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Science Friday® is produced by the Science Friday Initiative, a 501(c)(3) nonprofit organization.
Science Friday® and SciFri® are registered service marks of Science Friday, Inc. Site design by Pentagram; engineering by Mediapolis.
Severe weather in the south central U.S. this week spawned a string of tornadoes that killed at least 50 people. Generally spring and early summer are thought of as prime tornado season -- but if the conditions are right, tornadoes don't pay attention to the calendar. "Tornadoes can happen any time of year, any time of day," said Pam Knox, Georgia's assistant state climatologist.
We'll talk about the tornado outbreak and the conditions needed for tornado formation.


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|Caldwell Man Nabbed in Hudson Robbery
|Written by Steve Frank
|Wednesday, 01 May 2013 12:38
Friday, Sunshine Superette on Lower Cedar Valley Rd., Hudson, was robbed, the suspect making off with $200.00 cash and two packs of cigarettes. Caldwell County Sheriff's Investigative Division developed a suspect, Chris James Parlier II of 4000 Miracle Place in Hudson. Monday, just before 2pm,
Chris James Parlier II was apprehended by the Caldwell County Sheriff's Office at his residence. Parlier was interviewed and confessed his involvement in the robbery. A box cutter knife was said to be the weapon used in the Robbery. Chris James Parlier II was charged with Robbery with a Dangerous Weapon and given a $50,000.00 secured bond by the Caldwell County Magistrate's Office. Mr. Parlier was taken to the Caldwell County Detention Center where he remains in custody.
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Rosettes are delicate, deep-fried melt in the mouth cookies and Timbales are pastry shells served with either dessert or entree fillings.This set includes 6 forms (3 rosette and 3 timbale).
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Weights & Dimensions
|Material: Aluminum
|Pieces Included: 6 designs, 1 handle
|Heat Resistant: Yes
|Food Creation: Pastry shells
|Storage Case: No
|For Kids: Yes
|Oven Safe: No
|Microwave Safe: No
|Dishwasher Safe: No
|Refrigerator Safe: No
|Color: Black, Silver
|Number of Items Included: 7
|Non Toxic: Yes
|Scratch Resistant: Yes
|Chip Resistant: Yes
|Stain Resistant: Yes
|Rust Resistant: Yes
|Warp Resistant: Yes
|Odor Resistant: Yes
|Non-Stick Surface: No
|Product Type: Cooker maker
|Shapes: 3 Rosettes; 3 Timbales
Holiday Theme: Yes
Seasonal Theme: Yes
|Freezer Safe: No
|Handles: No
|Recipes Included: Yes
|Eco-Friendly: Yes
|Product Care: Dishwasher Safe
|Country of Manufacture: United States
About the ManufacturerNordic Ware is a family-owned, American manufacturer of kitchenware products founded in 1946. From their home office in Minneapolis, Minnesota, they have marketed an extensive line of quality cookware, bakeware, microwave and barbecue products for the last 60-plus years.
Nordic Ware's first products were ethnic bakeware products such as the Rosette Iron, Ebleskiver Pan and Krumkake Iron. An innovative manufacturer and marketer, Nordic Ware is best known for its Bundt® Pan. Today, there are nearly 60 million Bundt® pans in kitchens across America!
Nordic Ware, a pioneer in microwave cookware, introduced the patented Micro-Go-Round (automated food rotator) and revolutionized microwave cooking. Nordic Ware expanded its product line to include over 50 microwave accessories.
In addition, Nordic Ware offers a complete line of conventional cookware, ovenware, bakeware, indoor/outdoor barbecue cookware and specialty kitchenware distributed worldwide. The Nordic Ware name-associated with quality, dependability and value is recognized by millions of homemakers. Today 2 out of 3 American households own and use Nordic Ware products! In addition to consumer kitchenware products, the Nordic Ware® Industrial Coatings Division is one of the country's most respected coating applicators. The extensive finishing technology and history of quality, innovation and consistency in this highly technical and specialized area makes Nordicware a true leader in the industrial coatings industry.
Since the founding of Nordic Ware® in 1946, the company has prided itself in providing long-lasting quality products, which will be handed down through generations. The business is firmly rooted in the trust, dedication and talent of their employees, a commitment to using quality materials and construction, a desire to provide excellence in service to our customers and the never ending research of consumer needs.
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We want you to love it. If you don't, you may return your purchase within 30 days of delivery. All you need to do is visit our Self-Service Return Center for instructions. Return credits are issued within 24 hours once the item is received and inspected. Please note that shipping charges are non-refundable. The cost of return shipping will be deducted from your refund. 30-Day Return Policy
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Stylish and comfortable futon/sofa Karel from Hedgesville, WV on 10/02/2015 – Verified Buyer
Although it took a long time to arrive, I'm happy with the purchase. It was packaged extremely well and arrived with no issues. The only assembly was attaching the legs which was fairly easy. The color and style were true to the picture and the operation of putting the sides and back up and down are simple. It will work well as an extra bed with some cushioning.
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Holiday goodies. elaine from Cumming, GA on 01/06/2014 – Verified Buyer– Top 100 Reviewer
I wanted to make something different in addition to cookies for the holidays and decided to try this out. I hit the jackpot !!!Everyone loved the pastries and said it reminded them of childhood sweets their grandmas made from old European recipies. Some powdered sugar.....butter cream filling ...fresh fruits......delicious!!!!!. .......and so easy to use and clean......better than the bakery.
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very nice Daniel Edward from Apollo, PA on 01/15/2012 – Verified Buyer
Great irons and very quick shipping. Cookies came right off irons the first batch without needing to be seasoned.
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text:
|Publication number
|Publication type
|Application number
|Publication date
|Mar 20, 2008
|Filing date
|Nov 29, 2007
|Priority date
|Jun 8, 2005
|Also published as
|Publication number
|Dan Hammersmark, Stephen Kao, Craig Welk, Pablo Acosta, Joseph Karatt
|Original Assignee
|Xtent, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (1), Referenced by (39), Classifications (26), Legal Events (2)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation of U.S. Ser. No. 11/148,546 filed Jun. 8, 2005 which is incorporated by reference herein in its entirety.
This invention relates generally to vascular catheters, and more specifically to stents and stent delivery catheters for deployment in the coronary arteries and other vessels.
Stenting has become an increasingly important treatment option for patients with coronary artery disease. Stenting involves the placement of a tubular prosthesis within a diseased coronary artery to expand the arterial lumen and maintain the patency of the artery. Early stent technology suffered from problems with restenosis, the tendency of the coronary artery to become re-occluded following stent placement. However, in recent years, restenosis rates have decreased dramatically. As a result, the number of stenting procedures being performed in the United States, Europe, and elsewhere has soared.
Stents are delivered to the coronary arteries using long, flexible vascular catheters typically inserted through a femoral artery. For self-expanding stents, the stent is simply released from the delivery catheter and it resiliently expands into engagement with the vessel wall. For balloon expandable stents, a balloon on the delivery catheter is expanded which expands and deforms the stent to the desired diameter, whereupon the balloon is deflated and removed.
Current stent delivery technology, however, suffers from a number of drawbacks. For example, current stent delivery catheters are not capable of customizing the length of the stent in situ to match the size of the lesion to be treated. While lesion size may be measured prior to stenting using angiography or fluoroscopy, such measurements may be inexact. If a stent is introduced that is found to be of inappropriate size, the delivery catheter and stent must be removed from the patient and replaced with a different device of correct size.
Moreover, current stent delivery devices cannot treat multiple lesions with a single catheter. Current devices are capable of delivering only a single stent with a single catheter, and if multiple lesions are to be treated, a new catheter and stent must be introduced for each lesion to be treated.
Further, current stent delivery devices are not well-adapted for treating vascular lesions that are very long and/or in curved regions of a vessel. Current stents have a discrete length that is relatively short due to their stiffness. If current stents were made longer so as to treat longer lesions, they would not conform well to the curvature of vessels or to the movement of vessels on the surface of the beating heart. On the other hand, any attempt to place multiple stents end-to-end in longer lesions is hampered by the inability to maintain appropriate inter-stent spacing and to prevent overlap of adjacent stents.
Additionally, some stent delivery catheters and angioplasty balloon catheters, particularly those having movable external sheaths to enclose the stent or balloon, suffer from poor tracking and cumbersome interaction with guidewires. Some such catheters utilize an "over-the-wire" design in which the guidewire extends through an inner lumen of the catheter from its proximal end to its distal end, a design that makes catheter exchanges cumbersome and time-consuming. Rapid exchange designs have also been proposed for such catheters wherein the guidewire extends through the distal end of the catheter and out through a port in a sidewall of the sheath. However, in these designs the guidewire inhibits smooth retraction of the sheath and, if the sheath is retracted a substantial distance, the port can become so displaced from the distal end of the catheter that the guidewire does not slide smoothly as the catheter is moved.
Finally, many stent delivery catheters suffer from inflexibility and high cross-sectional profile, which hamper endovascular positioning.
For these and other reasons, stents and stent delivery catheters are needed which enable the customization of stent length in situ, and the treatment of multiple lesions of various sizes, without requiring removal of the delivery catheter from the patient. Such stents and stent delivery catheters should be capable of treating lesions of particularly long length and lesions in curved regions of a vessel, and should be highly flexible to conform to vessel shape and movement. Such stent delivery catheters should further be of minimal cross-sectional profile and should be highly flexible for endovascular positioning through tortuous vascular pathways.
The invention provides apparatus and methods for delivering prostheses or stents into body lumens. In one aspect of the invention, an apparatus for delivering a prosthesis into a target vessel comprises a flexible catheter shaft having proximal and distal ends and a first lumen therein. A tubular prosthesis is releasably carried near the distal end of the catheter shaft and is expandable to a shape suitable for engaging the target vessel. A sheath is disposed over the catheter shaft and the tubular prosthesis and is axially movable relative thereto. The sheath has proximal and distal ends, a sidewall, and an exit port in the sidewall between the proximal and distal ends. A guidewire tube extends through the exit port and has a distal extremity disposed within the tubular prosthesis and a proximal extremity disposed outside of the sheath, the guidewire tube being adapted for slidably receiving a guidewire therethrough.
Preferably, the guidewire tube is slidable through the exit port so that the sheath slides relative to the guidewire tube as it is retracted to expose the prosthesis for deployment. Usually the guidewire tube is fixed relative to the catheter shaft, and may be attached thereto. If an expandable member is mounted to the catheter shaft for prosthesis expansion, the guidewire tube may extend through and attach to the expandable member.
Because the guidewire tube exits the sheath in a distal extremity thereof the sheath has a low profile portion proximal to the exit port that has a smaller diameter than the portion distal to the exit port. Not only does this reduce the cross-sectional profile, but increases the flexibility of the device.
The exit port may be cut into the sidewall of the sheath to face laterally, or alternatively oriented so as to face generally in a proximal direction. The exit port is usually positioned so as to be closer to the distal end of the sheath than to the proximal end thereof, and is preferably a distance of about 20-35 cm from the distal end of the sheath. With the sheath advanced fully distally over the catheter shaft, the proximal extremity of the guidewire tube exposed outside the sheath is preferably about 3-15 cm in length, although various lengths are possible, even as long or longer than the catheter shaft itself. The proximal end of the guidewire tube is preferably disposed a distance of less than about one-half the length of the catheter shaft from the distal end thereof, but in some embodiments may extend further proximally, even as far as the proximal end of the catheter shaft.
The apparatus of the invention may be configured to deliver tubular prosthesis that are either self-expanding or expandable by a balloon or other expandable member. When self-expanding prostheses are used, the sheath is adapted to constrain the prosthesis in a collapsed configuration. Upon retraction of the sheath, the prosthesis is released and self-expands to engage the vessel.
For balloon-expandable prostheses, an expandable member is mounted to the catheter shaft near the distal end thereof. The tubular prosthesis is positionable over the expandable member for expansion therewith. Usually the expandable member will comprise a balloon in communication with an inflation lumen in the catheter shaft for delivery of inflation fluid to the balloon. The sheath is axially positionable relative to the expandable member and configured to restrain expansion of a selected portion of the expandable member. Preferably the sheath is reinforced to prevent expansion thereof by the expandable member.
In a preferred aspect of the invention, the tubular prosthesis comprises a plurality of prosthesis segments. The sheath is axially movable relative to the prosthesis segments and configured to restrain expansion of a selectable number of prosthesis segments. In this way, lesions of various lengths may be treated by adjusting the length of the prosthesis in situ, without removal of the device from the body. In these embodiments, a pusher may be slidably disposed within the sheath proximal to the tubular prosthesis. The pusher has a distal end in engagement with the tubular prosthesis for moving the tubular prosthesis relative to the catheter shaft.
In a further aspect of the invention, a method of delivering a prosthesis in a target vessel of a patient comprises inserting a guidewire through the patient's vasculature to the target vessel; slidably coupling a delivery catheter to the guidewire, the delivery catheter having a sheath and a guidewire tube, a proximal extremity of the guidewire tube being outside the sheath and a distal extremity of the guidewire tube being inside the sheath, the guidewire being slidably positioned through the guidewire tube; advancing the delivery catheter over the guidewire to the target vessel; retracting the sheath relative to the guidewire tube to expose a tubular prosthesis carried by the delivery catheter; and expanding the tubular prosthesis into engagement with the target vessel.
Usually, the guidewire tube will extend through an exit port in the sheath, and the guidewire tube will slide through the exit port as the sheath is retracted. The method may include sealing the exit port around the guidewire tube to restrict fluid flow therethrough, but preferably the exit port allows some fluid flow to provide flushing of the distal portion of the catheter.
In a preferred embodiment, an expandable member is fixed to a distal portion of the guidewire tube and the tubular prosthesis is positionable over the expandable member. The sheath is slidably disposed over the prosthesis and the expandable member and may be retracted a selectable distance to expose a desired length of the prosthesis and expandable member. The tubular prosthesis will then be expanded by expanding the expandable member. The sheath may be used to cover a proximal portion of the expandable member to constrain the proximal portion from expansion while a distal portion of the expandable member expands. Usually, the expandable member is inflatable and will be inflated by delivering inflation fluid to the expandable member through an inflation lumen in the catheter shaft. The guidewire tube preferably extends through the interior of the expandable member, which may be attached to the guidewire tube.
In a preferred aspect of the invention, the tubular prosthesis comprises a plurality of prosthesis segments, and the method includes positioning a first selected number of the prosthesis segments on the expandable member for expansion therewith. The method may further include positioning the sheath over a second selected number of the prosthesis segments to constrain expansion thereof. The first selected number of prosthesis segments may be positioned on the expandable member by pushing the first selected member with a pusher that is axially slidable relative to the expandable member.
In alternative embodiments, the tubular prosthesis self-expands when the sheath is retracted. In embodiments in which the prosthesis comprises multiple prosthesis segments, the sheath may be retracted relative to a selected number of such segments to allow the segments to self-expand into contact with the vessel.
In another aspect, the invention provides a balloon catheter for treating a target vessel that includes a flexible catheter shaft having proximal and distal ends and a first lumen therein. An expandable member is connected to the catheter shaft, and a sheath is disposed over the catheter shaft and the expandable member and is axially movable relative thereto. The sheath has an exit port in a sidewall thereof between its proximal and distal ends. A guidewire tube extends through the exit port and has a proximal extremity disposed outside of the sheath and a distal extremity disposed within the sheath that is coupled to the catheter shaft or the expandable member or both. The guidewire tube is adapted for slidably receiving a guidewire therethrough. The expandable member preferably comprises a balloon in fluid communication with the first lumen to receive inflation fluid therefrom. The sheath may be positionable to constrain a first selected portion of the expandable member from expansion while a second selected portion of the expandable member expands.
In a preferred embodiment of the balloon catheter of the invention, a tubular prosthesis is disposed on the expandable member and is expandable therewith. The tubular prosthesis will preferably comprise a plurality of unconnected stent segments that are slidable relative to the expandable member. The sheath is positionable to expose a first selected portion of the stent segments while covering a second selected portion of the stent segments.
In yet another aspect of the invention, an apparatus for delivering a prosthesis into a target vessel comprises a flexible catheter shaft having proximal and distal ends and a tubular prosthesis slidably coupled to the catheter shaft, the tubular prosthesis being expandable to a shape suitable for engaging the target vessel. A pusher is provided for moving the tubular prosthesis from a pre-deployment position to a deployment position near the distal end of the catheter shaft. The apparatus further includes a stop on the catheter shaft configured to engage the tubular prosthesis when the tubular prosthesis is in the deployment position.
In one embodiment, an expandable member is coupled to the catheter shaft and the tubular prosthesis is adapted for expansion by the expandable member. The expandable member, e.g. balloon, has an interior, and the stop is preferably disposed within the interior of the expandable member. The stop may also be disposed outside of or on the exterior surface of the expandable member. Alternatively, the tubular prosthesis is self-expanding and expands upon being released from the catheter shaft.
In a preferred aspect, a plurality of tubular prostheses are slidably coupled to the catheter shaft and are movable by the pusher to the deployment position. In addition, a sheath may be movably coupled to the catheter shaft and positionable over the tubular prosthesis or prostheses.
In a further method of deploying a tubular prosthesis in a target vessel according to the invention a catheter shaft is positioned in a target vessel and the tubular prosthesis is moved distally relative to the catheter shaft while the catheter shaft remains in the target vessel until the prosthesis engages a stop near the distal end of the catheter shaft. The tubular prosthesis is then expanded to engage a wall of the target vessel.
After expanding the tubular prosthesis, a second prosthesis (or any number of additional prostheses) may be moved distally relative to the catheter shaft until the second prosthesis engages the stop, and the second prosthesis then expanded to engage a wall of the target vessel. Alternatively, a second prosthesis may be moved distally relative to the catheter shaft simultaneously with moving the tubular prosthesis, and both the second prosthesis and the tubular prosthesis are expanded together to engage the wall of the target vessel. Usually, the tubular prosthesis and any additional prostheses are moved by a pusher movably coupled to the catheter shaft.
The tubular prosthesis is preferably expanded by inflating a balloon coupled to the catheter shaft. Alternatively, the tubular prosthesis may be self-expandable.
Further, the method may include retaining a second prosthesis in an unexpanded configuration on the catheter shaft while the tubular prosthesis is expanded. In one embodiment, the second prosthesis is retained within a sheath movably coupled to the catheter shaft.
Further aspects of the nature and advantages of the invention will become apparent from the detailed description below taken in conjunction with the drawings.
FIGS. 14A-B are side views of a stent segment embodiment having radiopaque markers affixed thereto.
FIGS. 15A-C are side views of stent segment embodiments having radiopaque marker coatings applied thereto.
FIGS. 15D-E are side views of multiple stent segments in their expanded configurations having radiopaque marker coatings applied thereto.
The present application relates generally to copending U.S. patent application Ser. No. 10/637,713, entitled "Apparatus and Methods for Deployment of Vascular Prostheses," filed Aug. 8, 2003, which application is hereby incorporated by reference.
A first embodiment of a stent delivery catheter according to present invention is illustrated in
A handle 38 is attached to a proximal end 23 of the sheath 25. The handle 38 performs several functions, including operating and controlling the catheter body 22 and the components included in the catheter body. Various embodiments of a preferred handle and additional details concerning its structure and operation are described in co-pending U.S. patent application Ser. No. 11/148,713, filed Jun. 8, 2005 entitled "Devices and Methods for Operating and Controlling Interventional Apparatus," which application is hereby incorporated herein by reference. Embodiments of another preferred handle and details concerning its structure and operation are described in co-pending U.S. application Ser. No. 10/746,466, filed Dec. 23, 2003 entitled "Devices and Methods for Controlling and Indicating the Length of an Interventional Element," which application is also hereby incorporated herein by reference.
The handle 38 includes a housing 39 that encloses the internal components of the handle. The inner shaft 27 is preferably fixed to the handle, while the outer sheath 25 is able to be retracted and advanced relative to the handle 38. An adaptor 42 is attached to the handle 38 at its proximal end, and is fluidly coupled to the inner shaft 27 in the interior of the housing of the handle 38. The adaptor 42 is configured to be fluidly coupled to an inflation device, which may be any commercially available balloon inflation device such as those sold under the trade name "Indeflator™", available from Guidant Corp. of Santa Clara, Calif. The adaptor is in fluid communication with the expandable member 24 via an inflation lumen in the inner shaft 27 to enable inflation of the expandable member 24.
The outer sheath 25 and guidewire 36 each extend through a slider assembly 50 located on the catheter body 22 at a point between its proximal and distal ends. The slider assembly 50 is adapted for insertion into and sealing within a hemostatic valve, such as on an introducer sheath or guiding catheter, while allowing relative movement of the outer sheath 25 relative to slider assembly 50. The slider assembly 50 includes a slider tube 51, a slider body 52, and a slider cap 53. These components are illustrated in greater detail in
In particular,
A slider seal 54 is illustrated in
The slider assembly 50 is constructed by installing the proximal end of the slider tube 51 into the internal recess 161 a of the tapered portion 161 of the slider body, taking care to align the first and second through-holes of each member appropriately. The slider seal 54 is installed in the internal recess 160 a of the cylindrical portion 160 of the slider body, and the slider cap 53 is placed over the slider seal 54 within the internal recess 160 a, again taking care to ensure that the first and second through-holes of each component are properly aligned. The components are then bonded together by heating or by use of adhesives or other suitable means. The completed slider assembly 50 is then placed over the catheter body 22 and the guidewire 34 as shown in
Referring now to
The outer sheath 25 further includes a valve member 58 within the garage 55 preferably spaced proximally from the distal end 57 a distance equal to, slightly larger than, or slightly smaller than the length of one of the stent segments 32. For example, in a preferred embodiment, each stent segment 32 has a length of about 4 mm, and the valve member 58 is located approximately 5 mm from the distal end 57 of the sheath or the distal end of the garage member 55. In other embodiments, the valve member 58 may be spaced from the distal end 57 a distance equal to about �-� of the length of one stent segment 32, more preferably one-half the length of one stent segment 32. Valve member 58 preferably comprises a necked-down circumferential waist or inwardly extending ring-shaped flange 60 configured to frictionally engage stent segments 32 and thereby restrict the sliding movement of stent segments 32 distally relative to sheath 25. Flange 60 may be a polymeric or metallic material integrally formed with sheath 25 or, preferably, with the garage 55, or a separate annular member bonded or otherwise mounted to the interior of the sheath 25 or the garage 55. The geometry of flange 60 may be toroidal with circular cross-section (like an O-ring) or it may have another cross-sectional shape such as triangular, trapezoidal, or pyramidal. Preferably flange 60 is a polymer such as silicone or urethane sufficiently soft, compliant, and resilient to provide frictional engagement with stent segments 32 without damaging the stent segment or any coating deposited thereon. Valve member 58 will extend radially inwardly a sufficient distance to engage the exterior of stent segments 32 with sufficient force to allow the line of stent segments 32 remaining within sheath 25 to be retracted proximally with sheath 25 so as to create spacing relative to those stent segments disposed distally of sheath 25 for deployment. At the same time, valve member 58 should not exert so much force that it removes or damages the coating on the exterior surface of stent segments 32 as sheath 25 is retracted relative to the stent segments to expose a desired number of stent segments 32. In a preferred embodiment, stent segments 32 have an outer diameter of about 0.040-0.050 in. (including coating) and sheath 25 and garage 55 have inner diameter 0.041-0.051 in. so as to provide clearance of about 0.001 in. with stent segments 32. Valve member 58 has a preferred inner diameter about 0.003-0.008 in. less than that of garage 55, or about 0.033-0.048″, so as to provide an interference fit with stent segments 32. Valve member 58 will preferably exert a force of about 0.5-5 lbs. on a stent segment 32 positioned within it. Various embodiments of valve member 58 are described in copending application Ser. No. 10/412,714, filed Apr. 10, 2003, which is incorporated herein by reference.
The structure of the garage 55 is illustrated in
A number of cut-outs or windows 59 are preferably formed in the body of the garage to increase its axial flexibility. Preferably, the garage 55 is constructed in a manner and of materials that allow it to bend about a transverse axis. Although the number, size, and shape of the cut-outs 59 may vary, the illustrated embodiment includes a preferred form. The distal end 55 a of the garage 55 is provided with no cut-outs in order to provide the greatest radial strength at the distal end of the sheath, where the restraining force against the expandable member 24 is the greatest. A pair of fist cut-outs 59 a having oval or rectangular shape are formed a short distance from the distal end 55 a of the garage, the pair of first cut-outs 59 a being aligned circumferentially around the periphery of the garage. A series of narrow second cut-outs 59 b having a linear or slot-like shape are formed over the central portion of the body of the garage 55. Preferably, the second cut-outs 59 b are provided in a staggered formation to provide greater axial flexibility over the central portion of the garage. A series of third cut-outs 59 c are located just proximally of the central portion of the garage. The third cut-outs 59 c are of a similar size and shape to the first cut-outs 59 a, but are circumferentially staggered from the first cut-outs 59 a. A series of fourth rectangular or oval-shaped cut-outs 59 d are located just proximally of the third cut-outs, and are both narrower and shorter than the third cut-outs 59 c. Finally, a series of fifth cut-outs 59 e having a hexagonal shape are provided near the proximal end 55 b or the garage. Each of the fifth cut-outs 59 e is substantially wider (i.e., greater longitudinal length) than the other cut-outs 59 a-d. As noted below, the position of the fifth cut-outs corresponds with the location of the valve member 58.
Turning to
As thus described, the sheath 25 has a distal extremity 62 configured to surround expandable member 24 and stent segments 32 disposed thereon when in an unexpanded configuration. Distal extremity 62 extends proximally to a junction 63, preferably aligned with the location of guidewire tube exit port 35, where distal extremity 62 is joined to a proximal extremity 64 that extends proximally to handle 38 (see
Preferably, proximal extremity 64 has a smaller transverse dimension than distal extremity 62 to accommodate the added width of guidewire tube 34 within the vessel lumen, as well as to maximize flexibility and minimize profile. In one embodiment, shown in
In an alternative embodiment (not shown), a hole is formed in the sidewall of distal extremity 62 or proximal extremity 64 to create guidewire tube exit port 35. Proximally of guidewire tube exit port 35, the wall of sheath 25 adjacent to guidewire tube 34 is flattened or collapsible inwardly thereby reducing the transverse dimension of sheath 25 to accommodate the width of guidewire tube 34.
Guidewire tube 34 is slidably positioned through guidewire tube exit port 35. The guidewire tube exit port 35 may be configured to provide a total or partial fluid seal around the periphery of guidewire tube 34 to limit blood flow into the interior of sheath 25 and to limit leakage of saline (or other flushing fluid) out of sheath 25. This may be accomplished by sizing guidewire tube exit port 35 appropriately so as to form a fairly tight frictional seal around guidewire tube 34 while still allowing the sliding motion thereof relative to sheath 25. Alternatively an annular sealing ring may be mounted in guidewire tube exit port 35 to provide the desired seal. Preferably, however, the guidewire tube exit port 35 is not totally fluid sealed, so as to provide a slight leakage or fluid flow to provide the ability to flush the distal extremity 62 of the catheter.
Guidewire tube exit port 35 will be positioned to provide optimal tracking of stent delivery catheter 20 through the vasculature and maximizing the ease with which the catheter can be inserted onto and removed from a guidewire to facilitate catheter exchanges. Usually, guidewire tube exit port 35 will be positioned at a location proximal to expandable member 24 when sheath 25 is extended fully distally up to nosecone 28, but a distance of no more than one-half the length of sheath 25 from distal end 57. In preferred embodiments for coronary applications, guidewire tube exit port 35 is spaced proximally a distance of about 20-35 cm from the distal end 57 of sheath 25.
Guidewire tube 34 should extend proximally from guidewire tube exit port 35 a distance at least as long as the longest possible stent that may be deployed, e.g., 30-200 mm depending upon the application, to allow for retraction of sheath 25 that distance while retaining a portion of guidewire tube 34 external to sheath 25. Preferably the guidewire tube 34 extends proximally a distance of about 35 to about 70 mm from the guidewire tube exit port 35 when sheath 25 is in a fully distal position, with the proximal end thereof disposed a distance of about 23-50 cm from the distal tip of nosecone 28. Where stent delivery catheter 20 is to be positioned through a guiding catheter, the proximal end of guidewire tube 34 will preferably be positioned so as to be within the guiding catheter when expandable member 24 is positioned at the target site for stent deployment. Guidewire tube 34 is preferably a highly flexible polymer such as PTFE, FEP, polyimide, or Pebax, and may optionally have a metal or polymer braid or fiber embedded in it to increase kink-resistance and tensile strength.
Inner shaft 27 forms an inflation lumen 66 that is in communication with interior of expandable member 24. The inner shaft 27 may be formed of a polymer material such as PTFE, FEP, polyimide, or Pebax, or the inner shaft 27 may be a metal such as stainless steel or Nitinol.
Expandable member 24 has an expandable balloon member 70 that is joined to a non-expandable tubular leg 72. Expandable balloon member 70 is a semi-compliant polymer such as Pebax, polyurethane, or Nylon. Non-compliant, fully elastic, or other materials such as PTFE may also be used. Preferably, the compliance of the balloon member allows the expanded diameter of balloon member 70 to be adjusted by selecting the appropriate inflation pressure delivered thereto, thereby allowing customization of the deployed diameter of stent segments 32. For example, in one embodiment, balloon member 70 may be inflated to a pressure of between about 5 and about 12 atmospheres, allowing the deployed stent diameter to be adjusted from about 2.0 mm to 4.0 mm. Of course, larger and smaller stent diameters are also possible by utilizing appropriate stent geometry and applying suitable inflation pressures. Tubular leg 72 is preferably a polymer such as polyimide, PTFE, FEP, polyurethane, or Pebax and may optionally be reinforced with a metal or polymer braid or metal or polymer fibers. Tubular leg 72 has an open proximal end 74 through which guidewire tube 34 extends. Proximal end 74 of tubular leg 72 is fixed to distal end 68 of inner shaft 27 and to guidewire tube 34, forming a fluid-tight seal. Guidewire tube 34 passes through the interior of balloon member 70 and is mounted to nosecone 28, thereby providing a passage through the distal portion of catheter body 22 through which guidewire 36 may pass. Balloon member 70 has a distal end 76 that extends over an annular stop 78, which is mounted to the distal end of guidewire tube 34 and/or nosecone 28. Distal end 76 of balloon member 70 may be bonded to stop 78, guidewire tube 34, and/or nosecone 28. The stop 78 has a size and shape selected to engage stent segment 32 and provide a stop against which stent segments 32 can be located in the ideal deployment position without being pushed beyond the distal end of balloon member 70. Additional details concerning stent stops suitable for use in the devices and methods described herein are disclosed in U.S. patent application Ser. No. 10/884,616, filed Jul. 2, 2004, which is hereby incorporated by reference herein.
Preferably, the stop 78 has a partial cylindrical shape, rather than a full cylindrical shape, as a relief to reduce interference with garage 55. For example,
Optionally, within the interior of balloon member 70 an annular base member 80 is mounted to guidewire tube 34 and has a diameter selected to urge balloon member 70 against stent segments 32 in their unexpanded configuration, thereby providing fictional engagement with stent segments 32. This helps to limit unintended sliding movement of stent segments 32 on balloon member 70. Base member 80 may be made of a soft elastomer, foam, or other compressible material.
An additional option or alternative structure for limiting unintended sliding or movement of the stent segments is the provision on the distal exterior portion of the expandable member 24 of a layer of material 84 having a high coefficient of friction so as to frictionally engage the stent segments 32. See FIGS. 12A-C. For example, a layer of a polymeric material 84, such as polyurethane, will prevent the stent segments 32 from sliding off the distal end of the balloon, and will cause the stent segments 32 to stop in the desired location near the distal end of the expandable member 24. The layer of material 84 is preferably formed over the entire circumference of the distal end of the expandable member 24, as shown in the Figures, but may alternatively be placed only at spaced intervals around the periphery. The material layer 84 is preferably formed of elastomeric materials and in a manner that allows it to expand and contract as the expandable member 24 expands and contracts. For example, the material layer 84 may be applied by dipping the expandable member 24 in a liquid polymer, by spraying, or by attaching a sheet or tube of material over the expandable member 24 by adhesive or heat treatment. As the stent segments 32 move distally relative to the expandable member 24 in its contracted state, the distal end of the most distal stent segment will come into contact with the layer of material 84 and the friction force encountered by the stent segment 32 will increase. This will inhibit or prevent additional relative movement between the stent segment 32 and the expandable member 24. In addition, the increased frictional resistance may serve as a tactile indicator to the user of the position of the stent segment 32 relative to the expandable member 24. Material layer 84 may be of equal thickness along it length, or the thickness of the material layer 84 may gradually increase in the distal direction to provide gradually increasing interference with stent segments 32. Material layer 84 may have an outer surface at the same height as the outer surface of expandable member 24 to provide a smooth transition therebetween, or material layer 84 may be of greater height to provide a step that enhances engagement with stent segments 32.
In a preferred embodiment as shown in
Annular radiopaque markers 82 may be mounted to the guidewire tube 34, facilitating visualization of the location of balloon member 70 with fluoroscopy and enabling appropriate positioning of stent segments 32 on balloon member 70. Referring to
Stent segments 32 are slidably positioned over balloon member 70. Depending upon the number of stent segments 32 loaded in stent delivery catheter 20, stent segments 32 may be positioned over both balloon member 70 and tubular leg 72. In an exemplary embodiment, each stent segment is about 2-20 mm in length, more preferably 2-8 mm in length, and 3-50 stent segments may be positioned end-to-end in a line over balloon member 70 and tubular leg 72. Stent segments 32 preferably are in direct contact with each other, but alternatively separate spacing elements may be disposed between adjacent stent segments, the spacing elements being movable with the stent segments along balloon member 70. Such spacing elements may be plastically deformable or self-expanding so as to be deployable with stent segments 32 into the vessel, but alternatively could be configured to remain on balloon member 70 following stent deployment; for example, such spacing elements could comprise elastic rings which elastically expand with balloon member 70 and resiliently return to their unexpanded shape when balloon member 70 is deflated. The spacing elements could be pushed to the distal end of balloon member 70 against stop 78 as additional stent segments 32 are advanced distally.
Stent segments 32 are preferably a malleable metal so as to be plastically deformable by expandable member 24 as they are expanded to the desired diameter in the vessel. Alternatively, stent segments 32 may be formed of an elastic or super elastic shape memory material such as Nitinol so as to self-expand upon release into the vessel by retraction of sheath 25. Stent segments 32 may also be composed of polymers or other suitable biocompatible materials including bioabsorbable or bioerodable materials. In self-expanding embodiments, expandable member 24 may be eliminated or may be used for predilatation of a lesion prior to stent deployment or for augmenting the expansion of the self-expanding stent segments.
In preferred embodiments, stent segments 32 are coated with a drug that inhibits restenosis, such as Rapamycin, Paclitaxel, Biolimus A9 (available from BioSensors International), analogs, prodrugs, or derivatives of the foregoing, or other suitable agent, preferably carried in a durable or bioerodable polymeric or other suitable carrier material. Alternatively, stent segments 32 may be coated with other types of drugs and therapeutic materials such as antibiotics, thrombolytics, anti-thrombotics, anti-inflammatories, cytotoxic agents, antiproliferative agents, vasodilators, gene therapy agents, radioactive agents, immunosuppressants, and chemotherapeutics. Several preferred therapeutic materials are described in U.S. Published Patent Application No. 2005/0038505, entitled "Drug-Delivery Endovascular Stent and Method of Forming the Same," filed Sep. 20, 2004, which application is hereby incorporated by reference herein. Such materials may be coated over all or a portion of the surface of stent segments 32, or stent segments 32 may include apertures, holes, channels, pores, or other features in which such materials may be deposited. Methods for coating stent segments 32 are described in the foregoing published patent application. Various other coating methods known in the art may also be used, including syringe application, spraying, dipping, inkjet printing-type technology, and the like.
Stent segments 32 may have a variety of configurations, including those described in copending application Ser. No. 10/738,666, filed Dec. 16, 2003, which is incorporated herein by reference. Other preferred stent configurations are described below. Stent segments 32 are preferably completely separate from one another without any interconnections, but alternatively may have couplings between two or more adjacent segments which permit flexion between the segments. As a further alternative, one or more adjacent stent segments may be connected by separable or frangible couplings that are separated prior to or upon deployment, as described in co-pending application Ser. No. 10/306,813, filed Nov. 27, 2002, which is incorporated herein by reference.
A pusher tube 86 is slidably disposed over inner shaft 27. The structure of the pusher tube 86 is illustrated in
Preferably, the proximal portion 90 of the pusher tube has a diameter that is smaller than the diameter of the distal extension 88. Thus, the stainless steel hypotube material making up the proximal portion 90 of the pusher tube and part of the ribbon portion 89 may have a first diameter, while the slotted tube making up the distal extension 88 and the distal portion of the ribbon 89 may have a second, larger diameter. As noted above, the slotted tube and the hypotube are preferably joined by a weld 91 formed in the ribbon portion 89.
As best shown in FIGS. 2A-B, the pusher tube 86 extends longitudinally within the outer sheath 25 and over the inner shaft 27 through most of the length of the catheter body 22. The distal extension 88 is slidable over the tubular leg 72 and engages the stent segment 32 at the proximal end of the line of stent segments 32. At its proximal end (not shown), the pusher tube 86 is coupled to an actuator associated with the handle 38 (see
It can be seen that with sheath 25 retracted a desired distance, expandable member 24 is allowed to expand when inflation fluid is delivered through inflation lumen 66, thereby expanding a desired number of stent segments 32 exposed distally of sheath 25. The remaining portion of expandable member 24 and the remaining stent segments 32 within sheath 25 are constrained from expansion by sheath 25.
In order to confirm the positioning of the stent segments 32 on the expandable member 24, fluoroscopy is used to visualize the stent segments 32 relative to the markers 82 located on the inner shaft 27. In addition, by fluoroscopic visualization of the marker 56 located on the garage 55 at the distal end of the outer sheath 25, the user can see the extent of retraction of the sheath 25 relative to the expandable member 24 and view the location of the exposed stent segments 32 relative to the sheath 25. Visualization of the stent segments 32 is further enhanced with the use of radiopaque markers and/or materials in or on the stent segments themselves. Markers of radiopaque materials may be applied to the exterior of stent segments 32, e.g, by applying a metal such as gold, platinum, a radiopaque polymer, or other suitable coating or mark on all or a portion of the stent segments. Examples of such markers are illustrated in FIGS. 14A-B. In those Figures, radiopaque markers 95 are attached to a plurality of circular openings formed in the body of the stent segment 32. Six such markers are formed in a circumferentially aligned pattern in the
Preferably, the radiopaque markers are configured so as to provide an indication of the number, location, and/or relative spacing of each stent segment 32 when deployed end-to-end in a line in a vessel or other body lumen. This allows the operator to determine how many stent segments 32 have been deployed at a vascular site, and the spacing between adjacent stent segments 32. The radiopaque markers allow the operator to visualize with fluoroscopy the divisions between adjacent stent segments 32 by observing radiopaque markers on the ends and for a middle portions of each stent segment 32. For example, in the embodiment of
Some of the possible materials that may be used in stent segments 32 include (by ASTM number):
FIGS. 5A-B illustrate a portion of a first embodiment of a stent segment 32. The Figures illustrate a portion of the stent segment 32 in a planar shape for clarity. The stent segment 32 includes two parallel rows 98A, 98B of I-shaped cells 100 formed into a cylindrical shape around an axial axis A. Each cell 100 includes upper and lower axial slots 102 and a connecting circumferential slot 104. The upper and lower slots 102 are bounded by upper axial struts 106, lower axial struts 107, curved outer ends 108 and curved inner ends 110. Each circumferential slot 104 is bounded by an outer circumferential strut 109 and an inner circumferential strut 111. Each I-shaped cell 100 is connected to the adjacent I-shaped cell 100 in the same row 98A or 98B by a circumferential connecting strut 113. All or a portion of cells 100 in row 98A merge or join with cells 100 in row 98B at the inner ends 110, which are integrally formed with the inner ends 110 of the adjacent cells 100.
In a preferred embodiment, a spacing member 112 extends outwardly in the axial direction from a selected number of outer circumferential struts 109 and/or connecting struts 113. Spacing member 112 preferably itself forms a subcell 114 in its interior, but alternatively may be solid without any cell or opening therein. For those spacing members 112 attached to outer circumferential struts 109, subcell 114 preferably communicates with I-shaped cell 100. Spacing members 112 are configured to engage the curved outer ends 108 of an adjacent stent segment 32 so as to maintain appropriate spacing between adjacent stent segments. In one embodiment, spacing members 112 have outer ends 116 with two spaced-apart protrusions 118 that provide a cradle-like structure to index and stabilize the curved outer end 108 of the adjacent stent segment. Preferably, spacing members 112 have an axial length of at least about 10%, more preferably at least about 25%, of the long dimension L of I-shaped cells 100, so that the I-shaped cells 100 of adjacent stent segments are spaced apart at least that distance. Because spacing members 112 experience little or no axial shortening during expansion of stent segments 32, this minimum spacing between stent segments is maintained both in the unexpanded and expanded configurations.
As an additional feature, circumferential slots 104 provide a pathway through which vessel side branches can be accessed for catheter interventions. Should stent segment 32 be deployed at a location in which it covers the ostium of a side branch to which access is desired, a balloon dilatation catheter may be positioned through circumferential slot 104 and expanded. This deforms circumferential struts 109, 111 axially outward, thereby expanding circumferential slot 104 and further expanding upper and lower slots 102, as shown in phantom in
One of the differences between the embodiment of
It should also be noted that the embodiment of
Referring now to
Optionally, lesion L may be pre-dilated prior to stent deployment. Pre-dilation may be performed prior to introduction of stent delivery catheter 20 by inserting an angioplasty catheter over guidewire GW and dilating lesion L. Alternatively, stent delivery catheter 20 may be used for pre-dilation by retracting sheath 25 along with stent segments 32 to expose an extremity of expandable member 24 long enough to extend through the entire lesion. This may be done while delivery catheter 20 is positioned proximally of lesion L or with expandable member 24 extending through lesion L. Fluoroscopy enables the user to visualize the extent of sheath retraction relative to lesion L by observing the position of marker 56 on the garage 55 contained at the distal end of the sheath 25 relative to the markers 82 formed on the guidewire tube 34 beneath the expandable member 24. To allow stent segments 32 to move proximally relative to expandable member 24, force is released from pusher tube 86 and valve member 58 engages and draws the stent segments proximally with sheath 25. The pusher tube 86 is retracted along with the outer sheath 25 by use of an actuator provided on the handle 38. With the appropriate length of expandable member 24 exposed, expandable member 24 is positioned within lesion L and inflation fluid is introduced through inflation lumen 66 to inflate expandable member 24 distally of sheath 25 and thereby dilate lesion L. Expandable member 24 is then deflated and retracted within sheath 25 while maintaining force on pusher tube 86 so that stent segments 32 are positioned up to the distal end of expandable member 24, surrounded by sheath 25.
Following any predilatation, stent delivery catheter 20 is repositioned in artery A so that nosecone 28 is distal to lesion L as shown in
With the desired number of stent segments 32 exposed distally of sheath 25, it is preferable to create some spacing between the stent segments to be deployed and those remaining enclosed within the sheath 25. This reduces the risk of dislodging or partially expanding the distal-most stent segment 32 with sheath 25 when expandable member 24 is inflated. Such spacing is created, as shown in
Expandable member 24 is then inflated by delivering inflation fluid through inflation lumen 66, as shown in
Expandable member 24 is then deflated, leaving stent segments 32 in a plastically-deformed, expanded configuration within lesion L, as shown in
It should be understood that when the movement of the pusher tube, sheath, or stent segments is described in relation to other components of the delivery catheter of the invention, such movement is relative and will encompass both moving the sheath, pusher tube, or stent segments while keeping the other component(s) stationary, keeping the sheath, pusher tube or stent segments stationary while moving the other component(s), or moving multiple components simultaneously relative to each other.
While the foregoing description of the invention is directed to a stent delivery catheter for deploying stents into vascular lumens to maintain patency, it should be understood that various other types of wire-guided catheters also may embody the principles of the invention. For example, balloon catheters for angioplasty and other purposes, particularly those having a slidable external sheath surrounding the balloon, may be constructed in accordance with the invention. Other types of catheters for deployment of prosthetic devices such as embolic coils, stent grafts, aneurism repair devices, annuloplasty rings, heart valves, anastomosis devices, staples or clips, as well as ultrasound and angiography catheters, electrophysiological mapping and ablation catheters, and other devices may also utilize the principles of the invention.
Although the above is complete description of the preferred embodiments of the invention, various alternative, additions, modifications and improvements may be made without departing from the scope thereof, which is defined by the claims.
|Cited Patent
|Filing date
|Publication date
|Apr 29, 2002
|Jun 26, 2007
|Advanced Bio Prosthetic Surfaces, Ltd.
|Guidewires and thin film catheter-sheaths and method of making same
|Citing Patent
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|Publication date
|Sep 1, 2006
|Feb 22, 2011
|Xtent, Inc.
|Custom length stent apparatus
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|May 10, 2011
|Xtent, Inc.
|Apparatus and methods for delivery of braided prostheses
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|Xtent, Inc.
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|Stent delivery for bifurcated vessels
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|Xtent, Inc.
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|Expandable stent
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|Multiple independent nested stent structures and methods for their preparation and deployment
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|Jun 11, 2013
|J.W. Medical Systems, Ltd.
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|Devices and methods for controlling expandable prostheses during deployment
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|J.W. Medical Systems Ltd.
|Apparatus and methods for delivery of braided prostheses
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|J.W. Medical Systems Ltd.
|Devices and methods for controlling and indicating the length of an interventional element
|Mar 19, 2007
|Feb 18, 2014
|J.W. Medical Systems Ltd.
|Apparatus and methods for deployment of linked prosthetic segments
|Feb 28, 2011
|Apr 22, 2014
|J.W. Medical Systems Ltd.
|Apparatus and methods for delivery of multiple distributed stents
|Aug 30, 2012
|Jun 3, 2014
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|Multiple independent nested stent structures and methods for their preparation and deployment
|Mar 24, 2011
|Jul 8, 2014
|Advanced Bifurcation Systems, Inc.
|Selective stent crimping
|Mar 24, 2011
|Aug 5, 2014
|Advanced Bifurcation Systems, Inc.
|Methods and systems for treating a bifurcation with provisional side branch stenting
|Mar 24, 2011
|Aug 19, 2014
|Advanced Bifurcation Systems, Inc.
|Stent alignment during treatment of a bifurcation
|Mar 24, 2011
|Sep 2, 2014
|Advanced Bifurcation Systems, Inc.
|Partially crimped stent
|Mar 24, 2011
|Sep 9, 2014
|Advanced Bifurcation Systems, Inc.
|Methods and systems for ostial stenting of a bifurcation
|Jan 27, 2011
|Feb 17, 2015
|J.W. Medical Systems Ltd.
|Custom length stent apparatus
|Mar 24, 2011
|Mar 17, 2015
|Advanced Bifurcation Systems, Inc.
|System and methods for treating a bifurcation
|Sep 28, 2010
|Mar 17, 2015
|J.W. Medical Systems Ltd.
|Thermo-mechanically controlled implants and methods of use
|May 22, 2009
|Mar 24, 2015
|J.W. Medical Systems Ltd.
|Devices and methods for controlling expandable prostheses during deployment
|Mar 6, 2008
|Aug 11, 2015
|J.W. Medical Systems Ltd.
|Apparatus having variable strut length and methods of use
|Dec 16, 2003
|Sep 23, 2004
|Xtent, Inc.
|Multiple independent nested stent structures and methods for their preparation and deployment
|Sep 5, 2002
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|Erik Andersen
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|Xtent, Inc. A Delaware Corporation
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|U.S. Classification
|623/1.11, 606/108
|International Classification
|Cooperative Classification
|European Classification
|Nov 30, 2007
Owner name: XTENT, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:HAMMERSMARK, DAN JEFFERY;KAO, STEPHEN;WELK, CRAIG;AND OTHERS;REEL/FRAME:020209/0761
Effective date: 20050816
|Feb 7, 2012
Owner name: J.W. MEDICAL SYSTEMS LTD., CHINA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:XTENT, INC.;REEL/FRAME:027668/0093
Effective date: 20111227


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MORRISTOWN The Morristown Central School District is interested in purchasing the vacant United Methodist Church, 504 Gouverneur St., that borders the school. We have an interest and were talking, Superintendent David J. Glover said, stressing that no price has been discussed and no offers have been made yet.
The Rev. Thomas A. Clemow, retired, a property management consultant with the Upper New York Annual Conference of the United Methodist Church, said the church is not yet publicly discussing the future of the property besides saying that it is going to be on the market.
We shall see where this leads, the Rev. Mr. Clemow said after noting that the church will do its due diligence as a seller.
The Morristown United Methodist Church was closed in August because of increasing financial obligations and declining membership.
Over the years the church and the school have had a close working relationship.
Mr. Glover said the school uses the church parking lot for faculty parking.
Weve had this mutual agreement where we get to use the parking spaces but we maintain the lot, he said. Its a mutually beneficial relationship.
The school also at times has used the church building for various functions including blood drives and kindergarten screening, Mr. Glover said.
With the building up for sale, Mr. Glover said, there is a possibility that the schools access to the spaces could be restricted by a future owner.
Losing parking is not something were looking forward to, he said.
The building also could be used for plays, musical events and community functions if the school purchased it, Mr. Glover said.
But the conversation about a possible purchase has just begun, he said, and there is no timeline established for how soon a sale could go through.
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Bontrager Baselayers
The Profila baselayer Condition Specific Content system ensures your peak performance through effective heat and perspiration management, no matter your riding environment.
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Best of Ringling Student Exhibitions
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Thurs., March 27, 5:00 p.m. tent in front of Ulla Searing Student Center followed by a reception until 7:00 p.m. Selby Gallery will be open 5:30
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The First Year: Work in Progress Exhibition features juried work by the first year Ringling College students from the CORE program and the various introduction to majors courses.
Best of Ringling Annual Juried Student Exhibitions
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Awards ceremony
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Gallery I & II
Part II includes juried work by Ringling College students from the departments of Computer Animation, Digital Filmmaking, Graphic Design & Interactive Communication, Illustration and Interior Design.
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ERIC HASERT/TREASURE COAST NEWSPAPERS Beto Rodrigurz (front), of Atlantic Interior Services Inc. of Tequesta, repositions his lift while assembling the aluminum framework for the ceiling and walls in the lobby of the The Humane Society of St. Lucie County's new Port St. Lucie Kindness Center in Port St. Lucie on Tuesday. The new humane society shelter is on track for completion in September.
ERIC HASERT/TREASURE COAST NEWSPAPERS David Robertson, Director of Operations at The Humane Society of St. Lucie County, looks over blueprints of the facility as work continues in the front lobby of the building. "Eventually, our surgery center would like to ramp up to somewhere between 4,000 to 5,000 spay or neuter surgeries annually, which is a tremendous amount of surgeries to do," Roberson said. "I don't know if anybody in the area does that many spay or neuters on a regular basis."
ERIC HASERT/TREASURE COAST NEWSPAPERS Images from The Humane Society of St. Lucie County's new facility currently under construction at 8890 NW Glades Cutoff Road in Port St. Lucie. (Tuesday March 12, 2013)


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An 11-year coaching veteran, Spencer Allen made his return to Creighton in the fall of 2012 as Creighton's Associate Head Coach/Recruiting Coordinator. Allen also serves as Creighton's hitting coach as well as the third base coach.
In his first season back with the Bluejays, the production at the plate soared, jumping over 30 points above the average of the 2012 season (.283 in 2013 •.251 in 2012).
Allen returned to Creighton after three seasons serving as a member of the Washington State University coaching staff. With WSU (2010-12), Allen coached both hitters and catchers, and also served as the recruiting coordinator. In his three seasons at WSU, Allen helped the Cougars to a 91-78 overall record, guiding five members of the 2012 squad to be selected in the Major League Baseball draft.
The Olympia, Wash., native also spent two seasons at Purdue (2008-09) as the Boilermakers' recruiting coordinator. Allen helped guide Purdue to two-straight Big Ten Tournament appearances. In 2008, the Boilermakers set school records with a .309 team batting average and 124 doubles. The doubles and Purdue's 44 home runs led the Big Ten. The Boilermakers won 32 games that season, their highest total since 2001, and set school records for conference victories (21) and conference series wins (six).
Prior to Purdue, Allen served as an area scout for the Detroit Tigers where his responsibilities included identifying and tracking Major League Baseball prospects in the Pacific Northwest and Canada. Allen was with the Tigers' organization during the 2007 season.
A member of the Creighton coaching staff during the 2005 and 2006 seasons, Allen worked primarily with the outfielders and catchers for the Bluejays. He assisted with recruiting, coordinated baseball camps and worked to improve the academic success of the baseball student-athletes.
The program compiled a 79-38 record during Allen's two seasons on the bench, winning the first Missouri Valley Conference title in school history in 2005. That squad finished with a 48-17 record, the second-most wins in program history (51 in 1991). Creighton advanced to the NCAA Tournament following the 2005 regular season, defeating 17th-ranked North Carolina State in Creighton's opening game of the Lincoln Regional.
In 2004, Allen was the volunteer coach at Iowa where he worked with outfielders and hitters on a team that posted a dozen wins in Big Ten play.
Allen's first coaching job was in 2002 when he was an assistant at Edmonds Community College.
A 2001 graduate of Iowa State, Allen played three seasons for the Cyclones (1999-2001). An All-Big 12 Academic selection in 2001, he served as team captain during his final season and was a two-time Iowa State Scholar-Athlete Award recipient (2000, 2001).
Allen is married to the former Jessica Draemel, who was a member of the Bluejay softball staff in the mid-2000s. The couple welcomed their first child, Jada, in June of 2013.
Servais on Allen:
"Spencer was here with us in 2005 and 2006 and it feels like he never left us. He has a lot of responsibility, serving as the hitting coach, the third base coach and the recruiting coordinator. We wanted him to shake up our offense and he has done an excellent job already, but he'll continue to grow and continue to grow our offense."
|Associate Head Coach/Recruiting Coordinator
|1 Year


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Aye me mateys!
It comes as a great sadness to me to inform everyone that the Xtn zealots infecting science are at it again with the apparent support of Queensland's and Australia's education systems.
Last week, a creationist scientist was invited to GSHS by the school chaplain, where I have two children attending school. I have of course responded as every good Pastafarian should, and opposed this move.
Here is the link to the local newspaper's article on the net, which was printed in the paper on the 16th August.
http://www.gympietimes.com.au/story/201 ... addcomment
I urge all fellow Pastafarians who wish to place their objection, please do so, especially those in Australia. I have commented under the pseudonym 'boxjellyfish'.
Here is a copy of the letter I sent to the paper, which was printed today (Sat 20 Aug)
'I thank Val Mackay for her letter on the high school allowing a lecture about creationist science to the students. I agree with Val when she says that our young ones should be given the freedom and dignity to hear all available evidence.
As a Pastafarian, therefore, I propose that GSHS invite our Prophet, Bobby Henderson to give a lecture on how the Flying Spaghetti Monster (PBUH) created the world with His Appendages 4000 years ago. This can be accompanied with the irrefutable evidence that His Noodlyness, whose Appendages contain many kilojoules of complex carbohydrates, tampers with scientific evidence, the evil seed of the Darwinists. This alters the chemistry of things to give lie to carbon dating, making us think that the world is much older than it really is.
If the school cannot meet this request then I can only ask that the school, which I have two children in attendance, stick to the evil, but unfortunately necessary path of teaching science as irrefutable evidence based on hypothesis, theory and proof. Also, that the chaplain remains focused on providing support services to students. It might also be a good idea for students to request copies of The Gospel of The Flying Spaghetti Monster be made available in the library to give further freedom of option. After all, I'm sure students will find the texts of other major religions available.
In the meantime, the truth can be found at www.venganza.org. May Sauce Be With You All!
Wayne Wilson'
And...yeah, May Sauce Be With Us All!


text:
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Welcome to Smogon! Check out the Smogon Info Hub for everything you need to know about starting out in the community. Don't forget to introduce yourself in the Introduction Thread, too!
Welcome to Smogon Forums! Please take a minute to read the rules.
The Fall of Standard (and Propositions on how to fix it)
Discussion in 'Office of Strategic Influence' started by UncleSam, Aug 16, 2010.
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Page 2 of 2


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It begins with a discussion of the formal components of logic—deductive and inductive reasoning—and a discussion of logic's champions, Aristotle and Plato, but then it quickly devolves into real-world conundrums.
For example, what should Google do in China, given that it appears it cannot ensure the security of its servers, even from the Chinese government? Answer, the Google boys Larry and Sergey say pull all of the servers out of China and relocate them to Hong Kong.
That's a simplification of a complex case, but it's a real-world example of the difficult questions today's business executives must wrestle with.
Ten Huntsman Scholars served as the inaugural class for "Critical Analytical Thinking" at the Huntsman School last spring. They were invited to debate different sides of thorny business issues. They played the roles of Sunni fighters, Shia citizens, American diplomats, and United Nations negotiators in wrestling with questions facing Iraq.
The course was taught by Senior Lecturer Christine Arrington, who graduated from Stanford Graduate School of Business and visited Stanford again to learn about its Critical Analytical Thinking course (CAT) from Dean Garth Saloner. He said Stanford puts its CAT course first, in a two-week program before the regular term begins, to throw students into the deep end, in a sense, and let them struggle with difficult questions, thereby engaging them deeply with the thorniest of problems.
Christine also attended a three-day AACSB seminar on Critical Analytical Thinking, led by Jackson Nickerson, Professor of Organization and Strategy, at the Olin School of Business, Washington University. He cited the IBM global survey of business executives that found critical analytical thinking was the number one skill desired by company executives worldwide.
The course will be offered again, for Huntsman Scholars only at this point, this coming spring.


text:
Sometimes our wardrobe wants are focused on a few desirable pieces, but this month our proverbial cup is literally running over with what we can only denote as legitimate shopping needs. Naturally we want to share this surplus of amazing finds, so we've made sure that the WhoWhatWear.com closet is filled to the brim with luscious outerwear, eye-catching accessories, and a smorgasbord of transitional-weather shoes. In fact, we'll go so far as to say that it's like a fully-catered feast, as it covers every group on the wear-worthy pyramid. Whet your palette with Maje's Milieu Rabbit Fur Gilet ($405)-a luxe version of one of our favorite fall essentials-a piece that pairs nicely with dark jeans and heavy-hardware shoes. If you're dying to sink your teeth into something other than buckle boots, try a more refined pair like Schutz's Suede Ankle Booties ($225), then emphasize their understated lines with opaque or patterned tights and a long sleeve mini, like Milly's Bridget Metallic Embellished Dress ($395). For our dessert course, we have to recommend a pair of wrist-length studded black gloves, which are sure to set you stylishly apart come cocktail hour. (We suggest Scoop's Stud Leather Gloves ($36) for a little delicacy at a very wallet-friendly price.) But please remember, dear readers, while what you see before you may seem like the chef's choice, it's simply an amuse bouche when compared with all the deliciousness that always abounds in our Shop The Closet section!-Liza Kaplan
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- Northern New York Newspapers
- Watertown
- Ogdensburg
- Massena-Potsdam
- Lowville
- Carthage
- Malone
- NNY Business
- NNY Living
- NNY Ads
MASSENA - For only the fourth time in history, the board of directors of the Greater Massena Chamber of Commerce presented its Board of Directors Award.
Previous recipients of the award include Larry Prashaw, Bob Coia, from Bobs Bakery, and the Chiefs and Sub-chiefs of the St. Regis Mohawk Tribe. This years recipients though made a contribution to the chamber, unlike any they had ever received before.
The Adath Israel Synagogue donated their home in downtown Massena to the chamber of commerce, giving the chamber a badly needed new home, and one that they could be proud of.
For many generations the Adath Israel Synagogue was the spiritual home to the Jewish community in the greater Massena area, chambe board President Sue Stiles said. The Jewish families in Massena have been active in the community as merchants, professionals, past chamber presidents and civic leaders. The opportunity for the chamber to maintain this historic building for use of the community is one we accept with honor.
Accepting the plaque, which will hang on the wall in the chambers new home, on behalf of the congregation were Judy Witek, Lenore Levine and Miriam Catapano.
Another prestigious award, the Business Leadership Award, was presented to Patrick Peets, who was unable to attend the dinner due to a death his family.
His daughter, Shannon Peets Hendricks, who together with her brother, Jeramy, represent the third generation of their family involved in Peets Jewelers, accepted the award.
Real Frenchie Coupal, who was the awards inaugural recipient presented the honor.
I remember sitting where Mayor Hidy is in 1986 when they gave it to me, he said. It was a surprise, but it was really for my employees. It takes a team, he said, noting teamwork has been a common thread between each of the awards recipients with Peets Jewelers, a family-owned and operated business being a perfect example.
The Gert Jurkovich Commitment to the Community Award was presented to Mark Bogdan.
The award goes to an individual, group or business that best exemplifies Gerts dedication to the community, said Ms. Catapano, who presented the honor. When the chamber looks at this recognition, it tries to identify someone who has left their thumbprint on the community.
She continued, When someone is recognized with this recognition, it isnt the reward that matters. It is the depth of commitment, the quality of service, the product of ones devotion. These are the things that are counted in life, she said. When you give purely, the honor is in giving, and that is honor enough.
Dee Peets was recognized as the chambers volunteer of the year.
Here is a list of just a few of the chamber activities that this person has been involved with in these past two years, said Tina Corcoran, who presented the award. Car, truck and motorcycle show, block dance, harvest festival, winter carnival, chamber office, where shes helped with newsletters, winter carnival, soliciting donation for chamber auctions, donations for other fundraisers, the heritage festival and chambers annual dinner.
Ms. Corcoran said the award celebrates an individual who has consistently given generously of their time in support of chamber events, projects and initiatives over a sustained period.
Mr. Bogdan also presented several awards, giving out four Community Support Awards.
An Italian Affair has supported the many sports teams in the Massena area, and activities, including the Massena Winter Carnival since the carnivals beginning in 2010, Mr. Bogdan said.
Describing Meals on Wheel he said, They provide more than a hot meal for those that are in need. Some days, it is the only personal contact the recipient has with the outside world.
The Village Inn, which was originally known as the Woodlawn Hotel and was the first or second recipient of a liquor license in St. Lawrence County following prohibition, was also honored.
The Village Inn has been a supporter in the community and a larger supporter of the Massena Winter Carnival these past two years. Last year hosting a karaoke night, and this year hosting the very successful trivia night.
The final Community Support Award was presented to Violis, a restaurant started by Ross and Dominic Violis parents in 1945.
In 1961, Rosario (their father) turned the business over to Dominic and Ross. The restaurant has supported many community events and fundraisers over those years, Mr. Bogdan said.
Chamber Director Michael Gleason also presented several awards, recognizing businesses for their longevity in the community. Both the Donaldson Funeral Home and A. Cappione, Inc., were recognized for 80 years of service. Ogdensburg Command Performances, Rite Aid and the Seacomm Federal Credit Union were each recognized for 50 years of service.
On hand to accept the award for Seacomm was CEO Scott Wilson. But Mr. Wilson brought a long a couple of guests, Earl Jackson and Gary Fuller.
Mr. Wilson noted the credit union started in 1963 with a group of 10 GM employees, who each contributed $5. Now we have nearly half a billion in assets and 40,000 members, he said.
Mr. Jackson is the lone surviving charter member of the credit union, and Mr. Fuller is a long-time member of its board of directors, Mr. Wilson said.
Looking back on the 2010 opening of the credit unions sixth branch in Ogdensburg, Mr. Wilson said, It was the first time in Seacomms history we didnt have a GM plant in operation. Although that physical symbol is no longer present, our vision hasnt changed and thats people over profit.
Mr. Wilson said the presence of Mr. Jackson and Mr. Fuller was a reminder of that.
Thats why I thought it would be good to have Earl and Gary there as a reminder of where we were five decades ago.
The evening, which serves as a fundraiser for the chamber of commerce, also included both a live and silent auction.
Thousands of readers like you have made Northern New York Newspapers the number one ranked website* for local news and sports coverage in the north country.
You can continue on to this article in a few seconds, or you can visit one of our websites:


text:
Barack Obama
US President Barack Obama plays a learning game while visiting... News PhotoBarack Obama,Child,Government,Horizontal,Politics,US President,USA,VisitPhotographer BRENDAN SMIALOWSKICollection: AFP 2013 AFPUS President Barack Obama plays a learning game while visiting children at College Heights Early Childhood Learning Center February 14, 2013 in Decatur, Georgia. Obama is in Georgia to promote economic and educational initiatives he spoke about in this week's State of the Union. AFP PHOTO/Brendan SMIALOWSKI (Photo credit should read BRENDAN SMIALOWSKI/AFP/Getty Images)


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|Print Page
This photo of a Helper firefighter battling a blaze in Kenilworth in 2001 can still be found on the Sun Advocate's Web site, located at www.sunad.com, even nine years after the event. All information on the Web site is open, and as time progresses and older newspapers get digitized, more and more information, photos and stories will be available to anyone at the click of a mouse.
For those that think they have gotten away with something that has been documented either in photos, in writing or in video within the last 10 years because a good deal of time has passed, they need to think again.
The web has become the tell-all about those that do good and bad long after most people have forgotten about it.
"The medium is persistant and the content doesn't go away," said Jason Bailey, the webmaster for the Sun Advocate. "It's the nature of the beast."
In the pre-web days something could be printed in the newspaper, and soon the pages it was printed on was being used to line bird cages, or stuffed away in some dusty archive in a library where one would have to spend days searching to find information about who said what, who did what and who was thinking what. That is no longer true.
To dust off a story that is only five years old now, all one has to do is get on an Internet connected computer, and if something was originally placed on the web or has been put there since, it may easily be found.
Now even newspapers that were printed before the advent of the web are starting to appear on the Internet. In recent years the University of Utah gained some grants to digitize many of the newspapers in the state from their inception up to present date.
The archive, called Utah Digital Newspapers, is searchable. At this point papers such as the Sun Advocate (and its predecessors)are on the that web site up to 1932, which is the year the Sun Advocate came into being when the News Advocate and The Sun merged. Other papers, like the Vernal Express, have archives from the beginning right up to present day.
While it is true that someone looking for something may have to search through a lot of data and screens to get exactly what they want, it is still so accessible it is amazing...and scary for some people.
Recently the Sun Advocate got a call from an out-of-state man who said that he had made a mistake a number of years ago and had been in trouble with the law in Utah. He said that he had gone straight now, was a businessman and was trying to make a go of it, but an article about the incident in the Sun Advocate's Web site kept cropping up as people looked him up, and it was causing him problems.
The policy at the Sun Advocate has always been that once something was in the paper, it could only be retracted if it was not true, but if it was true, it would not be changed.
Upon reviewing a web search, the article in question also showed up in a number of other places besides the Sun Advocate's site, including a state Web site. Within the same search results, the staff at the paper discovered that the same man had also been brought up on similar charges in his home state as well as in Alaska - the former in 2007 - and in the northern most state in 2009.
But while it would be impossible to remove all the references, it is also against the paper's policy to do so. It comes down to an issue of credibility, the credibility of reporting and writing history every day.
From the Internet, you can run but you cannot hide - not if someone is really looking for you or what you have done in the past. And even if an agency or business somehow agrees to take something off the Internet for an individual, forget the fact it was removed by them; someone else is bound to have it too.
That's because search engines like Google, Yahoo, MSN and others do a thing frequently referred to as "indexing." It is a process in which little pieces of software called "crawlers" meander through the World Wide Web, pursuing link after link, hopping from one site to another, digging for information to better their search offerings. That process also frequently includes storing a copy of the pages that have been indexed.
"They have what are called little bots that crawl through the sites," said Bailey. "They behave a lot like people that are looking for something. They gather up information from site to site, following link after link, site after site. Many of these indexing activities are for search purposes but some are for archival and research reasons."
But the situation lies well beyond just the realm of newspapers. In these times of information expansion on the web, if a person belongs to a bowling league, their names might be posted as a member or with their teams scores by a teammate or league. If they have delinquent taxes at the county level, their name will be posted on a government Web site. If they are mentioned as someone who was involved in a story on someone's personal Web site, that name will be there for all to see. And the social networking sites, while not generally indexed, still provide fodder for other people's personal sites.
But issues with the Internet extends far beyond what is actually published online.
"Privacy issues are huge," stated Bailey. "Right now Google (and other Internet search engines), while not tracking what each person does as an individual, does track user (web browsing) habits and are (performing) data mining. They are really pushing the privacy line."
Information overload is also becoming a real problem for individuals. It used to be the medium (television, radio, the printed word) sorted out information for the user. Now it can all be there as raw data - the full house bill on health care or every witnesses story to a tragic accident. It goes on and on.
"What the internet has really affected is politics," said Bailey. "Misconduct and behavior that happened years ago when someone was a college student pops up and a politician goes down. The issues on this have been at the top of the political and economic chain. But soon the common person will be affected more and more as well."
Change is inevitable; where it will end no one knows. But the fact is that as the world of information expands, it appears the rights and privacy of the indiviual could be challenged more and more.
|Print Page


text:
Welcome to Smogon! Check out the Smogon Info Hub for everything you need to know about starting out in the community. Don't forget to introduce yourself in the Introduction Thread, too!
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EV Training Spots in Black/White
Discussion in 'Wi-Fi' started by Mekkah, Mar 12, 2011.
Page 1 of 7
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text:
18 U.S. Code § 666 - Theft or bribery concerning programs receiving Federal funds
(a) Whoever, if the circumstance described in subsection (b) of this section exists—
(1) being an agent of an organization, or of a State, local, or Indian tribal government, or any agency thereof—
(A) embezzles, steals, obtains by fraud, or otherwise without authority knowingly converts to the use of any person other than the rightful owner or intentionally misapplies, property that—
(B) corruptly solicits or demands for the benefit of any person, or accepts or agrees to accept, anything of value from any person, intending to be influenced or rewarded in connection with any business, transaction, or series of transactions of such organization, government, or agency involving any thing of value of $5,000 or more; or
(2) corruptly gives, offers, or agrees to give anything of value to any person, with intent to influence or reward an agent of an organization or of a State, local or Indian tribal government, or any agency thereof, in connection with any business, transaction, or series of transactions of such organization, government, or agency involving anything of value of $5,000 or more;
shall be fined under this title, imprisoned not more than 10 years, or both.
(b) The circumstance referred to in subsection (a) of this section is that the organization, government, or agency receives, in any one year period, benefits in excess of $10,000 under a Federal program involving a grant, contract, subsidy, loan, guarantee, insurance, or other form of Federal assistance.
(c) This section does not apply to bona fide salary, wages, fees, or other compensation paid, or expenses paid or reimbursed, in the usual course of business.
(d) As used in this section—
(1) the term "agent" means a person authorized to act on behalf of another person or a government and, in the case of an organization or government, includes a servant or employee, and a partner, director, officer, manager, and representative;
(2) the term "government agency" means a subdivision of the executive, legislative, judicial, or other branch of government, including a department, independent establishment, commission, administration, authority, board, and bureau, and a corporation or other legal entity established, and subject to control, by a government or governments for the execution of a governmental or intergovernmental program;
(4) the term "State" includes a State of the United States, the District of Columbia, and any commonwealth, territory, or possession of the United States; and
(5) the term "in any one-year period" means a continuous period that commences no earlier than twelve months before the commission of the offense or that ends no later than twelve months after the commission of the offense. Such period may include time both before and after the commission of the offense.
Source(Added Pub. L. 98–473, title II, § 1104(a),Oct. 12, 1984, 98 Stat. 2143; amended Pub. L. 99–646, § 59(a),Nov. 10, 1986, 100 Stat. 3612; Pub. L. 101–647, title XII, §§ 1205(d), 1209,Nov. 29, 1990, 104 Stat. 4831, 4832; Pub. L. 103–322, title XXXIII, § 330003(c),Sept. 13, 1994, 108 Stat. 2140.)
1994—Subsec. (d)(3) to (5). Pub. L. 103–322struck out "and" at end of par. (3), substituted "; and" for the period at end of par. (4), and redesignated second par. (4) defining "in any one-year period" as (5).
1990—Subsec. (d)(4). Pub. L. 101–647, § 1209, added par. (4) defining "in any one-year period".
Pub. L. 101–647, § 1205(d), added par. (4) defining "State".
1986—Pub. L. 99–646, in amending section generally, made specific reference to applicability of section to agent of Indian tribal government or agency thereof, inserted provision that section does not apply to bona fide salary, wages, fees, or other compensation paid, or expenses paid or reimbursed, in usual course of business, struck out definition of term "organization", and otherwise revised structure of section.
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