text:
|Numķro de publication
|Type de publication
|Numķro de demande
|Date de publication
|21 mai 2009
|Date de dķp¶t
|30 oct. 2008
|Date de prioritķ
|16 nov. 2007
|Autre rķfķrence de publication
|Numķro de publication
|Y. King Liu, Jan R. Lau, Judson E. Threlkeld, Michael T. Lyster
|Cessionnaire d'origine
|Osseon Therapeutics, Inc.
|Exporter la citation
|BiBTeX, EndNote, RefMan
|Rķfķrencķ par (9), Classifications (20), ╔vķnements juridiques (10)
|Liens externes: USPTO, Cession USPTO, Espacenet
This application claims priority under 35 U.S.C. ¦ 120 as a divisional of U.S. patent application Ser. No. 11/941,764, filed on Nov. 16, 2007, currently pending, and incorporated by reference herein in its entirety.
The present invention relates to bone augmentation devices and procedures. In particular, the present invention relates to steerable injection devices and systems for introducing conventional or novel bone cement formulations such as in performing vertebroplasty.
According to the National Osteoporosis Foundation ten million Americans have osteoporosis, and an estimated 34 million with low bone mass are at risk of developing osteoporosis (http://www.nof.org/osteoporosis/diseasefacts.htm). Called the "silent disease," OSP develops slowly over a number of years without symptoms. Eighty percent of those affected are women, particularly petite Caucasian and Asian women, although older men and women of all races and ethnicities are at significant risk.
In the United States, 700,000 people are diagnosed with vertebral compression fractures as a result of OSP each year. Morbidity associated with vertebral fractures includes severe back pain, loss of height and deformity, all of which negatively affect quality of life.
Once microfracture of the vertebra begins, there is little the clinician can do except palliative medical treatment using analgesics, bed rest and/or restriction of activity. With time, the microfractures widen at one level and without surgical intervention, the fractures cascade downward with increasing kyphosis or "hunching" of the back. Once a mechanical lesion develops, surgery is the only option. Vertebroplasty or kyphoplasty are the primary minimally-invasive surgical procedures performed for the treatment of compression-wedge fractures due to OSP.
Vertebroplasty stabilizes the collapsed vertebra by injecting polymethylmethacrylate (PMMA) or a substantially equivalent bone cement into cancellous bone space of the vertebrae. Besides providing structural support to the vertebra, the exothermic reaction of PMMA polymerization is said to kill off the nociceptors or pain receptors in the bone, although no proof of this hypothesis has been provided in the literature. This procedure is typically performed as an outpatient procedure and requires only a short-acting local or general anesthetic. Once the surgical area of the spine is anesthetized, the physician inserts one or two needles through small skin incisions into either the pedicle (uni-transpedicular) or the pedicles of the vertebral body i.e., bi-transpedicular. PMMA is injected through the needle and into the cancellous-bone space of the vertebra.
Kyphoplasty mirrors the vertebroplasty procedure but has the additional step of inserting and expanding a nylon balloon in the interior of the vertebral body. Expansion of the balloon under pressure reduces the compression fracture and creates a cavity. After withdrawal of the balloon, PMMA is injected into the cavity to stabilize the reduction. The kyphoplasty procedure may restore the vertebral body height. Kyphoplasty is an in-patient surgery that requires hospitalization and a general anesthetic. Kyphon Inc. claims over 275,000 spinal fractures have been treated using their PMMA derivative and their "balloon" kyphoplasty procedure worldwide (Sunnyvale, Calif., Sep. 5, 2006, (PR NEWSWIRE) Kyphon study 2006).
Bone cement for both vertebroplasty and kyphoplasty procedures currently employ variations of standard PMMA in a powder and a methyl methacrylate monomer liquid. When the powder and liquid monomer are mixed, an exothermic polymerization takes place resulting in the formation of a "dough-like" material, which is then inserted into the cancellous bone space. The dough, when hardened, becomes either the reinforcing structure or the grout between the bone and prosthesis.
The average clinical in vivo life of the PMMA grout is approximately 10 years due to corrosion fatigue of either the bone-cement/prosthesis and/or the bone cement/bone interfaces. Jasty et al. (1991) showed that in cemented total hip replacements: "Fractures in the cement mantle itself were found on cut sections around all prostheses which had been in use for over three years." Jasty et al. also noted: "In general, specimens less than 10 years in situ showed small incomplete fractures while the specimens in place more than 10 years all showed large complete cement mantle fractures."
When an implant fails, a revision becomes mandatory. After removal of the cement and hardware, a cemented arthroplasty can be repeated if enough cancellous bone matrix exists to grip the new PMMA. Alternatively, cement-less prosthesis can be installed. Such a revision, however, can only be applied to total joint replacement failures. For vertebroplasty and/or kyphoplasty, a classical screw and plate internal fixation with autograft fusion is necessary.
Despite advances in the foregoing procedures, there remains a need for improved bone cement delivery systems which enable rapid and controllable deployment of bone cement for the treatment of conditions such as vertebral compression fractures.
According to one embodiment of the present invention, disclosed is a steerable vertebroplasty device, including an elongate tubular body having a proximal end, a distal end, and a central lumen extending therethrough; a deflectable zone on the distal end of the tubular body, deflectable through an angular range; a handle on the proximal end of the tubular body; and a deflection control on the handle. The handle and deflection control are configured for single hand operation. The deflection control can include a rotatable element. The distal end can include a distally facing exit port in communication with the central lumen, or a laterally facing exit port in some embodiments. The device can also include an actuator extending axially between the deflection control and the deflectable zone. The actuator can be an axially moveable element. The device can also include a port on the proximal end of the vertebroplasty device, in communication with the central lumen. The deflectable zone can be deflectable within a plane, and the port can reside in the same plane. In some embodiments, the tubular body includes a proximal zone and a distal, deflectable zone separated by a transition, and the transition can be at least about 15% of the length of the tubular body from the distal end.
Also disclosed herein is a method of treating a vertebral body. The method includes the steps of introducing a tubular injector having a longitudinal axis through cortical bone and into cancellous bone of a vertebral body; deflecting a distal section of the injector angularly with respect to the longitudinal axis; and introducing media through the injector and into the vertebral body.
In another embodiment, disclosed is a system for performing vertebroplasty. The system includes a steerable injection needle, a cement dispensing pump, and a mixing nozzle. The steerable injection needle has a proximal portion, elongate shaft, and a distal portion, the distal portion movable from a first substantially straight configuration to a second configuration not substantially coaxial with the proximal portion. The cement dispensing pump can include a first cartridge housing configured to house a cartridge containing two separate bone cement components. The mixing nozzle is present for mixing the first bone cement component and second bone cement component material into a bone cement composite. In some embodiments, the system also includes a stylet for creating an access pathway in a pedicle. The system can also include an introducer cannula. The first and/or second bone cement component can also be present in the system. The first bone cement component can include MMA. The second bone cement component can include from about 25% to about 35% by weight of bone particles, or at least about 35% weight percent of bone particles in other embodiments. The steerable injection needle can also include an input port for receiving bone cement from the cement dispensing pump. The input port can include a Luer lock. The steerable injection needle can include an adjustment control configured to adjust the curvature of the distal end. In some embodiments, the steerable injection needle includes an end cap on the distal end of the needle. The steerable injection needle can include a pull wire operably connected to the distal end of the needle. In other embodiments, the steerable injection needle includes a filter operably connected to a distal opening of the needle. The distal portion of the steerable needle can have a working length of at least about 20% of the total working length of the needle. The steerable injection needle may also include a spring coil.
Also disclosed herein is a method of treating a bone, including the steps of creating a pedicular access channel in a pedicle to access the interior of a vertebral body; inserting an introducer cannula into the pedicle; inserting a steerable injection needle through the introducer cannula into the interior of a vertebral body, the steerable injection needle having a proximal end and a distal end, the distal end having a first configuration substantially coaxial with a long axis of the proximal end; deflecting the distal end of the steerable injection needle to a second configuration that is not substantially coaxial with the long axis of the proximal end; and flowing bone cement through the steerable injection needle into the interior of the vertebral body. In some embodiments, the second configuration of the distal end of the steerable injection needle includes a curved portion. In some embodiments, deflecting the distal end of the steerable injection needle is accomplished by exerting tension on a pull wire operably connected to the distal end. In some embodiments, deflecting the distal end of the steerable injection needle is accomplished by withdrawing a sheath at least partially covering the distal end. The method can also include the steps of: providing a cement dispensing pump with a cartridge containing a first bone cement material and a second bone cement material out of contact with the first bone cement material, and a mixing nozzle; flowing the first bone cement material and the second bone cement material into the mixing nozzle, creating a bone cement; and flowing the bone cement into an input port of the steerable injection needle. Flowing bone cement through the steerable injection needle into the interior of the vertebral body can include releasing a first bone cement within the interior of the vertebral body. The bone cement can have at least 35% particles by weight in some embodiments. In some embodiments, flowing bone cement through the steerable injection needle into the interior of the vertebral body additionally includes releasing a second bone cement within the first bone cement, where the second bone cement includes less than about 35% particles by weight.
Also disclosed herein is a closed vertebroplasty bone cement injection system, that includes a cartridge containing at least a first chamber and a second chamber; a first bone cement component in the first chamber and a second bone cement component in the second chamber; a mixing chamber, for mixing the first and second bone cement components; an elongate injection needle, for directing bone cement into a treatment site in the spine; and a closed flow path for directing the first and second bone cement components from the first and second chambers, through the mixing chamber, through the injection needle and into the spine at the treatment site. The cartridge, mixing chamber, and/or injection needle can be releaseably connected to the flow path. The injection needle can have a deflectable distal end.
Also disclosed herein is a method of injecting bone cement into a treatment site in a bone, including the steps of: providing a first chamber having a first bone cement component, and a second chamber having a second bone cement component, the first and second bone cement components formulated to form a hardenable bone cement following mixing; providing a mixing chamber for mixing the first and second bone cement components; providing an elongate, tubular injection needle; connecting the first and second bone cement chambers, the mixing chamber and the injection needle into a closed flow path; and expressing first and second bone cement components through the mixing chamber, through the injection needle and into the site. The first and the second chambers can be contained in a single cartridge.
The present invention provides improved delivery systems for delivery of a bone cement or bone cement composite for the treatment of vertebral compression fractures due to osteoporosis (OSP), osteo-trauma, and benign or malignant lesions such as metastatic cancers and myeloma, and associated access and deployment tools and procedures.
The primary materials in the preferred bone cement composite are methyl methacrylate and inorganic cancellous and/or cortical bone chips or particles. Suitable inorganic bone chips or particles are sold by Allosource, Osteotech and LifeNet (K053098); all have been cleared for marketing by FDA The preferred bone cement also may contain the additives: barium sulfate for radio-opacity, benzoyl peroxide as an initiator, N,N-dimethyl-p-toluidine as a promoter and hydroquinone as a stabilizer. Other details of bone cements and systems are disclosed in U.S. patent application Ser. No. 11/626,336, filed Jan. 23, 2007, the disclosure of which is hereby incorporated in its entirety herein by reference.
One preferred bone cement implant procedure involves a two-step injection process with two different concentrations of the bone particle impregnated cement. To facilitate the implant procedure the bone cement materials are packaged in separate cartridges containing specific bone cement and inorganic bone particle concentrations for each step. Tables 1 and 2, infra, list one example of the respective contents and concentrations in Cartridges 1A and 1B for the first injection step, and Cartridges 2A and 2B for the second injection step.
The bone cement delivery system generally includes at least three main components: 1) stylet; 2) introducer cannula; and 3) steerable injection needle. See
The stylet is used to perforate a hole into the pedicle of the vertebra to gain access to the interior of the vertebral body.
The introducer cannula is used for bone access and as a guide for the steerable injection needle. The introducer cannula is sized to allow physicians to perform vertebroplasty or kyphoplasty on vertebrae with small pedicles such as the thoracic vertebra T5 as well as larger vertebrae. In addition, this system is designed for uni-transpedicular access and/or bi-pedicular access.
Once bone access has been achieved, the steerable injection needle can be inserted through the introducer cannula into the vertebra. The entire interior vertebral body may be accessed using the steerable injection needle. The distal end of the needle can be manually shaped to any desired radius within the product specifications. The radius is adjusted by means of a knob on the proximal end of the device.
The hand-held cement dispensing pump may be attached to the steerable injection needle by a slip-ring luer fitting. The pre-filled 2-chambered cartridges (1A and 1B, and 2A and 2B) are loaded into the dispensing pump. As the handle of the dispensing pump is squeezed, each piston pushes the cartridge material into the spiral mixing tube. The materials are mixed in the spiral mixing nozzle prior to entering the steerable injection needle. The ratio of diameters of the cartridge chambers determines the mixing ratio for achieving the desired viscosity. One particular non-limiting example of an exemplary system is described below.
Steerable Injection Needle
Cement Dispensing Pump and Spiral Mixing Nozzle
The bone cement implant procedures described herein use established vertebroplasty and kyphoplasty surgical procedures to stabilize the collapsed vertebra by injecting bone cement into cancellous bone.
The preferred procedure is designed for uni-transpedicular access and may be accomplished under either a local anesthetic or short-duration general anesthetic. Once the area of the spine is anesthetized, an incision is made and the stylet is used to perforate the vertebral pedicle and gain access to the interior of the vertebral body. The introducer cannula is then inserted and acts as a guide for the steerable injection needle.
Injection of the preferred bone cement involves a two-step procedure. The pre-filled Cartridges 1A and 1B are loaded into the dispensing pump. As the dispensing pump handle is squeezed, each piston pushes material into the spiral mixing tube. The diameter of each chamber may be utilized to determine the mixing ratio for achieving the desired viscosity.
The first step involves injecting a small quantity of PMMA with more than about 35%, e.g., 60% inorganic bone particles, onto the outer periphery of the cancellous bone matrix, i.e., next to the inner wall of the cortical bone of the vertebral body. The cement composite is designed to harden relatively quickly, forming a firm but still pliable shell. This shell is intended to prevent bone marrow/PMMA content from being ejected through any venules or micro-fractures in the vertebral body wall. The second step of the procedure involves a second injection of PMMA with an approximately 30% inorganic bone particles to stabilize the remainder of the weakened, compressed cancellous bone.
Alternatively, the steerable needle disclosed herein and discussed in greater detail below, can be used in conventional vertebroplasty procedures, using a single step bone cement injection.
Injection control for the first and second steps is provided by a 2 mm ID flexible injection needle, which is coupled to the hand operated bone cement injection pump. The 60% (>35%) and 30% ratio of inorganic bone particle to PMMA concentrations may be controlled by the pre-filled cartridge sets 1A and 1B, and 2A and 2B. At all times, the amount of the injectate is under the direct control of the surgeon or intervention radiologist and visualized by fluoroscopy. The introducer cannula is slowly withdrawn from the cancellous space as the second injection of bone cement begins to harden, thus preventing bone marrow/PMMA content from exiting the vertebral body. The procedure concludes with closure of the surgical incision with bone filler. In vitro and in vivo studies have shown that the 60% (>35%) bone-particle impregnated bone cement hardens in 2-3 minutes and 30% bone-particle impregnated bone cement hardens between 4 to 10 minutes.
Details of the system components will be discussed below.
There is provided in accordance with the present invention a steerable injection device that can be used to introduce any of a variety of materials or devices for diagnostic or therapeutic purposes. In one embodiment, the system is used to inject bone cement, e.g., PMMA or any of the bone cement compositions disclosed elsewhere herein. The injection system most preferably includes a tubular body with a steerable (i.e., deflectable) distal portion for introducing bone cement into various locations displaced laterally from the longitudinal axis of the device within a vertebral body during a vertebroplasty procedure.
Referring to
The manifold 18 is additionally provided with a control 26 such as a rotatable knob, slider, or other moveable control, for controllably deflecting a deflection zone 24 on the distal end 16 of the tubular body 12. As is described elsewhere herein, the deflection zone 24 may be advanced from a relatively linear configuration as illustrated in
Referring to
The central lumen 38 has an inside diameter which is adapted to slideably axially receive the steerable injection needle 10 therethrough. This enables placement of the distal end 34 adjacent a treatment site within the body, to establish an access pathway from outside of the body to the treatment site. As will be appreciated by those of skill in the art, the introducer 30 enables procedures deep within the body such as within the spine, through a minimally invasive and/or percutaneous access. The steerable injection needle 10 and/or other procedure tools may be introduced into port 40, through lumen 38 and out of port 42 to reach the treatment site.
The proximal end 32 of introducer 30 may be provided with a handle 44 for manipulation during the procedure. Handle 44 may be configured in any of a variety of ways, such as having a frame 46 with at least a first aperture 48 and a second aperture 50 to facilitate grasping by the clinician.
Referring to
As will be appreciated by those of skill in the art, the stylet 60 has an outside diameter which is adapted to coaxially slide within the central lumen on introducer 30. When block 68 is nested within recess 70, a distal end 64 of stylet 60 is exposed beyond the distal end 34 of introducer 30. The distal end 64 of stylet 60 may be provided with a pointed tip 72, such as for anchoring into the surface of a bone.
Referring to
The shaft 702 defines at least one lumen therethrough that is preferably configured to carry a flowable bone cement prior to hardening. Proximal portion 710 of shaft 702 is preferably relatively rigid, having sufficient column strength to push through cancellous bone. Distal portion 712 of shaft 702 is preferably flexible and/or deflectable and reversibly actuatable between a relatively straight configuration and one or more deflected configurations or curved configurations as illustrated, for example, in
Input port 704 may be provided with a Luer lock connector although a wide variety of other connector configurations, e.g., hose barb or slip fit connectors can also be used. Lumen 705 of input port 704 is fluidly connected to central lumen 720 of shaft 702 such that material can flow from a source, through input port 704 into central lumen 720 of the shaft 702 and out the open distal end or out of a side opening on distal portion 712. Input port 704 is preferably at least about 20 gauge and may be at least about 18, 16, 14, or 12 gauge or larger in diameter.
Input port 704 advantageously allows for releasable connection of the steerable injection device 700 to a source of hardenable media, such as a bone cement mixing device described herein. In some embodiments, a plurality of input ports 704, such as 2, 3, 4, or more ports are present, for example, for irrigation, aspiration, introduction of medication, hardenable media precursors, hardenable media components, catalysts or as a port for other tools, such as a light source, cautery, cutting tool, visualization devices, or the like. A first and second input port may be provided, for simultaneous introduction of first and second bone cement components such as from a dual chamber syringe or other dispenser. A mixing chamber may be provided within the injection device 700, such as within the proximal handle, or within the tubular shaft 702
A variety of adjustment controls 706 may be used with the steerable injection system, for actuating the curvature of the distal portion 712 of the shaft 702. Preferably, the adjustment control 706 advantageously allows for one-handed operation by a physician. In one embodiment, the adjustment control 706 is a rotatable member, such as a thumb wheel or dial. The dial can be operably connected to a proximal end of an axially movable actuator such as pull wire 724. See
In some embodiments, the adjustment control 706 allows for continuous adjustment of the curvature of the distal portion 712 of shaft 702 throughout a working range. In other embodiments, the adjustment control is configured for discontinuous (i.e., stepwise) adjustment, e.g., via a ratcheting mechanism, preset slots, deflecting stops, a rack and pinion system with stops, ratcheting band (adjustable zip-tie), adjustable cam, or a rotating dial of spring loaded stops. In still other embodiments, the adjustment control 706 may include an automated mechanism, such as a motor or hydraulic system to facilitate adjustment.
The adjustment control may be configured to allow deflection of the distal portion 712 through a range of angular deviations from 0 degrees (i.e., linear) to at least about 15░, and often at least about 25░, 35░, 60░, 90░, 120░, 150░, or more degrees from linear.
In some embodiments, the length X of the flexible distal portion 712 of shaft 702 is at least about 10%, in some embodiments at least about 15%, 25%, 35%, 45%, or more of the length Y of the entire shaft 702 for optimal delivery of bone cement into a vertebral body. One of ordinary skill in the art will recognize that the ratio of lengths X:Y can vary depending on desired clinical application. In some embodiments, the maximum working length of needle 702 is no more than about 15″, 10″, 8″, 7″, 6″, or less depending upon the target and access pathway. In one embodiment, when the working length of needle 702 is no more than about 8″, the adjustable distal portion 712 of shaft has a length of at least about 1″ and preferably at least about 1.5″ or 2″.
In some embodiments, the slots 718 can be machined or laser cut out of the tube stock that becomes shaft 702, and each slot may have a linear, chevron or other shape. In other embodiments, the distal portion 712 of shaft 702 may be created from an elongate coil rather than a continuous tube.
Slots 718 provide small compression hinge joints to assist in the reversible deflection of distal portion 712 of shaft 702 between a relatively straightened configuration and one or more curved configurations. One of ordinary skill in the art will appreciate that adjusting the size, shape, and/or spacing of the slots 718 can impart various constraints on the radius of curvature and/or limits of deflection for a selected portion of the distal portion 712 of shaft 702. For example, the distal portion 712 of shaft 702 may be configured to assume a second, fully deflected shape with a relatively constant radius of curvature throughout its length. In other embodiments, the distal portion 712 may assume a progressive curve shape with a variable radius of curvature which may, for example, have a decreasing radius distally. In some embodiments, the distal portion may be laterally displaced through an arc having a radius of at least about 0.5″, 0.75″, 1.0″, 1.25″, or 1.5″ minimum radius (fully deflected) to ∞ (straight) to optimize delivery of bone cement within a vertebral body. Wall patterns and deflection systems for bendable slotted tubes are disclosed, for example, in U.S. Pat. No. 5,378,234 or 5,480,382 to Hammerslag et al., the disclosures of which are incorporated in its entirety by reference herein.
Still referring to
A distal opening 728 is provided on shaft 702 in communication with central lumen 720 to permit expression of material, such as bone cement, from the injector 700. Some embodiments may include a filter such as mesh 812. Mesh structure 812 can advantageously control cement output by controlling bubbles and/or preventing undesired large or unwieldy aggregations of bone cement from being released at one location and thus promote a more even distribution of bone cement within the vertebral body. The mesh 812 may be created by a laser-cut crisscrossing pattern within distal end as shown, or can alternatively be separately formed and adhered, welded, or soldered on to the distal opening 728. Referring to
In some embodiments, the distal shaft 712 can generate a lateral force of at least about 0.125 pounds, 0.25 pounds, 0.5 pounds, 1 pound, 1.5 pounds, 2 pounds, 3 pounds, 4 pounds, 5 pounds, 6 pounds, 7 pounds, 8 pounds, 9 pounds, 10 pounds, or more by activating control 706. This can be advantageous to ensure that the distal portion 712 is sufficiently navigable laterally through cancellous bone to distribute cement to the desired locations. In some embodiments, the distal shaft 712 can generate a lateral force of at least about 0.125 pounds but no more than about 10 pounds; at least about 0.25 pounds but no more than about 7 pounds; or at least about 0.5 pounds but no more than about 5 pounds.
In some embodiments, the distal portion 712 of shaft 702 (or end cap 730) has visible indicia, such as, for example, a marker visible via one or more imaging techniques such as fluoroscopy, ultrasound, CT, or MRI.
The distal curved portion 734 may be configured to be axially movably received within an outer tubular sheath 738. The sheath 738 is preferably configured to have sufficient rigidity and radial strength to maintain the curved distal portion 734 of shaft 732 in a relatively straightened configuration while the outer tubular sheath 738 coaxially covers the curved distal portion 734. Sheath 738 can be made of, for example, a metal such as stainless steel or various polymers known in the catheter arts. Axial proximal withdrawal of the sheath 738 with respect to tubular shaft 736 will expose an unconstrained portion of the shape memory distal end 734 which will revert to its unstressed arcuate configuration. Retraction of the sheath 738 may be accomplished by manual retraction by an operator at the proximal end, retraction of a pull wire attached to a distal portion of the sheath 738, or other ways as known in the art. The straightening function of the outer sheath 738 may alternatively be accomplished using an internal stiffening wire, which is axially movably positionable within a lumen extending through the tubular shaft 736. The length, specific curvature, and other details of the distal end may be as described elsewhere herein.
In another embodiment, as shown in
Introducer 800 includes a needle-redirecting element 804 such as an inclined surface near its distal end. Needle-redirecting element 804 can be, for example, a laser-cut tang or a plug having a proximal surface configured such that when needle 802 is advanced distally into introducer 800 and comes in contact with the needle-redirecting element 804, a distal portion 814 of needle 802 is redirected out an exit port 806 of introducer 800 at an angle 808, while proximal portion 816 of needle 802 remains in a relatively straightened configuration, as shown in
The illustrated embodiment of
The interior sleeve 705 is preferably in the form of a continuous, tubular flexible material, such as nylon or polyethylene. In an embodiment in which the needle 702 has an outside diameter of 0.095 inches (0.093 inch coil with a 0.001 inch thick outer sleeve) and an inside diameter of 0.077 inches, the interior tubular sleeve 705 may have an exterior diameter in the area of about 0.074 inches and an interior diameter in the area of about 0.069 inches. The use of this thin walled tube 705 on the inside of the needle shaft 702 is particularly useful for guiding a fiber through the needle shaft 702. The interior tube 705 described above is additionally preferably fluid-tight, and can be used to either protect the implements transmitted therethrough from moisture, or can be used to transmit bone cement through the steerable needle.
In some embodiments, an outer tubular coating or sleeve (not shown) is provided for surrounding the steerable needle shaft at least partially throughout the distal end of the needle. The outer tubular sleeve may be provided in accordance with techniques known in the art and, in one embodiment, is a thin wall polyester (e.g., ABS) heat shrink tubing such as that available from Advanced Polymers, Inc. in Salem, N.H. Such heat shrink tubings have a wall thickness of as little as about 0.0002 inches and tube diameter as little as about 0.010 inches. The outer tubular sleeve enhances the structural integrity of the needle, and also provides a fluid seal and improved lubricity at the distal end over embodiments with distal joints 718. Furthermore, the outer tubular sleeve tends to prevent the device from collapsing under a proximal force on a pull wire. The sleeve also improves pushability of the tubular members, and improves torque transmission.
In other embodiments, instead of a slotted tube, the needle shaft of a vertebroplasty injection system may include a metal or polymeric coil. Steerable helical coil-type devices are described, for example, in U.S. Pat. No. 5,378,234 or 5,480,382 to Hammerslag et al., which are both incorporated by reference herein in their entirety. As shown in
Portion of spring coil 1014 which extends around axial flange 1024 is relatively inflexible. Thus, the axial length of flange 1024 can be varied to affect the deflected profile of the steerable sheath 1010. A deflection wire 1026 or other column support enhancing element is preferably secured with respect to a relatively noncompressible portion of tubular body 1012 at a proximal point 1028 and extends distally to a distal point of attachment 1030 to provide column strength. The distal point of attachment may secure the deflection wire 1026 to either or both of the spring coil 1014 and end cap 730. Deflection wire 1026 bends upon axial displacement of pull wire 724, with proximal point of attachment 1028 functioning as a fulcrum or platform.
Proximal attachment 1028 may be a solder, braze or weld joint, as is known in the art, with any excess on the radial outside surface of the tubular body 1012 being trimmed or polished to minimize rough edges. Distal point of attachment 1030 is similarly provided by any of a variety of conventional securing techniques which is appropriate for the construction materials of the steerable sheath 1010.
The length of the space between the proximal point of attachment 1028 and distal point of attachment 1030 affects the radius of the curve of the deflection wire 1026 and hence of the region 712, as will be appreciated by one of skill in the art. The deflection wire 1026 will tend to remain positioned along the exterior circumference of the curve during deflection by axial compression of the steerable sheath 1010. Since the circumference in a given steerable sheath 1010 will be a fixed distance, the radius of the curve during deflection will differ, depending upon the degree of deflection achieved.
Deflection at distal steering region 712 of steerable sheath 1010 is accomplished by providing a pull wire 724. Pull wire 724 is preferably secured at a distal point of attachment 1036 and extends proximally to the control end of the steerable sheath 1010. Axial displacement of the pull wire 724 will tend to pivot the steering region 712 of the tubular body 1012 around proximal point of attachment 1028, as shown in
Pull wire 724 is rotationally offset from deflection wire 1026 by at least about 90░. Preferably, pull wire 724 is rotationally offset from deflection wire 1026 by about 180░, as illustrated in
In another embodiment, an interior tubular sleeve (not illustrated) is additionally provided to facilitate flow of media through central lumen 1016 as described elsewhere in the application. In some embodiments, a heat-shrink outer tubular sleeve as described elsewhere in the application is also provided to enhance the structural integrity of the sheath, provide a fluid seal, as well as improve lubricity.
In one embodiment, the steerable injection needle (also referred to as the injection shaft) has an outside diameter of between about 8 to 24 gauge, more preferably between about 10 to 18 gauge, e.g., 12 gauge, 13 gauge (0.095″ or 2.41 mm), 14 gauge, 15 gauge, or 16 gauge. In some embodiments, the inside diameter (luminal diameter) of the injection needle is between about 9 to 26 gauge, more preferably between about 11 to 19 gauge, e.g., 13 gauge, 14 gauge, 15 gauge, 16 gauge, or 17 gauge. In some embodiments, the inside diameter of the injection needle is no more than about 4 gauge, 3 gauge, 2 gauge, or 1 gauge smaller than the outside diameter of the injection needle.
The inside luminal diameter of all of the embodiments disclosed herein is preferably optimized to allow a minimal exterior delivery profile while maximizing the amount of bone cement that can be carried by the needle. In one embodiment, the outside diameter of the injection needle is 13 gauge (0.095″ or 2.41 mm) with a 0.077″ (1.96 mm) lumen. In some embodiments, the percentage of the inside diameter with respect to the outside diameter of the injection needle is at least about 60%, 65%, 70%, 75%, 80%, 85%, or more.
The steerable injection systems described above are preferably used in conjunction with a mixing and dispensing pump for use with a multi-component cement. In some embodiments, a cement dispensing pump is a hand-held device having an interface such as a tray or chamber for receiving one or more cartridges. In one embodiment, the pump is configured to removably receive a double-barreled cartridge for simultaneously dispensing first and second bone cement components. The system additionally includes a mixing chamber, for mixing the components sufficiently and reproducibly to fully automate the mixing and dispensing process within a closed system.
Bone cement components have conventionally been mixed, such as by hand, e.g., in mixing bowls in the operating room, which can be a time-consuming and unelegant process. Use of a mixing device such as a double-barreled dispensing pump as disclosed herein is highly advantageous in reducing bone cement preparation time, ensuring that premature cement curing does not occur (i.e., the components are mixed immediately prior to delivery into the body), and ensuring adequate mixing of components.
Two separate chambers contain respective materials to be mixed in a specific ratio. Manual dispensing (e.g., rotating a knob or squeezing a handle) forces both materials into a mixing nozzle, which may be a spiral mixing chamber within or in communication with a nozzle. In the spiral mixing nozzle, all or substantially all mixing preferably occurs prior to the bone cement entering the steerable injection needle and, subsequently, into the vertebra. The cement dispensing hand pump may be attached to the steerable injection needle permanently, or removably via a connector, such as slip-ring Luer fittings. A wide range of dispensing pumps can be modified for use with the present invention, including dispensing pumps described in, for example, U.S. Pat. Nos. 5,184,757, 5,535,922, 6,484,904, and Patent Publication No. 2007/0114248, all of which are incorporated by reference in their entirety.
The actuator rod 981 and piston rods 982, 983 may be linked at a proximal end such as by a bridge 984 to which a pull knob 985 is attached, such that all rods 981, 982, 983 move simultaneously as an assembly. A piston plate 986 is attached to piston rod 983 at the distal end thereof proximate to the cartridge tray 977. A second piston plate 987 (illustrated as larger than first plate 986) is affixed to the distal end of piston rod 982 and optionally actuator rod 981. In this manner, the ejector gun 976 can be utilized with cartridges having cylinders 912, 914 of the same or different diameters. As depicted in
The tray 977 is held to the actuator portion 978 by a plurality of fasteners 989, or by welding, gluing, integral molding or other conventional means. Distal to the actuator 978, the tray has an end plate 990 with a cartridge docking cutout 991 for slideably receiving and embracing the cartridge 910 at the base of the outlet 922.
A cartridge support 997 may extend up from the bottom of the tray 977 and engage the cartridge to retain alignment with the motion of the piston plates 986, 987 to maximize the transfer of force from piston plates 986, 987 to expel the compound from the cartridge 910.
The present disclosure is directed primarily to a cartridge embodiment having two cylindrical chambers. This permits expression of media from the chambers using a plunger arrangement such as a common syringe. However, any of a wide variety of chamber configurations and structures for expressing media from the chamber may be utilized.
Currently favored bone cement compositions are normally stored as two separate components or precursors, for mixing at the clinical site shortly prior to implantation. As has been described above, mixing of the bone cement components has traditionally been accomplished manually, such as by expressing the components into a mixing bowl in or near the operating room. In accordance with the present invention, the bone cement components may be transmitted from their storage and/or shipping containers, into a mixing chamber, and into the patient, all within a closed system. For this purpose, the system of the present invention includes at least one mixing chamber positioned in the flow path between the bone cement component container and the distal opening on the bone cement injection needle. This permits uniform and automated or semi-automated mixing of the bone cement precursors, within a closed system, and thus not exposing any of the components or the mixing process at the clinical site.
Thus, the mixing chamber may be formed as a part of the cartridge, may be positioned downstream from the cartridge, such as in-between the cartridge and the proximal manifold on the injection needle, or within the proximal manifold on the injection needle or the injection needle itself, depending upon the desired performance of the device. The mixing chamber may be a discrete component which may be removably or permanently coupled in series flow communication with the other components of the invention, or may be integrally formed within any of the foregoing components.
In general, the mixing chamber includes an influent flow path for accommodating at least two bone cement components. The first and second incoming flow path are combined, and mixing structures for facilitating mixing of the components are provided. This may include any of a variety of structures, such as a helical flow path, baffles and or additional turbulence inducing structures.
In the embodiment illustrated in
The cement mixing gun, cartridge and mixing chamber are illustrated in
After cement is mixed in mixing nozzle 994, the cement is preferably immediately or eventually directed into the input port 704 of a steerable delivery device, either directly, such as via a Luer lock connector, or through a bridging tubing set.
Cement dispensing pump 976 is preferably configured to accommodate cartridges of appropriate volume for the formation of the amount of bone cement likely to be needed in a single level or a two level vertebroplasty. In some embodiments, cartridges have a volume sufficient to produce a unit volume of mixed bone cement between about 25-200 cc, preferably between 25-100 cc, and in one implementation about 50 cc.
In some embodiments, a bone cement composite is packaged in two separate chambers contained in a single cartridge. This may be useful, for example, for delivering conventional two part PMMA formulations in an otherwise conventional vertebroplasty or kyphoplasty procedure.
In other embodiments, the system is adapted for delivering a bone cement composite in which the final construct comprises a mass of hardened cement having a particulate content with a non uniform spatial distribution. In this embodiment, a total of three or four chambers will normally be used which may conveniently be distributed into two chambers each in two cartridges.
Tables 1-2 below depict the contents and concentrations of one exemplary embodiment of bone cement precursors. Chambers 1A and 1B contain precursors for a first cement composition for distribution around the periphery of the formed in place vertebral body implant with a higher particle concentration to promote osteoinduction, as discussed previously in the application. Chambers 2A and 2B contain precursors for a second cement composition for expression more centrally within the implanted mass within the vertebral body, for stability and crack arresting, as discussed previously in the application.
One of ordinary skill in the art will recognize that a wide variety of chamber or cartridge configurations, and bone cements, can be used with the present injection system. For example, in one embodiment, a first cartridge includes pre-polymerized PMMA and a polymerization catalyst, while a second cartridge includes a liquid monomer of MMA as is common with some conventional bone cement formulations.
In some embodiments, the contents of two cartridges can be combined into a single cartridge having multiple (e.g., four) chambers. Chambers may be separated by a frangible membrane (e.g., 1A and 2A in a first cartridge and 1B and 2B in a second cartridge, each component separated by the frangible membrane or other pierceable or removable barrier). In other embodiments, contents of the below cartridges can be manually pre-mixed and loaded into the input port of the injection system without the use of a cement mixing dispenser.
Chamber 1A
Methyl methacrylate (balance)
Hydroquinone (~75 ppm)(stabilizer)
N,N-dimethyl-p-toluidine (~0.9%)
Sterile bone particles (≧35 wt. %)
(catalyst for polymerization)
Barium sulfate (~20 wt. %)
Chamber 1B
Benzoyl peroxide (~2%)
Physiological saline or poppy seed oil
(activator for polymerization)
Chamber 2A
Methyl methacrylate (balance)
Hydroquinone (~75 ppm)(stabilizer)
N,N-dimethyl-p-toluidine (~0.9%)
Sterile bone particles (~30 wt. %)
(catalyst for polymerization)
Barium sulfate (~20 wt. %)
Chamber 2B
Benzoyl peroxide (~2%)
Physiological saline or poppy seed oil
(activator for polymerization)
As illustrated in
The stylet may have a diameter of between about 0.030″ to 0.300″, 0.050″ to about 0.200″ and preferably about 0.100″ in some embodiments. The introducer cannula 800 is between about 8-14 gauge, preferably between about 10-12 gauge, more preferably 11 gauge in some embodiments. The introducer cannula 800, which may be made of any appropriate material, such as stainless steel (e.g., 304 stainless steel) may have a maximum working length of no more than about 12″, 8″, or 6″ in some embodiments. One or two or more bone cement cartridges, each having one or two or more chambers, may also be provided. Various other details of the components have been described above in the application.
One embodiment of a method for delivering bone cement into a vertebral body is now described, and illustrated in
The cement implantation procedure is designed for uni-transpedicular access and generally requires either a local anesthetic or short-duration general anesthetic for minimally invasive surgery. Once the area of the spine is anesthetized, as shown in
Once bone access has been achieved, as shown in
The actual injection procedure may utilize either one or two basic steps. In a one step procedure, a homogenous bone cement is introduced as is done in conventional vertebroplasty. The first step in the two step injection involves injection of a small quantity of PMMA with more than about 35%, e.g., 60% particles such as inorganic bone particles onto the periphery of the treatment site, i.e., next to the cortical bone of the vertebral body as shown in
Injection control for the first and second steps is provided by an approximately 2 mm inside diameter flexible introducer cannula 800 coupled to a bone cement injection pump (not shown) that is preferably hand-operated. Two separate cartridges containing respective bone cement and inorganic bone particle concentrations that are mixed in the 60% and 30% ratios are utilized to control inorganic bone particle to PMMA concentrations. The amount of the injectate is under the direct control of the surgeon or interventional radiologist by fluoroscopic observation. The introducer cannula 800 is slowly withdrawn from the cancellous space as the bolus begins to harden, thus preventing bone marrow/PMMA content from exiting the vertebral body 1308. The procedure concludes with the surgical incision being closed, for example, with bone void filler 1306 as shown in
The aforementioned bone cement implant procedure process eliminates the need for the external mixing of PMMA powder with MMA monomer. This mixing process sometimes entraps air in the dough, thus creating porosity in the hardened PMMA in the cancellous bone area. These pores weaken the PMMA. Direct mixing and hardening of the PMMA using an implant procedure such as the above eliminates this porosity since no air is entrapped in the injectate. This, too, eliminates further weakening, loosening, or migration of the PMMA.
While described herein primarily in the context of vertebroplasty, one of ordinary skill in the art will appreciate that the disclosed injection system can be used or modified in a wide range of clinical applications, such as, for example, other orthopedic applications such as kyphoplasty, treatment of any other bones, pulmonary, cardiovascular, gastrointestinal, gynecological, or genitourinary applications. While this invention has been particularly shown and described with references to embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention. For all of the embodiments described above, the steps of the methods need not be performed sequentially and the individual components of the devices may be combined permanently or be designed for removable attachment at the clinical site.
|Brevet citant
|Date de dķp¶t
|Date de publication
|30 oct. 2008
|30 nov. 2010
|Osseon Therapeutics, Inc.
|Steerable vertebroplasty system
|16 nov. 2009
|27 mars 2012
|Innovative Health Technologies, Llc
|Implants and methods for performing gums and bone augmentation and preservation
|16 fķvr. 2012
|11 dķc. 2012
|Innovative Health Technologies, Llc
|Implants and methods for performing gingiva and bone augmentation and preservation
|12 juil. 2010
|19 fķvr. 2013
|The University Of Toledo
|Needle for directional control of the injection of bone cement into a vertebral compression fracture
|20 avr. 2012
|9 sept. 2014
|Osseon Llc
|Steerable vertebroplasty system with cavity creation element
|6 avr. 2010
|16 dķc. 2014
|DePuy Synthes Products, LLC
|Minimally invasive spine augmentation and stabilization system and method
|9 ao¹t 2011
|1 sept. 2015
|DePuy Synthes Products, Inc.
|Articulated cavity creator
|30 sept. 2010
|Dfine, Inc.
|Bone treatment systems and methods
|28 oct. 2010
|19 mai 2011
|Innovative Health Technologies, Llc
|Implants and methods for performing gums and bone augmentation and reservation
|Classification aux ╔tats-Unis
|606/92, 606/93
|Classification internationale
|Classification coopķrative
|Classification europķenne
|7 ao¹t 2009
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text:
Go Minneapolis is your home for exclusive experiences and deals in Minneapolis. Find all the best Minneapolis coupons here and save on attractions, restaurants and hotels in Minneapolis.» visit go.minneapolis.org for exclusive deals and experiences
Looking for nature? Lakes galore, the most bike-friendly city in the nation, a park every six blocks and four professional sports teams guarantee that your visit to Minneapolis will be active. Here's an overview of what the metro area possesses. Take a look around.
If you're truly an early bird, watch the sunrise over Lake Calhoun, one of the best places in the city to see nature and get some urban flavor at the same time. Enjoy yourself on the dock, and when the morning runners come out head to Common Roots Cafe for a chill, organic breakfast.
Next, take a drive out to the 'burbs. Don't worry—you're in for a treat. Make your way to the Minnesota Landscape Arboretum. Run by the University of Minnesota, the Arb features more than 1,000 acres of gardens, model landscapes and natural areas, from woodlands to wetlands to prairie. And, with 12.5 miles of garden paths and hiking trails, you'll be able to explore the area for hours. The Arb has great seasonal offerings, along with exhibits and more, so be sure to check them out before you enter their green utopia.
Dinner time! The hike has got you starved. Experience the 'burbs a little more and trek over to Lake Minnetonka—yes, the lake of Prince fame. Try Lord Fletchers, situated on the Lake's bank. They've got drinks, good and a guaranteed good time. If you hit it in the summer months, be sure to sit out on the docks for boat-watching and other merriment.
On your way back to the cities, hit up a rooftop bar for a little urban "nature": Solera and Seven Sushi have some of the best views of Minneapolis.
Meet Minneapolis is an accredited Destination Marketing Organization from Destination Marketing
Association International (DMAI). Click to learn more about
DMAI and the Accreditation Process.
|Meet Minneapolis
250 Marquette Ave S, Minneapolis, MN 55401
|Minneapolis Convention Center
1301 Second Ave S, Minneapolis, MN 55403

subset: commoncrawl


text:
By MICHAEL CRESPINContributing writer
After the Carbon School Board voted last week to ban most portable electronic devices from school grounds, a number of students were questioned as to how they felt about the new rules that would go into effect on Feb. 1.
"Well I agree with the district putting restrictions on electronics," said Tyler Konakis of Helper Junior High. "But they shouldn't punish everyone else for the mistakes of others."
The ban is a result of a couple of years of problems concerning such devices as cell phones (particularly with cameras) and other devices that can communicate with another device. And the problem isn't just at the high school.
"We had other rules and the students wouldn't live by it so we had to go more drastic and it's a district rule," said Jeff Jorgensen, a teacher at Carbon High. "It's not just a problem at Carbon but in the junior highs and elementaries too."
For some students not being able to use their cell phones seems ridiculous, even possibly dangerous.
"What if an emergency was to happen?" asked Miranda Gold a student at Carbon High. "Without my cell phone I wouldn't be able to call for help."
Another student, Venyce Martinez had a little different take on the issue of safety as it applys to the ban.
"It's needed on some level because it keeps kids from learning," she said. "But not being able to carry it (cell phone) is ridiculous. It could be helpful in certain situations and it's security for some of us who don't use them for anything but emergencies. Because I'm a diabetic I use my phone to get my mom to bring me something when my blood (sugar) is low or high. Sometimes teachers aren't there or aren't approachable and a lot of time there is nothing they can do."
Some students also say that rules that are already in place concerning cell phones aren't enforced now. They wonder how new ones can be enforced any better.
"It goes back to the no cell phone use in class policy," said Janine Thompson of Carbon High. "But there are so many students who do use them during class."
Some high school students see the adoption of the policy as the district saying they are not responsible enough to handle adulthood.
"It's ridiculous," said Mikka Pendergrass, a student at Carbon. "We are responsible enough when it is the appropriate time to use cell phones. You're obviously not going to use it on a test."
Others see the problems that have arisen as just a matter of manners more than anything.
"I think that cell phones aren't a problem as long as the students are doing their work," said Bandon Wilson, another Carbon High student. "If the sound is turned off they aren't a nuisance."
With most students in the high school and many in the junior highs owning at least a cell phone, how the policy plays out will be evident in the next few months.
It appears the board will review the policy before the beginning of school next year.


text:
Analysis of the Mexican and Central America and Caribbean Contact Center Outsourcing Services Market
This study examines the trends in the contact center outsourcing services markets in Mexico as well as Central America and the Caribbean. It forecasts market demand and provides an extensive coverage of the services delivered in each of the local markets and services supplied by these countries to overseas consumers. Furthermore, it shows the data for outsourcing offshore services alone, excluding in-house operations. Within this study, revenue is traced as it is received by outsourcing companies for the provision of customer/agent interaction services in Mexico and Central America and the Caribbean.
1. Mexican and Central American and the Caribbean Markets 2011
Features of this research
- Contact Centers, Industry Research, North America
- Enterprise Communications, Industry Research, Global
- Contact Centers, Industry Research, Global
- Information & Communication Technology, Industry Research, Global
- Contact Centers, Latin America
- Information & Communications Technologies - Total Integrated, Latin America
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For more information and general enquiries, contact Frost & Sullivan near you.
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This is the campus emergency information page. In the event of an emergency or weather-related incident, we'll have the latest information here.
In the event of a sustained power outage, we will use our back-up website: www.uwbalert.com. This site will contain emergency information only.
The UW Bothell Alert System provides current information on campus closures and delays due to inclement weather and emergency situations. Faculty and staff must "opt-in" to this service -- you won't receive messages if you haven't signed up.
Sign up for UW Alert
The kinds of major emergencies or disasters that can impact our university include:
Suspension decisions should be made prior to the following times, although unanticipated weather or emergency conditions may alter this schedule:
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Report threats, get advice or a safe escort to your car or office.
Report threats: 425-352-SAFE (7233)
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A confidential resource for anyone concerned about the well-being of a student.
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Set your smartphone to turn on and turn off automatically
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On the home screen
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Dine like royalty on a four-course feast and save big with these Travelzoo Local Deals for tickets to see the jousting and sword-fighting show at select Medieval Times Castles nationwide.
Some of the food options that come with each meal include tomato bisque, garlic bread, barbecue spare rib, chicken, potatoes and pastries.
This offer includes up to 40% off both adult and child (ages 3-12) ticket prices in the following cities:
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Product Details
Land Rover Range Rover 2010-2012, Catalina Mesh Bodystyling Grille Kit by Asanti®. Kit includes: Main Grille, Cowl Hood Grille, Side Vents and Badge. The car you drive says a lot about you. Make a statement with your car with the Asanti Bodystyling Kit. Your style and good taste will be on display for all the world to see. The main grille completely replaces your factory grille.
Note: Grille frame can be custom painted or color matched only, NOT available chrome plated. Please contact us to confirm desired paint combination and colors.
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When you purchased your car, it had to be just the way you wanted it: the color, the interior textures, and the options. Unfortunately, there was one important area where you had no choice: the grille, the most distinctive feature on any car and indeed, the defining feature for many automobile manufacturers. Now, thanks to Asanti, you can rectify this glaring oversight and make your car the way you really wanted it to come from the factory.
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ASANTI® luxury body styling kits are manufactured from the finest materials. Each piece is handcrafted and assembled in the USA. The Asanti grilles and side vents are formed to accentuate each vehicle, utilizing only the highest quality grade 304 stainless steel frames and finely woven, double-crimped mesh. Each body styling kit can be individually customized to the owner's specifications with options such as chrome, polished, powder coated and color matched mesh or frame.
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You will never pay more with CARiD! Not only will we match prices from any competitor's website or other reputable source, we will continue to honor that promise for up to one year after your purchase.
We'll match the price at time of purchase, or refund you the difference if done after the purchase. Either way, we are totally committed to providing you the best online shopping experience.
We're car and truck enthusiasts, just like you! And it's enthusiasts we hire in our Sales and Service Centers. Many of our staff are ASE certified and have spent years in the retail auto business.
We conduct our own in-house training, and we even bring vendors to us for hands-on product training demonstrations. You're getting true expertise when you phone or email us!
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What you need to know to navigate today's most critical debates.
Click here to receive the Daily Digest via e-mail.
President Offers Theme of Nation Seeing a Comeback (NYT)
Bolstered by positive economic trends, President Obama is campaigning on an optimistic message of recovery and rebirth. To be fair, he can't really go with "Wow, the last four years sucked. Can I get a do-over?"
The Two Cadillacs Fallacy (WaPo)
E.J. Dionne argues Romney and Santorum are both right-wing extremists who constantly say things that betray their regressive views. The difference is Santorum gets called on it while Romney gets a pat on the head for being a silly rich man.
After Many Tough Choices, the Choice to Quit (NYT)
Olympia Snowe is leaving the Senate after deciding there's no room for a moderate in a broken Congress that wants to relitigate contraception debates that were settled 50 years ago, back when some of her colleagues were having midlife crises.
Explainer: Why Do We Need a Volcker Rule? (The Nation)
Roosevelt Institute Fellow Mike Konczal looks at how the Volcker Rule serves as a modern-day Glass-Steagall, separating banks that are meant to be safe places to keep your money from freewheeling casinos that occasionally blow up the economy.
Occupy Vigilantes Write New Volcker Rule Script (Bloomberg)
Susan Antilla writes that the Occupiers' Volcker Rule strategy is proving not only that reports of the movement's death have been greatly exaggerated, but that they have a lot more savvy and policy expertise than many gave them credit for.
Check out "The 99 Percent Plan," a new Roosevelt Institute/Salon essay series on the progressive vision for the economy.
Can Occupy pull off a general strike? (Salon)
After a quiet winter, the Occupy movement is hoping to make a splashy return by organizing a nationwide general strike on May Day. Sometimes the only way to prove you're not a mob of unemployed hippies is to walk off your job and go protest.
Stop Starving Public Universities and Shrinking the Middle Class (Robert Reich)
Rick Santorum need not worry that sending everyone to college will breed a generation of monocle-wearing elitists. As Robert Reich notes, cuts to student aid and rising tuition costs are making it harder for anyone to afford an education.
Federal Reserve Chairman Sees Modest Growth (NYT)
Ben Bernanke spoke to the House yesterday and said the Fed plans to continue its stimulus efforts, and maybe Congress should too, wink wink, nudge nudge. Meanwhile, like a bored cat, Ron Paul was easily distracted by small, shiny objects.
A German History Lesson (TAP)
Robert Kuttner writes that German policymakers who expect Greece to accept endless economic punishment should remember that the Allies wrote off its debts after World War II and that post-World War I reparations led to, well, you know.
Wall Street Bonus Withdrawal Means Trading Aspen for Coupons (Bloomberg)
A single mom struggling to make ends meet while working two jobs might think she has it tough, but what about the 1% who have been forced to buy cheaper cereal and cut back on their summer vacations? If you prick them, do they not bleed?
With additional research by Roosevelt Institute intern Elena Callahan.


text:
"I believe that Carolina can be the leader in shaping the path for the great public universities in America. By preserving excellence and innovation, access and affordability, and a deep commitment to the state, we can gather strength to innovate and meet new challenges."
Carol L. Folt
Carolina's 11th Chancellor
When Carol L. Folt was installed as Carolina's 11th chancellor and first woman leader in October 2013, she said, "As America's first public university, Carolina became the gold standard. The founders passed the baton, and the future is up to us. How can we fulfill this honorable charge in a way that is ever fresh and relevant?" In her first year as chancellor, Folt – an internationally recognized environment scientist, award-winning teacher and accomplished administrator – has worked to fulfill that charge by preserving and expanding Carolina's academic excellence and innovation, access and affordability, and deep commitment to the state. Read more...


text:
- Northern New York Newspapers
- Watertown
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- NNY Business
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- NNY Ads
NORFOLK Same store, same suspect, same alleged crime.
A Norfolk woman was arrested by state police twice after she allegedly shoplifted from Al Smiths Superette, 4 S. Main St., on Dec. 29 and again on Tuesday.
Sasha S. Monroe, 26, of 841 County Route 38, initially was charged with one count of petit larceny, a Class A misdemeanor, after attempting to steal items from the store on the afternoon of Dec. 29, state police said.
Ms. Monroe was informed by store staff that she was not welcome to return, troopers said. Three days later, however, she allegedly went back to the market and tried to leave without paying for two bottles of soda.
The second incident earned her a second petit-larceny charge, as well as one count of third-degree criminal trespassing, a class B misdemeanor.
She is scheduled to answer the charges in Norfolk Town Court.
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.
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Hiring Workshop
Early in her career, Patrice wrote a book and taught classes on how to land a job – covering everything from resume writing to interviewing skills. In this section she shares some of her vast knowledge which has helped thousands of people successfully land their dream job!
Interview Tips for Hospitality Interviews
Preparation is Key
Giving A Great Interview
- Enthusiasm
- Compensation & Benefits
- Common Interview Questions
- What You Should Ask
- Avoid Simple Mistakes
Miscellaneous – More excellent tips:
- Turn the interview into a conversation
- Using Assumptive Interviewing techniques
- The Salary Question
- Blue Sky Questions
- When an interview closes
- My "TOP-10" (The Perfect Candidate)
Appropriate Follow-up


text:
- Northern New York Newspapers
- Watertown
- Ogdensburg
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Classic matchups and intriguing rematches were setup for Saturdays Section 10 Basketballs annual Class D-A-Rama at Potsdam Central when Heuvelton, Madrid-Waddington, Lisbon and Morristown advanced from Wednesdays preliminary round.
Seventh seeded Heuvelton (13-6) denied Hammond (6-13) 46-43 in overtime to move into a 1:45 p.m. matchup with second-seeded NAC West Champion Edwards-Knox (16-2). Sixth seeded and reigning Class D Champion Madrid-Waddington downed Hermon-DeKalb (3-15) 74-29 and filled the noon tip-off slot opposite third seeded Chateaugay (14-4).
Fourth-seeded Harrisville (15-4) downed Parishville-Hopkinton (0-16) 75-31 and fifth seeded Lisbon (14-5) bested Clifton-Fine (1-18) to fill the 6 p.m. game with an All NAC West matchup of teams.
Ninth seeded Morristown (7-11) prevailed at No. 8 Colton-Pierrepont (7-11) 48-34 and earned the right to challenge top seeded NAC East Champion St. Regis Falls 17-1.
For Heuvelton it will be the rubber game of a split NAC West series. E-K, which is ranked 11th in the latest state poll, won the first game 58-52 with Heuvelton rebounding to hand the Cougars their only league loss in a 58-54 decision in Heuvelton.
Madrid-Waddington, which reached the state championship game last March, and Chateaugay will stage a rematch of last years sectional finals. The longtime NAC East rivals met only once this season when M-W was moved into the NAC North. Chateaugay won that lone encounter 57-46.
Lisbon and Harrisville will stage a quick rematch from a Saturday game where the Knights prevailed 37-34 to reverse a 52-42 loss to Harrisville.
Morristown and St. Regis Falls will be meeting for the first time this season but have staged several close games in recent years at the Morristown Holiday Tournament which was not held this season.
Heuvelton 46 - Hammond 43 OT: The host Bulldogs raced out to an 11-0 lead converting turnovers off their fullcourt press and seemed to be on the verge of cruising into Saturdays quarter-final round.
But the Hammond steadied some obvious jitters, slowed the tempo down by protecting the ball and employing a zone defense which proved problematic to the Bulldogs, capped a methodical comeback with a tying fade-away three-pointer by Nolan Martin with just 2.4 seconds to play in the fourth quarter and found themselves possessing a 43-42 lead on the strength of Darin Bresett jumper and the ball with 44 seconds to play.
The Bulldogs went to their defense to stage a dramatic rally and regained the lead on two free throws by Mike Guardino with 33 seconds to go ahead.
Heuvelton upped its lead to 46-43 and Guardino hit to more free throws with 7.7 seconds play after a Dedrick Johnson steal with 23 seconds to play.
Coach Josh McAllisters team sealed the win with a defensive stand which forced Hammond final shot to be a running three-point attempt just before the buzzer.
We had a chance to put Hammond away early but we didnt and you have to credit the way they came back. They played very well and they hit some shots, said McAllister after the contest which was staged before a large and very animated crowd.
Darin Bresett hit two big shots in overtime but we showed good diligence tonight. We missed a several layup opportunities off turnovers in the second half but we stuck with it and played through some tough times. Dedrick Johnsons steal in overtime was very important.
Mike Guardino finished with 12 points to lead the winning offense and Cody Holland tallied 11 with three in overtime. Aaron Cobb and Dedrick Johnson followed with nine and six points and Jon Sloan buried a three at the buzzer of the first quarter to create a 17-6 lead.
The key for us on Saturday against Edwards-Knox is just bringing our best effort right from the start. Edwards-Knox brings it in every game all of the time, said McAllister.
Martin scored all of his 13 points in the second and netted six sparking Hammond to a 14-7 fourth quarter. Bresett finished with 12 points after hitting two foul line jumpers to give the Devils leads in overtime. Ryan Proven netted nine points and Payton Frisina added four points.
We did a good job settling down from some jitters and we played a very good second half, said Hammond Coach Brad Rogers.
If we played like that all season we would have a lot more than six wins. But it was very exciting game, the guys played very hard.
M-W 74, H-D 29: The Yellowjackets expanded a 20-10 first quarter lead to 43-13 at halftime.
We played pretty well as a team and our bench provided a lot of good minutes. Chateaugay is a tough matchup. We lost in our only game this season and they are led by four solid players in Bowes, Barnes, Martin and Young. In our last meeting, Chateaugay took advantage of our three to four minute lapse of play. Weve got to play smart and limit our mistakes that we can control, said M-W coach Aaron Jones.
Colin OBryan controlled for the flow for the Jackets on Wednesday scoring 13 points with five steals and four assists. Richard Wright hit two threes in a 12-point effort while TJ Gagnon added eight points. Zach Brock chipped in six points and nine boards while Terry Crump added eight points, Greg Thompson and James Hunt each scored six, Maurice Rease collected seven, and David Odendahl posted four.
Steve Gilbert scored 14 points for H-D. Cody Merritt added six while Macaulay Snell chipped in four.
Morristown 48, C-P 34: The Rockets earned their second win this season against the Colts gradually pulling away from a 9-4 first quarter lead.
Morristown went 21-30 from the foulline and that was kind of the difference, said Colton-Pierrepont coach Tim Doyle.
Ryan Vollmer was 10-for-11 at the foulline scoring 18 points for Morristown. Bobby Simmons netted two threes in a 14 point effort while Dakota Marshall added eight and Jacob Fox chipped in seven.
Zach Farrar tallied 12 points on four threes for C-P. Gyle Dominy added six points and Riley Doyle and Scott Boyce each posted four.
Lisbon 52, Clifton-Fine 27: Jimmy Robinson scored 10 of Lisbons 18 points in the first quarter and combined for 11 of the Knights 20 points in the third quarter with Jake Putney (six).
Robinson finished with 18 points, Putney logged 15 while David Turri added six and Adam Felt chipped in five as the Knights win posted their 10th win in the last 11 games. Matt Russell scored 10 for Clifton-Fine and Chase Koster added seven.
Harrisville 75, P-H 31: Nathan Weaver and Jared Dreythaler each scored 13 points for Harrisville. Nick Weir and Justin Hartle each scored 10 while Joey Butts added eight.
Mike Burns tossed in 12 for P-H. Mike Cook added 10 while Ryan Snyder and Ian Wilson added five and four.
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CSU Budget Request Balances System Needs with Fiscal Realities
System Seeks Reinvestment to Meet Enrollment Demand
Claudia Keith or
Mike Uhlenkamp
(562) 951-4800
(November 14, 2012) – The California State University Board of Trustees today approved its 2013-14 budget request of the Governor and the legislature, which seeks to balance the system's continued unmet needs with the state's fiscal challenges. CSU is requesting a total of $371.9 million over its current baseline budget that includes state funds, tuition and systemwide fees. The plan includes revenue for enrollment growth, compensation, as well as maintenance of facilities.
"This budget request is a genuine reflection of the fiscal needs of the university, but moderated by the reality of the state's fiscal challenges," said Robert Turnage, assistant vice chancellor for budget. "The revenue plan strikes a balance between a reasonable request to the state and revenue associated with enrollment growth."
The budget plan identifies increased funding needs of $441.8 million, and asks the Governor and the legislature for a total increase of $371.9 million in state support funds. The enrollment demand item will accommodate an increase in the number of students admitted, as well as additional courses for current students.
Specific funding requests include:
- Mandatory costs (health benefits, new space, energy) $48.2 million
- Compensation increase (3 percent "pool") $86.3 million
- Graduation Initiative/Student Success $58.0 million
- 5% enrollment demand $155.8 million
- Urgent maintenance needs $50.0 million
- Information technology infrastructure upgrade $20.0 million
- Instructional equipment replacement $23.0 million
- Center for California Studies $0.5 million
The expenditure plan would bring annual spending for support of the CSU to approximately $4.5 billion, including student fee revenues. Approximately $69.9 million in revenue will come from tuition fee revenue associated with enrollment growth of approximately 20,000 additional students. The budget also includes funds for a 3 percent compensation increase pool for faculty and staff (subject to collective bargaining for represented employees), funding for the Graduation Initiative, as well as funding for urgent maintenance needs and increased mandatory costs (health care benefits, energy).
About the California State University
The California State University is the largest system of senior higher education in the country, with 23 campuses, approximately 427,000 students and 44,000 faculty and staff. The CSU awards over 95,000 degrees annually and since its creation in 1961 has conferred nearly 2.6 million. The CSU is renowned for the quality of its teaching and for the job-ready graduates it produces. The mission of the CSU is to provide high-quality, affordable education to meet the ever changing needs of the people of California. With its commitment to excellence, diversity and innovation, the CSU is the university system that is working for California. Connect with and learn more about the CSU at CSU Social Media. Show how the CSU matters to you and take action.


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Mark your calendars for Wednesday, December 4th for the 17th Annual Dine Out for Life in Louisville. Last year 53 cities and 3,253 restaurants raised $4.27 million to support those who are affected or have HIV/AIDS. In 2012, Louisvillians raised $80,000 for the House of Ruth, a nonprofit that offers housing and support services with a holistic focus on individuals who are HIV-positive, as well as their family members who count on them for financial and emotional support.
Katrina Hutchins, the Director of Development for House of Ruth, says their goal this year is to pass the $100,000 mark. "Most people think that Dine Out for Life is just a dinner event, but we want to push people to dine out all day long for breakfast, lunch, dinner, ice cream, or even a drink afterwards at Chill Bar," says Katrina.
In Louisville there are 43 restaurant participating in 2013, (see the event poster below), with 25% of their total proceeds that day being donated to the charity.
When you dine at any participating restaurant in Louisville you will see table tents marking the occasion, event posters, and be greeted by a Dining Out for Life Ambassador to answer questions about the charity and explain how the event works. This ambassador is also registering every diner who participates to win a week long vacation getaway in Mexico. If you are unable to participate that day, you can also donate online at www.houseofruth.net.
Click here for full list of participating restaurants: http://www.diningoutforlife.com/louisville/restaurants


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Woody's CheeseSteaks
- 50% off
- Only on the App
- Midtown
- Cheesesteaks, Sandwiches, Hot Dogs
Here, the Philly CheeseSteak is served up with seasoned, grilled-to-order beef and smothered in gooey, white American cheese, all atop a fresh-baked bun. And, word to the wise, you'll want to pair that with a Banana Puddin' shake.Like some sort of lighthouse, Woody's CheeseSteaks beckons to us. The Philly CheeseSteak is served up the way it has been since 1975, with seasoned, grilled-to-order beef, smothered in gooey, melty white American cheese all atop a freshly baked bun (delivered daily from the same local bakery since 1981). Although said sandwich may certainly be taken "to go", we ask you: why? Why would one give up the chance to messily devour the CheeseSteak among Woody's quirky, rustic environs? The little wooden shack offers a small indoor eating area, with repurposed bus seats from the '70s, hand-painted wooden tables, and…avocado linoleum (ahem, also from the '70s). We, however, are staunch advocates of the outdoor patio with its strands of twinkling lights reflecting off the exposed beams and wooden exterior. It all feels rather like a tree house. Which we're more than okay with, for the record.
But if a warm, meaty, cheesy Philly (there's a veggie option, too) doesn't quite cut the mustard, Woody's is almost equally well-known for it's hand-dipped, hand-spun shakes, crafted with locally produced ice cream and shaken (not stirred) to order. And they come in nifty flavors like Oreo, Butterfinger and the oh-so-delicious Banana Puddin'. Yes, in addition to the local brews, Phillys and shakes, we'd say they've packed enough food into this little spot to feed half the town. And, in fact, they do. Owner Steven remarked, "We're the guilty pleasure of some of the finest chefs in Atlanta." Well, we may not be fancy-pants chefs, but we'll happily answer the call of their Philly CheeseSteak any ol' day.
Menu Highlights:
Cheesesteak, $6.50
Veggie Cheesesteak, $6.50
Nutella Shake, $4.25
Banana Puddin Shakes, $4.25
Sunday - Thursday, 11 a.m. to midnight
Friday & Saturday, 11 a.m. to 4 a.m.


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SAN FRANCISCO (MarketWatch) — The Standard & Poor's 500 Index SPX, +0.07% the broad benchmark for U.S. stocks, rose for the sixth week in a row. It's been a long time since that happened. In fact, according to CNBC, it's the first time since 1971 — when Three Dog Night's "Joy to the World" topped the charts — that the S&P has risen for the first six weeks of the year.
The Nasdaq Composite Index COMP, +0.41% also managed to put another week of gains. The Dow Jones Industrial Average DJIA, +0.20% wasn't so lucky, breaking its string of weekly gains by edging 0.1% lower. But for some small individual declines on the day, the Dow would also have managed a sixth weekly gain.
The start augurs well for the year. In 1971 the S&P rose 10.79% and returned 14.56%. Time will tell if 2013 is as lucky as 1971.
On Friday, the Dow rose 48.92 points to close at 13,992.97, a gain of 0.4%, while marking a 0.1% drop for the week. The Nasdaq rose 28.74 points or 0.9% to close at 3,193.87 and notched a 0.5% gain for the week. The S&P added 8.54 points or 0.6% on Friday to close at 1,517.93. For the week the index rose 0.3%.
Check out MarketWatch over the weekend, we'll have continuing coverage of winter storm Nemo and it's impact on the Northeast, as well as all the retirement and personal finance news you need to organize your life and your portfolio.
Meanwhile, please check out our week ahead videos.
U.S. week ahead: State of the Union, G-20
Europe's week ahead: Currency wars at G-20
— Christopher Noble, assistant managing editor
Proxy war
Dell Inc.'s US:DELL bold bid to go private may now lead to a proxy war, as the PC maker's largest institutional shareholder announced Friday that it plans to opposed the deal. Biggest Dell holder says 'No' to buyout deal.
Cash out
Predicting anything that Apple Inc. AAPL, +2.39% will do is a somewhat risky game, but some analysts are betting that the company may crack open its massive, bulging wallet in the near future to return more cash to shareholders. Apple may crack open the wallet, analysts say.
Not overvalued
LinkedIn Corp. LNKD, -1.22% got a significant amount of juice from its fourth-quarter earnings report, boosting its shares nearly 20% and setting an all-time high for the professional social network. Street says LinkedIn not over-valued...yet.
Sloppy thinking
Have you been gullible enough to believe all the recent talk about a Great Rotation? If so, Mark Hulbert has a bridge he wants to sell you. Great Rotation equals sloppy thinking.


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I'm a very junior developer fresh out of college, and in my first programming job. I'm pretty unhappy with my current company-the software engineering standards here are pretty shoddy-the code base is full of uncommented, undocumented source code, with whoppers like 664 line methods (with about 40 lines of commented out code) in our production code. I mentioned it to the boss and he doesn't care, and honestly at this point I don't either-I'm looking for a new job.
When I interview next, how much should I mention this to a prospective employer? That my former (current?) company has shoddy engineering standards, coded by people who seemingly got their CS degrees mail order (well, I'd be a bit more diplomatic about it). I don't think that maintaining code with 10,000+ lines of zero comments or documentation is a good way to start a career and develop good habits. The question is, how do I tell this to future prospective employers?
EDIT: I should mention that I have other, totally innocent reasons I can mentioned why I left/am looking for a new job, but don't know how much of the shoddy engineering I should mention.


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Ships in 1 to 3 days
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Blue Ocean Strategy: How To Create Uncontested Market Space and Make Competition Irrelevantby W. Chan Kim
Synopses & Reviews
Publisher Comments:
The global phenomenon, embraced by business worldwide and now published in more than 40 languages.
This international bestseller challenges everything you thought you knew about the requirements for strategic success.
Since the dawn of the industrial age, companies have engaged in head-to-head competition in search of sustained, profitable growth. They have fought for competitive advantage, battled over market share, and struggled for differentiation. Yet, as this influential and immensely popular book shows, these hallmarks of competitive strategy are not the way to create profitable growth in the future.
In the international bestseller Blue Ocean Strategy, W. Chan Kim and Renee Mauborgne argue that cutthroat competition results in nothing but a bloody red ocean of rivals fighting over a shrinking profit pool. Based on a study of 150 strategic moves (spanning more than 100 years across 30 industries), the authors argue that lasting success comes not from battling competitors, but from creating "blue oceans"—untapped new market spaces ripe for growth. Such strategic moves, which the authors call value innovation," create powerful leaps in value that often render rivals obsolete for more than a decade.
Blue Ocean Strategy presents a systematic approach to making the competition irrelevant and outlines principles and tools any company can use to create and capture their own blue oceans. A landmark work that upends traditional thinking about strategy, this bestselling business book charts a bold new path to winning the future.
Published by Harvard Business Review Press.
"Kim and Mauborgne's blue ocean metaphor elegantly summarizes their vision of the kind of expanding, competitor-free markets that innovative companies can navigate. Unlike 'red oceans,' which are well explored and crowded with competitors, 'blue oceans' represent 'untapped market space' and the 'opportunity for highly profitable growth.' The only reason more big companies don't set sail for them, they suggest, is that 'the dominant focus of strategy work over the past twenty-five years has been on competition-based red ocean strategies'-i.e., finding new ways to cut costs and grow revenue by taking away market share from the competition. With this groundbreaking book, Kim and Mauborgne-both professors at France's INSTEAD, the second largest business school in the world-aim to repair that bias. Using dozens of examples-from Southwest Airlines and the Cirque du Soleil to Curves and Starbucks-they present the tools and frameworks they've developed specifically for the task of analyzing blue oceans. They urge companies to 'value innovation' that focuses on 'utility, price, and cost positions,' to 'create and capture new demand' and to 'focus on the big picture, not the numbers.' And while their heavyweight analytical tools may be of real use only to serious strategy planners, their overall vision will inspire entrepreneurs of all stripes, and most of their ideas are presented in a direct, jargon-free manner. Theirs is not the typical business management book's vague call to action; it is a precise, actionable plan for changing the way companies do business with one resounding piece of advice: swim for open waters." Publishers Weekly (Copyright Reed Business Information, Inc.)
Book News Annotation:
Kim and Mauborgne present a non-competitive approach for achieving high business growth through the development of uncontested market space with practically limitless potential. Drawing upon a study of 150 strategic moves spanning more than 100 years and thirty industries, they explain how "value innovation" renders rivals obsolete and creates new demand. The authors teach strategy and management at INSEAD in Fontainebleu, France.
Annotation �2004 Book News, Inc., Portland, OR (booknews.com)
This landmark work upends traditional thinking about strategy, and explains how to create uncontested market space and make the competition irrelevant while charting a new path to capture new market space that is ripe for growth.
A landmark work that upends traditional thinking about strategy, and charts a new path to capture new market space that is ripe for growth.
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20 Things You Didn't Know About Nicki Minaj (page 3)
July 27, 2011 12:30 PM
Where Did Nicki Minaj Grow Up?
#3. Nicki was born in Saint James, Trinidad. She lived there for five years with her Grandmother while her mother looked for a home in Queens. She moved here to NYC and attended LaGuardia High School!


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I take it you will port the UI to QT# or the similar KDE bindings set for C# which I can't recall the name of.
i revived IrcLeech... from now on it's no longer a cross-platform .NET application, it is a Linux-only Mono application. Allthough the core library is still cross-platform and open source so if people want the windows version (most likely since the majority of my users are windows users) they'll just have to find someone who wants to code and maintain it. i will just be working on the core library, and the linux front end.
for those who are interested: check it out at www.ircleech.com (if you try it, don't let the horrible interface scare you... the interface will be redesigned soon)
I take it you will port the UI to QT# or the similar KDE bindings set for C# which I can't recall the name of.
nah i'm gonna stick with GTK# even though it sucks... i think it has a better future than QT#
edit: but there will be a new gtk# gui though...
[quote author=Ralinx link=board=9;threadid=9370;start=0#msg84977 date=1087918130]
GTK# [...]sucks
Might I ask why?
[quote author=Tyr_7BE link=board=9;threadid=9370;start=0#msg84979 date=1087919535]
Might I ask why?
short answer: it inherits from GTK+ and thus sucks only slightly less than GTK+
long answer:
- the API is supposed to be pretty OO because of it being an OO library (gtk# that is... not gtk+) allthough there are still many horrible functions and methods simply because they have to deal with the GTK+ uglyness and they just can't hide all that horror under a clean API. The API is just not intuitive to use unlike for instance QT or even System.Windows.Forms (SWF). SWF has a crappy implementation but it's API is pretty straightforward. Any API should be pretty straightforward.
- there is NO decent listview/treeview in GTK#. Sorry, make that GTK+ AND GTK#. The Gtk.Treeview is by far the biggest piece of shit i have ever seen. For one thing it's slow as fuck. Once you put a large amount of rows (say... more than 8000 or so) into the threeview (acting like a listview... that says enough right there), and you have sorting enabled, it becomes a cpu hog. If your application adds a couple of rows every second to that list, it will require way too much CPU. The Listview in SWF on the other hand is extremely fast. Also, the way you deal with retrieving values from a row in the treeview, or worse, updating the values is just way too much work than it should be. If you really want, i can post some code examples to illustrate just how much it sucks and how easy the SWF listview is
- because of it's horrible API, you often spend way too much time trying to figure out how to use a certain widget or how to make it behave exactly like you want it to behave. Similar actions are so intuitive in SWF that you don't even have to figure anything out. You just look at the API and you find what you need just like that. With GTK#, it's not that easy... you often think "hmm, should i do it this way, or do i have to do it that way?" and then it can even turn out to be a completely different way of doing it. You just waste too much time _because_ of GTK#
now, GTK# and GTK+ does have some strenghts (easy I18N, automatic resizing of controls) and in those regards it is vastly superiour to SWF. But QT also has those strengths, and none of the drawbacks of GTK+. But QT#... it's just a C# binding to still do everything in the QT way. Instead of doing it in the .NET way, at least GTK# attempts to do this. QT is by far the best GUI toolkit available (never mind your personal preference, when it comes to the technical aspects, NOTHING beats QT) but it's best used in C++. QT bindings just don't feel right. In C++ however, QT feels very right IMHO, even though it's not even standard C++.
Oh, I'll stop my own redesign then, I was mocking about with Glade# to see if I couldn't get a more sensible layout..
[quote author=Lovechild link=board=9;threadid=9370;start=0#msg84988 date=1087936945]
Oh, I'll stop my own redesign then, I was mocking about with Glade# to see if I couldn't get a more sensible layout..
by all means, continue with it
i have more stuff on my TODO list which is more important right now than the redesign of the GUI so if you can make a nice GUI, i'll definitely be willing to use it. that is if i like of course, but then again, it can't be worse than the current one