bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Reduction of Deviant Arousal
Authors: Marshall W.L. , Barbaree H.E. 
Published: June 2007

Rapists and child molesters come to the attention of therapists because of their aggressive acts against victims who did not or could not consent. It would appear obvious that a major focus of therapy should be to decrease sexually aggressive thoughts, urges, and behaviors. It is therefore quite surprising that when one investigates treatment programs for sexual aggressives, specific treatment to decrease this arousal is many times lacking. Instead, attention is focused on the offender's inability to interrelate with others. He is taught social skills, sex education, or any variety of new behaviors that do not directly relate to the reason for his incarceration, which is an aggressive sexual act. The reason for this lack of focus on the offender's aggressive behavior appears to be a lack of knowledge about various modalities that can reduce a child molester or rapist's urges to perpetrate this activity. Marshall and Barbaree briefly review four different treatment procedures whose goal is to reduce the offender's deviant urges and behaviors. They then discuss the use of a satiation procedure that they believe is effective because it reduces deviant behavior by destroying the erotic nature of deviant urges. This is accomplished by literally boring the offender with his own fantasies involving sexual aggression. The advantage of such a satiation treatment is that it reduces therapist's time, it is inexpensive, and, most important, it capitalizes on a naturally occurring phenomenon. Sexual arousal requires newness and variety to sustain itself. The opposite, boredom, destroys specific sexual arousal patterns. Finally, Marshall and Barbaree place the reduction of deviant arousal in its proper perspective, namely, one treatment component of many that are combined to form a total treatment package for the sexual aggressive.
Differentiating Sexual Aggressives With Penile Measures
Authors: Abel Gene G. , Becker Judith V. , Blanchard Edward B. , Djenderedjian Armen 
Published: June 2007

Evaluating how a client is doing in therapy is a problem faced by all therapists. This is an especially important issue when the client is a rapist or child molester, since not knowing that his control is poor or that he has failed to respond to treatment may jeopardize the safety of others. Therapists have traditionally relied on the client's self-report to evaluate how he is doing. This traditional method of assessment in some cases is quite efficient and provides the therapist with extensive details that assist in outlining further treatment plans for the offender. In working with sexual deviates, however, it is quite apparent that in many cases this self-report is totally unreliable. As a consequence, the therapist must rely on other methods to assess his client's progress. For a number of years, penile transducer measures have been used to assess the sexual arousal of various sexual deviates. This is accomplished by the use of a small penile transducer which encircles the penis and records erection responses during the presentation of various sexual stimuli. In recent years, this method has been applied to the assessment of child molesters and sexual aggressives. Abel, Blanchard, Becker, and Djenderedjian summarize their recent work on the use of penile transducers with child molesters and rapists. The correlation of such measures with the sexual aggressive's history of sexual aggressive behavior, the frequency of that behavior, the likelihood of excessive force being used during the commission of a sexual assault, the likelihood of the client being a sadomasochist, and age of the aggressive's preferred victim is discussed. Preliminary data indicate that these physiologic measures have tremendous potential for assisting the therapist in assessing not only the treatment needs of the sexual aggressive, but also his response (or failure to respond) to treatment.
The Civilian-Military Gap and Professional Military Education at the Precommissioning Level
Authors: Snider Don M. , Priest Robert F. , Lewis Felisa 
Published: June 2007

This article addresses whether there is a "gap" between the attitudes and perspectives of military students (at the military academies and at colleges with Reserve Officer Training Corps [ROTC] detachments) and students at civilian colleges. It is a limited study in that only three sets of student attitudes were examined, which were those pertaining to American society and its culture, military professionalism, and civil-military relations. The authors conclude that there is no significant gap between the attitudes and perspectives of military students in precommissioning undergraduate education and graduating seniors in civilian institutions. Rather, they were struck overall by the relatively high degree of similarity in responses. They also found a remarkably similar understanding of military professionalism, but, unfortunately, serious misunderstandings about proper civilmilitary relations on the part of both groups of students. Recommendations are proposed to correct the deficiencies noted in precommissioning professional military education.
The Soviet Military before and after the August Coup: Departization and Decentralization
Authors: Barylski Robert V. 
Published: June 2007

The August coup was a major quake in a series of political tremors that continue to shake the lands of the former Soviet Union. Societal forces had been building towards a break with the traditions of the unitary Soviet state under authoritarian Communist party rule. Gorbachev lost control and fell from power while attempting to harness rising demand for political pluralism and republican self-government. The Soviet military struggled to contain the same forces. This article is a brief political history of the Soviet military's adjustment to political pluralism and republican political power from March 1990 through September 1991. It chronicles the end of the political commissars, that quintessential Marxist-Leninst military institution, and the beginning of the breakdown of the USSR's unified, extraterritorial, multinational armed forces.
Surgical management of osteochondritis dissecans of the capitellum
Authors: Tivnon Michael C. , Anzel Sanford H. , Waugh Theodore R. 
Published: June 2007

Ten cases of osteochondritis dissecans of the humeral capitellum which were treated surgically are reviewed. All 10 cases were males and involved the dominant side. The ages at surgery ranged from 13 to 17 years. Follow-up ranged from 1 to 7 years. All of the youths had competed in organized athletics, either baseball or football. By position there were three pitchers, two catchers, two infielders, and one outfielder; in addition there were one quarterback and one linebacker. Only one patient presented with locking of the elbow, whereas the others presented with pain and limitation of extension. The locked elbow was explored immediately and the others were explored after immobilization failed to relieve their symptoms. In seven of the joints a loose fragment of the capitellum was found lying either in the joint or in a defect in the capitellum. The fragment had multiple small holes. In three cases there was no loose fragment. In this situation a cortical window was cut above the capitellum. The capitellum was then drilled and bone was grafted from above. Over all, there were one excellent, six good, one fair, and two poor results. There seemed to be little difference between curetting alone or curetting and drilling. The cases with the cartilage intact and bone grafted from above did worse, with one fair and one poor result of three cases. The two poor results required further surgery, which consisted of partial excision of the capitellum. All cases lacked elbow extension before and after surgery, but nine of 10 gained some motion after surgery. Pre- and postoperative x-rays are shown in this report and a brief review of the literature concerning osteochondritis dissecans is presented.
Presidential address
Authors: Kennedy John C. , Roth J.H. , Mendenhall H.V. , Sanford J.B. 
Published: June 2007

For years there has been a struggle for a satisfactory intraar ticular replacement in the anterior cruciate-deficient knee. This paper summarizes our basic and clinical research over the last decade and presents a potential solution to the problem. Instron testing reveals that the anterior cruciate ligament fails at 51.2 kg. Scanning electron microscopy demonstrates that there is little difference whether the ligament is tested just to the point of failure or taken to visible rupture. The technique of the MacIntosh quadriceps-patellar tendon transfer is outlined. Two modifications in the form of a new approach through the defect in the quadriceps mechanism, as well as a new instrument to aid in the passage of the transfer are described. The strength of the tissues about the knee that have been used to substitute for the anterior cruciate ligament are pre sented. Only the distal iliotibial band seems suitable on strength characteristics alone. Intraarticular semitendinosus transfers in rabbits revealed degeneration and a marked decrease in tensile strength at 6 months. We conclude from this experiment and the data from Instron testing on autopsy specimens, substantiated by our clinical impressions, that the long-term success of autogenous intraarticular transfers seems unlikely. We introduce the ligament augmentation device (LAD) as a possible answer. A polypropylene, diamond-braided device is sutured to the prepatellar tissue in the MacIntosh repair to increase its tensile strength. It will sustain the host tissue during the period of degeneration and weakening, and thus allow eventual collagenization. We present our animal work with regard to the LAD and early human clinical application.
Exercise effects on the strength of the rat anterior cruciate ligament
Authors: Cabaud H. Edward , Chatty Aida , Gildengorin Virginia , Feltman Robert J. 
Published: June 2007

Seventy-five rats were divided into a control and four exercise groups of differing frequency and duration. After 8 weeks of endurance-type exercise on a motorized treadmill, the rats were sacrificed and the anterior cruciate ligaments were tested to failure on an Instron materials testing machine at a strain rate of 95% sec-1. Of the 121 ligaments tested, 119 failed by pure interstitial failure. There was significant increase in both the strength and stiffness of the anterior cruciate ligaments in the exercised rats but those rats exercised more frequently (daily vs. every other day) and for shorter duration (30 min rather than 60 min) had the greatest increase in strength. This study has shown that endurance-type exercise is bene ficial to the anterior cruciate ligament as both strength and stiffness are increased and functionally the ligament remains unchanged by exercise.
Biomechanics of walking, running, and sprinting
Authors: Mann Roger A. , Hagy John 
Published: June 2007

A biomechanical study of 13 runners which consisted of 2 male sprinters, 5 experienced joggers, and 6 elite long-distance runners were studied. We obtained hip, knee, and ankle joints motions in the sagittal plane and electromyographic data from specific muscle groups. As the speed of gait increased, the length of stance phase progressively decreased from 62% for walking to 31% for running and to 22% for sprinting. The sagittal plane motion increased as the speed of gait increased. Generally speaking, the body lowers its center of gravity with the increased speed by increasing flexion of the hips and knees and magnifying dorsiflexion at the ankle joint. Electromyographic activity about the knee demonstrated increased activity in the quadricep muscle group and hamstring group with increased speed. Mus cle function about the ankle joint demonstrated that the pos terior calf musculature which normally functions during the midstance phase in walking became a late swing phase muscle and was active through the first 80% of stance phase, as compared to 15% in walking. Beside the changes in the electromyographic activity of the muscles, the anterior compartment muscles of the calf undergo a concentric contracture at the time of initial floor contact during running and sprinting but undergo an eccentric contrac tion during walking.
The athlete's mouthpiece
Authors: Schwartz Robert , Novich Max M. 
Published: June 2007

This article points out several needs. The first is the need to have research on the design of the athlete's mouthpiece. This study demonstrates that the most frequently used athlete's mouthpieces alter the relationship of the lower jaw to the upper jaw. Second, this article expresses the need for design change in the present mouthpiece. It shows statistics that indicate a design change could be very advantageous to the athlete's performance. A strong case is made for viewing the mouthpiece as an aid as well as a protector.
Intraarticular substitution for anterior cruciate insufficiency
Authors: Ivey F. Martin , Blazina Martin E. , Fox James M. , Del Pizzo Wilson 
Published: June 2007

Forty two patients with functionally incapacitating 2+ or 3+ anterior instability underwent anterior cruciate ligament sub stitution using a meniscus (25 patients) or central third of the patellar tendon (17 patients). Subjective and objective evalua tions were personally performed on all patients with an average followup of 15 months. Seventy-nine percent of the patients were objectively graded successful. Objective results were pri marily based on the surgeon's technical ability to correct completely all components of anterior instability at the time of surgery. Subjective results were multifactorial and were cor related primarily with patient expectations, the presence or absence of continued buckling and the ability to return to recreational activities. The only observed difference between the two types of cru ciate substitutions was the average loss of 6° of flexion in the central third of the patellar tendon group. Both the patellar tendon and meniscus clinically appeared to be successful in traarticular cruciate substitutes which can predictably correct moderate to severe anterior instability of the knee in a high percentage of patients.
Spontaneous partial subcutaneous ruptures of the tendo achillis
Authors: Skeoch Daniel U. 
Published: June 2007

Partial subcutaneous rupture of the Achilles tendon has been considered a rare condition. Physical signs and symptoms have not been well established. The current review of 11 patients with 16 involved subcu taneous ruptures of the Achilles tendon treated at Southwestern Orthopedic Medical Group between the years 1971 and 1976 is intended to delineate the entity more clearly. Preoperative and postoperative symptoms and physical findings were evaluated and operatively and nonoperatively treated groups were compared. All tendons treated demonstrated either a palpable, partial defect in the Achilles tendon or were found at surgery to have a partial rupture. Thompson's test was negative in all patients. Eighty-one percent of injuries occured in males (13 of 16). The average age at diagnosis was 47.6 years. Pretherapy symp toms existed an average of 6½ months before defini tive therapy was instituted. Eighty-one percent of in juries were incurred during athletic activity (13 of 16). Forty-four percent had had from one to five prior injections of corticosteroid into the Achilles tendon area (7 of 16). The most common pretherapy symp toms were pain after variable degrees of activity (100%), limping (100%), the sensation of weakness (81 %), and intermittent or continuous swelling (35%). Seven of 16 tendons were treated with nonoperative therapy. The remaining nine tendons underwent sur gical exploration and repair. Those treated surgically were repaired by excision of the defect, suture of the opposing ends, and reinforcement of the repair with fascial strips turned down from the posterior gastroc nemius. All patients completed detailed question naires after therapy. This study concludes (1) Partial subcutaneous rup ture of the tendo achillis occurs predominantly in young and middle-aged males involved in strenuous athletic activities; (2) predominant symptoms are pain, limping, weakness, and intermittent swelling; (3) pal pation of the Achilles tendon will generally reveal a palpable partial defect but Thompson's test will remain negative; (4) ablation of symptoms can usually be obtained nonoperatively but if symptoms persist be yond six months surgical exploration and repair is indicated; (5) the majority of patients can be expected to return to their preinjury level of activity.
Pathomechanics of the pivot shift maneuver
Authors: Tamea Conrad D. , Henning Charles E. 
Published: June 2007

This paper analyzes changes in instant centers of motion and joint surface velocity vectors in knees demonstrating a positive pivot shift test. Eight patients were studied on the basis of a sus pected tear of the anterior cruciate ligament. Clinical evaluation consisted of a history and examination with special attention to the anterior drawer test, Lach mann's test, and the pivot shift test. Control knees chosen had a negative history of injury and a normal examination. Serial roentgenograms were obtained on all knees through a range of motion from 0 to 90° of flexion, at increments of 7 to 10°. Internal rotation and valgus stress were applied to duplicate the pivot shift maneu ver during the filming. These serial studies were used to determine instant centers of motion, modifying the method of Rouleaux. Arthrography and arthoscopy were performed to document the pathologic anatomy. Alterations in instant center progression were noted in all patients with a clinically positive pivot shift as compared with the control group and a general pattern of progression was observed. From 0 to 20° of flexion the instant centers were located too near the joint line and displaced anteriorly. During the shift phase (from 20 to 45°) the instant centers were located posteriorly and proximally on the femur. These findings indicate that from 0 to 20° rolling predominated followed by a sudden change to gliding as the shift occurred. In a few cases the initial instant centers were actually located below the joint line, indicating a backwards glide phenomenon. From 50 to 90° the instant center progression was near normal. Surface velocity vectors were likewise abnormal in patients with pivot shift. During the initial phase of flexion the velocity vector was not tangential to the joint surface, indicating excessive friction and com pressive forces were present during knee motion. These findings demonstrate a possible mechanism for the development of posttraumatic arthritis of the tibial- femoral joint in patients with a positive pivot shift test. A quantitative analysis.of the pivot shift maneuver is shown which aids in understanding the pathomechan ics of the pivot shift maneuver. The method is also suggested for long-term evalu ation of anterior cruciate reconstructive procedures.
The fate of the acromioclavicular joint in athletic injuries
Authors: Cox Jay S. 
Published: June 2007

Of 164 acromioclavicular joint injuries to midshipmen at the US Naval Academy between July 1973 and November 1978, 99 were Type 1, 52 were Type 2, and 13 were Type 3. Follow-up examinations revealed that 36% of Type 1, 48% of Type 2, and 69% of Type 3 patients had residual symptoms. Positive physical findings were present in 43% of Type 1, 77% of Type 2, and 100% of Type 3 injuries. Roentgenographic changes were noted in 70% of Type 1, 75% of Type 2, and 100% of Type 3 patients. This evaluation suggests aggressive treatment and rehabilitation are indicated in acute acromioclavicular injuries. Residual problems from Types 1 and 2 inju ries are much more frequent than indicated in the literature. Symptoms in Type 1, but not in Type 2, injuries are directly related to the presence of positive physical findings. Roentgenographic changes are ex tremely common and are not correlated with symp toms. Treatment of Type 2 injuries with the acromio clavicular immobilizer resulted in fewer complications than symptomatic treatment.
Posterior problems in the knee
Authors: Fleming Richard E. , Blatz Douglas J. , McCarroll John R. 
Published: June 2007

During a recent three-year period, 39 patients under went surgical procedures for lesions of the posterior complex of the knee. The results in 28 followed for greater than six months (average followup, 16 months) are reported; eight are presently in the early rehabili tative phase and three have been lost to followup. In reconstruction for chronic laxity, a semitendino sus replacement of the posterior cruciate ligament with anterior advancement of the lateral arcuate com plex is recommended. Use of the medial gastroc nemius tendon is still advised in selected cases. Re construction for posterolateral rotatory laxity with an intact posterior cruciate is performed with anterior advancement of the popliteus tendon and the arcuate complex. Pes anserinus transfer, imbrication of the posterior oblique ligament, and biceps tenodesis may be performed as supplemental procedures.
The measured effect of taping on combined foot and ankle motion before and after exercise
Authors: Fumich Robert Mark , Ellison Arthur E. , Guerin Gary J. , Grace Paul D. 
Published: June 2007

The Inman ankle machine was modified to determine plantarflexion, dorsiflexion, inversion neutral, eversion neutral, plantarflexion inversion, and plantarflexion eversion before taping, immediately after taping, and with tape after a 2.5- to 3-hour football practice. The previously uninjured feet and ankles of 16 college- age football players were used. All were taped by the same method. A single-tailed paired-sample t-test was done to determine the minimum amount of restriction that could be expected for each motion after the exercise period. Ninety percent confidence intervals between untaped versus taped preexercise, untaped versus taped postexercise, and taped preexercise versus taped postexercise for all motions were determined. Inversion neutral, plantarflexion inversion, and ever sion neutral had an average residual restriction after exercise of 50%, or greater than the initial restriction prior to exercise. Plantarflexion, dorsiflexion, and plantarflexion eversion loosened significantly greater than 50%.
Skier's Thumb
Authors: Gerber Christian , Senn Edgar , Matter Peter 
Published: June 2007

Acute rupture of the ulnar collateral ligament of the metacarpophalangeal (MCP) joint of the thumb is often sustained in downhill skiing accidents and is hence called "skier's thumb." All complete ruptures seen at our hospital between 1975 and 1979 were operated using the "fishhook" pullout wire technique. Follow up results 29 months after early operation are pre sented for 47 cases. The overall results are excellent in 29, good in 14, and fair in 3 patients. One result had to be considered a failure. No patient had serious functional impairment or major constant pain. No pa tient took any pain medication. No reintervention was necessary. The distal bony avulsions showed the most favorable prognosis, and the ligamentous midsubst ance tears, the least favorable. The fishhook pullout wire technique can be used in both ligamentous and bony avulsions of the ulnar collateral ligament and provides good or excellent results in 90% of the cases.