No abstract

The quadriceps mechanism consists of the patellar ligament distally and the quadriceps tendon proximally. The quadriceps tendon is the confluence of the tendinous portions of the vastus medialis, vastus lateralis, vastus intermedius, and rectus femoris. Lieb and Perry (J. Bone Joint Surg. 5OA:1535-1547, 1968) have described the vastus medialis obliquus (VMO) and Hallisey et al. (J. Bone Joint Surg. 694.545549, 1987) have described the vastus lateralis obliquus (VLO). These muscles are the terminal medial and lateral insertions of the vastus medialis and vastus lateralis. This study delineates and quantifies anatomic sex differences for the medial and lateral angular terminal insertions of the vastus lateralis obliquus and vastus medialis obliquus in relationship to the longitudinal axis of the patella in 40 embalmed cadaver knees. A mathematical model is developed and discussed using least steps regression equations y = Ax + B, where y = the VLO insertion angle, x = the VMO insertion angle, A = the coefficients, and B = the y intercept. These equations are different in males and females, with males having more horizontally oriented VLO fibers than females. T h e vastus lateralis obliquus (VLO) insertion angle can be predicted based upon measurement of the vastus medialis obliquus insertion angle and sex: Log VLO = 1.36 + .00531 VMO -0.000166 (S x VMO), where S = 1 for females and S = 0 for males. In embalmed cadaver knees, the angular terminal insertion of the vastus lateralis obliquus related to the longitudinal axis of the patella is more horizontally oriented in males than in females. T h e angular terminal insertion of the vastus medialis obliquus of males and females does not increase equally with increases in the angular terminal insertion of the vastus lateralis obliquus.

A statewide sample of 199 mediated and 201 adversarial divorce cases in Connecticut was analyzed for differences in financial outcomes between the two formats. No differences were found between mediated and adversarial cases in family income or liability outcomes for women, in likelihood of periodic alimony being received, or in amount of alimony received. However, women in mediated cases obtained a significantly greater percentage of assets than women in adversarial cases, periodic alimony for a significantly longer duration, and significantly more child support. Adversarial cases had significantly more postjudgment modifications and took longer from complaint to judgment.

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Triage is a model project designed to overcome the organizational and financial barriers inhibiting the provision of appropriate care to the elderly. Teams made up of a nurse clinician and a social worker performed assessment, service coordination, and monitoring functions. Services arranged by the teams were financed through a series of waivers on the use of the Medicare Trust Fund. Three hundred and seven Triage clients were followed and compared to a group of 195 elderly in a two-year quasi-experimental The Triage Experiment: Project DescriptionTriage was designed as a model project for the coordinated delivery of medical and social services to the elderly. Unlike the conventional system, where the services provided to an individual depend upon what is available and reimbursable, the Triage system developed and organized services around the needs of the client and assured that these services were reimbursed. The purpose of the project was to test the effectiveness and measure the cost of this new system of delivering care to the elderly. A description of the project and preliminary first year (1977) findings have recently been reported by the authors.' This paper presents a more detailed description and findings from the full two years (1977)(1978) of comparative research.