text:
Personal Injury
We place special emphasis on obtaining reasonable compensation and benefits for injured persons in cases involving personal injury litigation and insurance settlements. These cases include automobile accidents, bicycle accidents, pedestrian accidents, "slip and fall" cases, products liability and wrongful death. Feel free to call for an exploratory discussion regarding the merits of your case (no charge). If you are unable to come to our office for an appointment, we can schedule a visit at your home or the hospital.
Why You Should Have a Lawyer
Except in cases where the liability is admitted and the injury is minor, it is usually beneficial to retain an attorney to deal with insurance claims. Insurance companies are for-profit corporations, and the more money paid out in claims, the less profitable they are. Even though many insurance adjusters are genuinely nice people, it is only common sense to recognize that they try to pay out as little money as possible.
Virtually all insurance adjusters will say that their goal is to reach a "fair settlement," but their job is to minimize the payout to claimants. Adjusters know the system and are trained to discourage claimants from seeking legal assistance. Studies show that represented claimants receive an average of two to three times more compensation than those who are unrepresented. In addition to the economic benefits of retaining a lawyer, the client no longer has to deal with the insurance company adjusters and can focus on more important things (like family and recovery).
Personal Injury Fees
We generally accept these cases on a contingency basis, meaning no attorney fees are incurred unless there is a recovery. However, we will discuss billing our services at an hourly rate if the client prefers that arrangement.
Please contact us if you are in need of, or have questions regarding, your Personal Injury claim:


text:
Born: February 20,1988 Saint Michael, Barbados
Zodiac: Aquarius
Biography: Robyn rihanna fenty (born february 20, 1988), known mononymously as rihanna, is a barbadian recording artist, actress and fashion designer. born in saint michael, barbados, she began her career as a result of meeting record producer evan rogers in late 2003. at age 16, she moved to the united states to pursue a music career and began recording demo tapes under rogers' guidance, subsequently signing a contract with def jam recordings after auditioning for american rapper jay-z.See full bio Read on Wikipedia
Rihanna : VideosSee more videos
Rihanna : Filmography
- Home (2015 Film)
- Happy Smekday!
- Home (2014 Animated Film)
- Home (2014 Comedy Film)
- Coldplay Live 2012
- Kidz Bop 23
- Now That's What I Call Christmas! 4
- The Best Of Bbc Radio 1's Live Lounge
- Now That's What I Call Music! 79 (uk Series)
- Now That's What I Call Music! 82 (uk Series)

subset: commoncrawl


text:
The Stars of the White Nights Festival has gained in
strength, popularity and international acclaim. The duration for the Festival it
has expanded from ten days to three months during the last sixteen year.
Renowned conductors and star-artists take as great honour the invitation to
perform at the Stars of the White Nights. Each year the Festival
programme includes the Theater's finest opera and ballet productions, great
symphonic works, masterpieces of chamber music and new premieres. During
the last years the Festival programme has included the works created by the
great classical composers Beethoven symphonies, Prokofiev's and Tchaikovsky's operas, ballets and
symphony music. Major events at the Stars have included the production
of Wagner's Der Ring des
Nibelungen, in addition to the Shostakovich and Mahler Symphonies
series.This festival is a must for ballet, opera and classical music
amateurs. The annual Stars of the White Nights Festival takes an
inspiration for its name from the short summer season when the sun never sets,
and the beauty of St-Petersburg White Nights contributes to the festival's
special atmosphere and its world-class programme of concerts, as audience comes
out of the historic theatre at midnight into daylight to stroll along the
streets of the theatrical setting of St Petersburg.
WHITE NIGHTS 2015: Mariinsky (Kirov) Opera and Ballet
theatre | Mariinsky hall plan |
Mariinsky Slide Show |
Mariinsky 3D View |
About Valery
| 2013 |
2012 |
2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001 | History (before
From May 28 to July 31 will take place the 22 Music Festival
"Stars of the White Nights" - a traditional summer parade of
musical events, attracting the attention of a wide range of fans of classical
music, opera and ballet. During the 65 days of the festival about
200 events will be held including 113 performances (58 operas, 55 ballets), 80
chamber and symphony concerts with the participation of guest
artists, Mariinsky opera and ballet soloists as well as Mariinsky
Chorus and Orchestra. Premiers of the opera and ballets are announced in
the playbill of the Fesival along with concert tour orchestras, opera, ballet
and drama troupes , performances by renowned dancers , singers ,
instrumentalists and conductors . The XXII Stars
of the White Nights music festival will open with
the premiere of "Les Troyens", an opera
by Hector Berlioz directed by Yannis Kokkos
who is making his second joint project with Mariinsky Theatre. The epic
dilogy conducted by Maestro Valery Gergiev will be presented
in Mariinsky-2 on May 28, 29 and 30 The festival ballet programme will be opened
by the season premiere of the ballet by Frederick
Ashton "Sylvia" (Mariinsky Theatre, May 28 and 29, 22 and 27 June). The first concert
of the symphony concert programme will take place in Mariinsky II
on May 31. Mariinsky soloists with the Mariinsky Chorus
and Orchestra conducted by maestro Valery Gergiev will perform the Glagolitic
Mass by Leos Janacek as well as the Cello Concerto
by Robert Schumann (with Mario Brunello as a soloist). The concert is
dedicated to the memory of Richard Colburn, the theatreÆs
friend and art patron. Another opera premiere
of the festival is the grandiose "War and Peace" by Sergey Prokofiev staged
by the British director Graham Vick with Paul Brown
as a production designer. The first performance conducted
by Maestro Valery Gergiev will be held
in Mariinsky-2 on July 15 and 16. Ballet premieres of the festival
will include the four one-act ballets created
by the outstanding contemporary Dutch choreographer Hans van Manen.
On June 15 and 17 four short pieces - "Adagio for Harpsichord", "Variations for two couples", "Solo" and
"Five Tango" - will be presented on the new stage of the Mariinsky Theatre. "Marguerite and Armand", a Frederick Ashton ballet with
Liszt music will be premiered on July 8 and 9.The Richard Wagner theatre.
Mariinsky Theatre is the only theatre in Russia where
the grand creation by Richard Wagner, the tetralogy Der Ring des
Nibelungen is performed in full. In 1990s, following
a nearly one-hundred yearsÆ gap, Valery Gergiev initiated the Warner
Renaissance in the theatre. On June 4, 5, 7 and 8 Mariinsky-2 will present the Der Ring des
Nibelungen conducted by Maestro Valery Gergiev. On June 16 Mariinsky-2 will feature "Lohengrin", an opera which was returned
to the theatre repertoire recently. And then, at the closing
event of the festival on July 31, the outstanding soloists, Evgeny Nikitin, Mlada
Khudoley, Mikhail Petrenko and Segey Skorokhodov will perform
the leading roles in "The Flying
Dutchman". Rodion Shchedrin Theatre.
Works by Rodion Shchedrin are in the focus
of the theatreÆs repertoire: three operas (Dead Souls, Enchanted Wanderer, the Lefthander) and three ballets (Anna
Karenina, Carmen Suite, the Little Humpbacked Horse) have been staged
here, and the composerÆs symphony music is frequently performed.
In the festival programme Rodion ShchedrinÆs works are represented with three
ballets: the Little Humpbacked Horse (June 1, 25, 26), Anna Karenina (June 21, 23, 24), and the Lefthander based on the story
by Nikolay Leskov (June 27). The St.-Petersburg
premiere of Rodion ShchedrinÆs Boyarina Morozova conducted by Maestro Valery Gergiev will be held
in Mariinsky-2 on June 22 (concert performance). This is a Russian
choral opera in two parts for four soloists, mixed chorus, trumpet,
kettledrums and percussion. The opera, which has been described
as one of the most outstanding works of the decade, is
based on the texts of The Life
of the Archpriest Avvakum and The Life
of Boyarina Morozova and deals with an extremely dramatic event
of the Russian history, the religious schism
of the 17th century. Three ballet companies will take part
in the festival. Scottish Ballet (Glasgow) will present "Highland Fling", a reworking of the classic romantic
ballet La Sylphide choreographed by the famous Matthew Bourne
(June 18 and 19). Alexander Spendiaryan State Academic Opera
and Ballet Theater of Armenia will perform Gayaneh in the historic venue
of the Mariinsky Theatre (July 22 and 23). Astana Ballet will present Oriental Phapsody (July 26 and 27). Special events.
The baroque ensemble ōLes Arts Florissantsö is one of the most famous
groups of its kind. Founded in 1979 by the Franco-American
harpsichordist and conductor William Christie, the ensemble takes its
name from an opera by Marc-Antoine Charpentier. The group consists
of a choir, an orchestra and soloists. In St.-Petersburg
the musicians will present a programme titled ōArias and dances
by Jean-Philippe Rameauö on the occasion
of the 250th anniversary of the composerÆs death.
The programme will be conducted
by Jonathan Cohen (June 27). Teatro Regio di Torino will perform Requiem by Giuseppe Verdi with Maria Agresta, Daniela Barcellona, Fabio
Sartori, Michele Pertusi, Chorus and Orchestra of Teatro Regio
conducted by Gianandrea Noseda (Mariinsky-2, July 9). Traditionally, a number
of monographic programmes are to be presented
at the festival. Atrium string quartet will present all quartets by Jakob Felix Mendelssohn (July 1 and 2). Two closing concerts of the programme including
all of Johann Sebastian BachÆs music for organ will be given
by Christopher Herrick (May 28 and 29). In the evening of organ music at the Concert Hall will
perform organist Christian Schmitt (July 7). A lot of attention
in the festival programme is paid to works by Johannes Brahms. The audience will have a chance
to hear Symphonies No 4 and No4, Piano Concerto No 2,
Op. 83, performed by Rudolf Buchbinder (June 23), Violin and Cello Concerto, Op. 102
with Sergey Khachatryan and Narek Hakhnazaryan (June 17), and Violin Concerto, Op. 77 performed
by Leonidas Kavakos (June 26) with Mariinsky orchestra conducted by Maestro Valery Gergiev. Song cycles
by Franz Schubert and Robert Schumann will be performed
by outstanding musicians: Ferruccio Furlanetto and Igor Tchetuev (Winterreise, June 30), Alice Coote and Christian Blackshaw (Dichterliebe, July 3).
The festival will feature the world opera stars, both
Mariinsky soloists and guest artists: Olga Borodina as Dalila (Samson et Dalila, June 1) and as Marfa
(Khovanshchina, June 9); Yevgeny Nikitin as High Priest
of Dagon (Samson et Dalila, June 1), as Wotan
(Siegfried, June 7), as Gunter (June 9)
and as the Dutchman (The Flying Dutchman, July 31); Alexei Markov as Iago (Otello, June 2), and as Prince Eletsky (The Queen of Spades, June 12); Mikhail Petrenko as Abimelech (Samson et Dalila, June 1),
as Mephistopheles (Faust, June 4), as Hunding (Die Walkure, June 5), as Hagen (Gotterdammerung, June 8), as Philip II
(Don Carlo, June 21), as Khan Konchak (Prince Igor, June 29), and as Daland (The Flying Dutchman, July 31); Alexander Antonenko as Otello (Otello, June 2); Ferruccio Furlanetto in his signature
role of Don Quichotte in the opera by Jules Massenet
(June 24 and 25), as Prince Gremin (Eugene Onegin, July 4) and in a solo recital (June 30); Ekaterina Gubanova as Princess Eboli (Don Carlo, June 21); Ildar Abdrazakov as Philip II (Don Carlo, June 15) and as Banco (Macbeth, July 29) Lyudmila Monastyrskaya as Lady Macbeth (the concert
performance of Macbeth, July 29); Oksana Dyka as Floria
Tosca, Marcelo Alvarez as Mario Cavaradossi, Gabriele Viviani as Baron
Scarpia (Tosca conducted by Carlo Montanaro, July 3 and 6); Oksana Dyka as Yaroslavna (Prince Igor, June 29); Tatiana Serjan as Leonora (Il trovatore June 19) and as Lady Macbeth
(Macbeth conducted by James Conlon, June 26 and 28); Maria Agresta, Daniela Barcellona, Fabio Sartori
and Michele Pertusi (Requem by Giuseppe Verdi, July 9); Maria Guleghina as Aida (Aida by Giuseppe Verdi, July 24), and as Princess Turandot (Turandot by Giacomo Puccini, July 27); Yekaterina Semenchuk as Didon (Les Troyens, May 28), as Carmen (Carmen, July 1) and as Azucena (Il trovatore, July 7); Anita Rachvelishvili in a solo recital (July 5); Sergei Semishkur as Vaudemont (Iolanta, July 20), as Vladimir Igorevich
(Prince Igor, June 29),
as B. F. Pinkerton (Madama Butterfly, July 30); Sergei Skorokhodov as Macduff (Macbeth, June 26 and July 29), and as Erik (The Flying Dutchman, July 31).
The festivalÆs ballet programme
will feature, apart from the festival premieres, the latest
performances of Sylvia choreographed by Frederick Ashton (Mariinsky
Theatre, May 28 and 29, 22 and 27 June), Infra by Wayne McGregor (July 17); George BalanchineÆs ballets as well as the best
classical ballets including Swan Lake, The Fountain of Bakhchisarai, La Bayadere, Don Quixote, Romeo and Juliet, La Sylphide, Giselle. The audience will have a chance
to appreciate the leading dancers of the company: Olga Esina, Yekaterina Kondaurova, Ulyana Lopatkina, Daria Pavlenko, Alina Somova, Timur Askerov, Andrei Yermakov, Danila Korsuntsev, Alexander Sergeev, Vladimir Shklyarov and Kimin Kim. Igor Zelensky gala with
the participation of Polina Semionova and Diana Vishneva will be held on July 15.
Instrumental soloists. Traditionally, the Stars
of the White Nights festival will feature solo recitals
of the pianists Peter Serkin (June 12), Alexey Volodin (June 18), Vadim Kholodenko (June 21), Igor Tchetuev (June 28), Christian Blackshaw (July 6), Daniil Trifonov (July 8), Polina Osetinskaya and Anton Batagov playing as
a piano duo (June 5). Another piano duo ¢ Boris Berezovsky and Alexander Gindin ¢ will be
presented on July 4. Maestro Rudolf Buchbinder with Mariinsky
soloists will perform Piano Quintets of Antonin Dvorak and Robert Schumann. Maestro Denis Matsuev, the regular guest
of the festival, will play with the Mariinsky Orchestra
on June 22. Cellist Mario Brunello will perform his original programme (June 4), and the cello of David Geringas will be complemented
by the musicians of the Mariinsky Orchestra cello section
(June 14). Violinists Janine Jansen (June 11), Leonidas Kavakos, this time playing
in duo with the pianist Nikolai Lugansky (June 25), and Sergey Krylov (July 9) will also present their solo programmes.
String quartets in the festival
programme. Atrium String Quartet, one of the leading
young ensembles on the music scene, will perform on July 1 and 2 with a programme of quartets by Jakob Felix
Mendelssohn. These charismatic musicians with their deep emotion, virtuosity
and technical brilliance, are highly acclaimed by audiences
and the press throughout the world. The State Borodin Quartet, old friends
of the Mariinsky Theatre, will play pieces by Pyotr Tchaikovsky,
Alexander Borodin and Franz Schubert, July 15.
Mariinsky chamber ensembles. Renaissance Percussion
and the Mariinsky Stradivarius Ensemble with Lorenz Nasturica-Herschcowici will perform
at the festival, July 18.
Youth orchestras will also participate
in the festival ¢ Bard Conservatory Orchestra with Leon Botstein
and Peter Serkin (June 9), All-Russian Youth Simpfony Orchestra conducted by Yuri
Bashmet (June 16), and Russo-German Music Academy (July 10 and 11). The Mariinsky Youth Orchestra is also
in the festival programme.
Internationally known conductors will lead the Mariinsky Orchestra. Paavo Jarvi (GRAMMY WINNER 2003 "Best Choral Performance -
Best Conductor") will conduct the programme of Gustav
MahlerÆs music (Symphony No.7 and Lieder eines fahrenden Gesellen, July 11) and James Conlon will conduct Macbeth
by Giuseppe Verdi on June 26 and 28 and music by Mozart and Zemlinsky on June 29. At the Concert Hall will be performed the
Symphony No 2 in C Minor by Gustav Mahler: under the control of Gilbert Kaplan (June 6). For control the Mariinsky Theatre Symphony Orchestra
will stand famous conductor Justus Frantz (concert June 14)
For the first time this year the festival programme will
include a drama performance. On June 10 and 11 the Moscow Chekhov Art Theatre will present The Little Humpbacked Horse directed by Evgeny Pisarev
in Mariinsky-2.
Concerts in chamber halls of Mariinsky-2.
The programme of the 22nd Stars
of the White Nights festival will, for the first time,
include concerts and lectures that will be held in Mariinsky-2 chamber
halls: Stravinsky Foyer, the Musorgsky Hall, the Shchedrin Hall
and the Prokofiev Hall. Mariinsky Orchestra soloists and students
of the Mariinsky Academy of Young Singers will perform their
interesting programmes solo or in duos, trios and chamber ensembles.
In the evenings of vocal music at the
Mariinsky Concert Hall will perform guest vocalists : mezzo-soprano Alice Coote (July 3) and mezzo-soprano Anita Rachvelishvili (July 5) , and the Mariinsky Theatre - soloists : soprano
Marina Shaguch , tenor Leonid Zakhozhaev (July 12) and baritone Vasily Gerello (July 26) . In the concerts under the conduction of Maestro Valery Gergiev at the Mariinsky Concert Hall will perform violin Janine Jansen (June 10) , violin Sergey Khachatryan and cello Narek
Hakhnazaryan (June 17) , piano Rudolf Buchbinder (23 June ) , the violin Leonidas Kavakos (June 26) and piano Bekhzod Abduraimov (July 30) . Also in the concert under the conduction of Maestro Valery Gergiev at the Mariinsky New
Stage will be the soloist (piano) Denis Matsuev (June 22) . At the stage of a Concert Hall Maestro Valery Gergiev will be conducting a
concert performance of "Samson and Delilah" by Camille Saint-Saens (June 1), and "Macbeth" by Giuseppe Verdi (29 July). Mariinsky-2 will show one-act ballets ½Inside the Lines╗ by Anton Pimonov and "Camera Obscura" by Yuri Smekalov (July 2). Their premiere takek place this season. On a
stage of Mariinsky-2 will be performed some opera premieres of this
season:: a new stage version of "Othello" (June 2) and "Il Trovatore" (June 19 and July 7), Giuseppe Verdi, and "Eugene Onegin" by Peter Tchaikovsky (July 25 and 26). The conductor is Maestro Valery Gergiev.Echo of the
festival dedicated to the 175th anniversary of Modest
Mussorgsky, will a view of the popular musical drama "Khovanshchina" at the Mariinsky Theatre (June 9) and semi-staged version of the unfinished opera
"Sorochinskaya Fair" at the Mariinsky-2 (July 18). At the Mariinsky Theatre will be shown
performances of the Academy of Russian Ballet of Vaganova (11, 14 and 16 June) . In ballet performances of the
Mariinsky Theatre will be performances with a guest soloists: Ludmila Pagliero
(Paris Opera) will perform the title role in "La Sylphide" (May 30), Olga Smirnova (Bolshoi Theatre) will perform Nikia in
"La Bayadere" (July 12) . Pyotr Tchaikovsky's ballet "Swan Lake", "card" of the Mariinsky Theatre, will be
shown at the Mariinsky New Stage (12 and 13 June), and the historical Mariinsky Theatre (July 6) .


text:
Assorted Carnations-350 Stems
Item #809184
At Costco.com we pride ourselves in our commitment to providing only the highest quality, farm direct fresh cut flowers. We believe our selection has something to satisfy everyone.
Our carnations are hand selected from farms in the Savannah of Bogota, Colombia. The optimal growing conditions in Colombia have an abundance of light and rain, making this an ideal place for flowers to be cultivated. Carnations are a spring and summertime favorite! Sent to your special recipient in a assortment colors, these long lasting beauties are sure to be an instant hit! Shipped fresh from our growers, these carnations are guaranteed to last!
*Our flowers are picked for you fresh from our farms and upon arrival will be in bud form to protect them in their journey to you. If you're needing more open flowers for a special event please order 2-3 days in advance*
Disclaimer: These "Assorted Color" flowers are a grower's choice of colors; the colors you receive may vary from colors in product picture.
All carnations from our farms are Rainforest Alliance Certified signifying environmental, social and economic responsibility.
- Plant: Carnations
- Quantity: 350 stems
- Length: 50 cm stem / Premium Carnations
- Vase Life: 7 days approximate
- Head Size: varies by variety
- No gift messaging available
Brand: Kendal Floral Supply
Number of Stems: 350
Please select a delivery address where the flowers can be cared for immediately upon arrival. Flowers are a perishable item and must be cared for properly.
Note: Due to the variance in monitor color and screen tones, the flowers you receive may vary in color from the image on your computer monitor. If you are purchasing bulk roses to complement your wedding tones, be aware that we cannot guarantee the same variety when more than one case is ordered. We will make every effort, however, to match the shade of color.
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As this may be a time sensitive purchase, please take the appropriate steps when you order by calling your bank to verify credit limit and make sure authorization goes through. Please double-check your information for accuracy. Credit Card holds or declines can delay your order beyond the stated delivery parameters above. Your credit card will be charged when the item ships.
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How to Return: For an immediate refund (including shipping and handling), simply return your purchase at any one of our Costco warehouses worldwide. If you are unable to return your order at one of our warehouses, please email customer service or call our customer service center at 1-800-955-2292 for assistance. To expedite the processing of your return, please reference your order number.
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text:
Wasielewski Named CoSIDA Academic All-District
2012 Season Wrap-Up
Text and photos by Rob Mattson
Music is among the oldest of arts in the world, and yet somehow it remains one of the most arcane. A bizarre barrier seems to stand between a piece of music and our best efforts at analysis – no matter how hard we try or the methods we use, something is always lost in the transition from notes to words. The magic we feel listening to a Beethoven sonata – an almost pure expression of mood, character, and ideas simultaneously – is never replicated by an analysis of that sonata.
By Rob Mattson
Football and painting seem to have as much in common as Nietzsche and NASCAR, but David Gloman can attest otherwise. The 19-year veteran of Amherst College, a resident artist in the Department of Art and the History of Art, was hired to create drawings of 30 of today's best football players as part of the ESPN production of the 77th Heisman Memorial Trophy Presentation. On Dec. 10, Baylor University player Robert Griffin III became the 32nd quarterback to earn college football's most coveted trophy, but the opportunity to be part of such an iconic event was a victory for Gloman as well, like a swollen river that finally crested, but only after years of ebbing, flowing, meandering and shaping the landscape of his life.
Catherine Sanderson, professor of psychology at Amherst College, also serves as a member of the town school committee, manages to find time to teach, conduct research, write books as well as advise members of the men's hockey team. She's also advised several football players over the years on academics, including Quarterback Alex Vetras.
Sarah Leyman, a senior and member of the Amherst women's basketball team, and Molly Mead, director of Amherst's Center for Community Engagement (CCE) discuss community service at Amherst College. Sarah, from Cincinnati, OH, was recently named one of five finalists from the NCAA's Division I, II and III for the prestigious 7th Annual Coach Wooden Citizenship Cup. Presented annually by Athletes for a Better World, the Wooden Cup is awarded to the most outstanding role model among college athletes in America.
Suzanne Coffey, Amherst College's director of athletics, and Lisa Melendy, Williams College's interim director of athletics, discuss athletics, academics and community service at the two liberal arts colleges.
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text:
What an awesome weekend up at Buxton MTB - full results can now be found on the results page
For the third year running, Buxton MTB Park will host the final round of the popular Victorian Enduro Series on Sunday 9th of November. Although being held on the Sunday the park will be open to riders on Saturday afternoon and Big Hill Events are encouraging riders to come and pre-ride the course.
The course itself is a 12k intermediate circuit of 100% singletrack which is bermed to an extent and as a result makes for a fun, fast flowing ride.
Saturday Events
On Saturday there will be a number of fun events starting from roughly 4pm for everyone entering the Sunday event - come and get involved with:
- 3k Buxton Dash Time Trial: Seed yourself for the XC Eliminator!
- XC Eliminator: Each lap the last person will be elinated tournament
- Huffy Toss Under Light: How far can you toss the Big Hill Events huffy - at night!
- Moonlight Cinema Fueled by Beechworth Bakery: A number of films showing off the projector once it gets dark, with bakery good supplied by Healesville Beechworth Bakery
- Camping is VERY limited this year, therefore we are not advertising that camping is available. We thoroughly recommend looking at local B&B's in Buxton / Marysville.
Velo de Buxton
In July 2012 we made a promo video for the Buxton MTB Park - 12k loops of pure mountain bike tailored single track - Check the video out here
What a weekend to end the 2013 Victorian Enduro Series. Despite the forecasted storms, we had beautiful, clear weather and over 300 riders turned up for The Buxton Bootcamp 6 and 3 hour Enduro.
On the Saturday Big Hill Events had everything set up and course marked for practice, the MTBSkills crew were out on track teaching different techniques and other riders were sampling the fresh new flow section at the end of the course.
The evenings activities included a huffy toss ? the mens category was won by MC Rich Grant and the womens category was taken by Jade Forsyth (who had demanded a female category) ? and a moonlight cinema screening of The Goonies. The majority of campers settled down for an early night, before the big race on the Sunday.
With the sun breaking and the coffee van's generator waking everyone up (who better to be woken up by though??), people slowly emerged from tents and cars to set up around the transition area and hear Big Rich's beautiful voice instructing riders to place their race plates on their bikes clearly, otherwise they'd be placed on the timing crews "Naughty List".
Dead on 10 the 6 hour race started and straight away we had some close racing?
And it begins?
The 6 Hour Solo Mens
This was the hotly contested battle ? between Peter Kutschera, Will Geor and Brad Clarke ? with just 15 points separating them. The first lap they all came through together, second lap Peter and Will had a 20 second lead on Brad, third lap Will was in front and Brad was chasing up?. But then in the 6th lap Brad and Peter both put the foot down and broke a gap of a minute between them and Will. Peter Kutschera leading the pack?with Will and Brad shortly behind?.
Unbelievably Brad stormed the last lap and came in first place ? roughly 5 minutes ahead of Peter Kutschera.
- Crazy as it sounds this means that after 7 rounds of racing, the 6 hour mens finale is a DRAW between Brad Clarke and Peter Kutschera.
----Big Hill Events would like to apologise for any confusion caused on the day with the 1st and 2nd place of the series ? which were manually calculated. With 1.5 factor points the round points, round up, rather than down: i.e. Brad's 5th place in Rd 2 is in fact 64.5 points and 2nd place in Rd 6 is in fact 97.5 points. Resulting in both Peter and Brad finishing on 345 points. Big Hill Events have contributed extra funds to the series so that Peter will also receive the same prize money as Brad. Both riders have been contacted and are happy with the outcome and are already looking forward to the next year of racing. ----
The 6 Hour Solo Womens
Karen Hill showed up for the battle of the VES first place, unfortunately April McDonough was still injured and unable to race. Karen still put in a fantastic performance racing against Katherine O'Shea who came in just 2 minutes after Karen, with Jo Murphy in 3rd.
- This saw Karen Hill run away with the 6hour Womens title for the VES, April McDonough in 2nd, and Tory Thomas in 3rd. However Tory Thomas only entered 3 rounds, so was ineligible for series prizes, therefore Jo Murphy cashed in with a strong finish in 4thplace.
The 6 Hour Solo Men 40+
This was another hotly contested battle throughout the whole series and one which saw the top 4 gents swap places a number of times. At the Buxton Bootcamp, Michael Brill put in an outstanding performance, completing 7 laps in 6 hours 37 minutes, a good 5 minutes ahead of Rod Barnard who had a great battle with 3rd place Brian John.
- Awesome racing: with Michael Brill entering every round of the series ? his best 5 results were a win at the Crazy 6, 2nd place at Mt Beauty, 6th at Ballarat, a 1st at the Rock Hop and another 1st place at the Buxton Bootcamp. Fantastic effort. In second place was Rod Barnard and Peter Shaw, all of which had a couple of podium places at rounds. Cheers for the great attitude these guys had, with good banter between them.
The 6 Hour Mens Team
Apollo Bikres p/b ozrider.com.au John Groves and Nick Morgan had the series under their belt with 5 wins throughout the series so they both raced in the 3 hour at the finale. Instead the battle was on between Bicycle Superstore JDT 1 (Ben Walkerden and Scott Liston) and Dusty Demons (Chris Palmer and Seton Macleod), with JDT 1 winning by mere 15 seconds! And Bicycling Bandidos (Mick Brown and Scott Thomson) in third place.
- Bravo to the top boys John Groves and Nick Morgan for the domination of the category. Fantastic effort by JDT1 for racing in every round of the series picking up podium spots at every round except 1. The Dusty Demons finally got their podium spot at the Buxton Bootcamp getting them a spot in third place of the series. Well done.
The 6 Hour Mixed Team
Don't Tell Ben ? Mel Anset and Ross Wilkinson had domination of the series under their belt, but still put in a strong performance at the Bootcamp, getting 8 laps in in just 6 hours 13 minutes! Milk was a bad idea!!! ? Ben May and Rishi Fox smashed out 8 laps in 6 hours 40 minutes and in 3rd place Repasado ? David Croxford and Britta Weller.
- So the iRide team Mel Anset and Ross Wilkinson walk away with the VES title ? with an outstanding 5 wins and 1 second place out of 6 rounds they raced. Bey May and Rishi Fox in 2nd place with their fantastic set of 2nd places and their win at Ballarat. In third place sees the Riders of Mass Obstruction ? who entered all by one round and goes to show that you don't need to get a podium spot at a round to get a podium spot for the series ? well done Stephen Johnson and Meg Lawson.
The 6 Hour Mixed Team 40+
Carbon Fibre Footprint ? David Rusden and David Scarlett were a rider short than they usually are at the rounds, showed their dominance at the Bootcamp with 8 rounds in just 6 hours 12 minutes. Super Chill Bozo's ? Justin Prior and Simon Renton came in 2nd (after they had been placed in the wrong category for the majority of the race) and CARBON FIBRE THUMBPRINT, Leigh Barrat, David Keir and Martin Keir had an AWESOME battle with Bazza Allstars for third place. Big shout out to these two teams for their understanding that "Super Chill Bozo's" hadn't changed categories so they could get a podium spot.
- With such great attendance from the top 2 spots in the series (and CFF dominance of wins) series organizers decided to award prizes to these two teams. Thanks again for the racing.
While the 6 hour race was still in full swing, the 3 hour riders were gearing up and getting ready for their sample of the Buxton course. The course bridges had been decorated with inflatable ducks and whales, there was a swearing parrot on track and aliens spotted at the entrance to the new flow track.
As all the 3 hour riders lined up, Rohin Adams, race director, parked himself 3 meters in front of everyone and announced "The start line is here" with a big grin on his face?.
The 3 Hour Solo Men
Banter started on Saturday afternoon between the top 3 in the series, working out that Rohin only had to finish one lap to win the series; or if Tom Ovens was to "damage" Rohin's bike somehow and then win he could win the series by 1 point. The actual race at the Bootcamp was won by "No mates" Nick Morgan who smashed his laps out winning by a good 3 minutes. The real race was for 2nd place, with Rohin Adams and Murray Spink off and on each others wheel lap after lap. Spink was trying to overtake Rohin on the Flow trail, trying to take the inside lines on the big berms, but to no avail. Rohin came in 2 seconds in front of Murray ? great racing all round.
- In the series Rohin came away with a strong win ? 100 points in front of Tom Ovens and Todd Cuthbert. With Tom Ovens entering every single round of the series. Shame that Warrack had his injury and then sold his bike half way through the series, otherwise it could have been pretty close.
The 3 Hour Solo Women
Another great category was the 3 hour womens. We were lucky enough to have all the top 4 placings at the Bootcamp. In the race Jackie Perkins came out of nowhere to claim 1stspot, with Monica Campi in 2nd place having a fantastic battle with Amanda Herd who came in 3rd. There was just 1 minute inbetween Monica Campi, Amanda Herd, Dora Bettridge and Aleisha Bald! Fantastic racing ladies.
- The final standings saw Dora take the titles by just 13 points, with Monica in 2ndplace, Linda Raineri in 3rd and Mary Hall in 4th place. These 4 ladies have had a wicked series of racing ? it's been great watching them in action.
And that's it ? the 2013 Victorian Enduro Series all done and finished with over $6,600 of prize money dished out and some very sexy new series trophies!
Big Hill Events would like to put a huge thank you out to everyone involved in the Buxton Bootcamp; including James Cowell (DSE) for the AMAZING course (anyone NOT have fun out there???), sponsors Tourism Victoria, Healesville Beechworth bakery, Magellan, Great Divide Coffee, White Rabbit Brewery, the Murrinidini Cycle Club, Fragas caf? and the Buxton Primary School for the food, Steve Taylors coffee and Sport Recovery. Big Shout out to Rich Grant for being our MC, our set up and timing boys, Dean and Scottish Dave, and John Groves and James Maebus who saved us an extra hour in the clean up by being our sweep riders.
Most of all ? thanks to all the riders who have made this such an awesome series. At the end of the day this series is all about racing and introducing people to mountain biking, with the great spirit and racing experienced throughout each round I think we've accomplished that goal.
Many thanks to all the clubs involved: Geelong MTB Club, Team Mt Beauty, Albury and Wadonga, Gippsland MTB, Ballarat Sebastopol, Dirt Riders and Big Hill Events.
There will be a series questionnaire sent out over the coming months and feedback is very much welcomed.
We now look forward to the 2014 series.


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Alliance Comments on Medicaid Proposed Rule
Federal Policy Brief | February 19, 2013
Files: Medicaid Comments (PDF | 157 KB | 4 pages)
This is an excerpt from the document. To download the full document, please use the link above.
This resource provides the National Alliance to End Homelessness (the Alliance) comments on the Medicaid Proposed Rule. Published on January 22, 2013, the proposal would implement various provisions of the ACA, including rules for Medicaid enrollment and eligibility, essential health benefits, and cost-sharing. The Alliance's comments address several issues that affect vulnerable adults who are chronically homeless, at-risk of becoming chronically homeless, or recovering from chronic homelessness in permanent supportive housing (PSH).
Access to health care is vital to ending homelessness. The most vulnerable homeless individuals are those who struggle with complex physical and behavioral health conditions, even after they have found permanent housing in the community (i.e., are no longer homeless). In fact, access to supportive services is the key to maintaining a stable housing situation, which in turn contributes to positive health outcomes.
Further, improving health and stability is a prominent goal of Opening Doors, the federal strategic plan to end homelessness, released in 2010. In particular, the federal plan calls for integrating primary and behavioral health care services with housing solutions, to "reduce people's vulnerability to and the impacts of homelessness." (Objective 7). Access to integrated housing and health care services is also part of the Strategic Plan's approach to reducing the risk of homelessness among young adults who have been in foster care as children. (Objective 8).
The Alliance actively supports the federal agenda to end homelessness, including its emphasis on housing and health together. To the extent that health care reform can advance integration in community-based service delivery for vulnerable populations, we have a close interest in ACA rulemaking.
Through various provisions, the ACA encourages states to expand Medicaid eligibility and service capacity, while increasing state flexibility to serve vulnerable people in the community, including those who experience chronic homelessness. In addition, the ACA modernizes processes for enrolling people in Medicaid, promising more timely and streamlined access to services. The Alliance's comments address Medicaid enrollment procedures, coverage of former foster youth, and cost-sharing requirements.


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News, reviews and interviews from award-winning crime / mystery author Declan Burke
"Burke shows again that he's not just a comic genius, but also a fine dramatic writer and storyteller." – Booklist. "Prose both scabrous and poetic." – Publishers Weekly. "Proust meets Chandler over a pint of Guinness." – Spectator. "A sheer pleasure." – Tana French. "Among the most memorable books of the year, of any genre." – Sunday Times. "A hardboiled delight." – Guardian. "Imagine Donald Westlake and Richard Stark collaborating on a screwball noir." – Kirkus Reviews. "A cross between Raymond Chandler and Flann O'Brien." – John Banville. "The effortless cool of Elmore Leonard at his peak." – Ray Banks. "A fine writer at the top of his game." – Lee Child.
Thursday, April 26, 2007
A Psycho Is A Person In Your Neighbourhood: American Skin, Ken Bruen
Ken Bruen's American Skin is getting the kind of reviews that tend to give writers moist nether garments ("the scariest damn book I've read all year" ... "a dark, hilarious nightmare of a book that stretches genres and concepts" ... "an instant noir cult classic" - and there's plenty more where they came from). It's also on Barnes and Noble's Best of 2006 crime list. So WHY THE HELL HASN'T IT BEEN RELEASED THIS SIDE OF THE POND? EH? And who the hell do we have to blow to get a review copy? Sheesh ...
Posted by Declan Burke at 1:37 AM
5 comments:
Forgive my ignorance as I'm pretty new to this crime novel lark, but what's Ken Bruen's best work to start off with?
Bobby the Rookie
- April 26, 2007 at 10:43 AM
- Declan Burke said...
Bob the Rookie ... try The Guards, it's the first of Bruen's Jack Taylor series ... or Rilke on Black, if you can get your hands on it ... or A White Arrest. Cheers, DB
- April 26, 2007 at 11:21 AM
I'll check him out.
Bobby the Rookie
- April 26, 2007 at 1:57 PM
My fave Bruen is actually London Boulevard, though Dec is right to call for The Guards. Here's an unruly review: http://www.criticalmick.com/criticalmick_the_guards.htm
- April 26, 2007 at 5:44 PM
Good review, Critical Mick. Thanks for that. I'll give it a go.
Bobby the Rookie.
- May 2, 2007 at 11:25 PM
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When Helen's husband was diagnosed with non-Hodgkins lymphoma earlier this year, she looked for ways to ensure he had the tools he needed and then some to fight back. Through her research, she came across a book titled "Anti Cancer: A New Way of Life" by David Servan-Schrieber, M.D., Ph.D.
She embraced Dr. David's recommendations and is asking her friends to read the book.
Through the miracle of inter-library loan, I checked out a copy from the Johnson City Public Library. Though I haven't read it cover to cover, I have read enough to know I am doing some things right but can do a lot more to take care of myself.
Here's what I'm doing right: I quit smoking nearly 15 years ago; I don't eat red meat; I eat about 70 percent organic; I've added soy to my diet; I eat whole grains instead of white flour; I use olive oil in cooking and in dressings; I drink green tea; I don't wear perfume; and I laugh a lot.
Here's what I don't do right: I don't exercise 30 minutes a day six days a week; I don't get five to seven servings of fruits and vegetables every day; I eat refined sugar; I haven't eliminated BPA-ridden plastics from my life; I don't filter my tap water for drinking and cooking; I eat too much meat; I tend to stress out; I don't screen my cosmetics for phthalates and parabens ... To make a long list short, I still have a long way to go.
It's not like I plan to live in a BPA-free bubble of organic bliss, heavily armed against free-floating radicals, denying myself the simple pleasures of life (like chocolate cake). I'm not an extremist. Still, the changes I've made over the years ended up being relatively painless. I haven't missed cigarettes for a long time.
The first time I quit, when I was about 20, I thought death was preferable to a nicotine-free life. What was the point of living, I thought, if I couldn't have a cigarette while I talked on the phone or after dinner or with my morning cup of coffee. Now I enjoy all of those things just as much or more without cigarettes (though I drink green tea instead of coffee).
Whole wheat tastes better than white bread; I love fruits and I'm learning to like a variety of vegetables. And so on. If I've done those things successfully, I have reason to believe I will learn to like exercise. Lots of people do.
Dr. David is a two-time cancer survivor who doesn't place blame. Guilt is not conducive to good health or recovery. But he does believe we can stack the odds in our favor, though genetics and environment sometimes will out.
With so much attention on the climbing cost of health care, the obesity epidemic, the prevalence of diabetes and the decline of our planet due to human interference, "Anti Cancer: A New Way of Life" is a book for our time.
And Helen, who is one of the smartest people I know, says I should read it and act accordingly. That's enough for me.
Jan Hearne is Tempo editor for the Johnson City Press. Reach her at firstname.lastname@example.com.


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Many parents and the children they send to college are paying rapidly rising prices for something of declining quality. This is because "quality" is not synonymous with "value."
Glenn Harlan Reynolds, University of Tennessee law professor, believes college has become, for many, merely a "status marker" signaling membership in the educated caste, and a place to meet spouses of similar status — "associative mating." Since 1961, the time students spend reading, writing and otherwise studying has fallen from 24 hours a week to about 15 — enough for a degree often desired only as an expensive signifier of rudimentary qualities (e.g., the ability to follow instructions). Employers value this signifier as an alternative to aptitude tests when evaluating potential employees because such tests can provoke lawsuits by having a "disparate impact" on this or that racial or ethnic group.
In his Encounter Books Broadside "The Higher Education Bubble," Reynolds says this bubble exists for the same reasons the housing bubble did. The government decided that too few people owned homes/went to college, so government money was poured into subsidized and sometimes subprime mortgages/-student loans, with the predictable result that housing prices/-college tuitions soared and many borrowers went bust. Tuitions and fees have risen more than 440 percent in 30 years as schools happily raised prices — and lowered standards — to siphon up federal money. A recent Wall Street Journal headline: "Student Debt Rises by 8% as College Tuitions Climb."


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Due to health issues we are no longer able to take orders or set up yard greeting displays. It is our hope that someone in the area will purchase our inventory and continue the Yard Greeting Business. If you are interested in purchasing our business visit our "For Sale" page for prices.
Create a Free Website


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2001 BMW 3 Series 325i 2.5 from North America
Best compact car in the world!
Sun roof headliner sometimes gets stuck back when opening sunroof. A manufacturer design fault.
General Comments:
Best car I have ever owned, and this is no. 19.
Handles brilliantly, suspension is not too hard or soft, BMW seriously got it right this time!
The standard wheels with low profile tires help the BMW hug the road when cornering at speed.
The standard leather interior looks brand new, even after 65000 miles.
The seats are super comfortable, and it seems that the whole interior fits the driver like a glove.
Engine has a lot of torque for a 2.5 and really pulls when accelerating, especially on the freeway.
The overall design of the car is awesome, there are not many cars out there these days that really are good looking, most cars just look like plastic pieces of...
The doors make a nice clean thump, when closed. You really feel like your in a safe car when you open the doors and get in.
Biggest complaints, which are pretty minor, are that the stereo is fairly plain compared with other brands, and the sunroof issues.
Basically I have owned 19 cars in the last 10 years and this car really stands out as being the best! Build quality, looks, performance, economy, it just beats every other car in its class. No wonder it was a Consumer Report top 10 car every year made.
Well done BMW!!
Would you buy another car from this manufacturer? Yes
Review Date: 26th May, 2009
27th May 2009, 17:57
Yes, the E46 generation of 3 series is really a delight and one of the best (if not the best) BMW ever made.
Drives very well, solidly built and quite reliable (though every car will have its foibles, regardless of make).
What a shame they replaced it with the E90 3 series, which is plug ugly even after its facelift and has a cheaper looking and feeling interior, even though it still maintains the BMW driving feel.
29th Aug 2013, 17:03
Couldn't agree with you more. I've had mine for a few months now and it's a joy to drive. Every time I look at it, I can't believe I own it!
I changed the tranny oil myself, even though BMW say it's a lifetime thing. Rubbish! Changes through the gears more smoothly now. Also replaced the fuel filter and rear diff oil.
Drove it on vacation recently for over 2000kms without any problems whatsoever. It's a tank and built to be driven hard. I'm not sure I'd ever sell it... Well... maybe for a 5 Series. I'm a big guy so that might suit me better. We'll see.


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We have rich conversations with our clients every day, and increasingly these conversations are happening online. We encourage you to ask questions, share your views, and connect with like-minded professionals.
The International Annual Review demonstrates our achievements and reflects the insights and expertise professionals bring to client relationships.
KPMG's Global IFRS Institute provides information and resources to help Board and Audit Committee Members, Executives, Management, Stakeholders and Government Representatives gain insight on the evolving global financial reporting framework.
KPMG's global network of climate change and sustainability practices helps you build long-term value in a rapidly changing world.
Mining organizations need to adapt across the mining asset lifecycle, from expansion to closure, as changing economic, political and regulatory environment demand greater flexibility.
The Chemical industry's landscape is changing fast - global companies are developing or launching new products and services – and appear optimistic - setting sights on geographic expansion.
Report shows VC-backed companies haul in US$32 billion across 1,819 deals globally in Q2 2015 driven by mega financing and rise of non-traditional investors.
Growth. Volatility. Disruption. Uncertainty. When it comes to doing business, CEOs globally are being challenged to navigate the path to success within an environment of constant change.
The global job search tool allows you to search available career opportunities within many of our 150 member firms worldwide.
KPMG's International Case Competition (KICC) is a chance for students to challenge yourself to solve a real business issue and an opportunity to meet new people across the globe.
In studying how successful organizations are developing their clinical and corporate governance, it becomes apparent that for a board to be 'in control' means having a culture devoted to quality, responsibility and accountability of staff, optimized and standardized processes, and systematic, real-time measurement.
Boards, C-suite executives, commissioners and regulators have spent decades developing the processes and activities associated with managing and reducing costs. However this research reveals they have much less experience and available guidance for quantifying, measuring and reporting the quality of patient outcomes in terms of safety, effectiveness, patient satisfaction and timeliness. Where other industries have introduced rigorous controls and reporting requirements, healthcare is still evolving its governance of quality care.
© 2015
KPMG International Cooperative ("KPMG International"), a Swiss entity. Member firms of the KPMG network of independent firms are affiliated with KPMG International. KPMG International provides no client services. No member firm has any authority to obligate or bind KPMG International or any other member firm vis-à-vis third parties, nor does KPMG International have any such authority to obligate or bind any member firm. All rights reserved.


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Devices and methods for electrolytic electrosurgery wherein a detector is located proximal to an active electrode on an electrosurgical probe, optionally disposed between the active electrode and a return electrode, the detector detecting at least on parameter relating to electrolysis. The detected parameter can include pH concentration, temperature, conductivity, impedance, ion, concentration, electrolytic gas consumption, electrolytic gas production, pressure or sound. The detected parameter can be employed in control systems to control systems to control activation or operation of the electrosurgical probe.
1. An apparatus for electrosurgery, comprising:
at least one active electrode for inducing electrolysis in an electrolyzable environment at a distal end of the apparatus; and
at least one detector proximal to the at least one active electrode for detecting a-temperature at the surgical site,
wherein the at least one detector comprises a thermo-luminescent crystal or a piezo-electric pyrometer adjacent to the at least one active electrode at the distal end of the apparatus that provides to a user a visible indication of the temperature at the surgical site at the at least one detector and wherein the at least one detector is positioned within the surgical site when the apparatus is in use.
2. The apparatus of
3. The apparatus of
4. The apparatus of
5. The apparatus of
6. The apparatus of
7. The apparatus of
This application is a continuation-in-part application of International Application No. PCT/US03/18116, International Publication No. WO 03/103521, entitled "Methods and Devices for Electrosurgery", filed on Jun. 6, 2003 and the specification thereof is incorporated herein by reference.
This application claims the benefit of the filing of U.S. Provisional Patent Application Ser. No. 60/387,114, entitled Methods and Devices for Electrosurgery, filed on Jun. 6, 2002, and of U.S. Provisional Patent Application Ser. No. 60/387,775, entitled Methods and Devices for Electrosurgical Electrolysis, filed on Jun. 10, 2002, and the specification of each of the foregoing is incorporated herein by reference.
The subject of this application is related to U.S. patent application Ser. No. 10/119,671, entitled Methods and Devices for Electrosurgery, to Morgan, et al., filed on Apr. 9, 2002, and to U.S. patent application Ser. No. 10/157,651, entitled Biologically Enhanced Irrigants, to Morgan, et al., filed on May 28, 2002 and the specifications thereof are incorporated herein by reference.
1. Field of the Invention (Technical Field)
The present invention relates to methods and devices for electrosurgery, including devices that operate in an electrolyzable media, including an aqueous electrolyzable media, by means of electrolysis and oxy-hydrogen combustion, and such devices with sensors and detectors for electrolysis and oxy-hydrogen combustion-specific parameters.
2. Description of Related Art
Note that the following discussion refers to a number of publications by author(s) and year of publication, and that due to recent publication dates certain publications are not to be considered as prior art vis-�-vis the present invention. Discussion of such publications herein is given for more complete background and is not to be construed as an admission that such publications are prior art for patentability determination purposes.
Electrosurgical devices have become widely popular for use in many medical treatment settings. However, limits in the ability to detect and measure the relevant parameters of the electrosurgical process have been known to impair the practitioner's ability to accurately and contemporaneously alter the electrosurgical application procedure to guard against treatment sequelae, induced iatrogenic damage, or to hinder the attainment of attaining treatment goals.
Although the need for such detection and measuring devices has been recently recognized, prior art contemplation and/or development of such devices has been limited to electrosurgical bulk property measurements such as temperature, fluid field impedance, and fluid field capacitance. This limitation has been due to both the inherent constraints in developing sensing and measuring devices within the foundation of the physiochemical paradigm of electrosurgery disclosed in the prior art, and to the perceived importance of such bulk property measurement for determining the extent and effect of electrosurgery.
As disclosed in U.S. patent application Ser. No. 10/119,671, electrosurgery has been incorrectly construed as being governed by plasma formation or related forms of ionization (see, e.g., U.S. Pat. Nos. 5,669,904, 6,206,878, 6,213,999, 6,135,998, 5,683,366, 5,697,882, 6,149,620, 6,241,723, 6,264,652, 6,322,549, 6,306,134 and 6,293,942, and the like), and this misconception has led to limited contemplation and development of detection and measuring devices for use during electrosurgical therapeutic applications. For example, in the plasma physiochemical paradigm of electrosurgery, it would be anticipated that detection and measuring devices would be contemplated and/or developed that require the use of instruments that can detect and measure the high energy emissions of plasma formation. Such emissions would include radiation elements such as free electrons, alpha particles, gamma particles, and x-rays. This approach has not been implemented, despite claims in the prior art that sufficient radiation signal intensity by means of a plasma is generated by the electrosurgical process, relative to normal background levels of radiation noise, necessary for treatment protocols and therapeutic effects. If sufficient radiation signal intensity is demonstrated, it would follow that useful detection and measuring devices could be developed with sensing and measuring algorithms for correlating these radiation measurements to treatment effects. However, this endeavor would require multivariate response surface modeling. Because modeling correlates currently exist only for highly idealized plasma generating environments utilizing vacuum chambers and/or magnetic field control, such detection and measuring devices have not been pursued. Extrapolating such ideal conditions to the in vivo application of electrosurgery methods and devices would prove insurmountable. For this reason, no further development of sensing and measuring devices of the electrosurgical process have been developed other than that of bulk property measurements; thus, plasma-related electrosurgical physiochemical paradigms have constrained the conceptualization and development of sensing and measuring devices for electrosurgery to those of the bulk property measurements as disclosed in prior art.
The perceived importance of bulk property measurement for determining the extent and effect of electrosurgery has been well documented. Quantifying energy input indirectly through temperature measurement, fluid field impedance measurement, and fluid field capacitance measurement is believed to indicated the degree to which electrosurgery will effect tissue and the host response thereof. Since such correlations have been extremely inconsistent in practice, a significant amount of confusion has surfaced regarding therapeutic electrosurgical protocols, often leading to the reduction in use of electrosurgical devices for certain applications. See, e.g., Thermometric determination of cartilage matrix temperatures during thermal chondroplasty: comparison of bipolar and monopolar radiofrequency devices. Arthroscopy, 2002 April; 18(4):339-46. The reliance upon bulk property measurements in developing therapeutic protocols incompletely addresses the true physiochemical processes of electrosurgery based upon the more detailed understanding of electrosurgery processes and phenomena described herein.
In the prior art, for example, temperature sensing devices have been disclosed that allow feedback measurement of the treatment environment temperature, such as referenced in U.S. Pat. Nos. 6,162,217, 5,122,137 and U.S. Published Patent Application 2001/0029369, and the like. These methods have been determined to be inaccurate due to the typically rapid changing milieu of the treatment locale. See, e.g., Radiofrequency energy-induced heating of bovine articular cartilage using a bipolar radiofrequency electrode. Am J Sports Med, 2000 September-October; 28(5):720-4. These devices do not accurately capture the multidimensional physiochemical occurrences of electrosurgery contemporaneously.
Further, fluid field impedance and fluid field capacitance sensing devices have been disclosed in prior art that allow feedback control of generator power output that drives the electrosurgical process, such as referenced in U.S. Pat. Nos. 6,306,134, 6,293,942, and the like. Energy delivery control is limited to these bulk properties which have yet to be accurately or completely correlated to the physiochemical governing relations of electrosurgery, and has proved to be too inaccurate relative to tissue response to serve as therapeutic benchmarking or controlling parameters.
However, as disclosed in U.S. patent application Ser. No. 10/119,671, the electrosurgical process is governed not by plasma or related forms of ionization but by electrolysis and oxy-hydro combustion. Therefore, development of electrosurgical devices and methods that are tailored to detect and measure the relevant parameters of electrolysis and oxy-hydro combustion are more appropriate and needed to enable desired treatment outcome. Clearly, there is a need for electrosurgical devices that are not only optimized to the true physical and chemical processes involved in the operation and use of such electrosurgical devices upon biologic tissue within safe energy spectra and power ranges, but also the need for the sensing and measurement of the true physiochemical occurrences of electrosurgery. Such devices will allow the more accurate and safe application of electromagnetic energy for electrosurgery to achieve intended outcomes.
Disclosed herein are two distinct means to accomplish these goals, which have heretofore not been contemplated or accomplished due to the lack of recognition of the electrolysis and oxy-hydro combustion process as inherent in electrosurgery: (1) the real-time simultaneous and contemporaneous detection and measurement of the relevant parameters of electrosurgery as described in the electrolysis and oxy-hydro combustion phenomena and (2) the placement of these detection and measurement devices within the surgical instrumentation itself, geographically juxtaposing sensing and measuring devices with treatment delivery devices, allowing for direct feedback of the treatment site to the medical practitioner.
In one embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member and means for sensing and transducing pH concentrations in proximity to the active electrode and return electrode. The means for sensing and transducing pH concentrations can include a miniature glass bulb and Ag—Cl sensing wire probe. The electrosurgical probe of the invention can further include an electrosurgical controller that incorporates the pH signal in control algorithms to meter power output to the active electrode.
In another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an elongated member with an active electrode and a return electrode separated by an insulating member at the distal end of such elongated member, with a thermoluminescent crystal generating a temperature signal positioned adjacent to the active electrode. The thermo-luminescent crystal can include a beacon insert within a larger insulating member. The thermo-luminescent crystal can be positioned so as to be immediately adjacent the active electrode. The electrosurgical probe can further include an electrosurgical controller that incorporates the temperature signal generated by the thermo-luminescent crystal in control algorithms to meter power output to the active electrode.
In yet another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a conductivity metering device that generates a conductivity signal. The conductivity metering structure can be located adjacent to the active electrode. The electrosurgical probe can further include an electrosurgical controller that incorporates the conductivity signal in control algorithms to meter power output to the active electrode.
In yet another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member and an acoustic detector device that generates an acoustic signal, thereby detecting the electrolysis phenomena and rate. The electrosurgical probe can further include an electrosurgical controller that incorporates the acoustic signal in control algorithms to meter power output to the active electrode.
In yet another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and an ion sensor device generating an ion sensor signal. The electrosurgical probe can further include an electrosurgical controller that incorporates the ion sensor signal in control algorithms to meter power output to the active electrode.
In yet another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a gas production sensor generating a gas production sensor signal. The electrosurgical probe can further include an electrosurgical controller that incorporates the gas production sensor signal in control algorithms to meter power output to the active electrode.
In yet another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a thermoelectric semi-conductor generating a thermoelectric signal. The electrosurgical probe can further include an electrosurgical controller that incorporates the thermo-electric signal in control algorithms to meter power output to the active electrode.
In yet another embodiment the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a piezo-electric thin-film pyrometer generating a piezo-electric signal. The electrosurgical probe can further include an electrosurgical controller that incorporates the piezo-electric sensor signal in control algorithms to meter power output to the active electrode.
The invention further provides a method wherein sensing, measuring, and detecting one or more relevant parameters of electrosurgery is performed, thereby allowing increased treatment safety, efficacy, and allowing the ability to more effectively utilize either electrolysis and/or oxy hydro combustion reactions and phenomena that occur during electrosurgical application, wherein such use of electrolysis and/or oxy-hydro combustion that occurs during electrosurgical application is part of the treatment protocol.
A primary object of the present invention is to devices and methods relating to detection of one or more parameters relevant to electrolytic electrosurgery.
Another object is to provide detectors or sensors located proximal to the active electrode of an electrolytic electrosurgery probe.
Another object is to provide detectors or sensors disposed between an active electrode and a return electrode of an electrolytic electrosurgery probe.
Another object is to provide detectors or sensors located within a cavity or chamber wherein the active electrode of an electrolytic electrosurgery probe is disposed.
Another object is to provide detectors or sensors located within a variable volume cavity or chamber wherein the active electrode of an electrolytic electrosurgery probe is disposed.
Yet another object of the invention is to provide detectors or sensors for measuring one or more parameters including pH concentration, temperature, conductivity, impedance, ion concentrations, gas production or sound.
Yet another object of the invention is to provide control systems for controlling an electrolytic electrosurgery probe utilizing detectors or sensors determining one or more parameters relevant to electrolytic electrosurgery.
Other objects, advantages and novel features, and further scope of applicability of the present invention will be set forth in part in the detailed description to follow, taken in conjunction with the accompanying drawings, and in part will become apparent to those skilled in the art upon examination of the following, or may be learned by practice of the invention. The objects and advantages of the invention may be realized and attained by means of the instrumentalities and combinations particularly pointed out in the appended claims.
The accompanying drawings, which are incorporated into and form a part of the specification, illustrate one or more embodiments of the present invention and, together with the description, serve to explain the principles of the invention. The drawings are only for the purpose of illustrating one or more preferred embodiments of the invention and are not to be construed as limiting the invention. In the drawings:
For many years, the etiology of the phenomena observed in medical procedures utilizing radio frequency energy sources has been misidentified. As an example, in a recent publication, Stalder et al: Repetitive plasma discharges in saline solutions, Applied Physics Letters, December 2001, the electrosurgical condition expected during a standard electrosurgery procedure was tested. The authors describe photon emission from a saline solution as the hypothesized result of the formation of free electrons and positively charged ions interacting within a thin vapor envelope. Despite their contention and physiochemical hypothesis, it has become clear that this paradigm is incorrect. It is not possible that this phenomenon, should it exist at all, exists to a level responsible for the effects observed in electrosurgery. In fact, the contribution of a plasma to the treatment of organic matter in this instance is negligible as disclosed below. A more reasonable cause of the phenomena observed during electrosurgical procedures and applications, which more clearly fits the observations of Stadler et al, is the result of electrolysis and oxy-hydro combustion, as disclosed in U.S. patent application Ser. No. 10/119,671.
As further clarification of this disclosure, review of the definition of plasma, a definition that has become well accepted in the scientific community, is relevant. This review demonstrates that as medical applications have been developed utilizing radio frequency energy, misconceptions regarding the use of the term "plasma" have surfaced due to the common and traditional link between radio frequency energy and plasma formation in other settings.
It is no longer necessary to hesitantly state as many early and recent textbooks did and do that a fourth state of matter exists in the universe—referred to as a plasma. Ionizing radiation is ubiquitous in the universe and is most commonly witnessed as the fusion process in stars. The ubiquity of plasma becomes clear when the total abundance of all elements in the universe is considered as more than 99% of the universe's total mass exists within stars. The state of matter found in stars is considered to be this fourth state of matter, or plasma. Related to a gas by the general disorder and random distribution of particles, a plasma differs from ordinary gases in that its particles are mostly deficient of an electron, making them positive ions. In natural stable plasmas like the sun, stability is maintained by the enormous gravitational forces which contain the particles. The conditions found in stars of high temperatures and gravitational forces results in the only non-transient, stable, free natural plasmas known.
Plasmas formed in laboratories and those used for industrial applications such as metal fabrication are considered metastable, as the equilibrium state of the plasma components at standard pressure and temperature is one of the more commonly known states of matter, i.e. solid, liquid, or gas.
Without sustained input energy, plasmas normally self-quench and revert to one of these more stable states of matter via several processes. The most common of these processes is the recombination of a free electron with an ion dropping the total internal energy of the plasma below its normal "activation" energy; in most cases this results in the formation of a gas. A second common scenario is the attraction of the positive ions within the plasma to a negative ground. Positive ions will naturally flow toward the strong negative potential generated by the earth (lightning provides a commonly known example), similar to the conditions responsible for the movement of charge in electrical circuits.
As a result of the natural propensity of a plasma to self-quench via these processes, man-made plasmas must overcome these obstacles. This feat is typically accomplished by the steady input of energy into the plasma to constantly strip electrons from atoms and the confinement of both the electron and ion via a magnetic field (preventing the flow to ground). Man-made plasma formation is the result of either of two well-known processes, radio frequency coupling or heating. These two processes are fundamentally different but create the same effect of ion formation and preventative recombination. Plasmas generated by radio frequency sources use high frequency, high potential electromagnetic radiation to strip electrons from the outermost shells of the atoms in a gas. The energy coupled to plasma not only creates the ions and electrons, but also keeps them from recombining. In plasmas generated by high temperatures, large electrical currents are passed through filaments which results in heating. This heating actually causes electrons to "boil" off, by means of thermal excitation, the filament. The electrons then interact with the gas surrounding the filament, easily displacing electrons from their respective orbital sites, creating positively charged ions. The high temperature case is the effect observed in stars (a result of hydrogen-hydrogen fusion into helium), wherein the temperatures are high enough to both strip electrons from the gas and keep them from recombining. What becomes evident from observation of man-made plasma in the laboratory or industrial case is that very high energy must be continuously added to the system to maintain matter in the plasma state.
Yet another obstacle in the plasma paradigm of electrosurgery is the containment of the plasma as to prohibit the loss of charged particles to a ground plane so that they may be available for therapeutic effects. This containment is ordinarily accomplished by confining the electrons and ions in a magnetic field, so that when plasma is condensed, the efficiency of free electron and gas interaction cascades, thereby converting yet more gas into plasma. In vacuum conditions, a small partial pressure of gas can be excited to form a plasma with just one single electron. A single electron yields a cascade effect inducing secondary electrons which in turn generate a third and multiple generation electrons to the point where a sustainable plasma is created. This is dependent upon the total pressure of the system and the necessary confinement of the plasma to prevent self-quenching. Without these conditions it is unlikely that a plasma could be sustained or even form at all. In laboratory practice, man-made plasma begins within near ideal vacuum conditions and is constrained by high energy magnetic fields. In the industrial case, prolonged high energy input is required as in metal fabrication.
Superimposing the plasma paradigm in the surgical setting increases the already manifold constraints governing creation of a plasma. Liquids as encountered in either endoscopic or in vivo conditions typical of electrosurgical applications are not the ideal medium for plasma formation, as the energy needed to create an electron-ion pair is higher, as energy first must be used to break molecular bonds. In traditional plasmas, as mentioned above, a considerable amount of energy is needed to sustain a plasma for its intended purpose. In order to create and sustain a plasma condition in the body, itself constituted largely of water, it becomes evident that large amounts of energy would be needed. It can be calculated that the energy needed to cause tissue ablation, cutting, or coagulation, for example, via plasma would cause serious collateral harm to the patient. This circumstance provides a significant problem for the plasma paradigm of electrosurgery.
The following calculations illustrate that a "plasma" does not contribute significantly to the overall clinical effect of electrosurgery. The energy current needed to vaporize water and then sufficiently ionize the remaining molecules into a plasma is beyond the energy input of the electrosurgical system. Further, the electrosurgical system exhibits impedance rather than conductivity within the instrument effecter area.
The phenomenon of electrolysis and oxy-hydro combustion provides a more accurate alternative to the plasma paradigm. It is generally accepted that an electrosurgical probe system must create a "vapor pocket" immediately about the active electrode surface in order for any plasma-like activity to become evident. As an example, this requires the complete vaporization of a 0.9% by weight solution of sodium-chloride in deionized water. Any such dilute solution will result in a boiling point elevation and require additional energy input to reach the saturated vapor state. The typical boiling point elevations for such solutions range from 1%-5% and can be considered negligible for the purposes of this exercise (i.e. a saline solution will not boil at exactly 100� C., but rather on the order of 10� C. to 102� C. depending on the specific ambient pressure conditions of the fluid field). If we assume that water makes up the bulk of the components in question and look to the thermodynamic requirements to boil water on a per-pound-mass basis, it is known that:
In an alternative analysis, it is noted that plasma states of matter, as highly ionized gas conditions, are known to be excellent electrical and thermal conductors due to the rapid Brownian motion of the constituent atomic particles and freely available electrons for conduction of current. This suggests some specific behavioral characteristics which can be illustrated simply.
Given that the ionization energies of typical atomic elements can be expressed as:
The electrical conduction characteristics of all plasmas are fairly well known and are most plainly called conductors. Plasmas do not exhibit high impedance characteristics that are common to simple gas volumes. Because they are highly ionized, there are sufficient free electrons to easily conduct current and as such do not provide significant impedance to current flow. A generic characteristic curve for a plasma's impedance profile once established is set forth in
It is evident that plasma would not behave electrically as does operation of an electrosurgical probe, because plasma would be an ideal conductor and show net reduced impedance to current flow once plasma was established. This is clearly not the case in the manifestation of a typical electrosurgical probe.
For the purposes of further analysis, the thermo-chemical approximations of water rather than a 0.9% NaCl aqueous solution can be utilized, again underestimating energy requirements, on the assumption that the initial state of the water starts out at approximately 25� C. and must result in full film boiling, approximately 100� C., to sustain the "vapor pocket" required for a "plasma." If the volume of water that is to be affected equals 0.3 cm3, then to initiate full film boiling:
With this background information at hand, a series of experiments was conducted to further clarify the relevant parameters of electrosurgery, as disclosed in
In one protocol, illustrated in
These experimental results, based upon the premise that ionizing radiation will produce detectable x-rays exceeding background levels, invalidate plasma formation as a means to achieve the effects of the electrosurgical process. Single ionizing events may occur on a theoretical basis, but would do so at a limit well below detection, and certainly would not be sufficient for any tissue treatment protocol. As an example, a theoretical mathematical exercise was conducted in which the assumption was made that plasma actually does form at a maximum energy level equal to background levels of 200 dpm (disintegrations/minute) or 3 dps (disintegrations/second). In the experimental set-up, it was estimated that the air-water interface reduced the total transmittance by a factor of 100 and the solid angle effect of the detector accounted for another factor of 1000 reduction. Using the transmittance reducing elements to estimate the disintegrations per minute of the plasma at its core, then we have (102�103�101�60 dps/dpm) or [air/water interface reduction]�[solid angle detector effect]�[nominal background level order of magnitude]�[min to sec. Conversion of 10], or a value of 107 dps, which is approximated as an x-ray yield from the electrosurgical tool during discharge. If each x-ray is the result of a single charged particle or free electron/solid interaction, which is a gross idealization erring on the side of higher charged particle/x-ray ratio, a maximum amount of ionized particles of 107 is possible. We know the energy of the charged particle is on the order of 1 keV, or approximately 10−16 Joules per particle. Multiplying the total ideal theoretically available particles by the maximum energy per particle (107�10−16) yields a total energy per second capacity on the order of 10−9 J, or a nano-Watt for the ion component. Since charged particles at 1 keV would travel no more than 100 Å, the total effected volume would be extremely and impracticably small. Since gross observation of the electrosurgical process and its function clearly demonstrate effects of the probe at ranges past a centimeter, the effects of an electrosurgical apparatus typically utilized for medical treatments cannot be due to such low level ionizing radiation, if it exists at all, as demonstrated by distances employed in practice. Theoretical single or small scale random and uncontrollable ionization events would be more reasonable terminology to describe any such creation of ions and electrons in the solution relative to treatment goals rather than plasma formation for those so inclined. Since the creation of ionizing radiation is not detectable above background radiation noise in which all tissue resides here on earth, the mechanism for electrosurgical procedures and the corresponding tissues effects are unrelated to these hypothetically proposed low level ionizing radiation occurrences.
Further, evaluation of the well known interaction of ionizing radiation with cells adds more evidence that ionizing radiation does not play a role in the electrosurgical treatment process. Ionizing radiation when applied to cells or tissue leads to molecular changes and to the formation of chemical species that are damaging to cellular constituents, such as chromosomal material. Such damage leads to irreversible alterations in the function and construction of the cell itself, damage that is readily observed histologically. The process that occurs when ionizing radiation is applied to the cell begins with conversion of water after ˜10−16 seconds. This is depicted as H2O→H2O++e− with the application of ionizing radiation. The next occurrences are as follows over the next ˜10−6 seconds: H2O+→H++OH; H2O+e−→H2O−; H2O−→H+OH−. H and OH are considered free radicals and participate in further reactions. The most prominent is the formation of hydrogen peroxide as follows: OH+OH→H2O2. These products react with the organic constituents of the cell and tissue, such as nucleic acids and hydrogen extraction from pentose, to release organic free radicals induced by radiation damage. Histological evidence of the electrosurgical process as disclosed in U.S. patent application Ser. No. 10/119,671 clearly does not provide evidence of radiation induced tissue damage at any level of linear energy transfer. Histological evidence demonstrates levels of necrosis, such as karyorrhexis and nuclear picnosis at one end of the spectrum to frank necrosis or vaporization at the other end of the spectrum, as would be expected from electrolysis and oxy-hydro combustion. It would be expected that any ionizing radiation effects, should they occur in electrosurgery, would have manifested themselves long term as local radiation injury, given that electrosurgical methods and devices have been in wide spread use for over 50 years. The disparity between the description of electrosurgery in the prior art as governed by plasma formation and/or ionizing radiation and concerns for the induction of ionizing radiation-related disease is readily apparent in prior art and the medical literature. This evaluation of radiation induced cellular and tissue changes adds additional evidence that sensing and measuring devices developed for the relevant parameters of electrosurgery would not include those that may detect hypothetical and necessarily irrelevant low level ionizing radiation.
The foregoing disclosure helps to define the relevant parameters of electrosurgery as related to electrolysis and oxy-hydro combustion as disclosed hereafter.
The equations of
Chemical equations 10 generally govern the process, whereby the initial liberation of elemental oxygen and hydrogen gases 30 occurs by means of electrolysis. Given that the underwater electrosurgical process occurs in a salt solution, either that applied as an irrigant or that of the tissue or cell itself, such as a 0.9% by weight saline solution, the true role of these elements has been reconciled. The presence and true action of the salt, such as sodium chloride (NaCl), can be accounted for by means of equations 10. The normal stoichiometry of the electrolysis reaction dictates that if elemental gas separation is occurring, then the solute participants must join with the remaining solution components of water to form a complementary acid-base pair. This pair is shown on the right-hand side of the upper half of equations 10 as hydrochloric acid 15 and sodium hydroxide 20 base pair. As is well known, hydrogen and oxygen gases 30 can be co-mingled without spontaneous exothermic reaction. A small amount of energy, such as RF energy 40, is required to initiate the nominally endothermic reaction and ignite the oxy-hydro combustion. Once ignited, the reaction will continue until all the reactants are consumed and reduced to the products shown on the right-hand side of the lower half of equations 10.
The equations of
The equations of
The equations of
The modes of electrolysis and oxy-hydro combustion operation described in
A preferred embodiment of the present invention disclosed herein is use of thermo-luminescent crystals 160 as depicted in
Yet another embodiment is the use of thermoluminescent crystal material, such as those described above, as depicted in
Yet another embodiment is shown in
It is further to be appreciated that a fixed cavity probe may be employed, such that one or more active electrodes are disposed within a cavity, the distal end of the probe ending beyond the end of the one or more active electrodes. Return electrodes may be provided, which return electrodes can be within the cavity or without the cavity, and in one embodiment are located on the exterior or interior surface of the probe on the portion of the probe forming a cavity. In this embodiment, one or more detectors or sensors may be provided, preferably located within the cavity. However, detectors or sensors may also be integrated into the probe body, such as by forming a part of the cavity wall, or may be located on the exterior of the probe.
Other detectors or sensors may be employed to determine parameters relevant to either electrolysis or to oxy-hydro combustion, or to both. In one embodiment, the detector detects local pressure changes, and includes a pressure sensor. Such pressure sensor may be employed to determine the position of a probe with respect to tissues, such as whether the probe touches a tissue, or may alternatively be employed to detect local pressure changes relating to either electrolysis or oxy-hydro combustion. In another embodiment, the detector detects consumption of interfacing media, particularly oxygen or hydrogen, such consumption including consumption by oxy-hydro combustion.
It is to be appreciated that the same sensor or detector may detect a parameter relating to electrolysis and also a parameter relating to oxy-hydro combustion, and may further detect parameters relating to the transition to oxy-hydro combustion. Thus electrolysis and oxy-hydro combustion may occur successively or simultaneously, and the relationship thereof can be monitored and determined by means of data collected by the sensor or detector.
It is also to be appreciated that any of the probes or devices disclosed herein may have two or more active electrodes, and may also have two or more return electrodes. In some embodiments, the return electrode may form a part of the body of the probe. Similarly, two or more different detectors or sensors may be provided, determining two or more different parameters. Alternative, two or more detectors or sensors may be provided, but at different locations on the probe, providing relevant information about either electrolysis or oxy-hydro combustion. For example, one temperature probe may be located at the distal end of the probe, to measure temperature at the site closest to tissue being treated, while a second temperature probe may be removed some distance, such as by locating on an insulated exterior surface of the probe, to determine the area of temperature change. Other such combinations and permutations are both possible and contemplated.
Understanding of the foregoing reaction conditions makes clear the utility of sensors or detectors proximal to the active electrode for local measurement of relevant parameters, such as temperature, pH, conductivity, impedance, ion concentrations, gas production—particularly hydrogen or oxygen production, and sound. Determination of relevant parameters allows adjustment in operation of the electrolysis probe, such as adjusting power, radiofrequency, electrolytic media flow or composition, and the like.
Accordingly, the use of methods and devices that allow sensing, detecting, measuring, and controlling relevant parameters of electrosurgery as described in this invention provide for new and unexpected advantages to the medical practitioner and patient in improving electrosurgical treatments, providing better control of electrosurgical treatments, and improving overall efficaciousness of electrosurgical treatments, as depicted in
Those skilled in the art will clearly see that controls for modern electrosurgery should rely upon sensing electrosurgical physiochemistry to better inform practitioners of potential harmful effects of electrosurgical treatments that are not desired for a particular therapeutic application. Furthermore, these methods and devices provide knowledge of the actual mechanisms at work in electrosurgery procedures that provide new paradigms for treatments heretofore unrecognized, to thereby enhance surgical outcomes.
The scope of the invention should be determined by the appended claims and their legal equivalents, rather than by the examples given. The preceding examples can be repeated with similar success by substituting the generically or specifically described elements and/or operating conditions of this invention for those used in the preceding examples.
Although the invention has been described in detail with particular reference to these preferred embodiments, other embodiments can achieve the same results. Variations and modifications of the present invention will be obvious to those skilled in the art and it is intended to cover in the appended claims all such modifications and equivalents. The entire disclosures of all references, applications, patents, and publications cited above are hereby incorporated by reference.
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