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Pedicle screws are inserted in spinal vertebrae in a manner to reduce the likelihood of nerve damage caused by improper screw placement. A screw opening is started in part of a skeletal region, e.g., a pedicle of a lumbar vertebra and an electric potential of a certain magnitude is applied to the inner surface of the opening while the patient is observed for nervous reactions such as leg twitching. The opening continues to be formed while the electric potential is applied until a desired hole depth is obtained in the absence of nervous reaction to the potential. The direction in which the screw opening is being formed is changed to a direction other than the last direction, after observing patient reactions to the electric potential when the screw opening was being formed in the last direction. A system for carrying out the procedure includes a tool handle and a probe member extending from the handle with a tip for working an opening in bone tissue. An electrical stimulator in the form of a self-contained nerve stimulator unit, or circuitry provided inside the tool handle, produces an electric potential at a selected level. The potential is applied to the tip of the probe member while the tool handle is manipulated and the tip is directed toward the bone tissue.
1. A surgical tool system for forming and working openings in a patient's bone having nerve tissue in the region of the openings to be formed, comprising:
an elongate tool handle shaped to be held and twisted by a surgeon when forming openings in the patient's bone;
a first probe member arranged to extend from an end of the tool handle and including a probe shaft;
electrically conductive tip means at a free end of said probe shaft, said tip means being suitably shaped and having sufficient strength for forming an opening in a selected bone when urged against the bone by said tool handle; and
stimulator circuit means coupled to the tip means on said probe shaft for producing an electric stimulation potential of at least a first level at said tip means when the tip means is forming said opening;
wherein said first level of the electric stimulation potential corresponds to a potential at which a predetermined nerve response is induced in the patient when said tip means is in proximity to said nerve tissue while forming said opening in the patient's bone.
2. A surgical tool system according to claim 1, wherein said stimulator circuit means includes means for selecting one of a number of different levels for the electric stimulation potential applied at said tip, means including said first level.
3. A surgical tool system according to claim 2, wherein said stimulator circuit means includes means for producing an electric stimulation potential of a second level at said tip means in accordance with operation of said selecting means, said second level corresponding to a potential at which a predetermined nerve response is induced in the patient when said tip means is in contact with a nerve or a nerve root in the patient's bone.
4. A surgical tool system according to claim 3, wherein said stimulator circuit means includes means for producing an electric stimulation potential of a third level at said tip means in accordance with operation of said selecting means, said third level being greater than said first level.
5. A surgical tool system according to claim 2, wherein said selecting means includes a number of switch button means each corresponding to a different level of said electric stimulation potential.
6. A surgical tool system according to claim 5, including means coupled to each of said switch button means for disabling the operation of said stimulator circuit means from producing said electric stimulation potential when more than one of the switch button means are operated simultaneously.
7. A surgical tool system according to claim 1, including socket means at one end of said tool handle for accepting an attachment end of said probe member, and for enabling the probe member to be detached from the tool handle when desired.
8. A surgical tool system according to claim 7, wherein said socket means includes ratchet means for enabling a probe member accepted in the socket means to be turned operatively by the tool handle in only one sense of rotation when the tip of the probe member is forming an opening in the patient's bone.
9. A surgical tool system according to claim 7, comprising a set of at least two different probe members including said first probe member, wherein each probe member has an attachment end to fit the socket means of the tool handle.
10. A surgical tool system according to claim 9, including a second probe member having a head end opposite its attachment end for driving a pedicle screw member.
11. A surgical tool system according to claim 1, wherein said stimulator circuit means is contained in said tool handle.
12. A surgical tool system for use in forming and working openings in a patient's bone having nerve tissue in the region of the openings to be formed, in combination with an elongate probe member having a conductive shaft, a handle at one end of the shaft, and a working part at the other end of the shaft to be placed in electrical contact with said bone when or after said openings are formed; said tool system comprising:
a stimulator circuit body including sleeve means for fitting on the shaft of said probe member in electrical conducting relation;
stimulator circuit means contained in said body and coupled to said sleeve means, for producing an electric stimulation potential of at least a first level along the shaft of said probe member when the stimulator circuit body is fitted on the shaft of the probe member, said shaft conducting said electric stimulation potential to the working part while the working part of the probe member is forming said openings;
wherein said first level of the electric stimulation potential corresponds to a potential at which a predetermined nerve response is induced in the patient when said working part of the probe member is in proximity to said nerve tissue while forming said openings in the patient's bone.
13. A surgical tool system according to claim 12, wherein said stimulator circuit means includes means for selecting one of a number of different levels for the electric stimulation potential applied at said working part, including said first level.
14. A surgical tool system according to claim 13, wherein said stimulator circuit means includes means for producing an electric stimulation potential of a second level at said working part in accordance with operation of said selecting means, said second level corresponding to a potential at which a predetermined nerve response is induced in the patient when said working part is in contact with a nerve or a nerve root in the patient's bone.
15. A surgical tool system according to claim 14, wherein said stimulator circuit means includes means for producing an electric stimulation potential of a third level at said working part in accordance with operation of said selecting means, said third level being greater than said first level.
16. A surgical tool system according to claim 16, wherein said selecting means includes a number of switch button means each corresponding to a different level of said electric stimulation potential.
17. A surgical tool system according to claim 16, including means coupled to each of said switch button means for disabling the operation of said stimulator circuit means from producing said electric stimulation potential when more than one of the switch button means are operated simultaneously.
This application is a continuation of Ser. No. 07/994,530, filed Dec. 21, 1992, now abandoned, which is a continuation-in-part of my patent application Ser. No. 07/876,861 filed Apr. 30, 1992, and due to issue as U.S. Pat. No. 5,196,015 on Mar. 23, 1993.
1. Field of Invention
The present invention relates generally to a procedure and apparatus for inserting pedicle screws into the spine as part of a spinal fixation instrument system, and particularly to a procedure whereby the likelihood of nerve damage caused by improperly placed pedicle screws can be reduced by implementing the present procedure with associated apparatus in situ.
2. Discussion of the Known Art
Instances arise when it becomes necessary to stabilize or fuse a portion of the spine from motion such as, for example, (1) after decompression wherein certain posterior spinal elements are removed to relieve pressure on neural elements, (2) after trauma, or (3) because of the presence of tumors. Instrument systems that accomplish spinal fixation are known in the form of pedicle screws which are adapted to be inserted in selected vertebrae, and stiff rods or plates that connect adjacent pedicle screw heads to one another after the screws are inserted, thus resulting in the fixing or bracing of all vertebrae spanned by the rod or plate. Commercially available pedicle screws are usually made of stainless steel having overall diameters (including threads) ranging between 5.5 mm and 6.5 mm, and with lengths ranging between 25 mm and 55 mm.
The pedicles are the strongest parts of the spinal vertebrae and thus provide a secure foundation for the screws to which fixing rods or plates are attached. See R. Roy-Camille, et al, Internal Fixation of the Lumbar Spine With Pedicle Screw Plating, Clinical Orthopedics (February 1986), at page 7; and H. N. Herkowitz, et al, Instrumentation of the Lumbar Spine for Degenerative Disorders, Operative Techniques in Orthopaedics (January 1991), at page 91.
In order to derive the greatest mechanical integrity when anchoring pedicle screws in a spine fixing instrument system, it is therefore essential that the screws be guided and threaded in alignment with the pedicle axis and not be allowed to deviate off axis in which case the screw body or its threads will break through the vertebral cortex and impinge on or become dangerously close to surrounding nerve roots. A jig adapted for providing locations on the pedicles of a vertebra for insertion of pedicle screws, is disclosed in U.S. Pat. No. 4,907,577 (Mar. 13, 1990). The patent observes that the vertebral bodies will be fixed more stably the deeper the screws are inserted in the pedicle, and that slight deviations in the angle of screw insertion can injure nerve roots or the spinal cord.
Much appears in the literature with respect to the problems of misalignment of pedicle screws and the symptoms arising when the screws make contact with neural elements after breaking outside the pedicle cortex. Cutting into a nerve root or simply contacting the root gives rise to various postoperative symptoms such as dropped foot, neurological lesions, sensory deficits, or pain. The Adult Spine--Principles and Practice, Vol. II, at pages 1937 and 2035-36 (Raven Press 1991); J. L. West, et al, Complications of the Variable Screw Plate Pedicle Screw Fixation, Spine (May 1991), at 576-79; and J. L. West, et al, Results of Spinal Arthrodesis with Pedicle Screw-Plate Fixation, Journal of Bone and Joint Surgery (Sep. 1991), at 1182-83.
Apart from the jig of the mentioned '577 patent, no tools or devices are known with which pedicle screws can be guided or inserted into a vertebra in such a manner as to ensure that parts of the screws do not rupture the cortex and impinge on or come dangerously close to nerve roots. Current practice calls for the use of recognized landmarks along the spinal column for purposes of locating pedicle entry points, and the use of X-ray exposures or fluoroscopy to monitor the advancement of a metallic pedicle screw through the vertebra. But prolonged radiation exposure of the patient for purposes of proper screw placement is of course undesirable and this technique still has a misplacement rate of up to 21%. The Adult Spine--Principles and Practice, supra, at 2035. Nonetheless, a disturbingly high number of reported pedicle cortical disruptions has prompted one author to observe that "[a]lthough pedicle disruption does not necessary cause neural deficit, keeping the screw contained within the pedicle is one sure way to prevent it." The Adult Spine--Principles and Practice, supra, at 1937.
It is known generally that electrical potential pulses may be applied on or into the body of a patient for purposes of treatment. For example, U.S. Pat. No. 4,461,300 (Jul. 24, 1984) discloses a specially formed electrode for healing of bone or soft tissue fractures in a patient. The electrode has a lead wire connected at its back end, and is capable of being drilled or otherwise inserted into the patient's body with the lead wire in place.
It is also known that muscular reactions to electrical stimulation can be observed while a procedure is continued in accordance with the observed reactions. U.S. Pat. No. 2,808,826(Oct. 8, 1957) shows electro-diagnostic apparatus and associated circuitry that act as a stimulator to measure the excitability of muscle or nerve tissue. A pair of electrodes are placed across a part of the patient's body and short duration pulses are applied with the pulse amplitude being slowly increased until a visible contraction appears. Electrical current readings are obtained for pulses of increasing duration, and a curve called a "strength-duration" curve is obtained, according to the patent. U.S. Pat. No. 4,824,433 (Apr. 25, 1989) discloses a puncturing and catheterizing device with a metal puncture needle and cannula suitable for puncturing nerve tracts. With the device connected to an electrical pulser, as long as the needle and surrounding cannula are inserted in the body through a nerve sheath, current pulses applied to the device induce visible motor reactions on body parts such as the hand. The visible reactions allow the physician to know that the puncture needle and cannula are being passed correctly along a space between a nerve and the nerve sheath.
Until applicant's invention, no technique, procedure or device was known that utilized visible motor reactions of a patient's limbs as a means for determining if a pedicle screw to be inserted in the patient's spine might impinge on or come in dangerously close proximity to a nerve root.
An object of the present invention is to overcome the above and other shortcomings in the prior art with respect to the location, placement and insertion of pedicle screws as part of a spine fixation instrument system in a patient.
Another object of the invention is to enable a surgeon to know, in situ, if a pedicle screw has (1) penetrated the cortex of a pedicle, (2) touched a nerve root, or (3) come in such close proximity to a nerve root as to require withdrawal and re-insertion of the screw.
A further object of the invention is to avoid the requirement of a new operation on a patient by ensuring that screw members stay contained within selected pedicles when a spine fixation instrument system is first applied in the patient.
Another object of the invention is to enable screw members forming part of an orthopaedic fixation instrument system to be inserted into a patient's bone tissue safely and without the requirement of continuous or frequent radiation exposure to ensure proper screw member alignment.
Yet another object of the invention is to reduce appreciably instances of postoperative complications such as dropped foot, neurological lesions, sensory deficits, or pain following surgery involving placement of screw members in a patient's spine.
According to the invention, a surgical tool for forming an opening in bone tissue for insertion of a screw member, comprises a tool handle and a probe member extending from the handle. The probe member has a tip adapted to work an opening in the bone tissue. Stimulator circuit means connected to the probe member produces an electric stimulation potential of a predetermined magnitude, and applies the stimulation potential to the tip of the probe member while the tool handle is grasped and the tip is directed toward the bone tissue.
For a better understanding of the present invention, together with other and further objects, reference is made to the following description taken in conjunction with the accompanying drawing, and the scope of the invention will be pointed out in the appended claims.
In the drawing:
FIG. 1 is a view of an operating room environment with a patient prepared to undergo lumbar fixation instrumentation surgery;
FIG. 2 is a view of a surgical field including a midline incision exposing a region of the patient's lumbar spinal region;
FIG. 3 is a posterior view of the lumbar spinal region and a tool for forming a pedicle screw opening according to the invention;
FIG. 4 is a lateral view of the lumbar spinal region and a pedicle screw driver tool according to the invention;
FIG. 5 is a schematic diagram of components of a stimulator for carrying out the present procedure;
FIG. 6 is a view of a tool handle;
FIGS. 7A-7D show a set of detachable probe members for use with the tool handle of FIG. 6;
FIG. 8 is a view of an operating room environment including a nerve stimulator unit; and
FIG. 9 is a schematic diagram of the nerve stimulator unit of FIG. 8 and switching circuitry associated with the tool handle of FIG. 6.
FIG. 1 is a view in an operating room showing a patient 10 lying prone on a spinal table 12. The patient's chest and groin are padded with suitable padding 14. In the illustrated example, the patient 10 is about to undergo lumbar fixation instrumentation surgery, thus making it preferable that the patient's abdomen hang free. The table 12 and padding material 14 should be substantially transparent to radiation from radiologic machinery 16 which is arranged to obtain exposures at various angles through the patient's lumber spinal region 18.
The radiologic machinery 16 is of the kind having a "C" arm 20 to permit rotation of an X-ray generating unit 22 at one end of the arm 20 together with an X-ray imaging unit 24 with which the generating unit 22 is aligned, so that the generating unit 22 and imaging unit 24 move in unison with one another as the C-arm 20 is positioned to expose a desired section in the patient 10.
Prior to making an incision, the lumbar region 18 is prepped and draped to maintain as much a sterile operating environment as is possible.
FIG. 2 is a view of a surgical field 26 as seen after a midline incision is made in the lumbar region 18 of interest. Tissue is dissected about the tips of the spinous processes, down to the tips of transverse processes 28 of the vertebrae to be fixed. Retractor arms 30 keep the surgical field 26 open sufficiently to allow the desired fixation instrumentation to be applied to the spine.
FIG. 3 is an enlarged posterior view of skeletal members of the lumbar spinal region 18 in the patient 10. The region includes a first lumbar vertebra 32 (L1), second lumbar vertebra 34 (L2), third lumbar vertebra 36 (L3), fourth lumbar vertebra 38 (L4), fifth lumbar vertebra 40 (L5), and sacrum 42 comprised of fused vertebrae S1-S5. Those vertebrae into which screw members are to be inserted are identified by the surgeon and pedicles, e.g., pedicle 44 of L4 vertebra 38, are probed for an entry point for the screw member.
Once an entrance point on the pedicle 44 is determined in accordance with surface landmarks or other known techniques (see H. N. Herkowitz, supra, at 93-94; and The Adult Spine, supra, at 1935), a screw opening is formed in the pedicle 44. The screw opening is formed first with a suitable probe member such as a drill bit, an awl or a curette. The opening may also be tapped if desired prior to insertion of a screw member.
Although the lumbar spinal region 18 of a patient is shown in the drawing for purposes of illustration, the present screw insertion procedure is not limited in application to the lumbar region of the patient 10, as will be appreciated by those skilled in the art.
In one version of the present procedure, a screw opening 46 is formed in the pedicle 44 using a probe tool 48 having a combined stimulator/handle 50, a probe tip 52 in the form of an awl or a curette, and a tool shaft 54 connecting the tip 52 to the handle 50. Tip 52, the shaft 54 and the outer wall of the handle 50 may be made of stainless surgical steel or other suitable conductive metallic material of sufficient strength and which is capable of sterilization for repeated surgical use.
Before urging the tip 52 of the tool 48 into pedicle 44, it may be necessary first to remove cortical tissue with a high speed drill. The probe tip 52 is then located at the entrance point of the pedicle 44. A radiological image of the tip 52 at the entrance point on the pedicle 44 may be obtained with the machinery 16 although the present procedure does not require such imaging for proper screw insertion, as will be explained below. The screw opening 46 then continues to be formed with the tool 48 until the probe tip 52 attains a desired depth for the screw opening 46 in the pedicle 44 as may be verified by graduated marking indicia (not shown in FIG. 3) on the tool shaft 54. If desired, an exposure with the radiologic machinery 16 can be made to confirm the tool depth.
Details of the construction of probe tool 48 are described in connection with FIG. 5.
Inside the casing of stimulator/handle 50 there is arranged the nerve stimulator circuitry shown in FIG. 5. The stimulator circuitry is powered by a replaceable battery 56 which is accessible through a detachable handle cap 58 (FIG. 3). The battery 56 has its negative terminal grounded to the handle casing, and the positive terminal is switched to connect to the stimulator circuitry through a latching type ON/OFF switch 60 (not shown in FIG. 3). Switch 60 is preferably located at a lower part of the handle casing so as not to be inadvertently operated during use of the tool 48. The handle casing is connected to a patient ground such as muscle tissue within 6-8 cm from the surgical field, via a ground lead 59. Grounding of the tool handle casing can also be accomplished using a conventional surgical grounding pad which is affixed to the patient 10 preoperatively.
A conventional timer integrated circuit U1 such as a type 555 IC device is connected to the switch 60 via supply voltage bus 61 to be powered by the battery 56 when the switch 60 is closed. The circuit U1 is set with appropriate external resistive and capacitive elements (not shown) to produce an output drive pulse at a repetition rate of about 2 Hz at timer output terminal 62. Output terminal 62 corresponds to terminal 3 of the mentioned type 555 timer IC.
A PNP current switching transistor Q1 has its base terminal connected to the output terminal 62 of timer U1 through a series resistor 64. An operating bias voltage level is set for transistor Q1 by bias resistor 66 connected between the timer output terminal 62 and the supply voltage bus 61. The emitter terminal of transistor Q1 is also connected to the supply bus 61.
A pulse current transformer T1 has one terminal of its primary winding 68 connected to the collector terminal of transistor Q1, and the other terminal of winding 68 is connected to a switch bus line 70. The cathode of a switching diode 72 and one terminal of a reverse current damping resistor 74 also connect to the collector of transistor Q1. The anode of the diode 72 and the other terminal of resistor 74 are connected to the switch bus line 70.
Three momentary SPST normally open push button switches 76, 78, and 80, each have one terminal connected to ground, i.e., the metal casing of the handle 50, respectively. Switch 76 corresponds to a high or H button 82 which protrudes through an opening in the handle casing as seen in FIG. 3. The other terminal of the switch 76 is connected to the switch bus line 70. Switch 78 corresponds to a medium or M button 84 protruding through the handle casing (FIG. 3), and has its other terminal connected to one terminal of a resistor 86. The other terminal of resistor 86 connects to the bus line 70. Switch 80 corresponds to a low or L button 88 also protruding through the handle casing (FIG. 3) and has its other terminal connected to a terminal of resistor 90. The other terminal of resistor 90 connects to the switch bus line 70.
Secondary winding 92 of the pulse transformer T1 is connected to a pulse output indicator lamp 94 through resistor 96. Winding 92 also connects across the terminals of a load resistor 98 one terminal of which is grounded, and the other terminal of which connects to one terminal of a current limiting resistor 100. The other terminal of the resistor 100 connects to the anode of Zener diode 102, and the cathode of diode 102 is grounded.
The shaft 54 of the probe tool 48 is connected to the anode of the Zener diode 102. Shaft 54 is electrically insulated by, e.g., epoxy resin or other strong electrically insulative material from the handle casing so that output stimulation pulses will not be "shorted" to ground through the tool handle 50.
With the switch 60 set to an ON state and the momentary switch 76 closed by depressing the switch push button 82, current of a certain magnitude is switched at a 2 Hz rate through the collector-emitter circuit of transistor Q1 in series with the transformer primary winding 68, by operation of the timer circuit U1. Transistor Q1 is biased by resistors 64 and 66 so as to induce relatively high (H) level voltage pulses across the secondary winding 92 of transformer T1 with switch 76 closed. For example, pulses having a peak voltage of about 80-100 or more volts may be induced across the secondary winding 92, and their presence observed via the indicator lamp 94. A sound transducer element (not shown in FIG. 5) may also be energized by the voltage pulses so as to provide an audible indication that pulses are present at the probe tip 52. Also, Zener diode 102 may comprise a number of Zener diodes connected in series so as to limit the peak pulse voltage that may be applied to a patient by the probe tip 52.
With only the switch 78 closed by depressing the push button 84, a medium (M) level voltage pulse is induced across the secondary winding 92 by limiting the amount of current switched by transistor Q1 through the primary winding 68. Resistor 86 is selected so that the medium level corresponds, for example, to a peak voltage of about 20 volts between the probe tip 52 and ground. This medium level voltage corresponds to a potential at which leg twitching would be induced if the pulses were applied in proximity to a nerve root as explained below.
When only the switch 80 is closed by depressing the push button 88 protruding from the tool handle casing, relatively low level voltage pulses are induced across the secondary winding 92 by further limiting the collector current through transistor Q1 via the resistor 90. The low level voltage pulses may, e.g., correspond to a peak voltage of about 4 volts between the probe tip 52 and ground. The low level voltage corresponds to a potential at which leg twitching would become observable if the pulses were applied directly on the nerve root.
In use, the surgeon applies the probe tip 52 at the entrance point of a pedicle into which a screw member is to be inserted, as mentioned above. The surgeon then urges the probe tip 52 into the pedicle 44 while holding the high or H level switch button 82 down and twisting the tool handle together with shaft 54 and tip 52 while urging the tool 48 in the direction of the pedicle axis. Administration of anesthesia should be tailored to allow muscle contraction in the patient for this stage of the surgery. As long as no twitching of the patient's leg is observed, the surgeon may continue to advance the probe tip 52 to the desired depth for the screw opening 46. If, however, twitching movement is observed, before advancing the probe tip further the surgeon releases the H button 82 and depresses the medium (M) switch push button 84.
If no twitching movement is observed, the surgeon continues to advance the tool with caution in the same direction. If, however, twitching movement continues to be observed, the surgeon then depresses the low (L) switch push button 88 to check for a nervous reaction. If none results, the surgeon may elect to continue in the same direction as previously, or to redirect the direction of the screw opening being formed through the pedicle. If a nervous twitch is observed even with only the low level switch 80 closed, the tool 48 should be withdrawn and a new pedicle screw opening 44 formed in a direction different from the last direction in which twitching movement resulted with only the low level pulses applied through the probe tip 52. Forming of the new screw opening proceeds as above with the surgeon urging the probe tip 52 in the different direction while depressing the H level button 82.
Instead of or in addition to observing the patient 10 for leg twitching while urging the probe tip 52 into the pedicle 44, a conventional electromyography (EMG) unit may be connected to at least one of the leg muscles including: extensor hallicus longus, tibialis anterior, peroneals, quadriceps, and gastrocnemius. Such EMG units will provide either visual or audible signals as an indication of nerve twitching.
FIG. 4 shows a second embodiment of a probe tool 120 according to the invention.
The probe tool 120 is adapted to slide onto a shaft 122 of a commercially available awl, tap or screw head driver 124. Specifically, the driver 124 has a handle 126 that is either non-conductive or is otherwise electrically insulated from shaft 122. The body of the probe tool 120 has a metallic sleeve 128 extending coaxially through the tool 120, and the sleeve 128 is arranged with set screws or other conventional locking means (not shown) to fit tightly on the shaft 122. The sleeve 128 is electrically insulated from an outer wall 130 of the tool body on which the three switch push buttons 82, 84 and 88 are accessible. The output indicator lamp 94 is also mounted on the wall 130.
Electrical circuitry inside the tool 120 is identical to the stimulator circuitry disclosed above in connection with FIG. 5, except that the pulse output is applied to the conductive sleeve 128 rather than the tool shaft 54 of the probe tool 48 in FIG. 3. Accordingly, even after forming a screw hole with the tool 48 in FIG. 3, proper insertion of a pedicle screw can be ensured by placing the tool 120 in FIG. 4 over the metal shaft 122 of a tap or screw driver tool, grounding the wall 130 to the patient, turning the tool 120 on, and checking for patient reaction at each of the H, M and L levels of stimulation produced by the tool 120 while the tap or screw driver 124 is engaged with a tap or screw member head in the bone tissue. Again, if a patient reaction is observed even with the tool 120 set at the lowest stimulation level (L), the tap or screw member should be withdrawn and a new screw opening formed in a different direction using the probe tool 48 in FIG. 3. A sounding device (see FIG. 9) may also be provided on the tool to sound an audible indication when stimulating pulses are present on the sleeve 128.
FIG. 6 and FIGS. 7A to 7D show a tool handle 200 and a set of detachable probe members 210, 212, 214 and 216 according to the invention. Unlike the stimulator/handle 50 shown in FIG. 3, tool handle 200 does not include all of the nerve stimulator circuitry and the handle may have a grip body 218 formed of an electrically insulative material capable of withstanding routine sterilization procedures. Tool handle 200 preferably has a ratcheting socket mechanism 220 at the forward end of the grip body 218, and an insulated electrical stimulator attachment cable 222 extending from the back end of the body 218. A cable connector 224 is provided at the end of the cable 222 remote from the tool handle 200 for attachment to a nerve stimulator unit such as one shown and described in connection with FIGS. 8 and 9. If included on the handle 200, the ratcheting socket mechanism 220 has a conventional square socket 226 with associated ratcheting members (not shown), so as to enable the handle to turn an attached probe member in only one sense of rotation (e.g., clockwise) while urged toward a pedicle. The socket 226 accepts any one of a number of interchangeable probe members having square-shaped attachment ends of the same dimensions.
A wire lead 228 is maintained in electrical contact with the ratchet socket 226 by a slip ring or other conventional means (not shown). Wire lead 228 runs axially through the grip body 218 of handle 200 and through the attachment cable 222 to the remote connector 224. Lead 228 carries nerve stimulating voltage pulses supplied from an external nerve stimulator unit 246 (FIGS. 8 & 9) to which connector 224 is adapted to be connected.
A set of three single pole, double throw (SPDT) momentary (NO, NC) push switches 252, 254 and 256 have switch push buttons protruding through corresponding openings in the forward region of the handle grip body 218. The switches each have three wire leads which connect to their terminals and which leads extend through the attachment cable 222 to terminate at corresponding pins of the connector 224.
FIGS. 7A-7D are various probe members capable of being attached to the tool handle 200 of FIG. 6. One or more of the probe members may be used when forming an opening in a vertebral pedicle or other skeletal portion.
Specifically, FIG. 7A shows a pedicle finder 210 in the form of a curette. Finder 210 has a spoon-shaped tip 210a and is useful for locating entrance points on pedicles, and for forming screw openings at least partially to a desired depth. Probe member 212 (FIG. 7B) has a fine wire-like tip 212a extending with a right angle bend, and is useful for probing or exploring the wall of an opening just formed in a vertebra. The tip 212a applies nerve stimulating pulses to the wall and thus helps to determine whether or not the wall of an opening is too close to a nerve root before driving a pedicle screw member into the opening.
Probe member 214 (FIG. 7C) is a tap having a threaded tap portion 214a for tapping newly formed pedicle openings with a thread at a desired pitch. The tap probe member 214 may also have indicia 214b along its shank to indicate a depth (in millimeters) to which the tap portion 214a has penetrated.
Probe member 216 (FIG. 7D) is a driver having a head end 216a in the form of a hex head, a blade or a Phillips head for driving any of the conventional pedicle screw members.
FIG. 8 is a view of an operating room environment, showing a patient 10' lying on spinal table 12' with the patient's chest and groin padded with suitable padding 14'. A conventional grounding pad 240 is adhered at the side of the patient's chest and is connected via a ground lead 242 to a ground terminal (G) on a nerve stimulator unit 246. The nerve stimulator unit 246 is explained in detail in FIG. 9, and may be situated on a table 248 located conveniently adjacent the spinal table 12' in the operating room. Stimulator unit 246 has a cable connector socket 250 on its front panel which socket is configured to receive terminal pins of the cable connector 224 for coupling with the tool handle 200 in FIG. 6. The stimulator unit 246 also has three light indicator lamps 270, 272 and 274 corresponding to low (L), medium (M) and high (H) pulse level settings for the stimulator unit 246. A sounding device 258 mounted on the stimulator unit provides audible sounds to indicate the presence of stimulating pulses of selected magnitudes at the cable connector socket 250 for delivery to the handle 200. The frequency or pitch of the audible sounds may correspond to the selected level setting (L), (M) or (H) for the pulses.
FIG. 9 is a schematic diagram of the nerve stimulator unit 246 shown in FIG. 8, and of stimulation level selection circuitry housed in the tool handle 200. Components of the stimulator unit 246 similar to those contained in the stimulator/handle 50 in FIG. 3, have corresponding reference numerals.
The unit 246 is provided with a conventional DC power supply 260 and an ON/OFF switch 262 for connecting the power supply 260 to the AC mains. The power supply 260 provides one or more operating voltages as may be required by components within the stimulator unit 246. A sounding device 258 in the form of a conventional sounding circuit provides an audible note at a pitch corresponding to a peak voltage at an input terminal 258a. A sample input voltage at the terminal 258a can be obtained, for example, at a tap terminal 259 of the load resistor 98'. Sounding device 258 can also be incorporated in the handle/stimulator 50 in FIG. 3.
Also shown in FIG. 9 is a circuit arrangement wherein simultaneous operation of more than one of the switches 252,254, 256 on the tool handle 200, will not allow stimulating pulses to be delivered to the connector socket 250. That is, inadvertent operation of two or all three of the handle switch buttons will disable the pulse generating circuit in the stimulator unit. It will be understood that such a safety feature can also be incorporated in the self-contained handle/stimulator 50 in FIG. 3.
Specifically, whenever one of the switches 252, 254, 256 is depressed to select the corresponding voltage for the stimulating pulses, ground potential is removed from the corresponding normally closed switch terminal 252a, 254a or 256a. The ungrounded switch terminal is set at a high level via a resistor connected between the terminal and a reference voltage level from the power supply 260. The terminals 252a, 254a, 256a are also each connected to a corresponding input terminal of an exclusive OR gate the output of which is connected to a gate input of an analog switch 290. The analog switch 290 is connected in series between the switch bus line 70' and the pulse transformer T'. Accordingly, only under the condition that one of the switches 252, 254, 256 is operated exclusively will the collector circuit of switching transistor Q1' be completed through the analog switch 290. The closed switch 290 will enable the generation of stimulating pulses at a terminal of the connector socket 250.
Each of the light indicator lamps 270, 272, 274 is driven by an associated lamp driver circuit 276, 278 and 280. The lamp driver circuits each have their inputs connected to the normally closed (NC) contact terminal of a corresponding one of the switches 252, 254, 256. Opening of one of the normally closed contacts 252a, 254a, 256a therefore causes the input of the associated lamp driver circuit to go high and the driven lamp to be illuminated.
A "Digistim III" nerve stimulator made by Neuro Technology, Inc. of Houston, Tex., was set at a 2 Hz pulse rate and a pulse duration of 0.2 milliseconds. While a patient was undergoing lumbar spinal fixation surgery that required insertion of pedicle screws into the L5 vertebra, pulse amplitude output levels were determined at which the patient's leg would visibly twitch with the pulses applied (1) through the machine output leads, (2) through a so-called K-wire after insertion in the pedicle, and (3) through an inserted pedicle screw. One of the machine output leads was grounded to the patient through a needle inserted in muscle tissue near the surgical field.
It was discovered that when the ungrounded machine output lead was applied directly on a nerve root at the left side of vertebra L5, twitching occurred at a pulse level corresponding to a current setting of 1.5 ma. When the same lead was applied on the root at the right side of L5, the pulse level at which twitching was observed corresponded to a current setting of 2.4 ma. These current settings correspond to pulse voltage levels of 3.0 and 4.8 volts when a 2000 ohm load is connected to the output of the Digistim III.
Next, a "proximity" gap between the ungrounded machine lead and the nerve root including surrounding tissue at the left and the right sides of L5 was defined to be about 3 mm of the tissue between the lead tip and the nerve root. When in such proximity, pulse levels applied by the lead tip attained a value corresponding to a 5.0 ma current setting at which the patient's leg twitched with the lead at the left side of L5, and the pulse level needed for twitching with the lead at the right side of L5 corresponded to a current setting of 3.0 ma on the Digistim III unit.
A K-wire, about 0.062 inch diameter stainless steel and of the kind ordinarily used to form guide holes for pedicle screws, was drilled through the left pedicle cortex to a depth of about 45 mm on L5, and the stimulator unit output was connected to the wire. The pulse level needed to observe leg twitching corresponded to 15 ma. The pulse level for the right pedicle of L5 corresponded to 12 ma.
Finally, the K-wire was withdrawn and a screw member inserted in the left pedicle of L5. When the stimulator unit was adjusted for a pulse level corresponding to 44 ma, no twitching movement could be observed. For the right pedicle of L5, twitching was observed at the 44 ma setting.
The stimulator unit used in EXAMPLE ONE was set for the same pulse rate and duration, and its output lead connected to 55 mm and 40 mm screws that were about to be inserted in a different patient's spine.
When the 55 mm screw touched the nerve root at the left side of L5, a pulse level corresponding to 12.9 ma was needed to produce twitching movement of the leg. When the stimulator unit output was applied through the 40 mm screw to the nerve root at the right side of L5, the threshold pulse level corresponded to a current setting of 9.8 ma.
With the screws properly inserted in the pedicles of L5, the pulse level had to be increased to a 71 ma setting to produce twitching movement, while no twitching movement could be induced with the stimulator unit lead connected to the screw inserted in the right pedicle of L5. A threshold pulse level corresponding to a 69 ma setting produced twitching when applied through the screw inserted in the right pedicle of L4.
The Digistim nerve stimulator unit used in EXAMPLE ONE was set again to a pulse rate of 2 Hz and a pulse duration of 0.2 milliseconds. Data was obtained with a third patient who underwent lumbar spinal fixation surgery.
The stimulator unit lead was applied directly on the nerve roots at the left sides of L4 and L5, with the threshold pulse levels needed for leg twitching corresponding to current settings of 2.3 ma and 2.1 ma, respectively.
When a K-wire used to form a screw opening in the left pedicle of L5 was attached to the stimulator unit output, no twitching movement was observable up to a pulse level corresponding to a 41.5 ma setting. Similarly, with screws inserted in the left and the right pedicles of L5, no twitching movement was observable through pulse levels corresponding to a 80 ma setting on the Digistim III stimulator unit.
While the foregoing description represents preferred embodiments of the present invention, it will be obvious to those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the invention.
For example, the stimulator circuitry of FIG. 5 has been disclosed as contained within the probe tool 48 in FIG. 3 or inside the "slide on" tool 120 of FIG. 4. The stimulator circuitry of FIG. 5 may also be incorporated into the handle of a so-called sound probe used for sounding out screw holes for interior wall strength once the holes are formed. That is, although a formed screw hole may produce an acceptable sound when probed interiorly, the inside wall of the opening could nonetheless be dangerously close to a nerve root so that postoperative complications would probably ensue after a pedicle screw is inserted in the opening and fixation instrumentation is applied to the patient. According to the invention, applying nerve stimulation pulses during formation of a screw opening, as well as during the tapping and screw insertion phases of fixation surgery, ensures that screw members will be properly located and that postoperative complications arising from misdirected pedicle screws will be negated.
Accordingly, the present invention is to be delimited only in accordance with the following claims.
Patent Citations
Non-Patent Citations
Referenced by
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text:
Guest Reviews
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Recommend This Property
Overall Experience
Recommend This Property
Nice and roomy, could stay a week with no problem.
June 24, 2015
This hotel was close to the event we attended. It was within walking distance of breakfast restaurant and grocery story. Gasoline stations and fast food restaurants were also close. Staff was helpful with other directions and friendly whenever I spoke with them.
Posted byHotelStaff
June 25, 2015
Dear Bethymae, We are so glad we were able to provide you with a comfortable stay. Hope you stay with us again in the future. Hotel Management
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Friendly staff
June 12, 2015
The staff were extremely helpful in answering any questions and they always greeted us.
Posted byHotelStaff
June 15, 2015
Dear vidalkris, Thank you for taking the time to complete our on line survey after your recent stay at Candlewood Suites Avondale. We use our guest surveys to grade our performance. We want all of our guests to feel welcome and "at home" when they stay with us. Your comments make us feel proud of our hospitality and tell us we are doing our jobs properly. Thanks, Hotel Management.
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Great staff!
June 06, 2015
I travel to New Orleans quite often and enjoy staying here because the staff is very friendly and helpful. They always make sure I am comfortable.
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June 08, 2015
Dear Angela5622, Thank you for staying with us at Candlewood Suites in Avondale, LA. We appreciate all guest comments and use them to better serve our guests. We are happy that you enjoy staying with us and hope to see you again on your next trip to New Orleans. Hotel Management
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Surprise Stay
May 27, 2015
Pleasant surprise for a frequent business traveler.
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May 29, 2015
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subset: commoncrawl


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No help from me, other than it has all worked normally on my end.
This is a discussion on What happened? within the Forum News, Feedback, Problems & Comments forums, part of the DefensiveCarry.com Forum Office category; About two weeks ago, this site began requiring me to log in each visit, despite me clicking the 'Remember Me' button. Nothing has changed with ...
About two weeks ago, this site began requiring me to log in each visit, despite me clicking the 'Remember Me' button.
Nothing has changed with my set-up. Same Apple iMac desktop, all my other forums keep their 'cookies' and log me in automatically. Except this one...
No help from me, other than it has all worked normally on my end.
Turn the election's in 2014 to a "2A Revolution". It will serve as a 1994 refresher not to "infringe" on our Second Amendment. We know who they are now.........SEND 'EM HOME. Our success in this will be proportional to how hard we work to make it happen.
It has been fine for me...
The last Blood Moon Tetrad for this millennium starts in April 2014 and ends in September 2015...according to NASA.
Certified Glock Armorer
NRA Life Member
Try deleting your cookies and then logging in again.
NRA Endowment Member
NROI Chief Range Officer
Cookies!........,Did somebody say Cookies!!!!!!?
Been working fine for me too.
Never pick a fight with an old man...If he's too old to fight, he'll just kill you - John Steinbeck
Come to Colorado...the governor is loopy
.................................................. .................................................. ......................They Live
I had the same problem on Gun Broker. Corrected it by clearing out the cookies, had too many. You can only fit so many cookies in a cookie jar !!
" The beauty of the second amendment is that it will not be needed until they try to take it." Thomas Jefferson
I delete all cookies and browsing history every time I shut my browser down. Chrome remembers all my passwords and userids and autofills them each time I log back on.
On an iMac you can delete the stores information for one site through Keychain Access. That is actually where your site logins are stored so you should be OK to wipe your cache and cookies and still have that stuff saved. At least that's been my experience.
sent via Tapatalk
Thanks, I'll try that. Please excuse my computer ignorance, but where do I find this "Keychain Access"? In Settings? Not in front of the iMac now, of course.


text:
Anonymous, which last week threatened to pulverize the Playstation Network because of Sony's support for the proposed SOPA (Stop Online Piracy Act), backed off its consumer-irking belligerence and this week shifted to threatening just the executives and sites of Sony and Nintendo. Anonymous—or people purporting to be members of the group—last week uploaded a video to Twitter in which the […]
Articles written by: Mickey
Japanese Nintendo Direct Presentation
Take a closer look at some upcoming games for both the 3DS and Wii. (This is a one hour video in Japanese)
Mario Kart 7 – Rainbow Road on Guitar
Composer: Kenta Nagata Electric Guitar: Epiphone Les Paul Custom Ebony Bass: Fender Jazz Effects: BOSS ME-70 Microphone: Shure SM57 Interface: Line 6 Pod Studio GX Video Software: Sony Vegas Pro 9 Audio Software: Reaper [YouTube]
Pokemon Generation Zero
This time's Pokemon is a story from the past! Translation of the copy on the image above: Set before the events in the games, Pokemon Red, Green, and Blue for the Gameboy, this game is set when the Pokedex was not around yet. Asked by Professor Fuji, a boy and a girl sets off on an adventure! The main characters […]
Android tablet rips off Wii U & iOS
JXD has just released its S7100, a fairly conspicuous 7-inch Android-powered gaming tablet marketed towards playing old-school arcade games. The device features a D-pad, face buttons, an 800 x 480 capacitive touchsceen, ARM Cortex A9 CPU, Mali 400 GPU, 512MB of RAM, 16GB of internal storage, 0.3 megapixel front camera, 2.0 megapixel rear camera and HDMI-out. A video trailer shows […]
Super Mario Bros. Coming to Japan eShop
The original Super Mario Bros. will soon be available to the public in Japan. Super Mario Bros. will be available on the eShop for 500 yen starting January 5 in Japan. This marks the second Famicom title to come to the eShop for purchase with The Legend of Zelda appearing last week. There is currently no word as to when […]
[3DS] Kingdom Hearts 3D – Japanese Debut Trailer
Become true Keyblade Masters as you follow Sora and Riku deep into the Sleeping Worlds to battle enemies never seen before in the Kingdom Hearts series.
Fortune Street – GT Review Pod
Monopoly, Mario, and the magic of Dragon Quest combine!
GT Game of The Year Awards – Best Motion Controls
Game Trailers – Game of the Year Awards 2011
GT Game of The Year Awards – Best 3DS Game
Game Trailers – Game of the Year Awards 2011
The Legend of Zelda: Skyward Sword – Zero Punctuation
The Legend of Zelda: Skyward Sword – Review Round-Up
Soccer Up! – New Screens, Price, & Release Date
Soccer Up is a funny soccer game that allows you a total control of any action of your team players: Control the ball, dribble and shoot with effect to confuse the goalkeeper and score a goal! The ball has inertia and will move freely over the field. Show your ability to control it and make short and long passes. Choose […]
Zelda Medley by Lindsey Stirling
I (lindsey) arranged this medley based off the Nintendo game Zelda!
Official Zelda Timeline Released by Nintendo
According to a fan translation at Kotaku, the timeline is actually comprised of three parallel universes, all of which are created due to Link's actions during and after The Legend of Zelda: Ocarina of Time. If Link fails in his quest to defeat Ganon, the events of A Link to the Past come to pass. However, if Link wins the […]


text:
They concluded that a high glycemic index/glycemic load diet and frequent dairy consumption are the leading factors in establishing the link between diet and acne. They also note that although research results from studies conducted over the last 10 years do not demonstrate that diet causes acne, it may influence or aggravate it.
The study team recommends that dermatologists and registered dietitians work collaboratively to design and conduct quality research. "This research is necessary to fully elucidate preliminary results, determine the proposed underlying mechanisms linking diet and acne, and develop potential dietary interventions for acne treatment," says Burris. "The medical community should not dismiss the possibility of diet therapy as an adjunct treatment for acne. At this time, the best approach is to address each acne patient individually, carefully considering the possibility of dietary counseling."
|Contact: Eileen Leahy
Elsevier Health Sciences


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The Barrier
[Sorry, the video for this story has expired, but you can still read the transcript below. ]
- Online NewsHour Special Reports: Israeli-Palestinian Conflict
- Extended Interviews: Palestinian legislator Hanan Ashrawi
- Political analyst Yaron Ezrahi
- Israeli Foreign Minister Silvan Shalom
- Institute of Jerusalem Studies Director Salim Tamari
- Jan. 15, 2004: Israel Shuts Down Gaza Crossing After Suicide Bombing
- Dec. 18, 2003: Sharon warns Israel may create new security line.
- Nov. 19, 2003: Update: Bush Urges Israel Not to Jeopardize Peace Process
ELIZABETH FARNSWORTH: The government of Prime Minister Ariel Sharon says it is constructing a barrier between Israel and the West Bank to prevent attacks like last month's suicide bombing in Jerusalem. A Palestinian from Bethlehem had boarded the bus and detonated 15 pounds of explosives, killing 11 people and wounding more than 50. More than 400 Israelis have been killed in suicide bombings since September 2000. Eli Beer is chief coordinator of a paramedic rescue unit.
ELI BEER: People see what terrorism can do. They don't want the options for terrorists to come here, and that's why the people of Israel want the wall. They want to prevent the children to die in these bombings.
ELIZABETH FARNSWORTH: Israeli foreign minister, Silvan Shalom.
SILVAN SHALOM: We have the responsibility to protect our people, and that's why we are building this fence. We are doing it, because it was the recommendation of the security forces. We adopted it, we are building it, and if we reach an agreement with the Palestinians, and I hope we will be in the near future, and we will agree, one with each other, to move it.
ELIZABETH FARNSWORTH: Israel began constructing the security fence two years ago. It's projected to stretch several hundred miles through the West Bank when finished.
As we'll report in our next story, Palestinian leaders consider the barrier a catastrophe for their people. They condemn it as an "apartheid wall" that is already cutting off large numbers of people in the West Bank from their fields, sources of water and work. In some places, the barrier consists of armed watchtowers, and concrete walls 25 feet high.
Elsewhere it's a fence with electronic sensors flanked by razor wire and a security road. In the North, the barrier — marked in red on this map — roughly traces what's known as the "green line," the armistice line between Israel and the Palestinian territories that existed before the 1967 Mideast War.
But further south, the path is more controversial. Near the Palestinian city Qalqilya, for example, the fence reaches several miles into the West Bank to incorporate Israeli settlements. From here, the fence is projected to extend 13 miles west of the green line to incorporate the settlement, Ariel. The fence will eventually stretch around the southernmost part of the West Bank. Prime Minister Sharon has also raised the possibility of building an eastern fence, which would leave the West Bank encircled; but no decision has been made on that yet.
ELIZABETH FARNSWORTH: As you know you're under a lot of criticism because you've deviated from the green line in many places. Is the route fixed or can you change that?
SILVAN SHALOM: First, if we had built this fence on the '67 borders, it would have been a political fence. Where we are building it now on this route it is a security fence. And I would like you to know, fence is moveable. We're already experienced with a fence– we moved a fence in Egypt after we signed the peace treaty with them.
ELIZABETH FARNSWORTH: Eighty-three percent of Israelis polled lay last year said they supported the construction of the fence. Igal Barazani sells flowers on a street in Jerusalem that has been the target of several suicide bombings.
IGAL BARAZANI: I saw them in many places in the city. It's horrible. It's terrifying. I'm a father myself. I don't let my children on a bus, because I'm so afraid. It's very hard. I say this fence can help a lot.
ELIZABETH FARNSWORTH: The Israeli defense forces arranged a tour of the northern fence for us with Lt. Col. Dotan Razili, commander of a tank battalion.
LT. COL. DOTAN RAZILI: We keep a high vigil here because we are not afraid, but one of the scenarios is a terrorist crossing over and going to the village.
ELIZABETH FARNSWORTH: To the east of the fence is the West Bank. A bit north is the Palestinian town Jenin, visible through the wire. On the other side are Israeli cities like Afula, where suicide bombers have struck in the past.
LT. COL. DOTAN RAZILI: Without the fence, it's a matter of an hour walking or 15 minutes by car. And you can get explosives, prepare himself in Jenin, get his directives, and go straight through, and the fence is actually a barrier that stops it. And it has been working since the fence was established it's been working. When you stand here, you understand the reason for the fence. The fence stops the terrorist from coming over from Jenin to Afula, or from Jenin to other parts of Israel.
ELIZABETH FARNSWORTH: The barrier here is actually a complex system of razor wire, an electronic fence, a sand path to trace footprints, a security road and more razor wire.
LT. COL. DOTAN RAZILI: A suicide bomb is a smart bomb. It is the smartest bomb in the world, and we have to use very — either technology or other methods to stop it.
ELIZABETH FARNSWORTH: Is it helping so far?
LT. COL. DOTAN RAZILI: Yeah, the fence has been great in helping. This is actually a barrier. Nobody crosses this barrier. Whoever tried to cross it, we catch them.
ELIZABETH FARNSWORTH: And we're standing here right now and you've got cameras somewhere that can see us?
LT. COL. DOTAN RAZILI: Yes, there's a camera that sees us, that watches us right now.
ELIZABETH FARNSWORTH: Where could it be?
LT. COL. DOTAN RAZILI: It's far away from here, I won't be able to point at it to show you.
ELIZABETH FARNSWORTH: It's far away but it can see us…
LT. COL. DOTAN RAZILI: …but it can see us, yes. The reason for building the fence is we have experience in other borders, Lebanon, Gaza, since 1996 if I'm not mistaken, no suicide bombers went out of the Gaza because we have fenced it.
ELIZABETH FARNSWORTH: There are some openings in the fence with checkpoints where Palestinians with the right papers are allowed to pass into Israel to trade or work, but here, as elsewhere in the West Bank, the process is slow and frustrating for those trying to cross.
Palestinians view the complex of barriers and guarded gates as a humiliating tool of control by an occupying power. But in Israeli towns like Kfar Saba, which is just a few miles from the West Bank, many residents are grateful for the protection. A suicide bombing in this mall just over a year ago killed a security guard.
ESHAI BRENER: We live so close here, you know. I'm not talking about the big issues. I'm just talking about my own life and as a human being, as a person. To hear every day that so many people get killed or to see so many people on television, you know, to see the blood, suffering, that's what I care about. I'm for the fence. That's it. It's very simple.
ELIZABETH FARNSWORTH: But nothing is simple in this tortured land, and the separation barrier is no exception. It has generated opposition not only in the West Bank, but in Europe and the U.N. as well, and President Bush said the path of the barrier would make it hard for Palestinians to build a contiguous state.
The idea for a barrier separating Israelis and Palestinians originated with the Labor Party. Ariel Sharon's Likud Party had long resisted drawing any line in the sand that would necessitate giving up large amounts of the West Bank and uprooting Israeli settlements. Ehud Barak, Labor prime minister between 1999-2001, advocated construction of a fence after the failure of his Camp David negotiations with Palestinian President Yasser Arafat.
EHUD BARAK: When I left power, the intifada, this new eruption of violence, was half a year old. We had 59 people killed on our side. They had some 500. Several weeks later I met with Sharon. I told him, "Look, there are now 70 people killed. When there will be 700, you will build the fence whether you like it or not. And I know why you reject it, you understand that the moment you delineate the line, it will mean politically — whatever you say about it, that that's a political line." That the beginning of a process that will disengage ourselves from the Palestinians.
ELIZABETH FARNSWORTH: Sharon's line, the path of the current fence, is aimed at including as many Israeli settlements as possible on the Israeli side of the fence, but Sharon has also warned repeatedly in recent weeks that most settlements in Gaza and a few in the West Bank will have to be uprooted in order to disengage from the Palestinians if violence continues.
During a visit to the coastal city Ashqelon last week, Sharon said, "Not only is this difficult for the settlers, but also it is more painful for myself than anyone in Israel. It pains me a lot, but I've reached a decision and I'm going to carry it out."
So far, Sharon is just talking about removing settlements, and there's some skepticism in Israel that he'll actually do anything. But political analyst Yaron Ezrahi said the rhetoric is something new.
YARON EZRAHI: The Sharon government, which I would say is the most right-wing government in Israel's history, has changed its rhetoric in that the prime minister and deputy prime minister have begun to speak against the occupation and about partial withdrawal. This is a very significant development.
ELIZABETH FARNSWORTH: According to former Prime Minister Barak, one reason for the change is demographics. The Palestinian population is increasing at a faster rate than the Jewish population, and Barak said Israeli leaders on all sides are beginning to recognize they will eventually have to give up lands to ensure a Jewish majority inside Israel.
EHUD BARAK: The political realities are such that we have to protect a Jewish majority for generations to come within our borders. If we control the Palestinians, as are the dreams of some of the right-wing extremists, we're going to end up either with a non-Jewish or a non-Democratic state.
ELIZABETH FARNSWORTH: Prime Minister Sharon's new rhetoric on disengagement from the Palestinians has infuriated some settlers and their supporters. More than 100,000 turned out in Tel Aviv last month to protest the plan to remove settlements. And on the Israeli left, some peace activists are also protesting the Sharon government's separation plans. Late last month, activists joined Palestinians in Abu Dis, a village on the border of east Jerusalem, in a demonstration against the wall. Mary Schweitzer moved to Israel from the U.S. 21 years ago.
MARY SCHWEITZER: There's nothing about security in the wall. The wall represents humiliation. It represents degradation. There is no reason at all that Jews should be building ghettos. Jews should be the first people to stand against ghettos.
ELIZABETH FARNSWORTH: Some of the left critics have in various ways compared what's happening in the West Bank with the fence to ghettos.
SILVAN SHALOM: It's unbelievable to hear it from Jews. They know it's not true. They are doing it only to picture Israel as the bad guy here in the region.
ELIZABETH FARNSWORTH: Whatever the disagreements within Israel, construction on the fence continues. Most Israelis still support the barrier. In the north, Lieutenant Colonel Razili said the fence recently played a role in stopping a suicide bomber headed towards an Israeli school.
LT. COL. DOTAN RAZILI: What we understand, from that incident, we understand the fence gives us time so we can acquire the target. We understood that someone tried to cross over. We found him before he crossed over. The fence gave us that time. That was important and we saved the kids.
ELIZABETH FARNSWORTH: With that kind of testimonial, the barrier may be here to stay, at least until there's a major change in relations between these neighbors whose enmity doesn't cease.
JIM LEHRER: Tomorrow night in part two, Elizabeth looks at the barrier from the Palestinian perspective.


text:
hi im lizziex :)x
i have anorexia nervosa and ive had it only for a short while so im quite new but i have a terrifying fear of gaining weight. how can over come that?
i have been taken away from school and my friends and im not even aloud to go out my house-pls help! :(
the doctor says i need to gain like 2 stone to be able to go back to school but im scared can anyone help me.x


text: Lip Lust: MAC Pencilled In Collection Preview Aprill February 7, 2015 Lip Lust: MAC Pencilled In Collection Preview2015-02-07T07:17:04+00:00 Lip Care Products 2 Comments Take your lipstick to the next level with the MAC Pencilled In Collection. Check out the images and details below: Precisely defined, intentionally bold and utterly classic, the Pencilled In lip never goes out of style. Craft a clear-cut pout with new envogue shades of M∙A∙C's profoundly pigmented Lip... Keep Reading »


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Arabian Nights
Alternate Title: Scooby-Doo in Arabian NightsArabian Nights (Scooby-Doo in Arabian Nights , Scooby Doo's Arabian Nights) (1994) Animated Cartoon Special
This page has been viewed 23 times this month, and 2322 times total.
- 1994
- Animated TV Special
- Hanna-Barbera Studios
- TV Special
- Cartoon Characters: Yogi Bear, Boo Boo, Magilla Gorilla, Scooby-Doo, Shaggy, Alliyah-din, Haman, Lord of the Amulet, Sultan, Prince, Scribe, Princess, Captain, Cyclops, Mrs. Rukh, Baby Rukh, Chef, Kitchen Worker, Dress Maker, Caliph, Guard.
- Vocal Talent: Greg Burson (Yogi Bear), Don Messick (Boo Boo), John Kassir (Haman), Tony Jay (Lord of the Amulet), Brian Cummings (Sultan), Rob Paulsen (Prince), Paul Eiding (Scribe), Jennifer Hale (Alliyah-din), Kath Soucie (Princess) (Alliyah-din and the Magic Lamp Segment).
Sinbad Segment: Charlie Adler (Captain), Allan Melvin (Magilla Gorilla), Maurice LaMarche (Cyclops), Frank Welker (Mrs. Rukh, Baby Rukh).
Scheherazade Segment: Don Messick (Scooby-Doo), Casey Kasem (Shaggy), Greg Burson (Chef), Nick Jameson (Kitchen Worker, Dress Maker), Eddie Deezen (Caliph), Brian Cummings (Guard).
- Directed By Jun Falkenstein, Joanna Romersa.
- Produced By Jun Falkenstein, Joanna Romersa, William Hanna, Joseph Barbera.
Executive Producers: William Hanna, Joseph Barbera.
- Animated By Joanna Romersa (Director of Animation).
Animation Directors: William Edwards, Frank Andrina.
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Cartoon Summary:
A politically corrected retelling of three classic stories from the Arabian Nights: "Alliyah-Din and His Magic Lamp," "Sinbad" and "Scheherezade." Scooby-Doo and... (more)
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text:
Photo/Film InternBookmark This
1909 N Lincoln Ave
Chicago, IL
DescriptionDrop is a lounge/nightclub in the city of Chicago, highlighting local artists and DJs in a unique, subterranean space.
We are looking for photography students to help capture the mood and vibe of each of our events, as well as assist in putting together a constantly-updated portfolio of promotional photos for digital and print marketing.
Must be 21 years old to apply.
Responsibilities- Assist in all aspects of video and photographic communications and contribute to planning and storyboarding
- Assist in the end-to-end process from storyboarding to logistics to shooting to editing and publishing
- Film video and shoot photographs in field environments
- Use existing original and stock footage to produce new videos
- Contribute to mixing and editing to create polished and engaging videos
- Publish videos primarily to the web and touch-up still photography
Requirements- Have the potential to deliver videos and photos that succinctly and clearly convey our brand
- Ability to deliver videos with cuts, graphics, sound and other elements that convey a quality production value and a level of technical sophistication
- Experience with Final Cut Pro, Adobe Premiere, Adobe Captivate and Adobe Photoshop
- Knowledge of digital videography and photography cameras and equipment


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That's because on Game of Thrones, conflict doesn't spring from competing moralities; it springs from competing desires.
Nowhere is this truer than the Israeli-Palestinian conflict.
The fact is that to respond 'proportionally' in warfare is merely to ensure the continuance of the conflict.
early 15c., "armed encounter, battle," from Old French conflit and directly from Latin conflictus (see conflict (v.)). Meaning "struggle, quarrel" is from mid-15c. Psychological sense of "incompatible urges in one person" is from 1859 (hence conflicted, past participle adjective). Phrase conflict of interest was in use by 1743.
conflict con·flict (kŏn'flĭkt')
A psychic struggle between opposing or incompatible impulses, desires, or tendencies.


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Residents who live in the Jamesville-DeWitt School District will, next week, not only vote on the 2011-12 fiscal budget but also for candidates running for seats on their respective boards of education. The Jamesville-DeWitt School District has four candidates vying for three open seats on the BOE; two of those candidates, Tom Taylor and Samuel Young, are incumbents. The newcomers are Susan Petrosillo and Donald VanStry.
Polls will be open from 7 a.m. to 9 p.m. Tuesday May 17 in the J-DHS main gym atrium area.
Susan Petrosillo
Petrosillo and her husband Mike, who have three young children in the school district, have lived in DeWitt for six years. A 1988 graduate of Colgate University, she earned a Bachelor of Art in mathematical economics before obtaining a Master of Science/Master of Business Administration from Northeastern University in Boston, Mass. In the mid-90s, she began to pursue a career in information technologies, which included work abroad. Currently, she works part time in Syracuse, managing technology projects.
Petrosillo said she is running for a seat on the board to represent the interests of elementary school parents as well as for residents who recognize the board will continue to make tough financial decisions going forward.
"I am community-focused, socially aware and fiscally responsible," Petrosillo said in a profile submitted to the district. "I am committed to using my broad business and life experiences to help the board identify non-traditional program solutions that maximize the use of existing revenues and identify revenue opportunities outside of taxes and state aid."
Donald VanStry
VanStry, a 10-year resident of DeWitt, has two children enrolled in the school district; his other two are graduates of J-DHS. A partner at the law firm of Weisberg, Zukher and VanStry PLLC, VanStry's practice includes adoption, education, criminal and family law.
"J-D is big enough to give our children a top-notch education, but still small enough that they receive a lot of personal attention and many choices of extra-curricular activities," he said in his district profile. "It is my hope that even in a time of financial hardships, that we as a school and a community can work together to continue providing this educational experience for our children."
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A: Were hoping that the United States government would recognize the mistake that it has done and accept, allow us to enter the United States. U.S. government captured us, U.S. government incarcerated us, locked us up in prison, and U.S. government said that we were not a threat and should be released.
Uighur-Americans came forward, made an offer to the United States government to accept us into Uighur-American society and community. They even went into the courts and contacted the lawyers and wrote a letter to the U.S. government officials asking them to consider releasing us into the United States. Unfortunately, it did not happen, a rather disappointing decision.
However, other countries such as Canada, Germany, Norway, Turkey would also be good countries for us to settle because of their sizable Uighur populations. Uighur culture is an interdependent culture where we always need to see our friends and sit down and talk with them. And especially in our situation, we need a lot of people around us helping us to forget this bitter life experience that we spent wasted in Guantanamo for the last four-and-a-half years.
Q: Are you angry at the United States?
A: I wouldn't call it angry. I would rather describe it as extreme disappointment. The Uighur people see the United States as a country that promotes democratic freedom and protects human rights of the people, particularly people like the Uighurs, my people. We look up to the United States as a source of hope, inspiration for our liberty. And because of that image that we hold of the United States and what we have experienced in Guantanamo, we feel extremely disappointed.
We are so fortunate to have a group of good-hearted American lawyers, who never gave up on us, and freed us. We would never be here if we didn't have the good American lawyers who helped us to be free. And for that we are very, very thankful.
Q: What were you doing when you were apprehended in Afghanistan? There are U.S. officials who have said you had associations with the Taliban or al Qaeda or received weapons training. What do you say?
First of all, let me correct. I was not captured in Afghanistan. I was picked up by a Pakistani bounty hunter in Pakistan and sold to the U.S. military for $5,000.
You may wonder why I went to Pakistan, but I originally, initially, was hoping to get to Turkey to join the Uighur community in Turkey. My friend in Pakistan advised me that there was a Uighur village in Afghanistan where I can stay while my visa was processed and they told me they will call me and I can come back and get my passport and go to Turkey to earn more money and support my family. So basically my departure from China was seeking greater economic and political freedom to be able to live well.
Q: Did you ever receive anything like weapons training?
I reject the motion that I ever received military training. When I went to Afghanistan, I find that quite compelling to use that opportunity to study the Koran ... Uighurs are physically Muslim, but they don't really know how to read [religious texts]. That environment provided me an excellent opportunity, so I spent most of my time reading the Koran, learning Islamic, taking Islam, learning more about Islam.


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Originally written on Fox Sports Wisconsin | Last updated 1/22/13
GREEN BAY, Wis. -- Kabeer Gbaja-Biamila and Chris Jacke are the headliners of the Green Bay Packers Hall of Fame 2013 class. Gbaja-Biamila played all nine of his NFL seasons with the Packers, accumulating a franchise-record 74.5 sacks along the way. After playing only seven games as a rookie, the team's 2000 fifth-round pick then began a streak of having at least 10 sacks for four consecutive seasons. Often known simply as KGB, the defensive end played 132 career games with Green Bay before being released by the team in 2008. He was a Pro Bowl selection in 2003. Jacke, the Packers' kicker for eight seasons from 1989-96, was drafted by the team in the sixth round. More than 15 years since playing his last game in Green Bay, he is still third on the Packers' all-time scoring list with 820 points, behind only Ryan Longwell and Don Hutson. Jacke has the most 50-plus yard field goal makes (17) in franchise history and also holds the team record for most field goals in a game (five), whic...
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Grunt task for uniting testing using JS Test Driver.
Runs JS Test Driver for crcross browser unit testing.
Install this grunt plugin next to your project's grunt.js gruntfile with:
npm install grunt-plugin
Then add this line to your project's
grunt.js gruntfile:
(Coming soon)
In lieu of a formal styleguide, take care to maintain the existing coding style. Add unit tests for any new or changed functionality. Lint and test your code using grunt.
(Nothing yet)
Copyright (c) 2013 Ricky Clegg
Licensed under the MIT license.


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Processed by: staff; machine-readable finding aid created by:M. Plarr
Pine Mountain Settlement School, Helen deLong Photograph Collection
ca. 1914-ca. 1929
Berea College Special CollectionsBerea, Kentucky 40404
Copyright has not been assigned to Berea College.
[Identification of item], Pine Mountain Settlement School, Helen deLong Photograph Collection, KYSX290-A, ca. 1914-ca. 1929Special Collections, Berea College, Berea, Ky.
57 items
These were assembled by deLong who was a younger sister of Ethel deLong Zande from Wilmington, Delaware.
Included are portraits of local inhabitants; and views of scenery, flax preparation, and dancing.
Open to researchers.
KYSX274-A supplies further information on the collection of which this series is a part.
Hosted by the University of Kentucky
Contact us: firstname.lastname@example.com


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D800E to be priced @ $3300?
Started Feb 7, 2012 | Discussions thread
D800E to be priced @ $3300?
Feb 7, 2012
unconfirmed...but if it's true...I'm pre-ordering!!!
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Harrison Ford has finally popped the question to his girlfriend of 5-years,
Calista Flockhart. Rumor has it that Ford proposed to Flockhart on April Fool's day. We hope it wasn't a bad joke that would be beyond sad.
Many thought Harrison Ford would never marry again considering the fact that he had one of the biggest divorce settlements in Hollywood. Ford had to fork over a whopping $85 Million to his ex-wife. That would scare the bejesus out of me too. Hope he has better luck this time around.


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Now Available - Yesterday
Yesterday is Now Available on Steam!
Yesterday is a thrilling and dark mystery from the masters of adventure, Pendulo Studios.
In New York City, beggars are disappearing one after another, only to be found burnt alive. Meanwhile, a Y-shaped scar forms in the palm of the hands of seemingly unrelated people. With the police and the media giving little attention to these events, Henry White, a young and rich heir dedicated to a charitable organization, and his friend Cooper, are the first to investigate these disappearances.
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text: No recent wiki edits to this page. With the ages long war between the Vampire and Werewolf Nations finally over, the surviving WetWorks teamp members hoped to be able to start their lives anew. Unfortunately, they found themselves summoned instead to the headquarters of International Operations, where the mysterious Dominique Faust asked these former Team 7 soldiers to once again become I.O.'s official strike team. Not trusting I.O. to determine their missions, the team rejected her offer. In retaliation, Dominique had WetWorks arrested on charges of treason and desertion, and placed them in a hi-tech prison. In the end, however, it turned out that Dane had a plan all along. WetWorks easily escaped their confinement, and proved to Dominique just how powerful and elusive they couls be. The team then returned to her office and agreed to work for I.O.... but only on their terms!


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Irish Library and Information SchoolsEmerald Group Publishing Limited 2009; US$ 199.00
The articles in this e-book of Aslib Proceedings reflect some current research concentrations in the School of Information and Library Studies (SILS) in University College Dublin (UCD). This is the only school or department of its type in Ireland, and currently the only such school in the island of Ireland. more...
UK Library and Information SchoolsEmerald Group Publishing Limited 2011; US$ 199.00
The latest E-Book of Aslib Proceedings reflects the breadth of activity currently being undertaken at The Information School at the University of Sheffield. The eleven papers in this special issue reflect the breadth of activity at the Information School, with contributions in educational informatics, health informatics, information retrieval, information... more...
Aberystwyth Library and Information Studies: Masters' dissertationsEmerald Group Publishing Limited 2012; US$ 199.00
The four articles that constitute the themed section of this e-book show the contribution from the Department of Information Studies, Aberystwyth University, whilst showcasing the work of the three research groupings within the Department, as well as some of the best of the work undertaken by new entrants to the profession. Each paper is based on a... more...
British Library and Information Schools - The Research of the Department of Information Science, City University, LondonEmerald Group Publishing Limited 2007; US$ 199.00
The papers in this e-book reflect the research and scholarly interests of the staff of the Department of Information Science at City University London. One theme emerges strongly: the continued vitality and variety of the information science discipline. The traditional concerns of the department are well-represented in several papers: healthcare and... more...
Evidence-based librarianship, Volume 24, Issue 3Emerald Group Publishing Limited 2006; US$ 199.00
Seeks to spread the concept of evidence based practice beyond the health sector. Librarians need to increase their reliance on sound evidence to support their programs and services. They also need to become more active in producing and publishing evidence for their peers and others outside the profession. This collection of articles examines the... more...
British library and information schools: the research of the Department of Information Studies, University of Wales AberystwythEmerald Group Publishing Limited 2006; US$ 199.00
This is the second in a series devoted to the research output of British library and information schools. This e-book focusses on the Department of Information Studies at the University of Wales Aberystwyth which recently celbrated its 40th anniversary. more...
International library educationEmerald Group Publishing Limited 2007; US$ 199.00
This e-book contains papers from the Forum on International Library Education held at the ALA Annual conference June 2006 more...
Restructuring LIS educationEmerald Group Publishing Limited 2004; US$ 199.00
New technologies mean library and information science is currently characterised by fast-paced change, with staff needing to be flexible in adapting and adopting new skills and levels of awareness. New developments need to be marketed and evaluated, and these are additional skills for information professionals to adopt. Findings of a research project... more...
Archival InformationABC-CLIO 2004; US$ 76.95
From original manuscripts and letters to sound recordings and birth certificates, archival information plays an increasingly important role in modern research. Libraries and the Internet have made finding information on a wide range of topics faster and easier, but not all information?particularly from primary sources?is available via local library... more...
Advancement in Library and Information ScienceOxford Book Co. 2009; US$ 95.00
This book has been designed as a manual which have invaded the field of library science, most notably that of information system management. Bringing within purview both concrete and digital libraries, the book delineates the processes, principles and practices which have defined information handling and access in recent years, and discusses what they... more...


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Who here actually works on a fan production?
View Single Post
October 23 2013, 05:58 AM
Location: las vegas
Re: Who here actually works on a fan production?
Hi Alec,
As you know, but for the sake of others, I've created and produced Star Trek Secret Voyage. We are in post production of our second installment, to complete our 2 part origin saga. Graphic designer turned film producer/director/writer/vfx/sound engineer/make-up artist/marketer/editor/talent agent. In the trenches I've learned volumes and wore several hats as needed to bring a dream to life. Those on here who have been able to turn their passions into a tangible product are few and far between. It's awesome how great many have been to support and encourage one another. I poo poo those that are filled with more opinion than actual experience.
We've have only a few pick-up shots to film and a few more vfx to complete before the final edit is locked. We then hope to get it to an audio engineer (still looking) for final master edit and to work with our composer. Release is dependent on these details.
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about 2 years ago
i am 15 years old you can know more about me on facebook : amanda ellerby
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Night life, popping bottles, acting like you wasn't impressed with that
from Tyga – Diced Pineapples Lyrics on Genius
Tyga ball hard in the club and this girl is impressed even though she act like she isn't.
Kind of McKayla Maroney did in 2012 London Olympic Games after winning silver medal in gymnastics.
Why so serious?
To help improve the quality of the lyrics, visit Tyga – Diced Pineapples Lyrics and leave a suggestion at the bottom of the page


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Health & Parenting
Parenting: Dealing With the Bedtime Struggle
My 6-year-old twins do not like bedtime.
Every night, it's the same story. I announce it's time to go to sleep, and the complaints and excuses start. "Oh, but I didn't get to watch TV." "Please, I just want to finish this game, Mom." "Can't we stay up a little bit longer?" Then, when we go upstairs, "I'm not even tired -- why do I have to sleep?"
Does this sound like your nighttime scenario, too? As a pediatrician, I hear it from both ends -- at home and from concerned parents who ask, "My child is going to bed late -- does he need more sleep?"
Why Sleep Is Important for Kids
The answer couldn't be clearer when it comes to kids' health, despite their protests to the contrary. Sleep is one of the most valuable gifts you can give your children. Sleep provides the brain with much-needed time to recharge, store information, and even solve problems. It helps boost the body's immune system as well. Lack of sleep can cause crankiness and anxiety, and has been linked to obesity and higher body mass index (BMI) in children.
One study followed hundreds of children from ages 3 to 7. The researchers found that each additional hour of sleep reduced the likelihood of a child being overweight at age 7 by 61%. Another study of more than 15,000 teens showed that teens with later bedtimes and fewer hours of sleep were more likely to become depressed and have thoughts of suicide. Lack of sleep also affects kids' performance at school -- plenty of research backs that up, too.
So how do you fight the nightly pushback? Most important, set a routine. Try to have the same events occur at the same place, same time each night. Second, no matter what your kids' ages, from preschool through high school, turn off all TVs, video game consoles, and digital devices at least an hour before bedtime. For young children, give them a bath, have them brush their teeth, and then read them a bedtime story.
Be patient. Change may not happen right away. After a few days of these new rules, my kids looked forward to bedtime and the storybooks that came with it. And guess what? At 8:15, with the twins tucked in bed, I kicked back and got some "me" time -- perfect for unwinding before my own bedtime.


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Brad's ridiculous flakiness with playing games wouldn't be so unbearable to listen to if he would at least just cop to being a flake. His weird insistence that he will play games, that everyone knows he won't finish, only for him to not finish them and then get pissed at people who expected him to, is one of his worst aspects.
Also, it's not the game's fault if you disappear from the game for a few weeks and then come back and forget what happened. I get that that's not fun to see everything in context; but that shit is on you.


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Featured Stories
GE Appliances and Keurig® Brew Up the Next Big Thing in Refrigeration
No matter how you prefer your cup of coffee, there's no denying the single-serve brewing trend is piping-hot. According to a 2014 National Coffee Association coffee drinking trends survey, 29 percent of respondents who drank coffee said they used a single-cup brewer, up nearly 50 percent from the previous year.1 Brewing at home is about to become even more appealing as GE introduces an industry first: the GE Café™ Series refrigerator with Keurig® K-Cup® Brewing System.
Featured Stories
"The Only Fridge as Smart as You," to Launch at CES
FirstBuild™, a new global co-creation community, today announced availability of its first community-generated product, ChillHub, the latest in smart home appliances.
Featured Stories
GE Agrees to Sell Appliances Business to Electrolux for $3.3B
GE announced today it has signed a definitive agreement to sell its Appliances business to Electrolux for $3.3 billion.
Featured Stories
New GE Monogram® French Door Wall Oven Puts Culinary Possibilities Within Reach
Today's consumers are bringing the professional-level appliances and techniques they see in culinary entertainment and restaurants into their kitchen to help create fine-dining-worthy creations. The influence of the professional chef on consumers has inspired GE (NYSE: GE) to introduce a new Monogram® French door wall oven with cooking features fit for the pros but designed for the home.


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Welcome to the Discovery Blog! Today is the official launch of this blog, and we're glad that you found us.
This month marks the 25th anniversary of Discovery Communications and the Discovery Channel. Over the last 25 years under the leadership of our Founder & Chairman John Hendricks, we at Discovery have been devoted to one thing: satisfying viewers' curiosity through world-class content. Discovery is a much bigger and global company 25 years later, with 120 worldwide networks and 28 network entertainment brands, but our mission of delivering high quality content has not and will not change.
This blog is a further extension of that focus. Check back with us regularly for news from across our networks — whether it's a premiere of a new show, a new development from one of our joint ventures, an interview with a Discovery executive or a report back from an event. We will also have lots more to share as we approach our birthday (June 17).
As excited as we are to tell you all of our news, we're equally excited to hear what you think about what we're doing.
Welcome to the world of Discovery!


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Digital Aquatics stuff works ok By lmay2024 on 1/9/2015lmay2024 wouldn't recommend this product to a friendI had no problems with the unit I received from BRS. I've had my reef keeper Elite for about 3 years and have had no major problems with it.
unpredictable causes instability By saltlick on 12/11/2014saltlick wouldn't recommend this product to a friendhad this for several years. I also have the SL2 which has worked fine so far. Problems: frequent false Ph alarms when MH turn off, every time I plug in the SID V2, and randomly. calibration is 2 point and inaccurate (good enough for trends which is all we need). Unrelated channel 4 relay outlet cycles randomly for hours at ~1 sec interval until I unplug the SL1
don't buy from bulk reef supply and digital aquatics product. By jose on 10/3/2014jose wouldn't recommend this product to a friendPurchased a rke few months ago from bulk reef supply and they sent me a broken pc4. Next thing i ordered is sl1 not to my surprise it's broken too. I appreciate brs sent me a replacement but the time I' spent waiting only to find out that item is not working is frustating. I hope brs test their products first before they sent it out for the consumer. Brs might delete this review but I'm just saying what's my experience with this company.
don't buy from bulk reef supply and rke By pogi on 10/2/2014pogi wouldn't recommend this product to a friendI ordered rke few months ago and received a broken pc4. Atleast they sent another one. Another thing I ordered is a sl1. Of course received a broken item again. I appreciate that they replace it. But the time I spent on waiting my item and found out that is not working is frustating and brs representative wont sent a new one asap until they received the one they sent me.I hope that they check their products first before they sent it out. Don't waste consumers time pls.
DA products are really bad, just check their FB or any reviews and you see what customer go through By DomDom on 11/22/2012DomDom wouldn't recommend this product to a friendi finally took the step of selling my RKE and my SL2 with all the probs i had, and got myself Neptune, and let me tell you all it was the best thing i have ever done since i got my first salt water tank. no more false promises and lies. i know chances of this post staying is almost none so i hope people read it before DA removes it:)
needed for ATO, By richard on 8/27/2011richard would recommend this product to a friendgreat product but i did not realize until after purchasing the basic reef keeper that i need this for an auto top off. Easy to set up and program this module with the reef keeper and works as advertised.
Great By email@example.com on email@example.com would recommend this product to a friendI love this Device! I use it to control everything. The ph is right on I don't use the ORP as it's not need for my saltwater tank, but I use the switch port for my ATO and love it. I use the second port for an ATO tank so the pump doesn't run dry.
Base Module, Must for temp monitoring! By Patrick on 8/3/2010Patrick would recommend this product to a friendSo, this is the base module that comes with most, if not all of the RKE packs, it's a bread and butter module for it's ability to do temp monitoring and control switched circuits. All in all, a well built, and stable module.