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A method and apparatus for electric surgery includes generating oscillations of high frequency electric energy of substantially constant amplitude, controlling the duration of and spacing in time between each series of oscillations generated and applying the generated energy through an electrode for the purpose of making surgical incisions and coagulating blood at the point of incision. A common generator serves as a source of the electric energy for different surgical procedures, the duration and spacing between each series of oscillations being closely controlled according to their intended application and in such a way as to minimize power requirements and the possible hazards of use either to the doctor or to the patient.
Claims available in
Description (OCR text may contain errors)
United States Patent Sittner 1 July 11, 1972 METHOD AND APPARATUS FOR HIGH FREQUENCY ELECTRIC SURGERY Weldon Rex Sittner, Westport. Conn.
Electro Medical Systerm, lnc., Englewood. Colo.
Filed: Feb. 4. I970 Appl. No.: 8,549
References Cited UNITED STATES PATENTS GND POWER SUPPLY CONTROL MULTIVIBRATOP FOREIGN PATENTS OR APPLICATIONS 897.961 6/1962 GreatBritain ....l28/303.|4 1.146.989 4/1963 Germany ..l28/303.l4
Primary Examiner-Channing L. Pace Armrney-Philip G. Hilbert ABSTRACT A method and apparatus for electric surgery includes generating oscillations of high frequency electric energy of substantially constant amplitude. controlling the duration of and spacing in time between each series of oscillations generated and applying the generated energy through an electrode for the purpose of making surgical incisions and coagulating blood at the point of incision. A common generator serves as a source of the electric energy for different surgical procedures, the duration and spacing between each series of oscillations being closely controlled according to their intended application and in such a way as to minimize power requirements and the possible hazards of use either to the doctor or to the patient.
llClaimsJDnwingI igures 101 COAGULATE |L2 B's ii IIIQOS PKTENTEUJUL 1 1 m2 SHEET 3 OF 3 x mm mobamzww n30 xm mm lu l m2 E. m mpzmuzmw PDQ METHOD AND APPARATUS FOR HIGH FREQUENCY ELECTRIC SURGERY This invention relates to medical electronic methods and apparatus, and more particularly to a method and apparatus for conducting electric surgery in a safe and highly effective manner.
Heretofore, devices have been designed which have employed radio-frequency (RF) electric energy for performing surgery on the human body. Typically, such devices included a cutting mode of operation wherein a continuous waveform of RF energy produced by a vacuum the generator was used to cut by means of the heat generated in the body tissue and a coagulation mode wherein a damped RF energy waveform provided by a separate spark-gap type generator was used to coagulate the blood flowing from the cut tissues. A disadvantage with such prior art devices was that in order to perform the cut/coagulation functions, two separate generators were required and which applied extremely high voltages to the active cutting electrode. Consequently, such devices and particularly the spark-gap generator unduly destroyed the tissue and further constituted significant hazards in their use both for the patient and the operating physician.
Accordingly, it is an object of this invention to provide a novel method and apparatus for cutting tissue and coagulating the blood at the area of the cut using the same RF generator and characterized by applying envelopes or packets of RF electric energy in an oscillatory waveform of substantially constant amplitude recurring at preselected spaced time intervals.
Another object of the present invention is to provide a novel apparatus for high frequency electric surgery which obviates the aforementioned disadvantage of prior art instruments by employing electric circuitry which enables the use of substantially lower RF voltages than heretofore possible and provides an essentially unmodulated oscillatory waveform.
It is another object of the present invention to provide novel apparatus for high frequency electric surgery as set forth which is capable of conducting both a cut mode of operation and a coagulation mode of operation, either simultaneously or independently of one another.
It is further an object of the present invention to provide a novel apparatus for high frequency electric surgery characterized by having an RF generator and control circuitry using solid state elements which is highly sensitive, reliable and effcient, and has close power regulation, and is closely adjustable and controllable in carrying out different selected surgical procedures and techniques in a safe dependable manner.
In accomplishing these and other objects, there has been provided in accordance with the present invention electric apparatus for performing high frequency electric surgery which includes an RF generator, and a control multivibrator, asymmetrical in operation, to control the RF generator to provide a combined cut and coagulation mode, and a coagulation mode of operation. Switching means are provided whereby the RF generator may be continuously operated or alternately controlled by the control multivibrator. The RF generator is connected to amplifying means for amplifying the RF power or energy generated by the RF generator and applying it to an active electrode for use in cutting or coagulating living body tissue. A return means in the form of a patient ground plate is positioned against the patient below the area of the body to be operated on for providing a return electric path to the amplifying means. A power supply means supplies relatively low DC voltages to the apparatus circuitry. In this way there is provided by a single electronic oscillator circuit a series of envelopes of RF electric energy in an oscillatory waveform of substantially constant amplitude with the envelopes recurring at selected spaced time intervals for coagulation of blood or combined cutting and coagulation or the energy in a continuous waveform for the usual cutting of body tissue.
A better understanding of the present invention may be had from the following detailed description when taken in conjunction with the accompanying drawings, in which:
FIG. 1 is partially a block diagram and partially a circuit diagram of an electric apparatus for high frequency electric surgery in accordance with the present invention.
FIG. 2 is a circuit diagram of the control multivibrator of FIG. 1.
FIG. 3 is a circuit diagram of the RF generator of FIG. 1.
FIG. 4 is a circuit diagram of the power amplifier of FIG. 1.
FIG. 5 is a circuit diagram of the power supply of FIG. I.
FIG. 6 is in part a plan view of the patient ground plate of FIG. I and in part a circuit diagram of the connection of the patient ground plate into the circuitry of the electric apparatus of FIG. I.
FIG. 7 is an illustration of the output waveforms generated by the apparatus of FIG. 1 in its different modes of operation together with a comparison of waveforms with a typical sparkgap type generator.
Referring now to FIG. I the electrosurgical apparatus in general is shown to include a control multivibrator circuit 10 for controlling an RF generator circuit 20, the output of which is applied to a power amplifier circuit 30 for increasing the power output together with a power supply 40 which generates the DC voltage required by the aforementioned circuits. In FIG. I, the RF generator 20 is shown to have a DC voltage supplied to generator terminals 22 and 23, and generator terminal 24 is connected to ground. The DC voltage applied to the terminals 22 and 23 is derived from the power supply 40 which generates DC voltages on its output tenninals 46 and 48, and output terminal 47 is grounded. A V- voltage, between terminal 47 and ground may be anywhere in the range of 0-180 volts, and is applied to the generator terminal 23 and to terminal 22 through a resistor 28. An RF bypass capacitor 29 is connected between terminal 22 and ground.
The RF generator 20 has a control terminal 21 which is connected to the fixed contact of one set of relay contacts of the relay 101, hereinafter referred to as the cut relay. A lamp L3 located on the control panel is connected across relay 101 to indicate when the apparatus is in the cut mode. The other of the contacts 100 is a dummy contact while the movable contact arm is connected through an on-off switch 102 to ground. Switch 102 is hereinafter referred to as the cut switch and is a toggle type switch located on the control panel. In the open position shown, the cut mode switch 102 is set for cut 2 and in the closed position it is set for cut 1.
Connected also to the generator terminal 21 is the output terminal 11 of the control multivibrator 10. The control multivibrator II) has DC voltage supplied to its terminals I4 and 15, the terminal 14 being at ground, and B voltage from the power supply 40 being supplied via the circuitry of a patient ground plate or indifi'erent electrode 103, to the terminal I5.
The B- voltage generated by the power supply 40 may, for example, be l4 volts. The control multivibrator 10 has the movable contact arm of relay contacts 104 of the relay 105 connected to its terminal 12. Relay 105 serves as the coagulate relay and a lamp L2 located on the control panel is connected across coil 101 to indicate when the apparatus is in the coagulate" mode. The multivibrator terminal 13 is connected to the other fixed contact of the relay contacts 104.
The RF generator 20 is transformer coupled by means of a step-up power transformer l 10 to the power amplifier 30. The generator 20 has its output terminals 25-27 connected to the primary winding of the transformer III). The power amplifier 30 has its input terminals 32, 33a, 33b and 34 connected to the transformer 110. V- and ground are connected to the terminals 31 and 35, respectively, of the amplifier 30 to supply DC power thereto.
The output of the power amplifier 30 is coupled by a transformer 111 to output lines 11-2 and 113. The primary of the transfonner I I1 is connected to amplifier output terminals 36, 37a, 37b and 38. The output lines 112 and 113 are connected across the secondary winding of the transformer III. A resistor 118 is connected between the output lines I 12 and 113 across which is developed the output voltage of the transfonner l I l.
The output line 112 is a shielded line having its shield connected to ground and is connected through DC isolation capacitors 109 and 1 14 and through a terminal connect 50 to an active electrode 115. Terminal connect 50 permits the electrode to be plugged into the control panel of the apparatus. The output line 1 13 is connected through a DC isolation capacitor 116 to the two terminal connects 51 and 52 of the patient ground plate 103. A capacitor 117 is connected between the terminals 51 and 52 for the purpose of preventing a B- voltage from being supplied to the control multivibrator terminal 15 whenever the patient ground plate 103 is not electrically connected to the electrosurgical apparatus at terminals 51 and 52. Connected to the side of the capacitor 117 adjacent the terminal 51 are a grounded capacitor 120 for DC isolation and an RF inductive choke 121 for isolating the power supply 40 from RF energy. A DC isolation capacitor 122 is also connected to the side of the choke 121 to which B- voltage is supplied.
The terminals 51 and 52 are mutually connected to a common point and from that common point are connected through a DC isolation capacitor 123 to the patient ground plate 103. Connected to the side of the capacitor 117 common with the tenninal 52 is one terminal of an RF inductive choke 124. The other terminal of the choke 124 is connected through an RF inductive choke 125 to the ground plate 103. Connected to the side of the capacitor 117 common with the terminal 52 is one terminal of an RF inductive choke 124. The other terminal of the choke 124 is connected through an RF inductive choke 125 to the line 112 and also the movable contact of a switch 127. The switch 127 is preferably a treadle switch and foot-operated by the physician and has fixed contacts I28 and 129, and is used for switching the mode of operation of the electric apparatus between "cut" and coagulate.
The fixed contact 129 of the switch 127 is connected through a diode 135 to the control multivibrator terminal 15. Similarly, the fixed contact 128 of the switch is connected through a diode 136 to the control multivibrator 15. Thus, 3-- voltage may be supplied to the terminal 15 through the electrical path defined by the choke 121, terminals 51 and 52, the choke 124, the switch 127, and the appropriate diode 135 or 136. In this way, the treadle switch 127 cannot actuate the cut or coagulate relays unless the patient plate 103 is plugged into the instrument. A capacitor 137 is also connected from the switch contact 129 to ground.
The electrical means for connecting the patient ground plate 103 to the exemplary electrosurgical apparatus additionally includes terminals 53 and 54, as better illustrated in H6. 6. The terminals 53 and 54 are shorted together and serve to short out a lamp L4 whenever the plate 103 is connected into the above-described exemplary apparatus. Terminals 51-54 are shown in FIG. 6 as mounted on a common plug represented at 55. B- voltage is supplied to the lamp L4 through a resistor 141. Lamp L4 is preferably located on the control panel and lit until the patient plate 103 is electrically plugged into the panel.
Referring now to FIG. 2, the control multivibrator 10 shown includes a conventional flip-flop circuit with transistors TR and TR6 arranged to alternately conduct and cut-ofi' in a repetitive sequence. The bases of transistors TR5 and TR6 are connected to timing capacitors C6 and C5, respectively. A third timing capacitor C30 is connected between one side of capacitor C5 and terminal 12 so that when terminals 12 and 13 are connected by the actuation of relay 105 the total capacitance in one side of the flip-flop circuit is the sum of the capacitance of capacitors C5 and C30 instead of only C5. This shortens the period of conduction of transistor TR5 and thereby changes the duty cycle for the flip-flop circuit. Variable resistors R6 and R7 connected to capacitors C5 and C6, respectively, may also be adjusted to vary the duration of the duty cycle on each side of the flip-flop circuit. Also included in circuit as shown in H6. 2 is a transistor TR7 having its base electrode connected through resistor R10 to the collector of TR5. The emitter-collector junction of transistor TR7 is connected between terminal 11 and grounded terminal 14. In this way when transistor TR5 is conducting, a suitable voltage is applied to the base of transistor TR7 to cause it to conduct between its emitter and base electrodes and in effect connect terminal 11 to ground or zero potential via transistor TR7 which will enable the RF generator to run for a selected time interval when TR5 is conducting and be off when TR5 is cut off during the cut 2" and coagulate" modes when terminal 21 is not grounded via contacts and switch 102 as described more fully hereinafter.
Referring now to FIG. 3 the RF generator circuit 20 is shown to include an RF oscillator circuit 200 transformer coupled by transformer T2 to a conventional driver amplifier circuit 20b. The driver amplifier circuit includes a transistor TR9 and functions to increase the power from the oscillator circuit 20a to the power amplifier circuit 30 and isolates the oscillator circuit therefrom.
The oscillator circuit 20a includes a transistor TRB having its collector connected to a series resonant circuit of capacitor C28 and winding W1 of transformer T2, with winding W1 having one end connected to grounded terminal 24. An RF choke CH5 is connected between the collector and grounded terminal 24 to provide an RF load for TR8. The emitter of transistor TR8 is connected to the V- voltage through bias resistors R12 and R28. An RF bypass capacitor C10 connects between the emitter and ground terminal 24. The base of the transistor is connected to a regenerative feedback network including a feedback winding W2 of transformer T2, diode D2, which rectifies the RF energy induced in the winding W2 together with a charging capacitor C7 connected between the diode D1 and terminal 22. Resistors R11 and R20 are connected from a mutual connecting point with diode D1 and capacitor C7 to control terminal 21 and a control diode D2 is connected between a mutual connecting point with resistors R11 and R20 and to the V- voltage via resistor 28.
Oscillator circuit 200 will oscillate when terminal 21 is at ground or zero potential either via contacts 101 and switch 102 or via the conduction of transistor TR7. When terminal 21, connected to resistor R20, is at ground or zero potential the feedback network has sufficient RF energy to enable the resonant circuit to sustain oscillations. More specifically, when terminal 21 is at ground diode D2 is back-biased and cannot conduct. This establishes a timing circuit of C1 and R11 plus R20, the capacitor being charged by RF energy rectified by diode D1 which will produce sufficient energy in the feedback network to sustain oscillations. However, when terminal 21 is not grounded diode D2 will conduct and, with only R11 and C7 forming the timing circuit for the feedback network, then there is insufficient RF energy available to sustain oscillations and the resonant circuit will continue to oscillate and induce RF power into winding W3 of the driver circuit. Under these conditions the potential at terminal 21 via diode D2 and resistor R20 is at the V-- voltage and transistor TR7 will now conduct each time transistor TR5 conducts and cut off each time transistor TR5 cuts off. In this way the flipflop circuit operates continuously when either relay 101 or 105 is actuated but during the cut 1 mode the control multivibrator is disabled since its collector is grounded via contacts 100 and switch 102.
Referring to FIG. 4, there is shown a conventional push-pull amplifier 30. The amplifier 30 has three serially connected transistor amplifier stages on each side consisting of transistors TRl, TR2 and TR3 on one side and transistors TR4, TR10 and T'Rll on the other side. The amplifier 30 operates as a power amplifier to amplify the RF energy or power generated by the RF generator 20. The power amplifier is driven relatively hard by the driver amplifier to achieve the desired performance.
Referring to FIG. 5, the power supply 40 includes input terminals 41 and 42 with an AC electric power source signal generator 200 connected thereacross. The AC electric power source may, for example, be a conventional 1 l5-volt 60-cycle power source into which the power supply 40 is connected. The power supply 40 also includes a conventional power control circuit 199 for varying the AC input by changing the phase and amplitude thereof and is commercially sold by General Electric Co. as G.E. TRlAC No. 510033. This circuit includes a triac element 201 and a diac or double-based diode element 202 connected to the control electrode of the triac element 201. A pair of terminals 43a, 44 are provided for selectively connecting a variable resistor 203 into the power control circuit 199 to change its output for the coagulation" mode, and similarly a pair of terminals 43b and 45 selectively connect a variable resistor 204 into the power control circuit 119 to change its output during the "cut mode. Resistors 203 and 204 are located on the control panel and are preset according to the desired power for either mode. The terminals 43a and 44 are shown as stationary contacts which are closed by a movable contact arm of the relay 105 which is selectively energized for the "coagulate" mode. Similarly, the terminals 43b and 45 shown as stationary contacts of relay 101 are selectively closed by a contact arm 59 movable in response to the energization of the relay 101 for the "cut" mode as shown in FIG. 1. The power control circuit 199 is also adjustable by means of the variable resistor 205 to vary the output of the power supply.
Included in the power supply is a transformer 206 which couples the out ut of the power source 200 to a diode bridge 207 to provide B- DC voltage across terminals 47 and 48, and a transformer 208 couples the output of the power control 199 to a diode bridge 209 to provide the V DC voltage across terminals 46 and 47. A power switch 211 located on the control panel connects the input power from the supply 200 to the power control 199 and a lamp L1 serves to indicate when the power is on to the power supply. A capacitor 212 is connected across terminals 47 and 48 for filtering of the 60-cycle power and a resistor 213 and capacitor 214 are connected across terminals 46 and 47, the latter also being used to filter the 60- cycle power to assist in prevention of its being applied to the electrodes. In this way the waveform of the energy produced by the RF generator is not appreciably amplitude modulated by the 60-cycle power source 200. Vacuum tube type generators previously used for the cutting of tissue provide an amplitude modulated waveform which is modulated by the 60- cycle input power line to the extent of being completely modulated at 120 cycles. The effect of such amplitude modulation is to provide a series or envelopes of RF energy oscillations which decrease to substantially zero amplitude at one point in each repetition thereof.
In operation, the electrosurgical apparatus of the present invention as shown in FIG. 1 is in situ with the active electrode 1 positioned to operate on a patient represented at 220. The indifferent electrode or patient ground plate 103 is placed in situ against the body of the patient usually with the patient lying on the plate 103. The power supply switch 211 is turned on and resistors 203 and 204 are set to the desired power levels. To perform a cut, the cut switch 102 would then be closed for the cut 1" mode. The treadle switch 127 would be switched to the cut" mode, by the surgeon, thereby connecting the movable contact arm of the switch 127 to its fixed contact 128 as shown. Thus, the relay 101 is energized closing the terminals 43b and 45 of the power supply 40 and closing switch 100 to ground terminal 21 of the RF generator to turn the RF generator 20 on" to produce a high frequency electric energy in an oscillatory waveform of substantially constant amplitude as represented at C in FIG. 7. This RF electric energy is then amplified by the power amplifier 30 and transformer-coupled to the electrodes 115 and 103. The RF energy then flows from the active electrode 1 15 for selectively cutting the body tissue of the patient 220 and the energy returns to the plate 103. The RF energy, after passing into the plate 103, is then dissipated in RF chokes 121, 124 and 125.
After each cutting operation, or periodically in the process of cutting or surgery, it is necessary to coagulate the blood flowing from the cut tissues. This is accomplished by operating the treadle switch 127 thereby to switch the movable contact arm thereof to fixed contact 129. Relay 101 is de-energized while relay is energized. Thus, contacts 100 open and terminal 21 is no longer grounded and contacts 104 close terminals 12 and 13 of control multivibrator 10 to connect capacitor C30 in parallel with C5. Also the terminals 430 and 44 of the power supply 40 are closed so that a higher level of power is generated by the power supply 40 across output terminals 46 and 47. In the "coagulate" mode the potential at terminals 11 and 21 alternately changes between two different electric potential levels with each level being of a selected duration which is established by the duty or timing cycle of the flip-flop circuit, and these potential or voltage levels in turn regulate the time on and time off for the oscillator circuit 20b. Thus the voltage waveform at the output of the control multivibrator 10 may be represented by a pulse-shaped waveform B as shown in FIG. 7. The voltage or potential level to turn the oscillator circuit on is zero or ground and this occurs as above described each time transistors TRS and TR7 conduct. However, when transistor TRS cuts off then transistor TR7 in turn cuts off and the potential at terminals 11 and 21 are a V- voltage supplied via resistors 28, diode D2 and R20 and this results in shutting the oscillator circuit off until TR7 again conducts as above described. Thus the RF energy in the form of a series or envelope of oscillations are generated by generator 20 as represented at E in FIG. 7 for each on-time for transistors TRS and TR7, this RF energy or electric power being amplified by the power amplifier 30 and applied to electrodes and 103. This RF electric energy may be characterized as envelopes or packets of a relatively short duration and recurring at regular intervals and operates through the active electrode 115 to coagulate the blood flowing from the severed blood vessels along previously cut body tissue.
A third mode in which this apparatus may be used is called cut 2 and in actuality is a mode whereby the active electrode 115 both cuts and coagulates. 1n the cut 2 mode the treadle switch 127 may remain in the cut position to retain the energization of relay 101 and the cut power at terminals 46 and 47; however, switch 102 is placed in the cut 2" position which opens the ground circuit to terminal 2]. In this way the control multivibrator 10 controls the enabling or on-time for the RF generator 20 and the disabling or off-time for the RF generator in the same manner as above described with reference to the "coagulate" mode. However terminals 12 and 13 of the control multivibrator 10 are open and capacitor C30 is removed so that the on-time is longer and the off-time is shorter as represented by waveform A in FIG. 7. The RF generator will then produce a series of envelopes of RF energy oscillations of a longer duration with shorter time intervals between each series, said energy being amplified and applied to the electrodes 115 and 103. This RF energy on the active electrode 115 efi'ects partially a cutting and partially a coagulating action on the body tissue of the patient 220.
Reference is now made to the waveforms of FIG. 7 to explain the advantages of the present invention: The electrical resistance of the body tissue through which the RF current flow is essentially a resistance impedance and therefore the waveforms of the RF current, RF voltage and instantaneous RF power or energy are essentially the same as represented by waveform C, and may be characterized by being oscillatory and of a substantially constant amplitude. A preferred frequency of this RF energy is 0.5Ml-lz so that the period of each cycle is the reciprocal of the frequency or equal to 2 microseconds. The duration of the "on-time" and the coagulate mode" is about l0 microseconds an a time interval of the off-time of about 40 microseconds or a l-to-4 ratio has been found to provide excellent blood coagulation results. Accordingly, this produces a series of oscillations of RF electric energy of the same duration and recurring at regular intervals as represented by waveform E. The terms envelope" or Packet as used herein are therefore intended to refer to a series of RF energy oscillations which occur during a particular duration or preselected time interval. Since the oscillations i .3, produced by generator 20 are of a substantially constant amplitude, the positive and negative peaks define a rectangular area which may be considered an essentially rectangular shaped envelope of RF energy. This is to be distinguished from an RF energy produced by a spark-gap type generator which has damped oscillations and the instantaneous power of which decreases rapidly as represented in FIG. 7 by waveform G.
The significance of the difference between the two is best understood by considering the average power waveforms for the two types of generators as represented by wavefomis F and H. The generator 20 producing a series or envelopes of RF power E has an essentially flat average power characteristic over the duration of the envelope as represented at F, whereas that of the spark gap-type generator rapidly decreases to zero along a parabolic shaped curve of progressively decreasing slope as represented at H. Therefore in order to provide equivalent average power over a similar duty cycle, the spark-gap generator requires considerably higher RF voltages and currents.
Comparative tests have shown that the instrument above described will operate at about 2,400 volts peak-to-peak at the active electrode whereas a comparable spark-gap type generator requires about 6,500 volts peak-to-pealt. This difference in operating voltages is an important factor from the standpoint of the safety of the patient, personnel and surgeon. Further, the AC power input to the vacuum tube type oscillator generator is usually on the order of 1,000 volts at 60 cycles as compared to the 1 l7 volts for the cut 1 mode in the present apparatus and the DC power of about I ,000 volts for the vacuum tube type generator as compared to the maximum of I80 volts in the exemplary apparatus.
The average power of the exemplary apparatus to meet cutting power and peak coagulating power requirements is about 500 watts and 700 to 800 volts maximum or peak. The output of the RF generator 20 of the exemplary apparatus is in the range of about -300 volts for the cut 1 mode and about 0-400 volts for the cut 2 and coagulate modes. In turn, the output voltage at the active electrode is in the range of about 0-1 .1 KV for the cut 1" mode and about 0-l .5 KV for the cut 2 and coagulate modes. These ratings compare to a peak voltage for coagulate in the spark-gap generator of about 4.5 KV and peak power ofabout 6.5 KW.
In addition, the solid state elements employed herein provide a circuit of much improved reliability and efficiency and closer power regulation over high frequency electrosurgical instruments heretofore provided. The relatively low DC voltage of l4 volts used as the bias voltage for the transistors and for the treadle switch I27 which is preferably explosion proof" adds to the safety. in the above described circuitry the DC voltage and 60-cycle power line voltage are efi'ectively isolated from the electrodes to minimize modulation of the main power 60-cycle frequency which would otherwise affect the RF generator output and for patient safety.
Although the present invention has been described with a certain degree of particularity, it is understood that the present invention has been made by way of example and that changes in details of structure may be made without departing from the spirit thereof.
What is claimed is:
l. A method for high frequency electric surgery comprising the steps of:
generating a continuous periodic waveform of high frequency electric energy wherein within each period of the waveform of the order of tens of microseconds there is at least one burst of substantially constant amplitude oscillations of high frequency electric energy with the duration of the burst being a predetermined fraction of the period of the waveform; and continuously applying the generated energy to a body site where a surgical change is desired in said body site. 2. A method as set forth in claim 1 wherein said electric energy is oscillating at a frequenc of about 0. SMl-lz.
3. method as set forth in c aim I wherein the bursts of high frequency electric energy are about 10 microseconds in duration and the time interval between bursts is about 40 microseconds.
4. A method as set forth in claim 1 wherein the bursts of high frequency electric energy are about 15 microseconds in duration and the time interval between the bursts of energy is about 20 microseconds.
5. The method of claim 1 wherein said predetermined fraction is in the order of one fourth, and the generated energy is continuously applied to said body site when it is desired to coagulate the blood flowing from said body site.
6. The method of claim 1 wherein said predetermined fraction is in the order of four sevenths.
7. Electrosurgical apparatus comprising: generator means for generating a continuous periodic waveform of high frequency electric energy wherein within each period of the wavefonn there is at least one burst of substantially constant amplitude oscillations of high frequency electric energy with the duration of the burst being a fraction of the period of the waveform;
selective control means including an assymetrical waveform generator for selectively controlling said generator means to change the fraction of the period in accordance with a desired surgical procedure;
user operable means for switching on and off when desired,
said generator means; and
electrode means coupled to said generator means for application of the electric energy generated.
8. The invention recited in claim 7 wherein said generator means is operable to generate RF energy.
9. The invention recited in claim 7 wherein said electrode means includes:
an indifferent electrode positioned against a body upon which surgery is to be performed, and
an active electrode positioned for selectively applying the high frequency electric energy generated to said body.
10. The invention recited in claim 7 wherein said generator means includes an RF oscillator circuit having a resonant circuit and feedback network to sustain oscillations in the resonant circuit, said oscillator circuit being turned off by said control multivibrator by disabling said feedback network.
ll. The apparatus of claim 7 and including means for changing the degree of assymetry of the assymetrical waveform.
t i i i i
Patent Citations
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10th Annual Canadian Technical Security Conference, April 21-23, 2015 at Strathmere, near Ottawa.
CTSC 2015 is a not to be missed three (3) day professional development and networking opportunity with others in the field, as well as with key TSCM and Test & Measurement equipment manufacturers.
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The attack on Blue Cross Blue Shield insurer Anthem could be a sign that hackers have shifted their focus away from retailers and toward other targets, cybersecurity experts say.

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SEI Poll: DC Schemes To Change Outdated Default Strategy Design
Sixty-two Percent of Respondents Expect Pension Scheme Members Will Keep Monies Invested Via Flexible Drawdown Post Retirement; 25 Percent Believe Members Will Purchase an Annuity
LONDON, 26 Aug., 2014 – The results of a survey published today by SEI (NASDAQ: SEIC) revealed U.K. pension schemes continue to undergo critical changes following the pension reforms announced in the U.K. 2014 budget, with nearly 66 percent of trustees looking to change their default strategy within the next 18 months.
The poll surveyed trustees and employers on their current approach to defined contribution (DC) pension scheme governance, in addition to their reaction to the changes announced in the U.K. 2014 budget.
Sixty-two percent of respondents said they expect pension scheme members to use flexible drawdown, while only 25 percent said they believe members will purchase an annuity. Additionally, 55 percent of respondents consider it feasible that members may withdraw a tax-free cash sum, while keeping the remainder invested until future needs arise. Forty percent of respondents believe members will choose to receive the entire pot as a cash lump sum.
Commenting on the results of the poll, Ashish Kapur, Head of Solutions for SEI's Institutional Group in the EMEA region, said:
"People are living longer and working more flexibly. A default investment strategy that targets an annuity purchase at retirement ignores the fact that the majority of DC scheme members may not suddenly stop working or require access to their pension money immediately. Therefore, it is important to review a member's DC scheme default to make sure there is an appropriate strategy leading up to and after retirement.
"Additionally, there will be a growing demand for alternatives to annuities, as many individuals regard pension accounts as another savings vehicle from which to withdraw monies as and when needed. The DC landscape is transforming inexorably and, following the successful launch of auto-enrolment, employers, trustees, and master trusts now need to evaluate how their schemes can accommodate greater flexibility. Effectively communicating these changes to scheme members will be key."
Other findings revealed by the survey:
- Fifty-two percent of respondents operating trust-based schemes are planning to implement new retirement solutions following the removal of compulsory annuitisation.
- Nearly 80 percent of respondents who operate a trust-based scheme intend to make changes to their default strategy within the next 18 months.
- An overwhelming 93 percent of respondents stated that they had met their auto-enrolment responsibilities.
- Seventy-four percent of participants maintain a form of governance committee to monitor their pension scheme.
The Defined Contribution Pensions Survey, conducted by SEI in June 2014, was completed by 61 pension professionals in the U.K. overseeing pension assets ranging from £10 million to £100 million. None of the participating organisations are clients of SEI's Institutional business. Please note that totals are rounded and may not always equal 100 percent.
The SEI DC Master Trust
The SEI DC Master Trust provides a fully-bundled solution for employers delivering Defined Contribution (DC) schemes. The Master Trust offers a range of flexible options for employers, including the ability to outsource management of deferred members as an alternative to DC scheme buy-outs and the capacity to design customised default investment strategies. The Master Trust also offers assistance meeting auto-enrolment obligations. Key benefits to employers include in-house investment management and oversight, organization of member communications, flexible scheme administration, and independent trustee oversight.
About SEI
SEI (NASDAQ:SEIC) is a leading global provider of investment processing, investment management, and investment operations solutions that help corporations, financial institutions, financial advisors, and ultra-high-net-worth families create and manage wealth. As of June 30, 2014, through its subsidiaries and partnerships in which the company has a significant interest, SEI manages or administers $602 billion in mutual fund and pooled or separately managed assets, including $249 billion in assets under management and $353 billion in client assets under administration. For more information, visit http://www.seic.com/enUK/index.htm.
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Refrigerant charge quantity for air conditioners & heat pumps: This air conditioning repair article series discusses the the diagnosis and correction of abnormal air conditioner refrigerant line pressures as a means for evaluating the condition of the air conditioner compressor motor, which in turn, is a step in how we evaluate and correct lost or reduced air conditioner cooling capacity.
We explain how overcharging or undercharging of refrigerant in an air conditioner or heat pump is detected and we list the effects of overcharged or undercharged refrigerant. We also explain the various causes of liquid slugging a compressor motor.
Green links show where you are. © Copyright 2015 InspectApedia.com, All Rights Reserved.
What are the Typical Air Conditioner or Heat Pump System Pressures During Normal Operation
Refrigerant pressure readings measured at the air conditioning compressor/condenser unit and which are found to be too low on the high pressure side (compressor output) or on the low pressure side (compressor input or suction line) can indicate a problem with the compressor's ability to develop normal operating pressure ranges and thus will affect the cooling capacity of the air conditioning system.
Abnormally high compressor output pressures are possible but less likely. (See Two Basic A/C Refrigerant Pressure Diagnostics below).
Article series contents
Definition of Air Conditioner High Side and Low Side Pressures
First let's explain "low-side" and "high-side" air conditioner compressor motor pressures and what they mean.
Air conditioning service manuals and training refer to:
Typical HVAC Refrigerant Pressures
Typical residential air conditioning refrigerant pressures vary depending on the model, compressor motor size and design, and the refrigerant used. The design pressures may be provided on labels attached to the equipment but the actual air conditioner operating pressure will vary in part as a function of the incoming air temperatures.
"Charging Charts" (such as the commercial unit charging chart shown here) are provided in service manuals to determine the target suction vacuum (negative) pressure and output pressure for a given compressor motor.
Use of the charging chart for the specific compressor is the correct way to service it. The following example pressures are based on "rules of thumb" that get you in the right "ballpark" if no charging chart is at hand.
Example actual air conditioner compressor high side output pressure: using R-22 refrigerant and assuming an outside air temperature of 85 degF called for 120 degF. inside the compressor (add 35 degF. to incoming air temperature) and an output high-side compressor pressure of about 260 psi.
Example of actual air conditioner low side input or suction line pressure during operation (low-side pressure) during normal operation of the same compressor model and refrigerant and the same outdoor air temperature of 85 degF called for 45 degF. temperature entering the compressor (subtract 40 degF. from incoming air temperature) which on the service chart indicates that the incoming or suction line pressure would be about 75 psi.
Example of a more theoretical air conditioner or heat pump pressure and temperature at the compressor and at the cap tube or thermostatic expansion valve during normal operation: at an outdoor temperature of 72 degF, liquid refrigerant (R12 for example) leaving the outdoor condensing coil and entering the cap tube or TEV might be at 100 psi and 95 degF.
These numbers vary by changes in ambient temperature, compressor model, and refrigerant gas used. On the low side of the TEV or cap tube (in the cooling coil in the air handler) where the liquid refrigerant is changing state to a gas, it may be cooled down to 10 degF. and by the time the refrigerant leaves the cooing coil (evaporator coil) and gets back to the compressor motor it will be all vapor and may be at just 15 psi. [R12 refrigerant changes from liquid to vapor at 14.6 psi at 10 degF.
Air Conditioner or Heat Pump Refrigerant Equalization Pressure - System-OFF refrigerant pressures
When you measure heat pump or cooling system pressures makes as much difference as where you measure it. When an air conditioning or heat pump system has turned off and been off for some time (30 minutes or more) pressures equalize throughout the system between the high and low sides.
At that point the refrigerant pressure in both the high side and low side of the air conditioner or heat pump system will be in accordance with the ambient air temperature and the properties of the particular refrigerant gas present.
The static or equalized system refrigerant pressure will be defined by the refrigerant gas type (which defines its boiling point and pressure at various temperatures).
For example with that cute old R12 refrigerant, as long as there is just about any refrigerant in the system - enough so that there is some liquid refrigerant, i.e. it's not all just gas) then in equalized condition at 70 psi ambient temperature the refrigerant pressure will be 70 psi.
With a temperature correction chart you can read the static or equalized refrigerant pressure for any refrigerant gas and the actual ambient temperature.
Reminder: this refrigerant gas behavior means that if you use pressure test gauges (GAUGE, REFRIGERATION PRESSURE TEST) to measure the refrigerant pressure in the static or equalized air conditioning or heat pump system, the gauges only tell you the refrigerant pressure, not the quantity of refrigerant that is present in the system.
A/C or Heat Pump Refrigerant Pressure Problem Diagnostic Checklist
Refrigerant Leak, short charge: Low head pressure: If the head pressure at the compressor is low we figure that there is a short charge - that is, the system has lost refrigerant.
Condenser coil plugged: High head pressure: if the head pressure at the compressor is abnormally high we figure that the condenser coil is plugged and needs replacement.
Short refrigerant charge: Low pressure on both the High and Low sides of the system typically means that there has been a loss of refrigerant or a short charge.
Frozen TEV: Low side pressure or zero pressure on the low side of the air conditioner or heat pump system may mean that the metering device such as a TEV is frozen or jammed and is not releasing any refrigerant into the cooling coil. In this condition the high side pressure may go up, then down. You can test and temporarily cure this condition by warming the TEV or cap tube.
Plugged or saturated drier: by comparison with the above conditions, a partially clogged drier will form a restriction in the refrigerant line so that the low side pressure drops and the high side pressure increases. You may also notice that the refrigerant line temperature is significantly different on the inlet and outlet sides of the drier.
High side pressures in the air conditioner or heat pump system that are too low
High side pressures in the air conditioner or heat pump system that are too low (100 psi for example) can indicate that the compressor is failing (cannot pump up to pressure) or that the refrigerant metering device is stuck wide open and the system is not developing enough pressure difference between the high and low sides.
High side pressures in the air conditioner or heat pump system that are too high
High side pressures in the air conditioner or heat pump system that are too high can also mean serious trouble: a blocked condensing coil, blocked filter/dryer on the high side, or a refrigerant metering device (TEV) that is stuck closed.
A small refrigerant pressure change on the high pressure side of a refrigeration system will make a big change on the low side. A common field diagnostic step is to quickly look at the system low-side pressure since if that reading is bad you know that there is a problem on the high side.
Low side pressures in the air conditioner or heat pump system at 90 psi or up mean trouble
Low side pressures in the air conditioner or heat pump system reflect the compressor's ability to draw refrigerant through the system and the rate of metering and evaporation of refrigerant in the cooling coil.
While newer higher efficiency air conditioners and heat pumps run at higher suction pressures than older units, a rule of thumb used by many HVAC techs is that the low side pressure should be well under 90 psi. If you are seeing 90-100 psi (or higher) on the low side of the system then either the compressor is damaged (not able to pump down to a low enough pressure) or the refrigerant metering device is stuck wide open and flowing too much refrigerant through the system.
How Much Refrigerant is in the Proper Charge?
The manufacturer specifies the quantity of refrigerant that should be placed into any system: air conditioner, heat pump, refrigerator, freezer.
Especially on residential systems installing the proper total refrigerant charge, which has to take into account not just refrigerant liquid volume but also ambient temperatures, is critical. [On many commercial refrigerant systems there is a receiver that holds a larger buffer quantity of refrigerant, so you'll notice the effects of refrigerant loss only after quite a bit has leaked out.]
Changes in air conditioner or heat pump operating pressure can be effected by adding or removing refrigerant from the system. Changing the amount of refrigerant will cause a pressure change at the point where the refrigerant changes state. Normally an HVAC technician will charge the system to its recommended pressure and we won't vary the total refrigerant charge away from what the system manufacturer recommends.
How to Use the Equipment Data Tag Information to Charge Air Conditioners, Heat Pumps, or other Refrigeration Equipment
Technical detail: refrigerators and some other equipment have a data tag that give a test pressure. Ignore this number when charging the system. This is a leak test pressure.
The data tag also gives the type of refrigerant that should be used in the system (no you cannot substitute). And the data tag will give the proper refrigerant charge quantity, typically in ounces. For a small residential equipment (a refrigerator) this may be 5-11 ounces.
Remember that the location of the frost line (on the cooling coil and refrigerant piping) can indicate evidence of overcharging.
Bottom line about overcharging refrigerants: even if you don't destroy the compressor motor by overcharging the system will be operating at a higher temperature and thus will be operating less efficiently. For residential equipment such as air conditioners, heat pumps, refrigerators, freezers, to work properly you must have exactly the correct charge in the system.
Effects of Overcharging the Refrigerant Level in an Air Conditioner, Heat Pump, or other refrigeration equipment
The effect of too much refrigerant in the system - overcharging, over-metering, or other high refrigerant pressure situations are detailed at EFFECTS of OVER CHARGING of REFRIGERANT
Watch out: over-charging refrigerant can damage or even destroy the compressor unit in some HVACR systems.
Effects of Undercharging the Refrigerant Level in an Air Conditioner, Heat Pump, or other refrigeration equipment
Effect of too little refrigerant in the system are described in detail at EFFECTS of UNDER CHARGING of REFRIGERANT
Separately at FROST BUILD-UP on AIR CONDITIONER COILS we also explain that in a properly tuned and adjusted refrigeration system there will be liquid refrigerant found all the way to just at the end of the evaporator coil .
Technical Background on Air Conditioner Pressure Gauge Readings
In our illustration of air conditioner service equipment pressure test gauges at page top and at left, you notice that there are two gauges and two sets of connectors and control valves. "
Gauge pressure" can read either the pressure inside the condenser unit (the "high side" of the system) or the pressure inside the evaporator (cooling coil) or "low side" of the system.
The gauge set accepts three connecting hoses:
Note that gauge pressure is an absolute pressure reading before any correction for ambient temperatures around the unit. When comparing measured or gauge pressure with recommended refrigerant pressures it is necessary to correct gauge pressure for ambient temperature variations. A/C equipment, gauges, refrigerant charging manuals etc. include pressure charts to aid in this correction.
Low-side pressure calculation example
Using now-obsolete R-12 refrigerant gas as an example, looking at the low-side refrigerant pressure (the low side is the side at which the refrigerant liquid has boiled into a gaseous state), we can calculate the temperature at which the refrigerant should boil for given ambient conditions:
(38-45 degF example) - (18 degF temperature difference between inside the condenser and ambient) = 20 degF = the temperature at which the refrigerant must boil, i.e. the state change from liquid to vapor. Looking at 20 degF. in the table for R12 state changes shows us that we should see 21 pounds of pressure.
High-side pressure calculation example
At 80 to 100 psi pressure on the high side, if ambient temperature is 72 degF, heat will be transferred successfully to outdoor air at temperatures of 84 degF to 117 degF at the condenser coil.
More Notes About Residential Air Conditioner Compressor Pressures
Put another way, high temperature or high pressure on the air conditioner low side is a sign of a problem. That is, as pressure on the high side goes way up, low side pressure will increase as well, and we may exceed the operating temperature of the system. The Low side temperature must be low enough to get transfer of heat from the indoor air into the evaporator coil. The High Side temperature must be high enough to get transfer of heat into the outdoor air.
If your air conditioning or heat pump system has lost its cooling capacity or won't start see REPAIR GUIDE for AIR CONDITIONERS.
Continue reading at REFRIGERANT SIGHT GLASS or select a topic from the More Reading links shown below.
More Reading
Green link shows where you are in this article series.
Frequently Asked Questions (FAQs)
(Feb 19, 2014) tommy said:
Does the volume of the Freon charge within a heat pump system need to be increased when it is heating a house vs. cooling the house. My HVAC contractor has told me that the system needs a larger volume of Freon when heating the house. He recently added two additional pounds over what was deemed a normal operating refrigerant charge condition during the summer months(cooling the house). This seems a bit fishy to me. I would appreciate some feedback on this tTommy,
Nice question. The answer is no. The refrigerant charge in an HVAC system does not change (unless there is a leak). In heating mode rather than cooling mode basically the same system is operating with the same components and refrigerant, but it runs backwards: moving heat from outdoors to indoors when in heating mode, and moving heat from indoors to outdoors in cooling mode. The same refrigerant and refrigerant quantities are used.
Your contractor may have been thinking of something else, or may be arm-waving, or we may have misunderstood. For example, s/he MIGHT have been trying to say that the total capacity of your heat pump was adequate for cooling but not for heating in your climate.
But by NO means would that problem be fixed by changing the refrigerant charge in the system. Instead you' need a different (greater capacity) heat pump system installed.
Technical note: unlike water whose volume changes only a small amount as a function of temperature, most refrigerant liquids change more significantly in volume. That's why on an old refrigerant charging cylinder you'd see that volume gauge printed right on the cylinder side giving different charge volumes at different temperatures.
To understand the relationships between pressure and volume of gases, such as refrigerant gas, take a look aty our discussion of Boyle's Law (P1V1 = P2V2) at WATER TANK PRESSURE CALCULATIONS and also at OIL TANK PRESSURE
(Mar 8, 2014) maryjo said:
hi, my trane air conditioner has pressure readings of 75 and 135 respectively. the a/c people that came out said that the unit was failing and should be replaced. Are these pressures ok?, and will it fail?. 1 month prior, a service guy came out to do the annual and said the unit was fine?....any suggestions?
Maryjo I'm sorry but I'm not sure how to interpret pressures without knowing where they were measured and what was the status of the equipment at the time. In general, if in an HVAC system that has the proper refrigerant charge quantity the compressor is unable to reach the proper high and low side pressures that something is wrong. The problem could be a costly - one: need a new compressor motor, or a less costly one such as a failing refrigerant metering valve (TEV or "thermal expansion valve"). I would listen to the tech's description of what she or he checked and found to get an idea of the scope of investigation that was made.
Luis Castro owner of castro mechanical said:
Re posted without prohibited link. - editor
5/13/14 Anonymous said
Where must the low pressure (green-hose) and the high pressure (red hose) on the refrigerator be connected because the yellow hose must be connected on the refrigerant ?
Anon, although the HVAC system you are looking at may not show the high and low side connector ports or just one of them, this sounds as if you ought to be asking for an on-site trained HVAC technician.
(May 15, 2014) Chris said:
When I connected the refrigerant gauge to the low port the reading was in a good range (green on the gauge). When I pulled the trigger the gauge goes to zero. I put one can in and the air did get much cooler, but the reading really did not change. Is this a indication the compressor is bad if the pressure is fine, but no cold air.
Chris I can't say, not knowing the system type, but it sounds as if you might want to check to see what is the proper charge for the system in the first place.
(May 17, 2014) zee said:
When I connected the gauge to my ac unit the low side read 10psig and high side read 100psig. What wrong with the unit? low freon, TEV block, air in the system, or bad compressor?
Sounds like a bad compressor in that you're not seeing much high side pressure, but a very low total refrigerant charge could also explain the problem so I'd start by evacuating the system and installing a proper charge quantity.
(May 23, 2014) Anonymous said:
shouldn't there be considerable pressure on a unit, even if it hasn't been run for a while?
No Anon. When the compressor is off the system PRESURE on typical residential cooling systems or heat pumps drops to the normal pressure for a refrigerant at that temperature. When the compressor motor has been off for 15-30 minutes or longer, the high side and low side pressures on most equipment will be the same. It's the compressor that creates the high pressures when it's running.
(May 27, 2014) Anonymous said:
yes, the system was running the low side read 10psig and high side read 100psig.
(June 7, 2014) Tim said:
System has capillary tubes and scroll compressor. AC cooling by -10 degrees (dry supply - dry return) and no cooling when measuring: (dry supply - wet return = 0).
What could be the problem. My understanding is that neither capillary tubes nor scroll compressor can partially malfunction. They either run or breakdown completely.
Appreciate your feedback and thanks for the great post.
Tim that's a rather high pressure on the suction line, suggesting a refrigerant metering problem.
(June 9, 2014) Priyam said:
(The system is in a laboratory, and is used for testing)
On a different note, great information on the website! Very useful.
Priyam, check the adjustment of the TEV itself.
(June 30, 2014) Rich English said:
Heat pump will not cool at high outside temps. I read your site (very nice job guys) and I will list what the problem isn't
Problem when out side temp hits 90F the system starts to cool less. Below 90 degrees I see a differential inside temp of about 18-22 degrees. at 90F the differential drops to about 15 degrees. at 95F outside we go down to about 12 degrees and at 98 degrees it drops to about 8-9 degrees making the system runs all day in the Texas summer. Unit is 20 years old and I'm wondering what part or parts could cause this strange problem. Please help as the ac guys have all failed to figure this out. I call them gas men as they seem to think playing with the refrigerant level will solve it.
A few more comments...
A couple of things to check first:
1. check the air temperature drop across the cooling coil.
2. check for partial frosting at the AC coil - a small refrigerant leak drops pressure and can cause that problem.
(July 18, 2014) Larry said:
I purchased a slightly used 2.5 ton R-22 heat pump to replace my 10 yr old a/c condenser unit. The "new" unit is pressurized but I don't know if the R-22 was pumped down into the condenser or was reclaimed and filled with inert gas. Is there a way to determine without losing the R-22? Would a non operating condenser filled with some amount of R-22 show about 120 psi at 78 degrees F? I have tried locating the original installer but have had no success. Worst case, I will recycle whatever is in it and refill with virgin R-22.
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'Pen fails as Jays allow M's to erase 7-run hole
SEATTLE Shawn Camp wasn't the only culprit in the Toronto Blue Jays' late-inning collapse against the Seattle Mariners on Monday night.
Davis Purcey, Octavio Dotel and Mark Rzepczynski had a hand in it, too.
Luis Rodriguez fought off nine pitches from Camp (0-1) before delivering a game-winning single, and Seattle rallied in the final three innings to stun Toronto 8-7 on Monday night.
"This is one of those days I was just missing," Rzepczynski said. "I think I could speak for the whole bullpen: We were all missing. I didn't let it affect me, but stuff happens."
Milton Bradley hit a solo home run in the seventh inning and the Blue Jays' bullpen began to waste away the lead in the eighth. A walk and two singles chased Purcey and loaded the bases. Dotel came on and walked in two runs before Rzepczynski walked in another and allowed a single to Justin Smoak that scored two and pulled Seattle within one.
Michael Saunders led off the ninth inning with a double down the left-field line and Ryan sacrificed him over to third. Ichiro Suzuki was intentionally walked and stole second to set up the winning hit.
"Rather than try and fight back into the count, I thought we would have a better chance to retire Rodriguez better than Ichiro in that situation," manager John Farrell said. "I recognized full well that it was putting the winning run on base, but we were playing for the win right there."
Josh Lueke (1-0) picked up his first career win.
"We really broke through there in the eighth inning," manager Eric Wedge said. "(Michael) Saunders got the big hit to lead things off after that in the ninth. You can't say enough about that at-bat that Luis Rodriguez had. Nine of 10 pitches with the game on the line right there, fighting through it, fouling some pitches off and ultimately came through and you love to see that. It was a good win for us."
Chone Figgins was handcuffed by a line drive from Jayson Nix that dribbled away and allowed Travis Snider to score and give the Blue Jays a 1-0 lead. The ball hit Figgins on the left thumb and he would leave the game in the fourth inning, being replaced by Rodriguez. Figgins had X-rays, which came back negative. Wedge said Figgins will probably be day-to-day.
Jose Bautista singled on a ball deep in the hole at shortstop and beat out the throw by Brendan Ryan. After a strikeout by Adam Lind, Bautista was off and running on a hit and run and was caught in a rundown between first and second when Aaron Hill failed to make contact, but Ryan dropped the ball as Bautista slid safely into second.
Hill promptly doubled down the left-field line to score Bautista. Hill then scored on a fielder's choice by Snider that gave the Blue Jays a three-run cushion.
Encarnacion led off with a single and Nix doubled to put runners on second and third with no out. A wild pitch scored Encarnacion from third and a sacrifice fly by Yunel Escobar scored Nix to give Toronto a 5-0 lead. Hernandez was done after the sixth after Corey Patterson added a two-run homer to make it 7-0.


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Mon-Fri: 7am-1am EST / Sat-Sun: 7am-11pm EST
ApplianceWhirlpool Dishwasher
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Time to do repair30 - 60 mins
Age of Appliance5 - 10 years
PliersScrew drivers
2 out of 4 people found this instruction helpful
I removed the three screws holding the motor on the housing. Then I took the two hoses off and from inside the washer I unscrewed the ring at the base of the wand that holds the housing in place and removed it. I then replaced the impeller and seals and reversed the process to put it back together. Cost me 26.00 for parts and shipping. I couldnt imagine what anyone else would have charged. I will do business with PartsSelect again in the future.
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The Economic Offences Wing of Mumbai police on Monday filed a 9,000-page supplementary charge sheet against MCX promoter Jignesh Shah arrested in the Rs5,600 crore NSEL scam.
The first charge sheet in the case had been filed against other accused in January. "The 9,000-page charge sheet has been filed in the special Maharashtra Protection of Interest of Depositors court and we have annexed the statements of around 250 witnesses besides other documents," said an EOW official.
Addl CP (EOW) Rajvardhan Sinha told dna that Shah was arrested on May 5.
The sessions court rejected his bail application on June 24 and he has now moved the high court.
Shah came under the scanner of EOW and other agencies last year when National Stock Exchange Ltd (a part of the Financial Technologies group founded by him) faced a payment crisis and nearly 18,000 of its investors allegedly lost millions.
Last year, an investor registered an offence against the directors and key management persons of NSEL for cheating, forgery, criminal breach of trust, and conspiracy.
Shah's defence has been that he was the non-executive director of NSEL and was not involved in day-to-day operations.
EOW also submitted a copy of the charge sheet before the Bombay HC.
NSEL issued a press statement saying: "Today, the EOW/Mumbai police has filed a charge sheet against Jignesh Shah, director of our company. We would be deeply examining the charges and appropriately defending it legally. We have full confidence in the judiciary...
Along with Shah, his close aide and NSEL board director Shreekant Javalgekar was arrested and both had applied for bail in the sessions court. Six others were held before Shah's arrest.
The court granted bail to Javalgekar but refused the relief to Shah on the ground that he could tamper with evidence in the case, the police said. Shah has now applied for bail in the Bombay HC.


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FDA Panel Backs Skin Substitute for Burn Grafts.
At a meeting of the Food and Drug Administration's General and Plastic Surgery Devices Panel, members generally agreed that the data from a 6-month study presented by the manufacturer, Ortec International Inc. of New York, provided reasonable assurance of the safety and efficacy of the product, which contains human keratinocytes and fibroblasts.
The FDA usually follows the non-binding recommendations of advisory panels.
The company calls the product "composite cultured skin" and plans to market it as OrCel. It was approved previously under a humanitarian device exemption for use in hand reconstruction and donor sites in patients with skin loss due to epider-molysis bullosa.
OrCel contains human fibroblast and keratinocytes derived from neonatal foreskin and enclosed in a gel-coated, bovine collagen sponge. It conforms to the shape of the wound, adheres to the wound when applied, provides for fluid evaporation, and "minimizes wound pain," according to the company.
The panel stipulated that the following must be included in the product labeling:
* In the preapproval study the rate of healing was not significantly different in OrCel-treated sites and active-control treated sites in patients aged 12 years and younger and in those with burns affecting less than 20% of total body surface.
* The product has not been evaluated in patients with sepsis, insulin-dependent diabetes, or severe inhalation injuries, and in those taking oral steroids within 30 days.
Ortec presented the panel with results of a prospective, multicenter, randomized study comparing healing rates of split-thickness donor sites treated with OrCel or Biobrane-L, a semipermeable collagen membrane used as an active control in 82 patients with burns that covered 10%-80% of their total body surface area.
Serving as their own controls, each patient had one donor site treated with OrCel and another treated with the control.
The primary effectiveness end point was the time to complete closure of the donor site wound, defined as 100% reepithelialization with no surface moisture and no dressing needed, as evaluated by independent experts who were blinded to the treatments and viewed photographs of the wounds.
OrCel-treated sites healed in a median of 15 days vs. 22 days for control-treated sites, a significant difference. Burn scar scores at 12 weeks were statistically in favor of OrCel, but the panel agreed that these were not clinically significant.
About 37% of patients in the trial were on oxandrolone--an anabolic steroid sometimes used to increase donor site wound healing--which could have had a substantial impact on the outcome, remarked panel member Dr. Joseph Boykin, medical director of the wound healing center at Virginia Commonwealth University, Richmond.
Safety outcomes were comparable in the OrCel and control groups. There was one infection at an OrCel-treated site and one at a control-treated site.
Although the panel was comfortable with the safety data, it had concerns about the lack of histologic data and the possibility that donor cells may be retained in the wound. The company plans to do histologic studies.
OrCel is being studied in patients with venous statis ulcers and diabetic ulcers.
Ortec is considering trials in patients with decubitus ulcers and in cosmetic applications such as scar revision.
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— THOMAS ADAMSON, AP Writer (Twitter: @ThomasAdamsonAP)
Welcome to your discussion forum: Sign in with a Disqus account or your social networking account for your comment to be posted immediately, provided it meets the guidelines. (READ HOW.) Comments made here are the sole responsibility of the person posting them; these comments do not reflect the opinion of Nashoba Publishing. So keep it civil.
NY teacher's prom role: Sewing-kit ace who fixes fashions
BAYPORT, N.Y. (AP) — Math teacher Carol Pitkewicz sees a common thread running through prom fashion over her decades at a Long Island high school. Full Story
(John Locher/AP)
2 B.B. King daughters allege 2 closest aides poisoned him
LAS VEGAS (AP) — Two B.B. King heirs who've been most outspoken about the blues legend's final days are accusing King's two closest aides of poisoning him. Full Story
( Jeffrey R. Staab )
David Letterman set trashed; Dumpster divers move in
Hours after the 'Late Show' finished taping, the crew began dismantling and throwing away iconic parts of David Letterman's set.


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Who knew BADgal could go blue! Our deep-blue-violet mascara enhances your eyes: blue appear more blue. brown eyes more golden. and hazel eyes more lus...
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Lots in the tube, nice shaped wand
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Serving at the highest levels of government for more than a decade, Dr. Tevi Troy is renowned for his skill as an astute advisor on today's most critical and complex issues. From 2007 to 2009, he was the Deputy Secretary of the U.S. Department of Health and Human Services - the second in command and chief operating officer of the largest civilian department in the federal government, with a $716 billion annual budget and 67,000 employees. While there, Dr. Troy oversaw all operations, including Medicare, Medicaid, public health, medical research, food and drug safety, welfare, child and family services, disease prevention, and mental health services.
Prior to joining Health and Human Services, Dr. Troy held various senior positions in Congress, executive agencies, and the White House, including as Deputy Assistant to the President for domestic policy. He is author of the book Intellectuals and the American Presidency: Philosophers, Jesters, or Technicians , a Senior Fellow at both the Hudson Institute and at the Potomac Institute as well as a sought-after writer and consultant on health care and domestic policy. Additionally, he is host of the popular podcast "New Books in Public Policy." An energetic and engaging speaker, Dr. Troy specializes in bringing humor, clarity, and historical perspective to difficult and intricate issues.


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The variety of insect pollinators (the principal animal pollinator of Asparagales) is extensive, but the most frequent is the bee. Among the adaptations that the flowers have developed for this mode of pollination are bright colours (except reds, which bees cannot distinguish from black), contrasting markings (nectar guides), and often a sweet odour. In some Orchidaceae—for example, Ophrys—the colouring and shape of the labellum (lowest of three petals) resembles a female bee of a particular species; the flower is pollinated during pseudocopulation by the male bee. In many American genera of Orchidaceae and Iridaceae, sweet (sugar-containing) nectar may be supplemented by oils secreted by stalked glands in the nectaries. Some of the Neotropical Orchidaceae that produce aromatic compounds are pollinated by male bees, which utilize them for marking territory and probably in mating behaviour; the nectar or pollen or both may be the reward offered. Carrion fly pollination is relatively uncommon, but in Africa pollination by flies of several families with long proboscises is common. Flowers with a long, thin perianth tube are typical of this pollination syndrome, especially in Iridaceae.
Birds are also an important but less frequent pollinator. Pollination by sunbirds is relatively common in African Asphodelaceae, such as Aloe and Kniphofia, and Iridaceae, notably in Gladiolus and Watsonia, and in some Australian genera, such as Blandfordia in Blandfordiaceae. In the New World, hummingbird pollination occurs in several Amaryllidaceae, some Agavaceae, including Beschorneria and Polianthes, and a few Iridaceae, as in Rigidella. Bird-pollinated species generally have a red perianth, a long, wide tube, and exserted stamens and stigmas. Despite the great floral diversity in Orchidaceae, bird pollination is rare.
Pollination by hawk moths occurs in many orchids that have long nectar-bearing spurs and in some Iridaceae with long perianth tubes. In addition, the flowers have a white or yellow perianth and a strong, sweet scent. The Yucca (Agavaceae) has an unusual pollination syndrome: females of the moth Tegeticula lay eggs in the ovary and then carefully transfer pollen to the stigmas. Bat pollination is rare in Asparagales, but it has been recorded in some species of Agavaceae.
Fruits and seeds
Fruits of Asparagales are mostly dry, dehiscent capsules or berries. Fleshy fruits (berries) are found in many taxa of the Northern Hemisphere (Convallaria, Smilacina, and Polygonatum), in Ruscus and its close allies of Eurasia, and in Asparagus (including Protasparagus and Myrsiphyllum), a largely African alliance. A few tropical members also have fleshy fruits, notably Dianella, which has glossy violet berries. Orchidaceae rarely have fleshy fruits, but the genus Vanilla is a noteworthy exception. It is cultivated in the tropics for its podlike berries, which yield the flavouring vanilla.
Seeds are especially variable in Asparagales and range in form from the basic globose to angular brownish or black seeds and in content from abundant hard endosperm (food reserves) to microscopic seeds without endosperm. The black colour of the seed coats in many Asparagales with capsular fruits is due to the presence of phytomelan, a carbonaceous substance, in the outer epidermis of the seed coat. These seeds are further specialized in that the tegmen (the derivative of the inner ovular integument) is completely crushed at maturity.
Seeds of Orchidaceae species are numerous and minute and usually lack endosperm. Only the outer layer of the outer integument generally persists as a membranous seed coat. Under natural conditions, orchid seeds germinate only after a symbiotic relationship has been established with a specialized fungus, which supplies nutrients to the developing seedling. Some Orchidaceae species have no chlorophyll (achlorophyllous) and remain saprophytic throughout their lives.
Fleshy seed coats, correlated with distribution by birds, are found in a few Iridaceae. Arils (fleshy seed appendages often derived from the ovule funiculus) also occur frequently. Seeds of Crinum and its close allies in Amaryllidaceae are large and fleshy, lack an outer seed coat (testa), and have lost their ability to become dormant. They germinate rapidly after being shed, sometimes even within the capsules, and the young seedlings develop rapidly from small bulbs, ensuring survival in the dry season, the onset of which may be quite soon after fruiting.
Ovules are basically crassinucellate (with ample nucellar tissue), but the tenuinucellate condition (without a parietal cell) has evolved repeatedly within several families. Both successive and simultaneous microsporogenesis (pollen production) occurs in Asparagales, and the resulting pollen grains are typically two-celled. Frequently, endosperm is formed by free-nuclear divisions, followed later by cell wall formation (nuclear endosperm formation), but helobial endosperm formation (mitosis) occurs in several lineages. Endosperm generally consists of hemicelluloses in thick cell walls; the seeds typically contain considerable endosperm (except for Orchidaceae species) and small embryos. Embryos generally have a single terminal cotyledon and a tiny lateral, sometimes sunken primary bud (plumule).
Seed dispersal is not markedly developed in Asparagales, but the fleshy fruits and the fleshy or brightly coloured seeds of some Iridaceae are dispersed by birds. Very small seeds, or those with wings, as in Gladiolus, are adapted for wind dispersal. Elaiosomes (fleshy white arils) are found in a few genera, notably many species of Iris. These adaptations are thought to relate to dispersal by ants, which store the seeds in their nests and eat only the fleshy part. Adaptation for water dispersal is developed in a number of genera that have corky or spongy seed coats (e.g., Crinum) and some species of Iris. For the majority of the order, however, dispersal is poorly understood, and the predominant mechanisms may be passive.


text: President Obama visited Ohio Wednesday--the second time in two weeks he has visited the swing state. The president is targeting voters in suburban Democratic strongholds with a message of reducing tax rates for middle-class earners. A survey conducted by the National Center for Suburban Studies at Hofstra University said 25 percent of swing voters in the United States live in the suburbs and that Obama and Mitt Romney remain deadlocked in support among suburban voters.


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EAST BORO APARTMENTS4165 Ivanhoe Dr, Monroeville, PA 15146 View On Map (412) 856-7480
For rates, availability, and other information fill out the availability request form and a representative from EAST BORO APARTMENTS will contact you shortly
East Boro Apartments is located in the Pittsburgh Area in the 15146 zip code. View this apartment on a map.
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Have you ever dreamed of becoming a published author? We're about to help you live your dream and get paid for it. Email firstname.lastname@example.com or call 561-290-4596 today.
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Ever wonder how online Kindle books are made? Want to find out how to turn your manuscript into a published book? Learn in our customized one-on-one session that moves ahead at your speed.


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What's New at Wooden Camera: NAB 2014
At NAB 2014, Wooden Camera shows off a rig they made for a Blackmagic Cinema Camera that's been modified for a PL mount that they made, featuring a cage, handle, and a custom 15mm/19mm convertible lens support system. The rig also has a Wooden Camera cross-converter to diversify the BMCC's signal output options. We hope you enjoy the video, and invite you to view the wide selection of other instructional and informative videos at B&H.com.
Please check back for pricing and availability


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i just love Dobby so will by grandson.very prompt and a pleasure to do business with.Published 10 months ago by sharron wyandt
too expensive for what it is. Unfortunately you were the only place we could get it. Why do you need more wordsPublished 12 months ago by Irene Cohen
This Dobby is the same one that is included in the "Freeing Dobby" Lego set, which sells for the same price as this single figure. Read morePublished on December 6, 2011 by bright shiny things
Dobby is by far the best lego person ever! he totally pwns all the wizard noobs until he dies:( but still this is awsome.you should buy it. Dobby thinks you should too.Published on July 11, 2011


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HolyGround >> Colossians 2:13-15
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And you, who were dead in your trespasses and the uncircumcision of your flesh, God made alive together with him, having forgiven us all our trespasses, by canceling the record of debt that stood against us with its legal demands.
This he set aside, nailing it to the cross. He disarmed the rulers and authorities and put them to open shame, by triumphing over them in him.
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But how are we made alive together with him?
1 Corinthians 12:13
For by one Spirit are we all baptized into one body, whether we be Jews or Gentiles, whether we be bond or free; and have been all made to drink into one Spirit.
Matthew 16:18-19
18 And I tell you that you are Peter,[a] and on this rock I will build my church, and the gates of Hades[b] will not overcome it. 19 I will give you the keys of the kingdom of heaven; whatever you bind on earth will be[c] bound in heaven, and whatever you loose on earth will be[d] loosed in heaven."
God told Peter He will give him, that is to say Peter the keys to the Kingdom or the understanding of the concept of salvation. Its interesting that it is Peter speaking in Acts 2:38
Acts 2:38
38 Peter replied, "Repent and be baptized, every one of you, in the name of Jesus Christ for the forgiveness of your sins. And you will receive the gift of the Holy Spirit.
...and Peter replied...interesting to note that Peter would have been present at the scene in Matthew 28:19
Matthew 28:19
Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit,
THAT NAME which is the name of the Father, and of the Son and of the Holy GHost....is JESUS and Peter understood this...therefore he has the keys to the kingdom.
*Holy Ghost Dances out of thread*
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COLOTRAQ CEO Dany Bouchedid to Speak at IMN's Data Center Event
Bouchedid will present at Information Management Network's Financing, Investing & Real Estate Development for Data Centers taking place May 30-31, 2013 in New York City
Parsippany, NJ (PRWEB) May 21, 2013
COLOTRAQ, the foremost global sourcing advisory firm and master agency for data center services, announced today that its CEO, Dany Bouchedid, was selected to participate in a panel discussion at Information Management Network´s 3rd annual spring forum on financing, investing and real estate development for data centers.
The conference will be held at the Conrad New York Hotel in New York City on May 30-31 and will feature more than 20 panel discussions with 30 data center CEOs and presidents. In attendance will be a cross-section of the industry´s leading data center owners, data center tenants, data center investors, and capital and service providers.
The panel in which Bouchedid will participate is entitled "What is the Next Big Service You Need to Offer? How Are You Pricing These Services in a Price-Pressured Environment?"
"This conference and our session specifically address the convergence going on in the data center arena," said Bouchedid. "Just a few short years ago, this conference was all about realtors and investors, and now it´s a technology forum."
"This panel will highlight the challenges and opportunities associated with that convergence," continued Bouchedid.
Topics to be discussed on the panel include: industry cross connects, adapting to big data, private clouds, security expectations, managed services, and more.
For more information on this event, visit: http://www.imn.org/dcny13
About COLOTRAQ
Colotraq is the foremost global sourcing advisory firm and master agency for colocation, managed hosting and infrastructure as a service (IaaS). Since 1999, Colotraq has been helping find data center infrastructure solutions for businesses and institutions through its unrivaled network of over 500 service providers in over 1,200 cities across 160 countries. Colotraq can instantly match customer requirements from a single rack to thousands of square feet of data center space and related network services.
For the original version on PRWeb visit: http://www.prweb.com/releases/prweb2013/5/prweb10747908.htm


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Home » Dressing » Vinegar Dressing » Balsamic Vinegar Dressing » Balsamic Vinegar Dressing
Balsamic Vinegar Dressing
8 Aug 2010
|Balsamic vinegar
|1 Cup (16 tbs)
|1 Cup (16 tbs)
|Fresh basil
|2 Tablespoon, minced
|Onion powder
|3 Teaspoon
|2 Clove (10 gm), peeled
|Pepper white
|1 Teaspoon
|Dried oregano
|1 Teaspoon
|Dried thyme
|1 Teaspoon
|Dill weed
|1 Teaspoon
|Prepared mustard
|1 Teaspoon
|Vegetable oil
|3 Cup (48 tbs)
In a blender, combine half of the first 10 ingredients; cover and process until blended.
While processing, gradually add half of the oil in a steady stream.
Transfer to a 1-1/2-qt.container.
Repeat with the remaining ingredients.
Cover and refrigerate dressing until serving
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Balsamic Vinegar Dressing Recipe


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Who Wants To Take Over Your 401(k) – Uncle Sam?
As I pointed out in my blog post about Entitlement Spending, the Social Security and Medicare trust fund has over $100 trillion in unfunded liabilities. How will Washington pay for this or make up the shortfall? Tax increases are an obvious solution, reducing benefits will have to be part of the equation. What other options exist?
One option would be to take the suggestion of the Service Employees International Union (SEIU) that wants to centralize all retirement plans for American workers, including private 401(k) plans, under one new retirement system for the United States. They will call it Retirement USA and they actually have a website.
The SEIU suggests this plan would provide universal security and adequate income for future retirees. This pool of assets – yours, mine, everyone else's, and the unfunded liability of social security would be professionally managed.
When I watch our government take over car companies, financial institutions, health care, and now maybe add our retirement accounts, I ask the question: have we left capitalism and are we zooming right past socialism? If you have reached the age of 59 ½ is now the time to maybe draw down your retirement account?
What happened to personal freedom and personal responsibility? I would love to hear your comments on this one.
This blog
by Scott Heintzelman - Scott is a CPA, CMA and CFE living in Pennsylvania. Scott is a partner serving on the executive team at McKonly & Asbury LLP, a regional accounting firm with multiple offices in the Mid-Atlantic. The firm has been an IPA ALL-STAR as well as winning Best Places to Work in Pennsylvania for numerous years.


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I am looking for a boat this size for some day sailing and maybe some longer trips along the East coast of Florida.
I came across this boat for a great price and was wondering if anyone knew anything about the model. I did some research but all I could find out was that the boat was German made and not too many of them were produced.
The boat floats and comes with sails but is in need of some TLC and a lot of cleaning. The floorboards need to be replaced. The cushions need to be replaced. Some rigging needs to be replaced. The hull and deck are in good shape though. There is mold on the inside bulkheads and inner hull. Is this a symptom of a bigger problem like hull leaks?
Also the boat is fitted for a single cylinder inboard (has a shaft and prop) but doesn't have one in it. How much is this going to cost me to purchase and install? I think somewhere between 1,500 and 3,000, is that about right?
The boat has a centerboard that can be raised up and lowered. I've never seen this in a 27 footer. Is this going to decrease the strength of the keel?
The boat floats and only costs $650.00. but with all the above problems is this boat going to be more of a restoration problem that a novice like me can handle?
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