electromagnetic tracking system. Sensors were secured cutaneously and with bone-pins to the scapula and humerus. Force-displacement testing was performed using a load applicator and manual displacement testing utilized the anterior/posterior drawer and inferior sulcus tests. A comparison of cutaneous and bone-pinned measures of laxity and stiffness revealed good to excellent criterion validity (r=0.68 to 0.79). Examination of displacement measures at increasing levels of force revealed increasing capsular laxity with symmetric directional compliance. No significant difference was observed between anterior and posterior translation (0.4 mm, p=.55), with significant differences between inferior and anterior (4.6 mm, p<.0001) and between inferior and posterior (5.1 mm, p<.0001). A comparison of manual cutaneous to bone-pinned manual and kinetic measures of translation revealed a significant difference between methods (p=.0024) and between directions (p<.0001) with no significant interaction (p=.0948). Estimations of the force required to achieve clinical end-point suggest that greater force is required in the anterior (173 N) direction compared to posterior (123 N) and inferior (121 N). We have developed two new methods to measure glenohumeral joint kinematics and reported new information regarding normal kinematics of the glenohumeral joint. / Graduation date: 2001