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A MR compatible monitoring system has a fiber optic data link between the patient monitor and the control room display/keyboard in a magnetic resonance imaging suite to allow for continuous monitoring of a patient's vital signs and provides critical care patients with the same diagnostic options as stable patients. The patient monitor is mounted on the far end of a magnetic resonance compatible patient transporter. The patient transporter sends video data and receives control data from the control room. During the imaging, the patient monitor is located within the magnet room. Magnetic resonance imaging systems are very sensitive to radio frequency interference (RFI) from other equipment and may produce image artifacts because of this interference. Using a fiber optic data link between the patient monitor near the magnet and the control room will minimize the potential RFI.
1. A MR compatible patient monitoring system for connecting to a remote terminal comprising:
a patient transporter;
a shielded enclosure attached to the patient transporter;
a system interconnect, positioned external to the the shielded enclosure;
a microprocessor, positioned within the shielded enclosure;
a LCD display, positioned within the shielded enclosure;
a control panel, positioned within the shielded enclosure;
characterizing means for characterizing a magnetic field;
a MR immune transceiver positioned within the shielded enclosure, connecting to the system interconnect; and
a physiomodule, being operative to monitor a patient, positioned within the shielded enclosure; wherein the LCD display, the control panel, the characterizing means, the MR immune transmission means, and the physiomodule are connected to the microprocessor.
2. A MR compatible patient monitoring system, as defined in claim 1, wherein the characterizing means includes a magnetic field sensor and a magnetic field indicator, connected to the magnetic field sensor, that indicates the magnetic field near the MR scanner.
3. A MR compatible patient monitoring system, as defined in claim 2, the magnetic field indicator further includes a visual indicator.
4. A MR compatible patient monitoring system, as defined in claim 2, the magnetic field indicator further includes an auditory indicator.
5. A MR compatible patient monitoring system, as defined in claim 2, the magnetic field indicator further includes a monitor protector that is operative to disable the patient monitoring system when a selected threshold is exceeded to prevent damage to the patient monitoring system.
6. A MR compatible patient monitoring system, as defined in claim 1, wherein the system interconnect is a manual cable connector assembly.
7. A MR compatible patient monitoring system, as defined in claim 6, where the characterizing means is a magnetic field sensor.
8. A MR compatible patient monitoring system, as defined in claim 6, wherein the system interconnect is a retracting cable assembly.
9. A MR compatible patient monitoring system, as defined in claim 1, wherein the MR immune transmission means is a fiber optic data link.
10. A MR compatible patient monitoring system, as defined in claim 1, wherein the MR immune transmission means is a duplex microwave link.
11. A MR compatible patient monitoring system, as defined in claim 1, wherein the MR immune transmission means is a duplex infra-red link.
This invention relates to a patient monitoring system that is compatible with an environment having strong electrical and magnetic field levels, such as that found near a magnetic resonance imaging system.
Although a patient may physically appear to be in good health, cardiovascular conditions, such as stenosis, are difficult for a physician to confirm with just his five senses and training. Preventive care measures cannot be suggested because the physician has insufficient data to make a diagnosis. A magnetic resonance (MR) scanner is a medical diagnostic tool which can provide this data by imaging the anatomy, as well as performing in-vivo, non-invasive, spectroscopic analysis of stable patients. The patient is positioned in a homogeneous polarizing magnetic field Bo and then briefly excited by irradiation with a radio frequency at the Larmor frequency (f=yBo, where y=42.57 MHZ/Tesla). The MR signals emanating from the patient in response to the stimulus are observed. The MR scanner includes a magnet, frequently of solenoidal design, which produces the polarizing magnetic field, typically between 0.2 and 2.0 Tesla. The bore of the magnet has a large diameter to accommodate the RF, gradient, and shim coil assemblies, as well as the patient. A sliding patient tray is used to position the patient within the bore. The patient tray is longitudinally aligned with the magnet at a fixed height for patient positioning.
If a patient undergoing a MR scan becomes critically ill, he must be quickly moved outside of the MR scanning room. This is necessary because most of the support equipment, (i.e. a defibrillator) used for critical patient care is not compatible with the MR scanning room environment. In the MR scanning room, there are strong magnetic and electric fields which may adversely affect the operation of the support equipment. Conversely, the support equipment may adversely affect the operation of the MR scanner.
The strong magnetic and electric fields found in the MR scanning room make it difficult to monitor a patient's vital signs. Because of these strong fields, the patient's vital signs are sometimes observed on monitoring equipment located externally to the MR scanning room. Long cables are then required to connect the patient to the monitoring equipment. These cables are subjected to the strong electric and magnetic fields found in the MR scanning room. These conditions place extreme demands on the shielding properties of the interconnecting cables. The length of these cables may introduce unacceptable signal loss and degradation of the associated physiological parameter measurements. In addition, these cables tend to drape across the patient as they exit the bore of the magnet. This cable placement poses a potential interference to quickly evacuating a patient from the MR scanner in an emergency situation. In addition, the cables are subject to damage should they be run over by the patient transporter during the movement of the patient. As a result of these issues, critical care patients are not always provided with continuous monitoring of their vital signs during MR scanning.
A patient monitoring system that is compatible with the MR scanning room environment and does not impede the transport of critical patients out of the scan room is therefore desirable.
A MR scanning room compatible patient monitoring system allows continuous monitoring of a patient's vital signs during the MR scans. This monitoring system may be mounted on the far end of the MR compatible patient transporter. The transporter is used to transfer the patient to and from the magnet in the MR scanning room. A fiber optic data link connects between the patient monitor, the MR scanner, and the control room.
The MR compatible patient monitoring system has an shielded enclosure that acts as a Faraday shield. The patient monitor's microprocessor, LCD display, a control panel, a magnetic field sensor, a fiber optic data link, and at least one physio module are contained within the shielded enclosure. A clinician can observe the patient's vital signs on the LCD display and make any adjustments via the control panel.
FIG. 1 illustrates a MR compatible patient monitoring system.
FIG. 2 illustrates a functional block diagram for the MR compatible patient monitoring system shown in FIG. 1.
FIG. 3 is a system diagram of the physio-module block shown in FIG. 2.
FIG. 4 illustrates the fiber optic data link shown in FIG. 1.
FIG. 1 illustrates a MR compatible patient monitoring system 10. A patient monitor 12 is mounted at one end of a patient transporter 14. The patient transporter 14 has a patient tray 16 which slides into a bore of a magnet 18. A system interconnect 20 connects between the patient transporter 14 and the magnet 18.
FIG. 2 illustrates a functional block diagram for the MR compatible patient monitoring system 10 shown in FIG. 1. A processor/memory block 22 is connected to a magnetic field sensor 24, a LCD display 26, a control panel 28, physio module block 30, power supply 32, and a fiber optic data link 34. The magnetic field sensor 24 is further connected to the power supply 32. The power supply 32 and the fiber optic link 34 are connected to a system interconnect 20. All of the aforementioned components are contained within a shielded enclosure 36.
The processor/memory block 22 provides the central computing and control function required for the monitoring system 10. This includes the acquisition and processing of the patient's physiological signals, the control and verification of the various subsystems as well as the display 26 and user control panel 28. In this embodiment, this block is based on a high performance 32 bit microprocessor. The associated program and data memory requirements are provided by the processor/memory block's RAM and EEPROM memory arrays.
The magnetic field sensor 24 senses the ambient magnetic field that the patient monitor is operating in. It calculates the absolute magnitude of the ambient field by using a Cartesian coordinate field sensor. The absolute magnitude of the ambient field is then compared against three threshold values. As the patient transporter 14 is moved through the MR scanner room, the patient monitor may be subject to magnetic field levels which would adversely affect its operation. The magnetic field sensor 24 warns the user by visual and audio indicators if the ambient field strength is approaching the level (the first threshold) at which operation of the monitor would be affected. If the field continues to increase and then exceeds the second threshold, the magnetic field sensor 24 will disable the operation of the patient monitor until the field level falls below a preset value (the third threshold). The sensor 24 continues to provide the user with an indication of the ambient field level even when the monitor is disabled.
The power supply 32 provides the power requirements for the patient monitor. In this embodiment, the power supply 32 consists of a DC-to-DC converter, battery charger, and rechargeable battery. The DC-to-DC converter converts the battery voltage into the various voltages required by the patient monitor. The battery charger maintains the battery's charge when the monitor is connected to either the MR scanner or to an external charging port.
The fiber optic data link block 34 provides the data and control link between the patient monitor and the MR scanner. The fiber optic data link block 34 supports remote displays and control of the patient monitor, as well as the exchange of data, control and status information between the MR scanner and the patient monitor. The block features a high speed, duplex long wavelength fiber optic transceiver. The interface between the fiber optic transceiver and the processor subsystem is handled by a set of specialized receive and transmit integrated circuits. This chip set provides the parallel-to-serial and serial-to-parallel data conversion, data formatting, clock recovery, and link control logic.
The system interconnect 20 provides the connection between the patient monitor and the MR scanner. It consists of an umbilical cable 20A and a connector 20B featuring both electrical and optical contacts. The cable 20A is routed through the patient transporter 14 where it is then mated to the matching receptacle on the MR scanner 18.
The umbilical cable 20A consists of a duplex fiber optic cable pair and a pair of electrical conductors surrounded by a common PVC outer jacket. Each of the fiber optic cables has a core diameter of 62.5 micrometers and a cladding diameter of 125 micrometers. These fiber optic cables are used to support the duplex data and control link between the patient monitor and the MR system. The electrical conductors are used to supply the patient monitor's DC to DC converter/battery charger.
The connector 20B features a pair of fiber optic contacts. These contacts are capable of repeated mate/demate cycles while maintaining the required optical performance. The connector body is made of a structural plastic, i.e. PEEK, to minimize the production of particulate during the mate/demate cycle. These particulates and environmental factors, such as dirt, dust, and smoke, could reduce or obscure the transmission of light through the connector. To safeguard against the environment factors, the connector uses a sealing cap that retracts during the mating cycle. The matching receptacle on the MR scanner uses a set of shutter doors which prevent degradation of the contacts due to environmental factors. The shutter doors swing aside during the mating cycle.
In one embodiment, the system connector 20B is a cable/connector assembly that the user can plug into a matching receptacle on the MR scanner once the patient transporter has "docked" with the MR scanner. The user will unplug the cable when the transporter has been "undocked". The cable is managed by a cable retraction system on the patient transporter to prevent the cable from damage when not in use. Alternately, the system connector can be part of a docking mechanism which automatically makes and breaks contact as the transporter is "docked" and "undocked" with the MR scanner.
The LCD display 26 presents the patient parameter data to the clinicians. An LCD type display was selected because the strong magnetic fields in proximity of the MR scanner make use of a CRT type difficult.
The control panel 28 allows the user to control the operation of the patient monitor. It contains an array of keys and indicator LEDs.
The shielded enclosure 36 serves two major functions. The first is to reduce the radiated emissions from the patient monitor internal circuits to a level where they will not cause any interference to the operation of the MR scanner. The second function that it serves is to reduce the internal level of the ambient electrical fields.
FIG. 3 is a system diagram of the physio-module block 30 shown in FIG. 2. The physiomodules support the acquisition and conditioning of several patient parameters. Three such modules, such as 30A-C, are shown by way of illustration.
The ECG physio-module 30A handles the patient's ECG signal. It contains isolation amplifiers, filter states, analog to digital convertors, and adaptive filtering stages. The adaptive filters use knowledge of the operation of the MR scanner to filter the gradient noise components from the ECG signal.
The pulse oximeter block 30B handles the patient pulse oximeter parameter. It uses a transducer which uses fiber optic cables to send the light from a set of visible and infrared light sources to the measuring site and to return the transmitted component to a photo detector. This transducer is usually applied to a finger and the ratio of transmission of the visible and infrared light sources to the finger is measured. This ratio is used to calculate the percentage of oxygenated hemoglobin for the patient. The block contains a light source driver stage, photo detector amplifier, and filter stages, and analog to digital convertors.
The non-invasive sphygmomanometer 30C handles the measurement of the patient's blood pressure. It uses an inflatable cuff which is applied to the patient's arm or leg. The cuff is connected to the monitor via a non-conductive air tube. The block contains the cuff pump, pressure sensor, and analog to digital convertor. The cables which are used to connect the patient to the three parameter blocks are integrated into the patient transporter with a cable management system. This system protects the cables during transport to and from the MR scanner and while the patient table is sliding in and out of the magnet.
FIG. 4 illustrates the fiber optic data link 34 shown in FIG. 1. An Electrical/Optical (EO) block 38 is connected to a Serial-to-Parallel block 40 and a Parallel-to-Serial block 42. A Link Control block 44 is connected to the Serial-to-Parallel block 40 and the Parallel-to-Serial block 42. The Link Control block 44 is further connected to a Microprocessor Interface Controller 46. The Microprocessor Interface Controller 46 is further connected to a Receive Data Demultiplexor 48, a Transmit Data Multiplexor 50, and a Voltage Level Translator block 52. The Voltage Level Translator block 52 is further connected to the Receive Data Demultiplexor 48 and the Transmit Data Multiplexor 50. The Receive Data Demultiplexor 48 is further connected to an Analog-to-Digital Converter block 54.
The EO block 38 converts the incoming optical signal to a serial electrical signal and conversely, the serial electrical signal into an optical output signal. The optical signals are coupled to and from a duplex fiber optic cable. In this embodiment, this block is comprised of an Hewlett-Packard HFBR 5205 Multi-mode Fiber Transceiver that operates at a wavelength of 1300 nm.
The Serial-to-Parallel block 40 converts the serial electrical output signal from the EO block into a parallel digital signal. This block contains the clock recovery, signal detect, and framing circuits.
The Link Control block 44 controls the operation of the fiber link. Upon being connected to the fiber optic link cable through the system interconnect, it outputs a series of unique data packets which are designed to facilitate synchronization with the matching fiber link subsystem at the other end of the fiber cable. It also initiates a search for these synchronization packets on the incoming optical path via examining the EO serial output. Upon detection of the synchronization packets, it enables data to be sent to and received from the link. The link control block 44 monitors the operation of the operation of the link and flags any data errors. For non-recoverable errors, it disables local use of the link and periodically attempts to re-establish connection.
In this embodiment, the Serial-to-Parallel 40, Parallel-to-Serial 42, and the Link Control 44 blocks were implemented using the Hewlett-Packard HDMP1012 and HDMP1014 integrated circuit chipset.
The Voltage Level Translator block 52 bidirectionally translates the data, control, and status signals from one set of logic levels to another. In this embodiment, the logic voltage levels are TTL and PECL.
The Transmit Data Multiplexor 50 organizes the parallel data which is to be sent as output on the fiber link. There are several sources for this data. These include the remote display video data, physio data, and monitor status data.
The Receive Data Demultiplexor 48 inputs the received and translated parallel data from the Serial-to-Parallel block 40. The data is demultiplexed and sent to a number of outputs. The outputs include video update data, remote keyboard and system control data and external data.
The Analog-to-Digital Converter block 54 converts the externally received digital data via the link into an analog signal. This signal is output to an analog multiplexor and it can be used by the patient monitor to provide local audio annunciation, as well as an analog source useful for signal injection and system verification.
The Microprocessor Interface Controller block 46 provides two major functions. The first function is to support the patient monitor interface to the fiber data link. It contains several state machine logic circuits which in conjunction with the control logic of the Link Control block 44, determine the operation of the fiber link. It coordinates the synchronization of the operation of the Transmit Data Multiplexor 50 and the Receive Data Demultiplexor 48 to ensure the correct data position in the multiplexing cycle. The second function of this block is to support access to the fiber link and it's operation by the patient monitor resident microprocessor. It provides an interface that appears to the microprocessor as a series of registers. Read and write cycles to these registers allow the microprocessor to send and receive data, control the mode of operation as well as to examine the status of the fiber data link.
Patent Citations
Referenced by
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The Adventure Knitting pdf includes the pattern collection as a DIY book that you can print out, fold up, bind, and cover into a full on book! Print out the pages you want (8 pages for the full pattern, and 2 optional pages for the charts), plus the cover if you like, and grab some scissors.
Here's a video tutorial; scroll down for photos and written how-to's (or see the video on YouTube here)...
fold the individual booklets
print out each booklet page on your standard size paper, centered, fit to page so that no text gets cut off (it's okay if you need to shrink it to make it all fit)
note: for all these folds, do not crease super hard now.
if the page did not print centered, fold on that line, then trim off excess white space to make the edges line up when it's folded on the line
fold page widthwise, folding on the little notch in the middle of the long line, which is the center of the book page
with the page folded widthwise, bring each side up to that center fold, making folds that land at the ends of the long line (so you are dividing the page into fourths, fold lines between the book pages)
trim off excess white space on either edge that goes up past the center, so that if you open up the center fold, the edges just meet and don't overlap
once your page is folded, and all excess white space has been trimmed off, you should have the page divided into eight equal size rectangles, with all the fold lines running between the book pages
with page folded in half widthwise, cut along center printed line, up to the next fold line, through both layers of the folded page (you're cutting a slit through the center of the page)
open up the page, then fold lengthwise, and the paper should open up like you see here
find the cover page of the booklet, and wrap all the pages around with the cover on top
hold those pinched pages down on your tabletop, held neatly lined up, and bring the cover page up over the top, as tightly as possible, then crease everything into place
now you should have a neatly folded booklet
bind into a full book
you'll need your 8 or 10 folded booklets, a pencil, a sewing needle (an embroidery needle works well), and sturdy thread
go in top center page of second book, out bottom
*if you are going to use the cover and don't want the first and last pages hidden inside the pockets, make blank pages to add on
neatening up the spine:
extra bound binding

subset: commoncrawl


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Thank you for over 12.9 million views of the SuccuWiki!
From SuccuWiki - The Wiki of the Succubi
For other uses of the word Succubus, see Succubus (disambiguation).
General Information
- Item Number: ZR003
- Figure Name: Luzbelle
- Manufacturer: Zenit Minitures
- Released on: November 28, 2008
- Series: Zenit Reload 33mm Figure Series
- Notes: Metal miniature, 33mm, requires assembly and painting.


text:
News Release
Sr. High Principal Appointed
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Emily Acquaviva will play softball at SUNY Stony Brook and Zach Kesterson will play baseball at Duke University. Congratulations!
Jostens Presents Miss Sullivan, Adviser, with Yearbook Program Excellence Award
Congratulations Suveer Desai!
The 2014 High School Student Council is proud to gift three (3) new picnic tables and two (2) vinyl "welcome" banners to the High School community. The funds for these gifts were provided through the annual Talent Show and were chosen by the current officers: Christina Zeina (President), Cameron Oliver (Vice-President), Vanessa Ambrose (Secretary), and Ian Wallace (Teasurer).
The New Hartford High School Jazz Ensemble received a GOLD rating
Congratulations Suveer Desai!
Forty-two Years Going Strong: New Hartford High School Students Have the Opportunity to Experience Raquette Lake!
In a national ranking of schools by US News and World Report New Hartford is considered a Gold Medal School


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Crown Point The drive across the Lake Champlain Bridge is more than scenic. It's historic.
That's why the managers of the Crown Point State Historic Site and the Chimney Point (Vt.) Historic Site have decided to join forces for a guided walk across the span that links the two sites and states.
The event will begin at the Crown Point State Historic Site museum at 1 p.m. Sunday, July 28. The cost is $6 for adults and includes admission to the Chimney Point and Crown Point museums. Children younger than age 13 will be free. The tour is expected to take about two hours.
"If you've wanted to learn more about what you see as you walk or drive over the new Lake Champlain Bridge, join us for a guided walk," said Tim Hughes, manager of the Crown Point site.
He'll be joined by Elsa Gilbertson, manager of the Chimney Point site.
"We will lead a walk across the bridge and back and will discuss the 9,000 years of human history visible this important location on Lake Champlain," Hughes said. "At this narrow passage on Lake Champlain, humans have crossed here, as well as traveled north and south on the lake since glacial waters receded over 9,000 years ago. The channel with its peninsulas, or points, on each side made this one of the most strategic spots on Lake Champlain for the Native Americans, and French, British, and early Americans in the 17th and 18th centuries."
Hughes suggested people wear a hat and bring a camera and/or binoculars.
The Chimney Point museum has a new exhibit highlighting recent archeological findings. The Crown Point museum offers an audio-visual presentation on the site's history.
The program will be repeated Sunday, Aug. 25, at 1 p.m. beginning at the Chimney Point site and Sunday, Sept. 29, at 1 p.m. beginning at the Crown Point site.
For information call the Crown Point State Historic Site at 597-3666.
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I have been neglecting blogging world even more so my freelance jobs.Work is seriously stressful and I have to wake up at 6 in the morning everyday for it. I have this burning desire to head back to school and maybe take up my Masters degree. But, I hate the fact that school around Singapore is VERY expensive. So, maybe online studies? Then, I would need a much compact and lighter laptop. I'm planning on getting that 14-inch Mac Air for my birthday.*Note to self: Get that HI Certification and ace it!
I bought this Photoshop book back in August of 2010 but so far, I have only finished reading chapter 1 of it. [Read more…]


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Cognitive Support Technology
The new StepPad is an easy-to-use tool for people who have trouble completing multi-step tasks independently.
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Our Big Buttons have a large active area and an extremely low profile. You can communicate without lifiting your hand off the table.
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Rigorous, scientifically-based programs designed for elementary students with moderate–severe intellectual disability or autism.
Prepare Students for ELSB
Pathways to Literacy is for students with significant developmental disabilities who don't always use words, pictures, or symbols to communicate.
Literacy Development
Promoting Awareness of Speech Sounds (PASS) is a research-based phonological awareness curriculum for young children with IEPs.
Attainment's Diversity
Our products are developed to teach reading, writing, math, safety, social skills, self-determination, communication, and work/life skills to children and adults with special needs. Using interactive software, our educational programs combine instructive lessons with games designed to engage and challenge learners with special needs at any age. Our learning materials, software, and AAC (augmentative alternative communication) devices offer cutting-edge solutions to help children and adults with special needs realize their full potential and attain their goals!
Please view our partner site for individuals and families at AttainmentFamily.com.


text: Avenue of the Arts Wyndham Hotel in Orange County Discover an urban escape of refined hospitality and luxury amenities at our lakeside property within walking distance to South Coast Plaza and within steps to world-class performances at Segerstrom Center for the Arts. As our guest, enjoy classic American dining, pool and fitness center, elegant events space and Grand Ballroom, plus free airport shuttle transportation to John Wayne/Orange County Airport in Santa Ana. Contact us now for assistance making your Costa Mesa hotel reservations and receive expert travel assistance. We'll be delighted to make sure you get the best hotel special, plus insider tips for enjoying the spectacular attractions surrounding our Orange County location.


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Inge Koch, 91, of Turkey Creek, Kentucky, died Saturday, October 6, 2012.
She was born to the late Ferdinand Gustav Oskar and Gisela Kniepf, September 7, 1921 in Pontianak, West Borneo.
Inge grew up in the Dutch East Indies, living on her family's rubber plantations in Borneo and Java until the outbreak of World War II. She spent some time in a Dutch internment camp before moving to China, where she lived for the rest of the war, working as a nurse's aide in a Chinese Hospital.
She met her future husband, Christian Budick Koch in 1945, in Shanghai, China while he was on active duty with the United States Army Air Corps. They were married in Melbourne, Australia, in 1947. She became a naturalized citizen of the United States in 1954. They lived together in Morgantown, W.Va., from 1951 until Christian's death in 1986.
Inge is survived by three children, John Koch of Alexandria, Va., Michael Koch of Turkey Creek, and Thomas Koch of Williamson, W.Va.
Inge led a very interesting life. She was fluent in several languages and had traveled all over the world. She maintained active correspondence with her numerous friends and relatives in many different countries. She contributed to charities in the United States, Indonesia and Africa. Inge recently published her memoir, Born in Borneo.
R. E. Rogers Funeral Home of Belfry is in charge of arrangements.


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Booking photo of Joshua Gergish (left) and Marcus Gergish in a court appearance.
The brother of a Johnson City man facing murder charge is now accused of threatening witnesses in the case and committing an unrelated robbery of a city tobacco outlet.
Joshua Gergish, 30, 1206 Flora Ave., Johnson City, was arraigned Friday in Washington County General Sessions Court on three counts of coercion of a witness and one count of aggravated robbery.
Johnson City police arrested Gergish early Friday after investigating a hold-up at Discount Tobacco, 2608 W. Market St. Officers responded there around 9 p.m. Thursday after a clerk at the tobacco store called and said a man pulled a knife on him and demanded money.
Gergish ran from the store with $303 in cash. An eye witness to the robbery later identified Gergish as the person who held up the store, according to police.
Gergish was later located at his residence, but he ran from police. Officers chased him down and made the arrest a short distance away.
Officers were already looking for Gergish after several alleged threats towards a witness in his brother's murder case.
The incidents occurred at the apartment complex where Marcus Gergish, 34, also of 1206 Flora Ave., is accused of gunning down Timothy Peregoy Sr. in the parking lot after and alleged drug transaction on April 3.
The shooting happened in the parking lot of Timothy Peregoy Jr.'s apartment complex on Nathaniel Avenue.
The younger Peregoy testified at Marcus Gergish' preliminary hearing that Gergish came to see him the night of the shooting and wanted Suboxone strips, which are used to treat addiction to opiates and often are abused like the pain medication.
After Gergish' preliminary hearing in April, the two families exchanged words in the courthouse lobby and were separated before being escorted from the building.
Johnson City police said in a court document that Joshua Gergish had driven through the apartment complex several times and made threatening gestures to a female juvenile and on one occasion yelled, "I'm going to kill your daddy you snitches."
The document does not identify the juvenile or her father.
On another occasion, the girl told police that Gergish followed her and a friend until they sought refuge in another apartment.
Joshua Gergish is jailed on an $80,000 bond. He has a court hearing scheduled for July 25.
Marcus Gergish remains jailed on a $100,000 bond. He has an appearance in Criminal Court Monday.
Marcus Gergish was on probation for nine counts of identity theft, forgery and failure to appear when he was charged with first-degree murder in Pergoy's death. He faces an Aug. 30 hearing on the violation of probation charge.


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Compost Made Simple Part 1
I now see how people get obsessed making dirt. I would describe the experience as a cross between being an alchemist, an acclaimed LA salad chef, and Mother Nature's favorite Facebook friend.
Click on the links to know more and get started.
Click on the links to know more and get started.
Before & After (Gold, a perfect salad, or the best FB message exchange with Ma Nature – you choose).
My DIY compost bin - I was hammering nails in until a friend saved me with an electric drill
The details :
Things you see hanging around park dirt patches, etc. are what you want to keep out of your compost – e.g sticks and twigs, stuff that has or will mold, not to mention the obvious cigarettes and plastic. Also keep out greasy and smelly things that would attract mice, etc. (e.g. meat, oil, eggs). The experts all say you have to balance your browns and your greens (browns = Carbon and greens = Nitrogen; nutrients microorganisms down in the composting trenches need a balanced diet of). I find it easier to think of balancing Dead and Alive. Dead = brown leaves, paper [bags, towels, ...], sawdust, etc. Live = everything with vibrant colors and tastes. My main challenges were 1) I live in an apartment building with VERY little space and no garden complete with corner to dedicate to a compost palace (not to mention working hard to not piss off neighbors) and also that the main component of my bin was a real "other" category - paper mats soaked in baby pee. It's hard finding resources given the glamorous topic of human waste, but the gDiaper website helped ease my mind and the folks at Garden for the Environment gave me great pointers, I just had to figure out how to make it work for me…and my pail.
- Popular Environmentalism
- Compost Made Simple Part 2