A pedicled bone graft from the acromion: an anatomical investigation regarding surgical feasibility.

OBJECTIVE: To investigate the technical feasibility of harvesting a vascularized bone graft from the acromion pedicled on the acromial branch. BACKGROUND: Complex fractures of the proximal humerus may result in partial or total avascular necrosis of the head fragment. Treatment of avascular necrosis of the humeral head is dependent upon the stage of disease as well as the dimension and location of necrosis. In general, the outcome is poor and complete restoration of the shoulder function is rarely attained. Contrary to osteonecrosis of carpal bones (where vascularized bone grafts have been routinely carried out for decades), reports of analogous procedures at the humeral head are anecdotal. METHODS: Based on selective post-mortem computer-tomographic angiography of 5 and the dissection of 30 embalmed human cadaver shoulders, we describe the anatomy of the acromial branch of the thoracoacromial trunk. The main focus was the constancy of its anatomical course, its dimensions and potential use as a nutrient vessel for a pedicled bone graft from the acromion. RESULTS: The course of the acromial branch revealed a constant topographic relationship to anatomical landmarks. Its terminal branches reliably supplied the anterior part of the acromion. The vascularized bone graft could be sufficiently mobilized to allow tension-free transfer to the humeral head as well as to the lateral two-thirds of the clavicle. CONCLUSION: We demonstrated the feasibility of vascularized bone graft harvesting from the acromion. This technique could be a joint-preserving procedure for osteonecrosis of the humeral head or may assist in the revision of a clavicular pseudoarthrosis.

Investigation into Randolph Public Library's Closed Session Violations, December 11, 2006

Investigative report produced by Iowa Citizens' Aide/Ombudsman

Report on Special Investigation of Selected Accounts at Kennedy High School, Cedar Rapids Community School District, For the Period June 1, 2003 through May 31, 2006

Community School District Audit Report - Special Investigation

An investigation of the potential of DIP-STR markers for DNA mixture analyses

The genetic characterization of unbalanced mixed stains remains an important area where improvement is imperative. In fact, using the standard tools of forensic DNA profiling (i.e., STR markers), the profile of the minor contributor in mixed DNA stains cannot be successfully detected if its quantitative share of DNA is less than 10% of the mixed trace. This is due to the fact that the major contributor's profile "masks" that of the minor contributor. Besides known remedies to this problem, such as Y-STR analysis, a new compound genetic marker that consists of a Deletion/Insertion Polymorphism (DIP) linked to a Short Tandem Repeat (STR) polymorphism, has recently been developed and proposed [1]. These novel markers are called DIP-STR markers. This paper compares, from a statistical and forensic perspective, the potential usefulness of these novel DIP-STR markers (i) with traditional STR markers in cases of moderately unbalanced mixtures, and (ii) with Y-STR markers in cases of female-male mixtures. This is done through a comparison of the distribution of 100,000 likelihood ratio values obtained using each method on simulated mixtures. This procedure is performed assuming, in turn, the prosecution's and the defence's point of view.

Report on Special Investigation of the City of Sandyville, For the Period July 1, 1999 through April 28, 2006

City Audit Report - Special Investigation

Special Investigation of the Central Iowa Fair, For the Period July 1, 2004 through September 30, 2006

Other Audit Reports - Special Investigation

Investigation of Maquoketa's Pit Bull Ban Ordinance and Enforcement, 2006

Case File 0603634 On September 13, 2006, Kelly Wilslef submitted a complaint to the Ombudsman about the Maquoketa City Council (Council). Ms. Wilslef stated a Maquoketa police officer served her an abatement notice for violating the city ordinance preventing owners from keeping pit bull terrier dogs in the city. The Council subsequently determined her dog was a pit bull mix, and ordered her to remove the dog from the city. Ms. Wilslef claimed the Council unreasonably relied on non-expert testimony supporting the city’s position her dog was a pit bull mix. She further claimed that if her dog was in fact a pit bull mix, the city ordinance did not apply to mixed-breed pit bulls; therefore, the Council acted contrary to law when it concluded she violated the city ordinance and ordered her to remove her dog from the city.

Investigation of Luther City Council Violation of Open Meetings Law, 2006

Case File 0603454 The Ombudsman received a complaint on August 29, 2006 alleging violations of the Iowa Open Meetings Law by the Luther City Council (Council) in its meeting on August 2, 2006. Based upon my review of the complaint, I identified the following allegations for investigation: • The Council violated Iowa Code section 21.5 by failing to announce the reason session on the August 2, 2006 meeting agenda. • The Council violated Iowa Code section 21.5 by holding a closed session for an impermissible reason. • The Council violated Iowa Code section 21.5(2) by discussing unrelated issues in the closed session.

Investigation Into the Timeliness of the Death Notification to the Surviving Spouse of a Motor Vehicle Accident Victim, 2005

Report: #05-02 Kirke C. Quinn, Attorney for Jo Anne Holland, first contacted the Ombudsman by letter dated January 2, 2004. Quinn also addressed his letter to the Governor’s Office, Iowa State Patrol (ISP), and Iowa Department of Public Safety (DPS). Quinn characterized his letter as a complaint against ISP regarding “the method and manner of reporting the death of Ross Holland to his surviving spouse.” According to Quinn, Mrs. Holland “went through hours of misery as a result of the patrol’s inattention to a tragic situation.” On January 7, 2004, the Ombudsman asked ISP Major Gary Hoskins, Supervisor of Field Operations, how ISP and DPS intended to respond to Mr. Quinn’s letter. Major Hoskins stated he would refer Quinn’s letter of complaint to DPS’ Professional Standards Bureau (PSB) for investigation and response. After speaking with Major Hoskins, the Ombudsman told Mr. Quinn that DPS would do an internal investigation and if he were not satisfied with the results he could contact the Ombudsman again. On March 29, 2004, Mr. Quinn contacted the Ombudsman and stated he was not satisfied with DPS’ response. Quinn stated he would send a copy of the response to the Ombudsman, along with a letter stating his outstanding issues and concerns. In his letter to the Ombudsman, dated May 5, Quinn simply stated: “Please find enclosed [a] copy of the letter received from the Department of Public Safety. We think this is an absolute outrage. We welcome your input.”

Report on a special investigation of programs administered by the Central Iowa Employment and Training Consortium (CIETC) and Iowa Workforce Development (IWD) for the period July 1, 2003 through December 15, 2005

Report on a special investigation of programs administered by the Central Iowa Employment and Training Consortium (CIETC) and Iowa Workforce Development (IWD) for the period July 1, 2003 through December 15, 2005

Special investigation of the Washington Community School District for the period June 1, 2003 through October 31, 2006

Special investigation of the Washington Community School District for the period June 1, 2003 through October 31, 2006

Audit report on a special investigation of the Bear Creek Narcotics Task Force for the period July 1, 2003 through November 30, 2006

Audit report on a special investigation of the Bear Creek Narcotics Task Force for the period July 1, 2003 through November 30, 2006

Report on a special investigation of the Dallas County Jail for the period July 31, 2000 through February 5, 2007

Report on a special investigation of the Dallas County Jail for the period July 31, 2000 through February 5, 2007