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- Digestive system (1)
- Endoscopy (1)
- Fibrotest (1)
- Hepatotoxicity (1)
- Intestinal neoplasms (1)
- Liver enzymes (1)
- Self-expandable metal stents (1)
- Self-expandable metal stents complications (1)
- Molecular basis of telaprevir resistance due to V36 and T54 mutations in the NS3-4A protease of the hepatitis C virus (2008)
- Background The inhibitor telaprevir (VX-950) of the hepatitis C virus (HCV) protease NS3-4A has been tested in a recent phase 1b clinical trial in patients infected with HCV genotype 1. This trial revealed residue mutations that confer varying degrees of drug resistance. In particular, two protease positions with the mutations V36A/G/L/M and T54A/S were associated with low to medium levels of drug resistance during viral breakthrough, together with only an intermediate reduction of viral replication fitness. These mutations are located in the protein interior and far away from the ligand binding pocket. Results Based on the available experimental structures of NS3-4A, we analyze the binding mode of different ligands. We also investigate the binding mode of VX-950 by protein-ligand docking. A network of non-covalent interactions between amino acids of the protease structure and the interacting ligands is analyzed to discover possible mechanisms of drug resistance. We describe the potential impact of V36 and T54 mutants on the side chain and backbone conformations and on the non-covalent residue interactions. We propose possible explanations for their effects on the antiviral efficacy of drugs and viral fitness. Molecular dynamics simulations of T54A/S mutants and rotamer analysis of V36A/G/L/M side chains support our interpretations. Experimental data using an HCV V36G replicon assay corroborate our findings. Conclusion T54 mutants are expected to interfere with the catalytic triad and with the ligand binding site of the protease. Thus, the T54 mutants are assumed to affect the viral replication efficacy to a larger degree than V36 mutants. Mutations at V36 and/or T54 result in impaired interaction of the protease residues with the VX-950 cyclopropyl group, which explains the development of viral breakthrough variants.
- Letalität auf der Warteliste und Transplantation bei Leberallokation nach MELD Score in Deutschland - erste prospektive Ergebnisse bei 100 Patienten (2008)
- Meeting Abstract : Deutsche Gesellschaft für Chirurgie. 125. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 22.-25.04.2008 Einleitung: Am 16.12.06 wurde im Eurotransplant-Gebiet der MELD-Score (MELD) als Allokationsbasis zur Lebertransplantation (OLT) eingeführt. Ziel ist eine Reduktion der Sterblichkeit auf der Warteliste. Material und Methoden: 100 Patienten wurden in die prospektive Analyse der MELD-Allokation vom 16.12.06 bis 15.09.07 einbezogen. Ergebnisse: Aktuell warten 68 Pat., 28 Pat. wurden transplantiert, 4 Pat. sind auf der Warteliste (WL) verstorben (4%). Der mittlere MELD auf der WL beträgt 17,2 +/- 5,2 (7-28). Bei 12 Pat. liegt eine Standard-exception (SE) (n=10 HCC, n=2 metabolische Erkrankung) mit einem Match-MELD von 25,6 +/-2,06 vor (24-28). Die Todesursachen der vier auf der WL verstorbenen Pat. waren eine akute Varizenblutung (MELD 9), zwei kardiale Versagen (MELD 13, 18) und eine MRSA-Sepsis (MELD 29, NT-Status). Die 28 transplantierten Pat. hatte zum Zeitpunkt der Transplantation einen mittleren MELD von 27,66 +/- 5,1 Punkten (21 bis 40). 20 Pat. wurden aufgrund des Labor-MELD (28,4 +/- 5,3, 24-40) transplantiert, wobei 7 Pat. einen MELD über 30 aufwiesen. Die Wartezeit lag bei 11,55 +/- 5,3 Tagen. 8 Pat. erhielten bei SE bei HCC (MELD 24 +/- 0, 24) ein Organ nach einer Wartezeit von 320 +/- 9,7 Tagen. Aktuell leben 23 der 28 transplantierten Pat. Bei zwei verstorbenen Pat. war die Todesursache ein kardiales Versagen, bei zwei Patienten eine primäre Non-Funktion sowie ein septisches Multiorganversagen. Schlussfolgerung: Während der ersten Monate der MELD Allokation lag die Letalität auf der WL in unserem Zentrum bei 4%. Patienten mit einem mittleren MELD über 27 erhielten Organangebote und konnten nach kurzer Wartezeit transplantiert werden.
- A multi-variant, viral dynamic model of genotype 1 HCV to assess the in vivo evolution of protease-inhibitor resistant variants (2010)
- Variants resistant to compounds specifically targeting HCV are observed in clinical trials. A multi-variant viral dynamic model was developed to quantify the evolution and in vivo fitness of variants in subjects dosed with monotherapy of an HCV protease inhibitor, telaprevir. Variant fitness was estimated using a model in which variants were selected by competition for shared limited replication space. Fitness was represented in the absence of telaprevir by different variant production rate constants and in the presence of telaprevir by additional antiviral blockage by telaprevir. Model parameters, including rate constants for viral production, clearance, and effective telaprevir concentration, were estimated from 1) plasma HCV RNA levels of subjects before, during, and after dosing, 2) post-dosing prevalence of plasma variants from subjects, and 3) sensitivity of variants to telaprevir in the HCV replicon. The model provided a good fit to plasma HCV RNA levels observed both during and after telaprevir dosing, as well as to variant prevalence observed after telaprevir dosing. After an initial sharp decline in HCV RNA levels during dosing with telaprevir, HCV RNA levels increased in some subjects. The model predicted this increase to be caused by pre-existing variants with sufficient fitness to expand once available replication space increased due to rapid clearance of wild-type (WT) virus. The average replicative fitness estimates in the absence of telaprevir ranged from 1% to 68% of WT fitness. Compared to the relative fitness method, the in vivo estimates from the viral dynamic model corresponded more closely to in vitro replicon data, as well as to qualitative behaviors observed in both on-dosing and long-term post-dosing clinical data. The modeling fitness estimates were robust in sensitivity analyses in which the restoration dynamics of replication space and assumptions of HCV mutation rates were varied.
- Serum microRNA-21 as marker for necroinflammation in hepatitis C patients with and without hepatocellular carcinoma (2011)
- Background: MicroRNA-21 (miR-21) is up-regulated in tumor tissue of patients with malignant diseases, including hepatocellular carcinoma (HCC). Elevated concentrations of miR-21 have also been found in sera or plasma from patients with malignancies, rendering it an interesting candidate as serum/plasma marker for malignancies. Here we correlated serum miR-21 levels with clinical parameters in patients with different stages of chronic hepatitis C virus infection (CHC) and CHC-associated HCC. Methodology/Principal Findings: 62 CHC patients, 29 patients with CHC and HCC and 19 healthy controls were prospectively enrolled. RNA was extracted from the sera and miR-21 as well as miR-16 levels were analyzed by quantitative real-time PCR; miR-21 levels (normalized by miR-16) were correlated with standard liver parameters, histological grading and staging of CHC. The data show that serum levels of miR-21 were elevated in patients with CHC compared to healthy controls (P<0.001); there was no difference between serum miR-21 in patients with CHC and CHC-associated HCC. Serum miR-21 levels correlated with histological activity index (HAI) in the liver (r = −0.494, P = 0.00002), alanine aminotransferase (ALT) (r = −0.309, P = 0.007), aspartate aminotransferase (r = −0.495, P = 0.000007), bilirubin (r = −0.362, P = 0.002), international normalized ratio (r = −0.338, P = 0.034) and γ-glutamyltransferase (r = −0.244, P = 0.034). Multivariate analysis revealed that ALT and miR-21 serum levels were independently associated with HAI. At a cut-off dCT of 1.96, miR-21 discriminated between minimal and mild-severe necroinflammation (AUC = 0.758) with a sensitivity of 53.3% and a specificity of 95.2%. Conclusions/Significance: The serum miR-21 level is a marker for necroinflammatory activity, but does not differ between patients with HCV and HCV-induced HCC.
- Assessment of liver fibrosis and associated risk factors in HIV-infected individuals using transient elastography and serum biomarkers (2012)
- Background: Liver fibrosis in human immunodeficiency virus (HIV)-infected individuals is mostly attributable to co-infection with hepatitis B or C. The impact of other risk factors, including prolonged exposure to combined antiretroviral therapy (cART) is poorly understood. Our aim was to determine the prevalence of liver fibrosis and associated risk factors in HIV-infected individuals based on non-invasive fibrosis assessment using transient elastography (TE) and serum biomarkers (Fibrotest [FT]). Methods: In 202 consecutive HIV-infected individuals (159 men; mean age 47 ± 9 years; 35 with hepatitis-C-virus [HCV] co-infection), TE and FT were performed. Repeat TE examinations were conducted 1 and 2 years after study inclusion. Results: Significant liver fibrosis was present in 16% and 29% of patients, respectively, when assessed by TE (≥ 7.1 kPa) and FT (> 0.48). A combination of TE and FT predicted significant fibrosis in 8% of all patients (31% in HIV/HCV co-infected and 3% in HIV mono-infected individuals). Chronic ALT, AST and γ-GT elevation was present in 29%, 20% and 51% of all cART-exposed patients and in 19%, 8% and 45.5% of HIV mono-infected individuals. Overall, factors independently associated with significant fibrosis as assessed by TE (OR, 95% CI) were co-infection with HCV (7.29, 1.95-27.34), chronic AST (6.58, 1.30-33.25) and γ-GT (5.17, 1.56-17.08) elevation and time on dideoxynucleoside therapy (1.01, 1.00-1.02). In 68 HIV mono-infected individuals who had repeat TE examinations, TE values did not differ significantly during a median follow-up time of 24 months (median intra-patient changes at last TE examination relative to baseline: -0.2 kPa, p = 0.20). Conclusions: Chronic elevation of liver enzymes was observed in up to 45.5% of HIV mono-infected patients on cART. However, only a small subset had significant fibrosis as predicted by TE and FT. There was no evidence for fibrosis progression during follow-up TE examinations.
- A common HLA-DPA1 variant is associated with hepatitis B virus infection but fails to distinguish active from inactive Caucasian carriers (2012)
- Background and Aims: Chronic infection with the hepatitis B virus (HBV) is a major health issue worldwide. Recently, single nucleotide polymorphisms (SNPs) within the human leukocyte antigen (HLA)-DP locus were identified to be associated with HBV infection in Asian populations. Most significant associations were observed for the A alleles of HLA-DPA1 rs3077 and HLA-DPB1 rs9277535, which conferred a decreased risk for HBV infection. We assessed the implications of these variants for HBV infection in Caucasians. Methods: Two HLA-DP gene variants (rs3077 and rs9277535) were analyzed for associations with persistent HBV infection and with different clinical outcomes, i.e., inactive HBsAg carrier status versus progressive chronic HBV (CHB) infection in Caucasian patients (n = 201) and HBsAg negative controls (n = 235). Results: The HLA-DPA1 rs3077 C allele was significantly associated with HBV infection (odds ratio, OR = 5.1, 95% confidence interval, CI: 1.9–13.7; p = 0.00093). However, no significant association was seen for rs3077 with progressive CHB infection versus inactive HBsAg carrier status (OR = 2.7, 95% CI: 0.6–11.1; p = 0.31). In contrast, HLA-DPB1 rs9277535 was not associated with HBV infection in Caucasians (OR = 0.8, 95% CI: 0.4–1.9; p = 1). Conclusions: A highly significant association of HLA-DPA1 rs3077 with HBV infection was observed in Caucasians. However, as a differentiation between different clinical courses of HBV infection was not possible, knowledge of the HLA-DPA1 genotype cannot be translated into personalized anti-HBV therapy approaches.
- Soluble serum CD81 is elevated in patients with chronic hepatitis C and correlates with alanine aminotransferase serum activity (2012)
- Aim: Cellular CD81 is a well characterized hepatitis C virus (HCV) entry factor, while the relevance of soluble exosomal CD81 in HCV pathogenesis is poorly defined. We performed a case-control study to investigate whether soluble CD81 in the exosomal serum fraction is associated with HCV replication and inflammatory activity. Patients and Methods: Four cohorts were investigated, patients with chronic hepatitis C (n = 37), patients with chronic HCV infection and persistently normal ALT levels (n = 24), patients with long term sustained virologic response (SVR, n = 7), and healthy volunteers (n = 23). Concentration of soluble CD81 was assessed semi-quantitatively after differential centrifugation ranging from 200 g to 100,000 g in the fifth centrifugation fraction by immunoblotting and densitometry. Results: Soluble CD81 was increased in patients with chronic hepatitis C compared to healthy subjects (p = 0.03) and cured patients (p = 0.017). Patients with chronic HCV infection and persistently normal ALT levels and patients with long term SVR had similar soluble CD81 levels as healthy controls (p>0.2). Overall, soluble CD81 levels were associated with ALT levels (r = 0.334, p = 0.016) and severe liver fibrosis (p = 0.027). Conclusion: CD81 is increased in the exosomal serum fraction in patients with chronic hepatitis C and appears to be associated with inflammatory activity and severity of fibrosis.
- Baseline MELD score predicts hepatic decompensation during antiviral therapy in patients with chronic hepatitis C and advanced cirrhosis (2013)
- Background and Aims: In patients with advanced liver cirrhosis due to chronic hepatitis C virus (HCV) infection antiviral therapy with peginterferon and ribavirin is feasible in selected cases only due to potentially life-threatening side effects. However, predictive factors associated with hepatic decompensation during antiviral therapy are poorly defined. Methods: In a retrospective cohort study, 68 patients with HCV-associated liver cirrhosis (mean MELD score 9.18±2.72) were treated with peginterferon and ribavirin. Clinical events indicating hepatic decompensation (onset of ascites, hepatic encephalopathy, upper gastrointestinal bleeding, hospitalization) as well as laboratory data were recorded at baseline and during a follow up period of 72 weeks after initiation of antiviral therapy. To monitor long term sequelae of end stage liver disease an extended follow up for HCC development, transplantation and death was applied (240weeks, ±SD 136weeks). Results: Eighteen patients (26.5%) achieved a sustained virologic response. During the observational period a hepatic decompensation was observed in 36.8%. Patients with hepatic decompensation had higher MELD scores (10.84 vs. 8.23, p<0.001) and higher mean bilirubin levels (26.74 vs. 14.63 µmol/l, p<0.001), as well as lower serum albumin levels (38.2 vs. 41.1 g/l, p = 0.015), mean platelets (102.64 vs. 138.95/nl, p = 0.014) and mean leukocytes (4.02 vs. 5.68/nl, p = 0.002) at baseline as compared to those without decompensation. In the multivariate analysis the MELD score remained independently associated with hepatic decompensation (OR 1.56, 1.18–2.07; p = 0.002). When the patients were grouped according to their baseline MELD scores, hepatic decompensation occurred in 22%, 59%, and 83% of patients with MELD scores of 6–9, 10–13, and >14, respectively. Baseline MELD score was significantly associated with the risk for transplantation/death (p<0.001). Conclusions: Our data suggest that the baseline MELD score predicts the risk of hepatic decompensation during antiviral therapy and thus contributes to decision making when antiviral therapy is discussed in HCV patients with advanced liver cirrhosis.
- SEMS vs cSEMS in duodenal and small bowel obstruction: High risk of migration in the covered stent group (2013)
- AIM: To compare clinical success and complications of uncovered self-expanding metal stents (SEMS) vs covered SEMS (cSEMS) in obstruction of the small bowel. METHODS: Technical success, complications and outcome of endoscopic SEMS or cSEMS placement in tumor related obstruction of the duodenum or jejunum were retrospectively assessed. The primary end points were rates of stent migration and overgrowth. Secondary end points were the effect of concomitant biliary drainage on migration rate and overall survival. The data was analyzed according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS: Thirty-two SEMS were implanted in 20 patients. In all patients, endoscopic stent implantation was successful. Stent migration was observed in 9 of 16 cSEMS (56%) in comparison to 0/16 SEMS (0%) implantations (P = 0.002). Stent overgrowth did not significantly differ between the two stent types (SEMS: 3/16, 19%; cSEMS: 2/16, 13%). One cSEMS dislodged and had to be recovered from the jejunum by way of laparotomy. Time until migration between SEMS and cSEMS in patients with and without concomitant biliary stents did not significantly differ (HR = 1.530, 95%CI 0.731-6.306; P = 0.556). The mean follow-up was 57 ± 71 d (range: 1-275 d). CONCLUSION: SEMS and cSEMS placement is safe in small bowel tumor obstruction. However, cSEMS is accompanied with a high rate of migration in comparison to uncovered SEMS.
- Vitamin D levels vary during antiviral treatment but are unable to predict treatment outcome in HCV genotype 1 infected patients (2014)
- Background: Different parameters have been determined for prediction of treatment outcome in hepatitis c virus genotype 1 infected patients undergoing pegylated interferon, ribavirin combination therapy. Results on the importance of vitamin D levels are conflicting. In the present study, a comprehensive analysis of vitamin D levels before and during therapy together with single nucleotide polymorphisms involved in vitamin D metabolism in the context of other known treatment predictors has been performed. Methods: In a well characterized prospective cohort of 398 genotype 1 infected patients treated with pegylated interferon-α and ribavirin for 24–72 weeks (INDIV-2 study) 25-OH-vitamin D levels and different single nucleotide polymorphisms were analyzed together with known biochemical parameters for a correlation with virologic treatment outcome. Results: Fluctuations of more than 5 (10) ng/ml in 25-OH-vitamin D-levels have been observed in 66 (39) % of patients during the course of antiviral therapy and neither pretreatment nor under treatment 25-OH-vitamin D-levels were associated with treatment outcome. The DHCR7-TT-polymorphism within the 7-dehydrocholesterol-reductase showed a significant association (P = 0.031) to sustained viral response in univariate analysis. Among numerous further parameters analyzed we found that age (OR = 1.028, CI = 1.002–1.056, P = 0.035), cholesterol (OR = 0.983, CI = 0.975–0.991, P<0.001), ferritin (OR = 1.002, CI = 1.000–1.004, P = 0.033), gGT (OR = 1.467, CI = 1.073–2.006, P = 0.016) and IL28B-genotype (OR = 2.442, CI = 1.271–4.695, P = 0.007) constituted the strongest predictors of treatment response. Conclusions: While 25-OH-vitamin D-levels levels show considerable variations during the long-lasting course of antiviral therapy they do not show any significant association to treatment outcome in genotype 1 infected patients.


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|My First Storytime
Event Type: Children's Storytime
Date: 11/21/2013
Start Time: 10:30 AM
End Time: 11:00 AM
For babies and 1s, with a caregiver. Boost your baby's brain power with simple board books, engaging props, fun rhymes, singing and socializing. This class helps to develop enriched language skills, builds an early love of reading, and connects you with your little one. No registration required.Library: Oak Park Public Library Dole Branch
Location: Meeting Room - Dole Branch
Contact: Dole Branch Library
Contact Number: 708.386.9032


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We had our small group meeting recently and the topic was about the life of Jacob and here were the questions that were asked during the discussion, hope you could help shed some light.
If God already choose Jacob to be blessed even before he was born and we all know that everything happens in God's perfect time, why did God still chose to wrestle with Jacob so He can repent and be able to bless him?
When Jacob do not want to let go of God until after the "wrestling" for He was asking God to bless him first before God leaves, did God gave in? Did he blessed Jacob so he would just let God go?
If God showed himself to Jacob, how come there it didn't become a big deal? meaning is there any written article the tackles about it even more?
Sorry for the questions, these are the questions that lingered in the mind of a friend which I do not know how to properly address it.
Please help. God bless.


text: The Element Baseball T-Shirt features Element detailing throughout. Constructed of 100% organic cotton, making this tee an eco friendly pick. Seamless graphic tag at neck. Available in colorways as seen below. Men's sizes: SM (34-36), MD (38-40), LG (42-44), XL (46-48) unless otherwise noted. Skate Warehouse shows all colors that we have in stock. In rare cases the logo or the color pictured may be slightly different than what is shipped. Model wears a medium.


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It's time to renew old friendships and make new ones as the Cedar Key School gears up for its homecoming activities.
A parade at 4:30 p.m. Thursday, Jan. 22 gets things underway. All parade participants will line up along G Street at 3:30 p.m.
Everyone is invited to participate – residents, businesses, civic groups – because organizers say the bigger the better.
Manatee deaths appear to be down last year compared to the record numbers reported by state officials in 2013.
As of December, 2014, 368 manatee deaths were reported for the year by the Florida Fish and Wildlife Conservation Commission. One-hundred-twenty-five of those deaths were labeled as undetermined. Manatee infant deaths accounted for 99 mortalities. Sixty-seven were the result of collisions with watercraft. Twenty-six were attributed to natural causes and 24 died due to cold stress.
Unemployment rate was 7.1 percent in November,
The Supervisor of Elections office removed a mailbox from its lawn after the Florida Secretary of State said ballots can only be received in the supervisor's office.
County workers got a 2 percent pay increase that was back dated to Oct. 1, 2013. That was on top of a 3 percent increase they received 7 months earlier.
Monroe Crossing will hold a benefit for Cedar Key School at 7 p.m. Jan. 14 at the school, Whiddon Avenue.
Pepper busters Daniel Barrand, Richard Baker, Kit Lane, Roger McDaniels and Milli Chapell spent their holidays eradicating the colorful Brazilian pepper plant from the area. This hardy foreigner has come into the state and is considered an invasive plant as birds eat and spread its red berries.
The Cedar Key Commission is considering adopting a purchasing policy ― one that would set standards for buying, bidding and preference standards for local businesses.
Commissioner Royce Nelson said he got with City Attorney Norm Fugate to discuss a possible ordinance and Fugate provided him with a copy of an ordinance used by the City of Chiefland and he would like the commission to look it over.
A big push for ecotourism has led the state and local tourism officials to develop paddling trails that allow canoers, kayakers and paddleboarders to circumnavigate the state.
But if you are looking for a map telling you how to pass through Levy County on the Big Bend Saltwater Paddling Trail (BBSPT) on the state Fish and Wildlife Conservation Service website or in its publications, the trail through Levy County is not to be found.
Decisions have been made on how to handle construction and the re-routing of traffic for the two Gulf Boulevard bridge replacements at Daughtry Bayou and Lewis Pass, but a solution that will make everyone happy on the C Street bridge work is more elusive.
By MARK SCOHIER
and ASHLEY THORNTON
An anonymous person with a big heart — and pocketbook — made a stop in the Chiefland Walmart Monday and paid for about $51,000 worth of merchandise that shoppers had put on layaway in previous weeks.
"It's a good thing. It's a great act of kindness," Walmart Co-Manager Jason Ashley said.
Monday was the last day to pick up layaway items.
Copyright © 2015
The Cedar Key Beacon is your source for local news, sports, events, and information in Levy County and Cedar Key Florida, and the surrounding area.


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In a desperate mission to stop the Romulan ship, Narada, from destroying Earth, the Enterprise follows the Narada and hides undetected in Titan's magnetic field. Spock and Kirk secretly beam aboard the Narada to recover the red matter, a black hole creation device. As planned, Spock finds the red matter inside the Jellyfish, a captured Vulcan ship.
Spock commandeers the Jellyfish and blasts into warp with the Narada in hot pursuit. The ships drop out of warp, and the Jellyfish turns to collide with the Narada. The Narada fires missiles at Spock, even though the Jellyfish still has the red matter aboard. The Enterprise arrives suddenly and destroys the Romulan missiles in flight, allowing Spock to escape unharmed.
Scotty beams Kirk and Spock back to the Enterprise, right before the Jellyfish collides with the Narada and explodes. The explosion of the Jellyfish releases the entire stockpile of red matter, creating a black hole that swallows the Narada.
The gravitational pull of the black hole tugs on the Enterprise, keeping it from escaping, even with its engines at warp speed. The pressure heavily damages the ship as Kirk orders Scotty to get them out of there at all costs. Scotty ejects the warp core and detonates it near the black hole, pushing the Enterprise to safety.
Example of a MultiWay Xtra™ payout:
This following diagram shows a sample reel outcome, focusing only on the Spock symbol. Because there is at least one Spock symbol in each of the first four columns, the player has won the 4 Spock MultiWay Xtra™ award which pays 50 coins per way. To determine the payout for this combination, count the number of Spock symbols in each column. For example, the second column has 2 Wild symbols in it, and the third column has 3 Wild symbols in it. In both cases, Wild symbols substitute for the Spock symbol. Next, multiply those counts together to obtain the number of winning ways. In this example, that would be 1 x 2 x 3 x 1 = 6 winning ways. Finally, multiply the number of winning ways times the payout for the 4 Spock MultiWay Xtra™ award. In this example, that would be 6 x 50 = 300 coins won. The actual amount won in currency would be based on the coin value.
Payout example: 1 x 2 x 3 x 1 Spocks → 6 winning ways:
|Column 1
|Column 2
|Column 3
|Column 4
|Column 5
Since the game pays right to left as well as left to right, a reel outcome with Spock symbols in the last four columns would pay in a similar way to the above example.
Energizing Wilds Feature
The Energizing Wilds Feature may trigger randomly after any reel spin, except when a Scatter award is won, the Enterprise Defender Bonus is triggered, or one or more Wild symbols are visible on the reels. When the Feature triggers, the Transporter Cursor appears and randomly turns 2 or more reel symbols Wild on the three middle reels, up to a maximum of 5 additional Wild symbols.
Wins paid based on the final reel state only.
Enterprise Defender Bonus
Ready to defend the Enterprise and attain the rank of Captain?
Trigger the Enterprise Defender Bonus by getting five Bonus symbols anywhere on the reels.
Press START BATTLE and defend the Enterprise against incoming Romulan missiles for 45 seconds. Use the cursor to aim the Enterprise weapon which fires automatically. Incoming Romulan missiles may split into a number of Romulan bomblets. Missiles and bomblets damage the Enterprise shields and suspend the Enterprise weapon fire momentarily. If shields are reduced to zero, the shooting ends early. Earn points by destroying missiles and bomblets.
|Romulan missile
|Romulan bomblet
Item Points
Romulan missile 500
Romulan bomblet 100
|Score Needed
Based on earned rank, spin a random wheel for that rank. There are nine wheels total, three wheels per rank. Higher ranked wheels have higher top awards, but every wheel has the same average payback. Press SKIP TO WHEEL to skip the battle and spin a random wheel.
Earn one spin of the chosen wheel. If the first spin lands on a value, this becomes the final award. If the first spin lands on a special feature slice, a second spin is awarded.
|Wheel Description
|Wheel slices can award a second spin with two wheel pointers, two 2X wheel pointers, or two 3X wheel pointers.
|Wheel values are randomly boosted by 7X, 10X, or 15X before the spin.
|Wheel slices can award a second spin with two, three, or four wheel pointers. On the second spin, collect one to nine shields for a special shield award in addition to any other awards indicated by a pointer.
|Wheel slices can award a second spin with two, three, or six wheel pointers.
|Wheel values are randomly boosted by 5X, 7X, or 10X before the spin.
|Land on a shield slice to collect the number of shields on the slice and spin a second time. Win a special shield award based on the number of shields collected (up to eight shields) across both spins. This shield award is paid in addition to any awards indicated by a wheel pointer.
|Wheel slices can award a second spin with two, three, or four wheel pointers.
|Wheel values are randomly boosted by +1000, +2500, or +5000 before the spin.
|Land on a shield slice to collect the number of shields on the slice and spin a second time. Win a special shield award based on the number of shields collected (up to six shields) across both spins. This shield award is paid in addition to any awards indicated by a wheel pointer.
All awards in the Bonus multiplied by the Bonus triggering coin value.
Graphics Quality
Adjust the quality of the graphics to get the optimal animation performance.
• BEST mode - Graphics look best, but performance may suffer.
• HIGH mode (default) - Optimal graphics and performance setting.
• MEDIUM mode - Lower quality but increased performance.
• LOW mode - Degraded graphics, but smoothest animation performance is achieved even on slower computers.
Rules and Additional Information
Misuse and malfunction voids all pays and plays.
MultiWayXtra™ awards pay for the same symbol in any position in adjacent columns.
Same symbol in same column multiplies award.
MultiWay Xtra™ awards pay left to right and right to left.
Only the highest paying MultiWay Xtra™ award for each symbol is paid per spin.
MultiWay Xtra™ awards are multiplied by the coin value.
Wild symbol only appears on reels 2, 3, and 4.
Only the highest scatter pay award is paid. Scatter pays are multiplied by the total bet.
Scatter awards are independent from MultiWay Xtra™ awards and are also added to the total amount paid.
Awards are shown in currency.
Regardless of the bet size, there is an award cap on any single transaction. See the paytable for details. A transaction includes the results of the Bonus plus the outcome which launched the Bonus.
No Federation vessels were disabled or destroyed in the making of this game.
All trademarks are registered trademarks or pending trademarks of IGT and/or its licensors in the U.S. and/or other countries. © 2012 IGT. All rights reserved.
TM CBS Studios Inc. © 2012 Paramount Picture Corporation. STAR TREK and all related marks and logos are marks of CBS Studios Inc. All Rights Reserved.
The theoretical average return to player (RTP) is 92.51 - 95%. This RTP represents the long-term expected payback of the game which has been calculated by an independent testing company.
Malfunction Voids all Pays & Plays.
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New York City's new system of teacher evaluation and development.
We're looking for great teachers, principals, administrators, executives, and more. Join us today.
The renewal report describes the performance of a charter school over the course of its charter on academic achievement, educational environment, financial/organizational viability, and board capacity. Findings from a multi-day site visit conducted at the school are also described in the report. A renewal report answers four critical questions: 1) Is this school an academic success?, 2) Is this school a viable organization?, 3) Is this school in compliance with all applicable laws and regulations?, and 4) What are the school's plans for its next charter term? The report also contains the Chancellor's recommendation on whether or not the school's charter should be renewed, the length for which it should be renewed (up to five years), and any conditions related to the renewal recommendation. This recommendation does not become a finalized decision until it is approved by the New York State Board of Regents.


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NEW YORK — While the Grammy Awards couldn't come close to the freakishly high ratings generated in 2012 because of Whitney Houston's death and Adele's smashing success, this year's show had the second-largest audience for the program since 1993.
The Nielsen company said Monday that music's annual awards show was seen by 28.4 million people Sunday night on CBS.
The Grammys this year were packed with high-powered musical moments and, in its awards, celebrated the industry's diversity rather than overwhelmingly honoring one artist. It also had a few water-cooler moments: Which boyfriend was Taylor Swift specifically dissing in her latest performance of "We Are Never Ever Getting Back Together?" Was Chris Brown flaunting his revived relationship with Rihanna?
The music academy's decision to turn the televised Grammys into more of a showcase than an awards show appears to be bearing fruit, too.
The show's audience was nearly 2 million higher than the 26.7 million who watched in 2011. From 2005 to 2009, the Grammy Awards audience fluctuated from 17 million to 20 million viewers.
Last year, 39.9 million people tuned in to see how the industry would react to Houston's death just before the awards and celebrate the coronation of its hottest star, Adele, who won six Grammys.
This year's show featured the musical return of Justin Timberlake, collaborations honoring Bob Marley and Levon Helm, and performances by the majority of stars up for major awards.
The Grammys far outpaced the Emmys, which had 13.3 million viewers last September for its more traditional awards show, and the Golden Globes, which had 19.7 million viewers in January. The upcoming Oscars usually get more than 30 million viewers.
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We do not edit user submitted statements and we cannot promise that readers will not occasionally find offensive or inaccurate comments posted in the comments area. If you find a comment that is objectionable, please click the X that appears in the upper right corner when you hover over a comment. This will send the comment to Facebook for review. Please be reminded, however, that in accordance with our Terms of Use and federal law, we are under no obligation to remove any third party comments posted on our website. Read our full terms and conditions.


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A suspect has been arrested in the New Year's Eve shooting death of an Aiken man.
Investigators with the Aiken Department of Public Safety have arrested Jamar Nicholas White of Aiken on Tuesday for the murder of Joseph Brown, according to Sgt. Jake Mahoney.
White, 28, is charged with murder and possession of a weapon during the commission of a crime.
Brown, 22, was pronounced dead at 4 a.m. on Tuesday at Georgia Health Sciences University in Augusta following an altercation Monday night on the 400 block of Fairfield Street N.E., according to Aiken County Coroner Tim Carlton. Brown was transported to the hospital after receiving multiple gunshot wounds.
Investigators responded to the scene at approximately 9:30 p.m., according to Mahoney, and found Brown had been injured in the apparent shooting incident.
An autopsy is scheduled for today in Newberry.
The Aiken Department of Public Safety was assisted in the investigation by the Aiken County Sheriff's Office and South Carolina Law Enforcement Division.
White is currently being held at the Aiken County detention center.
Notice about comments:
Aiken Standard is pleased to offer readers the enhanced ability to comment on stories. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We ask that you refrain from profanity, hate speech, personal comments and remarks that are off point.
We do not edit user submitted statements and we cannot promise that readers will not occasionally find offensive or inaccurate comments posted in the comments area. If you find a comment that is objectionable, please click the X that appears in the upper right corner when you hover over a comment. This will send the comment to Facebook for review. Please be reminded, however, that in accordance with our Terms of Use and federal law, we are under no obligation to remove any third party comments posted on our website. Read our full terms and conditions.


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10 Great Breakfasts in the East Village
The East Village may be best known these days as a nightlife neighborhood, but it also has breakfast down. And we don't mean brunch: we mean breakfast, available before you go to work on a weekday, something to nourish you rather than just nurse a hangover. More


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OSSIAN — Indian Springs Middle School's wrestling team began its season with an undefeated record.
The Eagles faced New Haven and Norwell Wednesday night in a triple dual, topping Norwell by a decisive 72-15 score and beating New Haven by default.
The Bulldogs only brought seven grapplers.
Picking up wins against New Haven were: A.J. Chapin, Matt Wright, Seth Rosen, Jake Elkins and Jackson Wilcoxson.
Fifteen grapplers picked up wins over Norwell, including Braden Baker, Joe Willson, Jacob Wigent, Drew Rethlake, Jon O'Dell, Hunter Reed, Wright, Rosen, Jamison Brown, Elkins, Wilcoxson, Westin Ottinger, Trevor Fries and Josh Pequignot.
ISMS will be back in action Monday when the Eagles travel to DeKalb.
Two more middle school sports stories can also be found in the Feb. 15 paper:
For a more in-depth look at this story, see the Feb. 15 issue of The Post and Mail. Don't have a subscription? Call (260) 244-5153 or subscribe to our e-edition [1]. For breaking news, sports updates and additional coverage, bookmark the homepage [1] and find us on facebook [1].
[1] http://thepostandmail.com/http


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Quick Links
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Make a statement with this Gold Tone Mesh Bracelet with Lobster Clasp. The bright intricate weaving of this gold mesh really makes you stand out in a crowd and will have everyone asking about it! This gold-plated bracelet measures 7.5 inches long.
Eve's Addiction.com wants you to be a happy customer. We want you to be completely satisfied with the sterling silver jewelry that you receive from us, as we only sell high quality silver and cubic zirconia cz jewelry. We do understand that you may not like your purchase for some reason.
You may return or exchange your jewelry within 60 days of purchase if you are not satisfied with it. The jewelry must be returned in its original condition for a refund or exchange. Engraved, personalized, photo, monogram, name and initial, chocolate and clearance items are not returnable or exchangeable.


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9YR Light / 5YR Med
Conceal and contour. The return of a shu uemura classic: an easy-to-use, double-ended pencil concealer for precise contouring and adjustable finish.
- Soft-blend formula glides smoothly on skin for a natural finish
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The ingredients list may differ. Please refer to the product for the official ingredients list.


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Science Matters
Assistant Administrator Paul Anastas Returns to Yale
EPA's Assistant Administrator for the Office of Research and Development stepped down in mid February.
Paul Anastas, the "Father of Green Chemistry" and EPA Assistant Administrator for the Office of Research and Development, said goodbye on February 16th. After serving EPA for two years, Anastas's departure was marked with sadness. He will return to his family in Connecticut and to his teaching and leadership position at Yale University's Center for Green Chemistry and Green Engineering.
Read about Paul Anastas's tenure as Assistant Administrator here - http://www.eenews.net/public/Greenwire/2011/06/20/4


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"Preferred Choice" - Creative Child Magazine
"Seal of Approval" - Parents' Choice
Chicco Red Bullet helps children quickly learn how to get the balance they need to ride a two-wheeled bike; using the Chicco Red Bullet makes it so easy for kids to start riding a real bicycle with less difficulty.
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Shipping Note: This item ships via FedEx Ground within contiguous United States only. Cannot be shipped to AK/HI, PO boxes, US territories, or APO/FPO addresses.


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Darksiders, Red Faction collections coming this year
But the Red Faction collection isn't coming to Xbox 360 because it doesn't comply with Microsoft's guidelines.
But the Red Faction collection isn't coming to Xbox 360 because it doesn't comply with Microsoft's guidelines.
Alex from XCAR joins Danny on a voyage to Mars where they blow up rocks, shoot fish and sympathise with the plight of the space man.
Court-supervised sale process will see bidding on franchises including Darksiders, Red Faction and licensed software like Marvel Super Hero Squad.
Jason Rohrer, John Romero, and Jenova Chen compete to make a game religion and Chain World is born.
Two-hour telefilm could be pilot for full-fledged series; future installments in game franchise will be developed in cooperation with television network's game arm.
THQ confirms that third installment in its Mars-set, destructible-environment-filled PC, 360, and PS3 shooter will arrive the week after E3.
We test out an early version of the N-Gage version of this sci-fi-themed first-person shooter.
THQ Wireless announces that Monkeystone Games will develop a version of the popular first-person shooter for Nokia's upcoming mobile gaming platform.
Ubi Soft's Dungeons & Dragons role-playing game sequel takes the lead in NPD's latest list of best-selling games.
EA's virtual-life game bounces back into the lead on NPD's latest list of best-selling games.
Greg Kasavin talks about the PC version of the first-person shooter Red Faction in the video review.
THQ gives us a brief update on the status of its upcoming sci-fi shooter.
We've already played through the single-player campaign in earlier builds, but what can you expect out of Red Faction's multiplayer component?
The PC version of Volition's first-person shooter is nearing completion.
THQ has shipped its PlayStation 2 first-person shooter.
Find out what we expect to see of Red Faction for the PC.
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A method of manufacturing a microwave antenna assembly includes the step of providing a proximal portion having an inner conductor and an outer conductor. Each of the inner and outer conductors extend through the proximal portion and the inner conductor is disposed within the outer conductor. The method also includes the step of placing a junction member adjacent to a distal end of the proximal portion such that the inner conductor extends through a channel defined in the junction member. The method also includes the step of placing a proximal end of a distal portion adjacent to a distal end of the junction member such that the inner conductor extends within a channel defined within the distal portion. The method also includes the step of affixing the inner conductor to the distal portion such that the proximal portion and the distal portion apply a compressive force on the junction member.
1. A method of manufacturing a microwave antenna assembly for applying microwave energy therapy, comprising:
providing a proximal portion having an inner conductor and an outer conductor, each extending therethrough, the inner conductor disposed within the outer conductor;
placing a junction member adjacent to a distal end of the proximal portion such that the inner conductor extends through a channel defined in the junction member;
placing a proximal end of a distal portion adjacent to a distal end of the junction member such that the inner conductor extends within a channel defined within the distal portion;
heating the inner conductor; and
affixing the inner conductor to the distal portion such that the proximal portion and the distal portion apply a compressive force on at least a portion of the junction member, wherein affixing the inner conductor to the distal portion comprises a method selected from the group consisting of welding, brazing, and soldering the inner conductor to the distal portion.
2. The method of
3. The method of
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5. The method of
6. The method of
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11. The method of
This application is a divisional of U.S. application Ser. No. 10/961,761, filed Oct. 7, 2004, now U.S. Pat. No. 7,318,824 which is a divisional of U.S. application Ser. No. 10/052,848, filed Nov. 2, 2001, now U.S. Pat. No. 6,878,147, the contents of which are each hereby incorporated by reference into the present disclosure.
The invention relates generally to microwave antenna probes which may be used in tissue ablation applications. More particularly, the invention relates to microwave antennas which may be inserted directly into tissue for diagnosis and treatment of diseases.
In the treatment of diseases such as cancer, certain types of cancer cells have been found to denature at elevated temperatures which are slightly lower than temperatures normally injurious to healthy cells. These types of treatments, known generally as hyperthermia therapy, typically utilize electromagnetic radiation to heat diseased cells to temperatures above 41� C. while maintaining adjacent healthy cells at lower temperatures where irreversible cell destruction will not occur. Other procedures utilizing electromagnetic radiation to heat tissue also include ablation and coagulation of the tissue. Such microwave ablation procedures, e.g., such as those performed for menorrhagia, are typically done to ablate and coagulate the targeted tissue to denature or kill it. Many procedures and types of devices utilizing electromagnetic radiation therapy are known in the art. Such microwave therapy is typically used in the treatment of tissue and organs such as the prostate, heart, and liver.
One non-invasive procedure generally involves the treatment of tissue (e.g., a tumor) underlying the skin via the use of microwave energy. The microwave energy is able to non-invasively penetrate the skin to reach the underlying tissue. However, this non-invasive procedure may result in the unwanted heating of healthy tissue. Thus, the non-invasive use of microwave energy requires a great deal of control. This is partly why a more direct and precise method of applying microwave radiation has been sought.
Presently, there are several types of microwave probes in use, e.g., monopole, dipole, and helical. One type is a monopole antenna probe, which consists of a single, elongated microwave conductor exposed at the end of the probe. The probe is sometimes surrounded by a dielectric sleeve. The second type of microwave probe commonly used is a dipole antenna, which consists of a coaxial construction having an inner conductor and an outer conductor with a dielectric separating a portion of the inner conductor and a portion of the outer conductor. In the monopole and dipole antenna probe, microwave energy generally radiates perpendicularly from the axis of the conductor.
The typical microwave antenna has a long, thin inner conductor which extends along the axis of the probe and is surrounded by a dielectric material and is further surrounded by an outer conductor around the dielectric material such that the outer conductor also extends along the axis of the probe. In another variation of the probe which provides for effective outward radiation of energy or heating, a portion or portions of the outer conductor can be selectively removed. This type of construction is typically referred to as a "leaky waveguide" or "leaky coaxial" antenna. Another variation on the microwave probe involves having the tip formed in a uniform spiral pattern, such as a helix, to provide the necessary configuration for effective radiation. This variation can be used to direct energy in a particular direction, e.g., perpendicular to the axis, in a forward direction (i.e., towards the distal end of the antenna), or a combination thereof.
Invasive procedures and devices have been developed in which a microwave antenna probe may be either inserted directly into a point of treatment via a normal body orifice or percutaneously inserted. Such invasive procedures and devices potentially provide better temperature control of the tissue being treated. Because of the small difference between the temperature required for denaturing malignant cells and the temperature injurious to healthy cells, a known heating pattern and predictable temperature control is important so that heating is confined to the tissue to be treated. For instance, hyperthermia treatment at the threshold temperature of about 41.5� C. generally has little effect on most malignant growths of cells. However, at slightly elevated temperatures above the approximate range of 43� C. to 45� C., thermal damage to most types of normal cells is routinely observed; accordingly, great care must be taken not to exceed these temperatures in healthy tissue.
However, many types of malignancies are difficult to reach and treat using non-invasive techniques or by using invasive antenna probes designed to be inserted into a normal body orifice, i.e., a body opening which is easily accessible. These types of conventional probes may be more flexible and may also avoid the need to separately sterilize the probe; however, they are structurally weak and typically require the use of an introducer or catheter to gain access to within the body. Moreover, the addition of introducers and catheters necessarily increase the diameter of the incision or access opening into the body thereby making the use of such probes more invasive and further increasing the probability of any complications that may arise.
Structurally stronger invasive probes exist and are typically long, narrow, needle-like antenna probes which may be inserted directly into the body tissue to directly access a site of a tumor or other malignancy. Such rigid probes generally have small diameters which aid not only in ease of use but also reduce the resulting trauma to the patient. A convenience of rigid antenna probes capable of direct insertion into tissue is that the probes may also allow for alternate additional uses given different situations. However, such rigid, needle-like probes commonly experience difficulties in failing to provide uniform patterns of radiated energy, they fail to provide uniform heating axially along and radially around an effective length of the probe; and it is difficult to otherwise control and direct the heating pattern when using such probes.
Accordingly, there remains a need for a microwave antenna probe which overcomes the problems discussed above. There also exists a need for a microwave antenna probe which is structurally robust enough for direct insertion into tissue without the need for additional introducers or catheters and which produces a controllable and predictable heating pattern.
A microwave antenna assembly which is structurally robust enough for unaided direct insertion into tissue is described herein. The microwave antenna assembly is generally comprised of a radiating portion which may be connected to a feedline (or shaft) which in turn may be connected by a cable to a power generating source such as a generator. The microwave assembly may be a monopole microwave antenna assembly but is preferably a dipole assembly. The distal portion of the radiating portion preferably has a tapered end which terminates at a tip to allow for the direct insertion into tissue with minimal resistance. The proximal portion is located proximally of the distal portion, and a junction member is preferably located between both portions.
The adequate rigidity necessary for unaided direct insertion of the antenna assembly into tissue, e.g., percutaneously, preferably comes in part by a variety of different methods. Some of the methods include assembling the antenna under a pre-stressed condition prior to insertion into tissue. This may be accomplished in part by forcing an inner conductor, which runs longitudinally through the assembly, into a tensile condition by preferably affixing the inner conductor distal end to the distal radiating portion of the antenna assembly. Another method includes configuring the proximal and distal radiating portions of the antenna to mechanically fasten to each other. That is, the proximal and distal radiating portions may be configured to "screw" into one another directly or to a junction member located between the two portions and which is threaded such that the portions each screw onto the junction member separately.
Another method includes attaching the proximal and distal radiating portions together by creating overlapping or interfitting joints. In this variation, either the proximal or the distal radiating portion may be configured to create an overlapping joint by interfitting with each other through a variety of joints. For instance, the distal portion may be configured to intimately fit within a receiving cavity or channel at the distal end of the proximal portion. The two portions may also be configured to have a number of pins or conical members extending to join the two. Alternatively, the two portions may be frictionally interfitted by an interference fitted joint; or depressible/retractable projections may be disposed on either portion to interfit with corresponding depressions in the opposite portion.
To further aid in strengthening the antenna assemblies, a variety of methods may also be used for attaching the tip or distal portion. For instance, a variation may have a distal portion which may screw onto a threaded inner conductor or another variation may have an inner conductor having an anchoring element capable of holding the inner conductor within a splittable distal portion. Furthermore, a multi-sectioned distal portion may also be utilized for first attaching an inner conductor to the distal portion and then assembling the distal portion with additional variable sections. In many of the variations described herein, it may be preferable to have a dielectric material applied as a layer or coating between the two radiating portions.
Affixing the inner conductor within the distal radiating portion may be accomplished in a variety of ways, for instance, welding, brazing, soldering, or through the use of adhesives. Forcing the inner conductor into a tensile condition helps to force the outer diameter of the antenna into a compressive state. This bi-directional stress state in turn aids in rigidizing the antenna assembly.
To enable a compressive state to exist near the outer diameter, the junction member between the distal and the proximal radiating portions in some of the variations is preferably made from a sufficiently hard dielectric material, e.g., ceramic materials. The hardness of the junction member aids in transferring the compressive forces through the antenna assembly without buckling or kinking during antenna insertion into tissue. Furthermore, materials such as ceramic generally have mechanical properties where fracturing or cracking in the material is more likely to occur under tensile loading conditions. Accordingly, placing a junction under pre-stressed conditions, particularly a junction made of ceramic, may aid in preventing mechanical failure of the junction if the antenna were to incur bending moments during insertion into tissue which could subject portions of the junction under tensile loads. The junction member may also be made into uniform or non-uniform, e.g., stepped, shapes to accommodate varying antenna assembly designs.
Moreover, to improve the energy focus of an antenna assembly, an electrical choke may also be used in any of the variations described herein to contain returning currents to the distal end of the antenna assembly. Generally, the choke may be disposed on top of a dielectric material on the antenna proximally of the radiating section. The choke is preferably comprised of a conductive layer and may be further covered by a tubing or coating to force the conductive layer to conform to the underlying antenna.
Additionally, variations on the choke, the tubing or coating, any sealant layers, as well as other layers which may be disposed over the antenna assembly may be used. Certain layers, e.g., a heatshrink layer disposed over the antenna assembly, may have wires or strands integrated within the layer to further strengthen the antenna assembly. Kevlar wires, for instances, may be integrally formed into the layer and oriented longitudinally with the antenna axis to provide additional strength.
In invasively treating diseased areas of tissue in a patient, trauma may be caused to the patient resulting in pain and other complications. Various microwave antenna assemblies, as described herein, are less traumatic than devices currently available and as described in further detail below, methods of manufacturing such devices are also described. Generally, an apparatus of the present invention allows for the direct insertion of a microwave antenna into tissue for the purposes of diagnosis and treatment of disease.
In some applications a microwave antenna requires adequate structural strength to prevent bending of the antenna, e.g., where the antenna is directly inserted into tissue, where the antenna undergoes bending moments after insertion, etc. Accordingly, there are various configurations to increase the antenna strength without compromising desirable radiative properties and the manufacturability of such an antenna. One configuration involves placing the antenna assembly under a compressive load to stiffen the radiating portions. Another configuration involves mechanically fastening, e.g., in a screw-like manner, the radiating portions together to provide a joint which will withstand bending moments. A further configuration may also involve creating overlapping joints between the radiating portions of the antenna assembly to provide a high-strength antenna. Furthermore, alternate configurations of attaching a distal tip or distal radiating portion to an antenna may be utilized to further increase the antenna strength.
Antenna Assembly Via Compression
Generally, the antenna assembly 10 in
Feedline 14 may electrically connect antenna assembly 10 via cable 15 to generator 28 and usually comprises a coaxial cable made of a conductive metal which may be semi-rigid or flexible. Feedline 14 may also have a variable length from a proximal end of radiating portion 12 to a distal end of cable 15 ranging between about 1 to 10 inches. Most feedlines may be constructed of copper, gold, or other conductive metals with similar conductivity values, but feedline 14 is preferably made of stainless steel. The metals may also be plated with other materials, e.g., other conductive materials, to improve their properties, e.g., to improve conductivity or decrease energy loss, etc. A feedline 14, such as one made of stainless steel, preferably has an impedance of about 50Ω and to improve its conductivity, the stainless steel may be coated with a layer of a conductive material such as copper or gold. Although stainless steel may not offer the same conductivity as other metals, it does offer strength required to puncture tissue and/or skin.
In operation, microwave energy having a wavelength, λ, is transmitted through antenna assembly 30 along both proximal and distal radiating portions 36, 38. This energy is then radiated into the surrounding medium, e.g., tissue. The length of the antenna for efficient radiation may be dependent at least on the effective wavelength, λeff, which is dependent upon the dielectric properties of the medium being radiated into. Energy from the antenna assembly 30 radiates and the surrounding medium is subsequently heated. An antenna assembly 30 through which microwave energy is transmitted at a wavelength, λ, may have differing effective wavelengths, λeff, depending upon the surrounding medium, e.g., liver tissue, as opposed to, e.g., breast tissue. Also affecting the effective wavelength, λeff, are coatings which may be disposed over antenna assembly 30, as discussed further below.
The compression load is preferably first created by feeding distal portion 48 over inner conductor 44 until junction member 62 is under compression, then inner conductor 44 is preferably affixed to distal portion 48 to maintain the compression load on junction member 62. Some clearance may be necessary between junction member 62 and inner conductor 44 to avoid any interference resistance between the two. Inner conductor 44 may be affixed to distal portion 48 along interface 72 by a variety of methods, such as welding, brazing, soldering, or by use of adhesives. The compression loading occurs such that while inner conductor 44 is placed under tension along direction 76, distal portion 48 places the outer portions of junction member 62 under compression along directions 74. Inner conductor 44 may be heated prior to affixing it to distal portion 48 by any number of methods because heating inner conductor 44 may expand the conductor in a longitudinal direction (depending upon the coefficient of thermal expansion of the inner conductor 44).
For example, heating inner conductor 44 may be accomplished during the welding or soldering procedure. Upon cooling, inner conductor 44 may contract accordingly and impart a tensile force upon the conductor 44 while simultaneously pulling junction member 62 into compression. To allow the compression loading to transfer efficiently through assembly 70, junction member 62 is preferably made of a dielectric material which has a sufficiently high compressive strength and high elastic modulus, i.e., resistant to elastic or plastic deformation under a compression load. Therefore, junction member 62 is preferably made from materials such as ceramics, e.g., Al2O3, Boron Nitride, stabilized Zirconia, etc. Alternatively, a junction member 62 made of a metal and sufficiently coated with a dielectric or polymer may be used, provided the dielectric coating is sufficiently thick to provide adequate insulation. To prevent energy from conducting directly into the tissue during use, a dielectric layer having a thickness between about 0.0001 to 0.003 inches, may be coated directly over antenna assembly 70. The dielectric coating may increase the radiated energy and is preferably made from a ceramic material, such as Al2O3, TiO2, etc., and may also be optionally further coated with a lubricious material such as Teflon, polytetrafluoroethylene (PTFE), or fluorinated ethylene propylene (FEP), etc. In addition to the dielectric coating, a sealant layer may also be coated either directly over the antenna assembly 70, or preferably over the dielectric layer to provide a lubricious surface for facilitating insertion into a patient as well as to prevent tissue from sticking to the antenna assembly 70. The sealant layer may be any variety of polymer, but is preferably a thermoplastic polymer and may have a thickness varying from a few angstroms to as thick as necessary for the application at hand. Varying these coating thicknesses over antenna assembly 70 may vary the effective wavelengths, λeff, of the radiation being transmitted by the antenna. Thus, one may vary the coating thicknesses over the assembly 70 to achieve a predetermined effective wavelength depending upon the desired results.
The location of tip 98 may be proportional to a distance of λ/4 of the radiation being transmitted through assembly 80, but because tip 98 terminates at tapered end 96, the angled surface of taper 96 may be taken into account. Thus, the total distance along the outer surfaces of assembly 80 from B to C plus the distance from C to D may accord to the distance of λ/4. The length of proximal radiating portion 82, i.e., the distance along the outer surface of assembly 80 from A to B, may also accord to the distance of λ/4, as above. Although it is preferable to have the length of the radiating portion of the antenna accord with a distance of the wavelength, λ, it is not necessary for operation of the device, as described above. That is, an antenna assembly having a radiating portion with a length in accordance with a first wavelength may generally still be used for transmitting radiation having a second wavelength, or third wavelength, or so on, although with a possible reduction in efficiency.
In addition to stepped junction member 102,
However, having channel 122 extend from the distal tip 124 to inner conductor 112 may limit the sharpness of tip 124. Accordingly, variation 130 in
While most of the variations described above are related to dipole antenna assemblies,
To improve the energy focus of an antenna assembly, an electrical choke may also be used to contain returning currents to the distal end of the antenna. Generally, the choke may be disposed on the antenna proximally of the radiating section. The choke is preferably placed over a dielectric material which may be disposed over the antenna. The choke is preferably a conductive layer and may be further covered by a tubing or coating to force the conductive layer to conform to the underlying antenna, thereby forcing an electrical connection (or short) more distally and closer to the radiating section. The electrical connection between the choke and the underlying antenna may also be achieved by other connection methods such as soldering, welding, brazing, crimping, use of conductive adhesives, etc. The following description is directed towards the use of a choke on a compression antenna variation for illustration purposes only; however, the choke may also be used with any of the antenna variations described below.
Variation 160 illustrates electrical contact between conductive layer 224 and outer conductor 196 in detail 178 occurring at the proximal location of electrical choke portion 170, but choke 172 may be formed without forcing contact between outer conductor 196 with layer 224 provided the length of choke 172 is chosen appropriately. For instance, choke 172 having a sufficiently long length, e.g., a length of λ/2, may be used without having to force contact between the layers. Outer dielectric layer 226 may be disposed upon conductive layer 224. Outer dielectric layer 226 may also be made of any of the various polymers as described above and is preferably a heat shrinkable layer that may force conductive layer 224 to conform more closely to the underlying layers to not only force a better electrical connection, but also to reduce the overall diameter of the antenna section.
Further steps may optionally be taken to further increase the strength of an antenna assembly by altering any of the layers, such as sealant layer 210 or any of the other heatshrink layers discussed above.
Antenna Assembly Via Mechanical Fastening
Aside from using a compressive load to increase antenna strength, as described above, alternative methods may be employed for increasing antenna strength to withstand direct insertion into tissue. An alternative variation may include assembling an antenna using mechanical fastening methods.
Junction member 246 is preferably comprised of any of the dielectric materials as described above. Alternatively, a dielectric coating or layer may also be applied to the inside of channels 248, 260 which contacts junction member 246. First and second mating sections 252, 254 may be threaded 256, 258, respectively, such that the thread pitch on each section 252, 254 is opposed to each other, i.e., the pitch angle of threading 256 may be opposite to the pitch angle of threading 258. Alternatively, the thread pitch on each section 252, 254 may be configured to be angled similarly for ease of antenna assembly. Proximal portion 242 may have a receiving cavity or channel 248 which is threaded 250 at a predetermined pitch to correspond to the pitch and angle of the threading 256 on first mating section 252. Likewise, distal portion 244 may have a receiving cavity or channel 260 which is threaded 262 at a predetermined pitch to correspond to the pitch and angle of the threading 258 on second mating section 254. Having opposed pitch angles may be done to ensure a secure fit or joint when variation 240 is assembled by screwing proximal portion 242 and distal portion 244 together onto junction member 246.
A further screw-on variation 270 is shown in
Antenna Assembly Via Overlap
Another variation on assembling an antenna is by use of overlapping or interfitting joints to attach proximal and distal portions together.
Another variation is shown in distal portion 352 where rather than having a conical interfitting member, separate pins or dowels 360 may be used to extend into receiving channels 356′ of proximal portion 354′. These pins 360 may be integral with distal portion 352 or they may be separate members inserted and held in distal portion 352; in either case, pins 360 are preferably made of a hard dielectric material or a metal sufficiently coated with a dielectric material for insulation. As seen in
Alternate Methods of Tip or Distal Portion Attachment
Aside from various methods of assembling microwave antennas, there are also a variety of methods for attaching the tip or distal radiating portion to a remainder of the assembly. The various methods described below may be used in any of the assembly variations discussed herein depending upon the desired antenna assembly characteristics.
Another variation for attaching the distal portion is shown in
To further aid in tip or distal portion attachment to the antenna assembly, various distal portions may be used to facilitate assembly and use in a patient. As previously described, the distal tip is preferably tapered and terminates at a tip to facilitate antenna insertion into tissue with minimal resistance. Also, attaching the inner conductor to the distal portion may be facilitated by an access channel defined in the distal portion so that the inner conductor may be attached by welding, soldering, etc. within the distal portion. To further facilitate this assembly process, the distal tip may be formed into an arcuate or curved face terminating into a tip, as seen in
Alternate Distal Portion Attachments
As discussed above, the energy with a wavelength, λ, is transmitted down a microwave antenna and is subsequently radiated into the surrounding medium. In operation, microwave energy having a wavelength, λ, is transmitted through the antenna assembly along both proximal and distal radiating portions. This energy is then radiated into the surrounding medium. The length of the antenna for efficient radiation may be dependent at least on the effective wavelength, λeff, which is dependent upon the dielectric properties of the medium being radiated into. Energy having the effective wavelength radiates and the surrounding medium is subsequently heated. An antenna assembly through which microwave energy is transmitted at a wavelength, λ, may have differing effective wavelengths, λeff, depending upon whether the energy is radiated into, e.g., liver tissue, as opposed to, e.g., breast tissue. Also affecting the effective wavelength, λeff, are coatings which may be disposed over the antenna assembly.
Accordingly, various distal portions having varying diameters are shown in
The applications of the antenna assemblies and methods of making the assemblies discussed above are not limited to microwave antennas used for hyperthermic, ablation, and coagulation treatments but may include any number of further microwave antenna applications. Modification of the above-described assemblies and methods for carrying out the invention, and variations of aspects of the invention that are obvious to those of skill in the art are intended to be within the scope of the claims.
Patent Citations
Non-Patent Citations
Referenced by
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About This Book
- LINQ to Objects
- LINQ to XML
- LINQ to SQL
- LINQ to DataSets
- LINQ to XSD
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This book is for .NET developers who want to find out exactly what LINQ is, what it can do for them, and how to program with LINQ.
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Table of Contents
What You Will Learn
- Overview of new features for LINQ in .NET 3.0—partial methods, expressions, anonymous types, initializers, and implicitly typed local variables
- Accessing in-memory data structures using LINQ—lists, arrays, and dictionaries
- Directly querying the collections and filtering the required values without using powerful filtering, ordering, and grouping capabilities
- Creating and manipulating XML data through .NET using XElement and XAttribute
- Creating and navigating XML trees using Functional Construction
- Importing and exporting data from dictionaries, databases, objects, and CSV files
- Creating and manipulating the database objects using the DataContext object
- Working with stored procedures, user-defined functions, handling concurrency conflicts, and transactions during database updates
- Working with .NET framework data providers and DataSets
- Using DataSet for easier and faster querying of cached data
- Working with typed and un-typed XML trees using XSD
- Examining standard query operators provided by LINQ and using them to query data sources
- Implementing your own standard query operators
- Building an ASP.NET web application
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Chapter 7 looks at standard query operators provided by LINQ, and how you can use some of them against different data sources.
In Detail
This book gets you started with LINQ and shows how it will make your programming life easier by making use of new features from the .NET Framework 3.0. This book is split into seven chapters, each of which is dedicated to presenting a feature of LINQ and its usage in real-life scenarios.
Language Integrated Query (LINQ) is a new feature in Visual Studio 2008 that extends its query capabilities, using C# and Visual Basic. Visual Studio 2008 comes with
LINQ provider assemblies that enable the use of LINQ with data sources such as in-memory collections, SQL relational databases, ADO.NET Datasets, XML documents, etc.
In Visual Studio 2008, Visual C# and Visual Basic are the languages that implement the LINQ language extensions. LINQ language extensions use the new standard query operators API, which is the query language for any collection that implements IEnumerable<T>.


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Houston Section Meeting
Date: Wednesday, October 9, 2013
Title/Topic: Value Engineering Using Super-Additive Packages Nanomanufactuered for Advanced Lubrication in the Oil and Gas Industry
Presenter: Dr. Ajay P. Malshe is the Founder and Cheif Technology Officer of NanoMech Inc. NanoMech Inc. is a materials sciences company equipped with a nanomanufacturing factory enabling four divisions to introduce an array of products.
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Brady's Landing Restaurant
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11:00a.m. - 11:30 a.m. Arrival / Social
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Boone County 'Trick-or-Treat' times announced
Boone County 'Trick-or-Treat' is scheduled for Tuesday, Oct. 30, from 5 to 7 p.m., according to the Boone County Sheriff's Office.
Wharton Elementary School Harvest Day
Wharton Elementary School Harvest Day is Nov. 9, from 9:30 a.m. to 3 p.m.
Everyone is welcome to attend. Apple Butter will be made by the Gordon Union Church Prices are: pints $5 or quarts $8. Proceeds go to the school.
Van Elementary School Fall Festival
Van Elementary School Fall Festival/ Kids Carnival/Bazar will be held on Nov. 10, from 10 a.m. to 2 p.m.
Rented table space is $10 and Tarp/Tent space is $20 (bring your own). Great for small business, crafters and yard salers. Make checks payable to VES PTO. You can mail the payment to VES PTO, P.O. Box 360, Van, WV 25206.
We will have door prizes, cake walk, Van Fire Dept., Gordon Union Church will be demonstrating how to make Apple Butter and it will be for sale and many more fun things for your family to enjoy! Reserve your table or space today.
Contact Kimberly Jarrell 304-245-8811, Misty Price 304-245-8175 or Kelli Pauley 304-369-0140 for more information.
Neighborhood Watch Meeting
Neighborhood Watch Meeting for the Ashford-Nellis-Ridgeview-Costa area for October 23, 6PM at Nellis Archives Building.
Boone Madison Public Library meeting
The Boone Madison Public Library will have its Board of Directors meeting Thursday, Oct. 18, at 5:30 p.m. at the library. Meetings are open to the public.
Boone County Chapter AARP
The Boone County Chapter of the AARP will meet Tuesday, Nov. 6, at 1 p.m. at Black Diamond Arbors. Ms. Leah Comis, Phard D Candidate WVU School of Pharmacy will be the guest speaker. Following the meeting, there will be a "Pig-In-A-Poke" sale. All members are asked to bring several items for the sale.
BCARSE meeting
The Boone County Association of Retired School Employees (B.C.A.R.S.E.) will meet Wednesday, Nov. 14, at 10 a.m. at Park Avenue Restaurant in Danville.
Betty Grubbs will present the Devotional. All military veterans will be recognized. The newly elected WVARSE President John Riddle will be present and door prizes will be given.
Our elected Legislative representatives will present the program. A question and answer time will follow. Mrs. Jenny Light, president, encourages all members to attend this meeting.
Sherman Community Bazaar
November 10, 2012 at Sherman High Gymnasium and it is open to the Public from 9 a.m. to 2 p.m. Sherman High School Student Council is raising money for our annual community Christmas dinner and also for our honor banquet.
We are looking for vendors for our community bazaar. The bazaar will be made up of businesses as well as people from the community. We are looking for people interested in setting up tables for an indoor yard sale.
We are also interested in setting up booths for businesses such as, Thirty-one, Sabika, Avon, Mary Kay, Photography, Pharmacy, Child Gyms, Arts and Craft vendors etc. Local businesses are also welcome to set up tables.
Tables start at $10 in advance and $15 at the door. If you are interested in a table, with electricity they are $30. Sherman High School is going to have a concession stand.
If you are interested please contact Regina Larkin at Sherman High School at 304-837-3301 or email at email@example.com
Danville/Madison Kiwanis Club
The Danville/Madison Kiwanis Club would like to open the membership doors for membership to the Kiwanis Club. The Kiwanis Club is over 100 years old and has members from all around the world. The members of the Kiwanis club take their club seriously making a difference in one child one community at a time. The Kiwanis Club does all that it can for its citizens and children that live within the community, Kiwanis Club works with other Civic Organizations. Everyone benefits from membership in the Kiwanis Club. Service Leadership programs, such as Circle K for College students, Key Club for High Schoolers, Builders Club for the middle school, and K-Kids for Elementary students, are some of the things. The members are made up of citizens within the community that want to make a difference in their community. If you would like to become a member of the Danville/Madison Kiwanis come on down on Wednesday evenings at the Coffee Connection on Main Street in Madison. The meeting starts at 6:30 p.m. and we would love to see you there.
What: Secret Santa Applications
End: November 2, 2012
Where: Boone County Community Organization, 347 Kenmore Drive, Lick Creek Road (Behind the Health Department)
Phone: 304-369-0451
Time: 9 a.m. until 3 p.m.
The age limit for Secret Santa is children 12 and under. If you receive food stamps you automatically qualify but must bring your food stamp card with you. If you don't receive food stamps you must bring in proof of all household income and do the monthly expenses to see if you qualify based on household size. You also need Social Security numbers for all household members.
ACT Exam
On Saturday, October 27, 2012, at 8 a.m. the will be an ACT Exam. There will be study session for ACT (Mathematics) on Monday, Oct. 22 and Thursday, Oct. 25 in the afternoon at the Boone County Honors Academy. Bring your calculator and students are to sign up with their counselors or principals.
Essay contests
The Daniel Boone Veterans of Foreign Wars Post 5578 and its Ladies Auxiliary are sponsoring two essay contests. The Voice of Democracy Contest is a typed and audio essay. This year's theme is: "Is Our Constitution Still Relevant?" The contest is open to students in grades 9-12, home schooled students are also eligible. Deadline is Nov 1, 2012—-The Patriot's Pen Essay is a contest open to students in grades 6-8. Also open to home schooled students. This is an essay of 300 to 400 words. This year's theme is: "What I would Tell America's Founding Fathers" Deadline for the contest is Nov. 1, 2012. All entry forms are in the schools and are also available in PDF form on the VFW Ladies Web site. For more information call: 304-836-5124 or 304-369-4318.
Veteran's Memorial
Madison VFW Post 5578 is building a Veteran's Memorial to honor mothers of veterans and veterans. Purchase a brick for $50. Call 304-369-6248 or mail to Daniel Boone VFW Post 5578 Attn: Memorial Fund, P.O. Box 272, Madison, WV 25130. Post 5578 is constructing a Veteran Memorial to honor the mothers' of Veterans and Veterans. A Brick Campaign lets you send a special tribute, inspiring message or create a permanent legacy of caring.
Coat Drive
Do you have coats that you don't need anymore? Donate them!
Winter is here and there are people in our community who could use a nice warm coat. Between now and Nov. 5, there will be a box available for you to donate your gently-used coats. They will be going to BC Residents/Union Mission, which is in desperate need of coats. You can drop the coats off at the Town of Danville Community Center! Please only donate clean, reusable coats! If you have any questions, please contact Josh Barker at 304-369-7050.
Dislocated miners can acquire grants
Some dislocated miners and family members affected by a coal mining layoff may be eligible to receive up to $5,000 for classroom training in a high-demand occupation.
To qualify, coal miners and family members must have been affected by a layoff after March 1 that was covered by a notice issued under the federal Worker Adjustment and Retraining Notification, or WARN, act.
This includes workers at Long Branch Energy, Pine Ridge Coal, Alpha Natural Resources/Black Castle Mining, Alpha Natural Resources/Progress Coal Co., Alpha Natural Resources/Marfork Coal Co., Hobet Mining LLC, ICG Eastern, LLC/Arch Coal, Fola Coal Co., Little Eagle Coal Co., and Patriot Coal/Mountain Edge Mining.
WorkForce West Virginia will provide information about the grant opportunities this week at informational sessions in Montgomery and Ghent.
The Montgomery session will be from 2 p.m. to 7 p.m. Wednesday at Bridgemont Community and Technical College. The Ghent session will be from 2 p.m. to 7 p.m. at New River Community and Technical College.
Information also is available by calling the United Mine Workers of America Career Center in Beckley at 304-253-3772 or 1-877-798-8692.
In addition, information is posted online at www.wvcommerce.org/business/workforcewv/public_notices/miner-training/default.aspx
New Alcoholics Anonymous Meeting
There will be new AA meetings in Alum Creek at Lyons Club Park every Friday at 6:30 p.m. For more information, men call Chris F. at 304-767-0395; women call Brandi M. at 304-807-7802.
Medicare Part D counseling
Mark your calendars! Marcia Meeks, Director of WV SHIP, will be at the McCorkle Community Center on Tuesday, October 23. She will have a Medicare session at 1 pm and 6 pm to answer questions about Medicare Part D Open Enrollment. In between, Ms. Meeks offers one-on-one counseling so she can review your options and compare Part D plans and Medicare Advantage plans. Be sure to bring your Medicare card and a list of ALL your medications. Include the name of the medication, dosage, and how often you take each medication. This is a FREE service provided by the WV SHIP program.
The Charleston Coin Club
The Charleston Coin Club would like to announce its annual coin show on Nov. 3-4, 2012, at the Charleston Civic Center. The show is from 10 a.m. to 5 p.m. on Saturday and 10 a.m. to 3 p.m. on Sunday. There is no admission fee.
Dealers from West Virginia, Ohio and Kentucky will be in attendance to buy, sell and trade coins, paper money, gold jewelry and coal mine scrip and West Virginia tokens.
For more information, call 304-727-4062 or visit the online Web site at www.kvcc.eznetway.com
Crafters needed
Crafters are invited to participate in the Appalachian Center for Independent Living's 12th annual Community Christmas Party to be held on Saturday, Dec. 1, 2012, from 11 a.m. to 3 p.m. at the National Guard Armory at Coonskin. Table space cost is $20. To reserve a table, call 304-965-0376 by Nov. 28, 2012. This day includes live entertainment, raffled items, a silent auction, free food and much more.
The Faces of Meth
"The Faces of Meth" – an honest look at the effects of Meth amphetamines on Oct. 20, 2012 (Saturday) at 6 p.m. at McCorkle Community Center, 13 Ely Fork Road, Sumerco, WV. It will be presented by David Vickers, Lincoln County Sheriff and Greg Hensley, Chief Deputy of Lincoln County. It is sponsored by the East Lincoln County Crime Watch.
Boone Republican Party
The Boone County Republican Party will meet the first Monday of every month at 6 p.m. at Park Avenue Restaurant in Danville.