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Welcome to news pages of the Coleshill Website - keeping you up to date with all that is going on, in and around Coleshill. If you have any events or information that you would like included on these pages, please
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Village Day 2016
The weather was glorious for the afternoon although we had erected the marquee and gazebos in the rain in the morning. We laughed at the time about needing them for sun protection and in the end that is what we needed.
The church was filled with all manner of posies fit for the Queen which made for a magical display.
We started with a fascinating talk from David Robinson about his time in the Queen's protection service. This ended with prayers of thanks.
Next our guest judge for the Coleshill Bake Off competition viewed the colourful array of beautifully baked and decorated cakes from both children and adults. Hannah Watts won the adult prize and Lily Swindle and Eric Louis shared the junior prize.
We then had a relaxing hour enjoying sharing picnic tea and cakes with friends with the background music of hits from the First World War years to now. Linda Daly and her team ably provided us with hundreds of cups of tea and delicious scones freshly baked by Sally Pool that morning. The Red Lion team kept us supplied throughout the evening with a delicious BBQ and their bar very soon needed supplies of Pimms replenishing.
Before the bands started, a large tractor digger arrived at the paddock. This proved to be the inventive means of raising John Jefford above the assembled villagers for a group photo to mark this memorable occasion. Another one for the village annals.
At 6pm on a lovely sunny early summer's evening the ever popular Straight Eight began to play in their entertaining upbeat style followed by the Night Jars starring our own Andrew Aylett on bass. Then Straight Eight finished off the evening with some great cover versions which had everyone dancing. By 8pm when it ended everyone felt we had celebrated the Queen's 90th birthday in grand style.
Many thanks to Susan Smith and Heather Auton and their team for putting together such a memorable celebration, including the weather!
Serena Hodgson
Coleshill Colts win Wooburn Cricket Tournament
On 3rd July, the Coleshill Colts cricket team won the Wooburn Cricket Tournament. It's a great achievement in only the second season of our coaching activity.
We played the tournament at Wooburn Narkovians Cricket Club. The boys beat Wooburn, Farnham Common, Hurley, Beaconsfield (1st and 2nd teams) and finally Winchmore Hill in the Final during a long day's cricket, playing for around 6 hours altogether.
It was a very well organised day and the boys were presented with their Cup and medals by Olympian Sam Mead who is the Team GB hockey centre forward.
We are looking forward to having more competitive matches and playing in more tournaments having only started a Colts Cricket effort last year at Coleshill CC. Next year we hope to be playing Colts League Cricket for the first time.
The team members were:
- Thomas Alexander
- Tom Cornelius
- Ollie Harris
- Oliver Lawler-Smith
- Hugo Meakin
- Tom Richards
- Thomas Scott
Diary Dates
Monday 11th July
"The Little Red Hen" dress rehearsal at Village School
11th July to 15th July
Barracks Hill Road Closure
Monday 18th July
Parish Council Meeting at Cricket Pavilion
Thursday 21st July
School Leavers' Service
Thursday 21st July
History Group meeting
Sunday 24th July
Memorial Service for Patsy Wright-Warren
Thursday 28th July
History Group outside visit
Sunday 28th August
Dave Dunn Cup cricket competition
Monday 19th September
Parish Council Meeting
Saturday 1st October
Tennis Club Dinner
Sunday 2nd October
All Saints' Harvest Festival
Friday 7th October
Harvest Supper
Thursday 13th October
W.I. meeting "Tales from the Opera"
Thursday 20th October
Julian Hunt at History Group meeting
22nd to 23rd October
Gone to Pieces exhibition
Friday 25th November
Tennis Club panto
If you have diary dates for inclusion in future editions of the newletter, please let the Editor know.
Village Festival 2015
The run of glorious weather that we have been lucky enough to experience over the last couple of years continued this year and set us up for another hugely enjoyable festival which again brought the whole village together on 11th July.
Proceedings kicked off at lunchtime at the Red Lion, with the Aldbury Morris Men, complete with their highly entertaining hobby horse and insistence on full audience participation.
That set things up perfectly for the main festival which opened at two o'clock. Highlights of the afternoon were the excellent performance from the Amersham Community Brass band, childrens' entertainer John Joliffe with his Cheeky Monkey Show which kept the children enthralled for an hour, and, of course, the display of country dancing from the boys and girls at Coleshill Infant School without which the festival wouldn't be complete.
With the good weather continuing through the day, the tea tent, run by Linda Catley and her hard working team, did a good trade, with the teas, soft drinks and delicious home baked cakes contributing £300 to help cover the costs for the day and evening. This together with the quiz night held in early May allows the whole day to be free of charge for the Coleshill community.
The cup winners at the village show are shown separately in this newsletter but, needless to say, the standard of entries across all categories was as high as ever. Thanks to everyone for their contributions and especially to Heather Auton and Susan Smith for their hard work organising the show, and to all the ladies who created the stunning festival of flowers in the church celebrating the 100th anniversary of the WI.
This year we were keen to extend the fun of the afternoon into the evening festivities at the Red Lion, and the combination of our DIY disco and local band, Blemish Of Gravity, did just that. With a mix of rock classics and contemporary music, all ages were on their feet dancing until closing time, fuelled by Paul's BBQ food and the odd beer or glass of wine. And, with perfect timing, just as all the equipment had been cleared from the Red Lion car park at 11pm, the rain started!
Very many thanks go to Serena Hodgson for again taking on the daunting task of organising the Festival, and doing it with such good grace, patience and determination.
Next year, due to the nationwide Queen's 90th birthday celebrations, there won't be a Village Festival as such, but look out for details of Coleshill's village arrangements on the weekend of 11th/12th June 2016.
Andrew Aylett
Festival Photos by Penny Ware and Andrew Aylett
Christian Aid Walk 2015
Blessed with a beautiful day, on Sunday 10th May, 17 walkers and 2 dogs set off from the
Red Lion car park across the fields over the A355 and then on to Hodgemoor Woods, where we were treated to refreshments at the half way point and, suitably re-energised, we then continued through the woods and back to Coleshill. I think everyone enjoyed this most relaxing walk, making new friends and catching up with old ones. The countryside looked stunning, lambs gambolled in the fields and the bluebells provided the perfect blue carpet in the woods. Raising money for a worthwhile charity while enjoying a community activity is very satisfying and I look forward to another ramble next year.
Village Bus
From 24 February the timetable for the no.73 Red Rover bus through the village has changed yet again. Transport for Bucks do this from time to time in order to keep us all on our toes and to demonstrate in due course that no one uses the service and it can therefore be safely abolished. So please use it if you can!
For the record, the Monday-Friday service towards Amersham now leaves the Red Lion at 0914, 1141, 1341 and 1726, arriving at the station at 0937, 1154, 1354 and 1737 respectively. On Saturday, departures are at 1028, 1228, 1428 and 1628 (all arriving at the station 13 minutes later).
In the reverse direction, weekday buses leave for Coleshill (via Penn Street and Winchmore Hill) at 1115, 1315 and 1650. Departures are from outside Carrols. On Saturdays, buses leave Amersham for here at 1015, 1215, 1415, 1615 and 1715.
Dick Ware
Bus user
Maundy Money for Dumpy Swerling
Dumpy Swerling had the honour of receiving Maundy Money from the hand of the Queen in Christchurch Cathedral on Maundy Thursday this year. Her nomination came from the Bishop of Oxford in recognition of over 50 years of devoted community service.
This article describles the origins of Maundy Money
Photographs by John Jefford
The word Maundy is derived from the Latin mandatum (command) and lies behind the name Maundy Thursday (the day before Good Friday in the Christian calendar). John 13:34 tells of Christ at the Last Supper giving his disciples a new commandment, that they should love one another. This command has been symbolized since at least the 13th century (the first record is of King John – who, given this, was clearly not a wholly Bad King) by the sovereign displaying humility to a selection of the poor of his kingdom. The ceremony initially took the form of washing the feet of the chosen poor (after courtiers had washed them several times first) and then distributing alms as money, food and clothing. James II was the last monarch to wash feet and the food and clothing elements have also subsequently fallen by the wayside.
Today, the Queen gives two purses of money to the same number of men and women as her current age (so 87 of each this year). They are chosen for services to their church or local community. A white purse contains the Maundy Money itself – sterling silver coins in denominations of 1p, 2p 3p and 4p, in a total amount summing to the Queen's current age -- while a second, red, purse contains the monetary equivalent of the previously distributed food and clothing. This sum has been deemed to be worth £5.50 for some years now.
Although most monarchs in the 18th and 19th centuries delegated the annual task to court officials, Elizabeth II has been absent on only four occasions since she came to the throne.
Dick Ware
Fibre Broadband Arrives!
BT are now accepting orders for Fibre Broadband from customers served by Amersham Cabinet no.3, the cabinet that serves Coleshill. The service can be ordered from BT Internet and also from a number of other Internet Service Providers. You can see a list of service providers at the following link: http://www.superfast-openreach.co.uk/at-home/buy-it-now.aspx
Note that not everyone in the parish will necessarily be able to receive the fibre service because of line length limitations. You can check availability using this link: https://www.btwholesale.com/includes/adsl/main.html. (The fibre service is labelled "WBC FTTC" in the list of services.)
Happy Surfing!
Village Hall WiFi
WHOOPEE !!!!!!! we have Wi-Fi.
Grove Mill Restoration
Following a recent detailed study of the windmill, Mr Mayank Patel has engaged the services of leading millwrights to repair and restore the cap and sails. In September the sails were taken down by crane, the wooden cap lifted off and a temporary roof placed on the windmill.
A small number of History Group members were invited to view the restoration in progress and were interested to hear from the millwright, Paul Kemp (one of only 6 or 7 left in the country), about the difficulties of lifting off the sails and the cap and the meticulous repair that is being done (overseen by the Historic Buildings Officer of CDC) to put the mill in good stead for another 30 years or more. The windmill had been without sails for many years until Mr and Mrs Dawson put them back (without canvas) in the mid 80s. Whilst all the winding gear is intact, there is no longer any machinery inside the tower, so a return to milling is not an option (though nationally there has been a revival of flour production from working mills in recent years).
The mill was built to a Kentish design (see Herne Mill, Kent, for comparison) – not at all typical of Buckinghamshire. It was only working actively from the 1860s until about 1920. The cap might originally have been made of pitch pine but is being repaired with Douglas fir, which is lighter than oak. The cap weighed around 6 tons at the time of its recent removal by crane.
There are photos of Grove Mill in the Historic Photographs section of the website and Luke Borwick, one of the consulting millwrights, has directed us to the Mills Archive Trust which has several more.
Penny Ware
New Christmas Lights
From Christingle to Twelfth Night the churchyard lights have been a long standing feature of the festive season, their erection and destruction in the hands of The Master of Lights. The Master had warned that their reliability and luminosity, not his, was failing. The Jubilee party was their final outing. In deference to the past Master the new, collective, Master foreswore colour. The spectrum of 'white' was one feature of the choice to be made by the new regime - bright white or cream. Visibility from Bottrell's Lane was a further criterion - a pandering to outlying villagers of rank.
Collective forces contrived a new Aufklärung for Christingle 2012. The past Master appraised: "You have passed muster" but none of it could have been done without Lamps & Tubes.
Sub-Station Update
As part of the work to enhance the views of the common, work is continuing on the electricity sub-station at the northern end of Windmill Hill. The trees surrounding the sub-station have been removed and will be replaced by natural hedging when the soil has lost its toxicity caused by the tree roots. In the meantime 'hurdles' have been woven on site to screen the unsightly sub-station.
The screening work was carried out by Mike of Micksticks Wattle Fencing.
Pictures from Before and After the Work
The New Magpie Club
The New Magpie Club Toddler Group & Coffee Bar
Every Friday 9 – 11am
Coleshill Village Hall
Pictures From the First Meeting - 19th October
Best Kept Village Competition
Coleshill wins 'Highly Commended' Grade
The Buckinghamshire Association of Local Coubcils (BALC) have awarded Coleshill the Highly Commended grade in the Morris Cup in this year's Best Kept Village competition.
The judges state of Coleshill, "It is obvious that the community takes pride in this village. The overall appearance is very good".
Well Done all villagers who helped us achieve the certificate of merit which is displayed below:.
Walk4Life is a free website that promotes health and fitness through walking. The site allows you to find walking routes nearby and to share your own routes with others. You can also monitor your progress by recording the distance you walk and your average speed.
To visit Walk4Life, click on this link
Reporting Potholes and Blocked Rights of Way
Bucks County Council now have a web page where you can report problems with roads and rights of way (footpaths). The web page has a map that you can zoom to specifiy the precise location of a problem, and a simple form that allows you to describe the problem.
Please use the page to report potholes in roads, blocked footpaths, etc. You can find the page at this link
Stitch and Bitch Club
Churchyard Gravestones
A new section of the website has been published that describes the gravestones and memorials in All Saints' churchyard, together with a location plan showing the position of each grave. To visit the section, click on this link.
Common Cows
Five Dexter cows arrived today (Tuesday 20th September) to graze the common for the next few weeks. A rota of villagers will regularly check the cows and the state of the electric fence.
About half of the grassy area of the common has been fenced off for the cows. When they have muched their way through that, the fence will be moved to the remaining area for the cows' second helpings!
'Beating the Bounds' Walk
On 15th May, Christian Aid organised a traditional 'Beating the Bounds' walk around the historic boundary of Coleshill.
About 30 intrepid villagers and their friends set off from the Water Tower at 11.30am, of whom about 15 arrived back at the Water Tower nearly four hours later. The animation below from Google Earth shows the progress of their walk as recorded by a GPS receiver. The animation is speeded up 20 times so the circuit completes in about 10 minutes.
So whether or not you participated in the walk, please sit back and enjoy the action replay. It's almost as good as the real thing!
Beating the Bounds Photo Gallery
Rogation Day
Rogation Day was traditionally on 25th April or, if this was at Easter, the following Tuesday. There were in addition three minor rogation days on the three days leading up to Ascension Day (this year 2nd June). Rogation derives from the Latin "rogare: to ask" and the day itself was an opportunity to ask God and the Saints for blessing on the Parish and its lands.
The Church took the festival over from earlier pagan rites, used for similar purposes, and indeed pagan elements remained in medieval English Christianity. The processions and the associated "beating of the bounds" were an opportunity to whip (with switches of willow) devils and evil spirits out of the Parish. For this reason and also the frequent invocation of the Saints which formed an important part of the festival, Rogation processions were frowned upon during and after the Reformation, though they were still permitted for secular reasons (i.e. establishing and confirming boundaries).
To remind ourselves of the importance attached to the occasion 500 years ago, however, the following extract from Eamon Duffy's "The Stripping of the Altars" sets the scene:Late medieval Rogationtide processions, with handbells, banners and the parish cross, were designed to drive out of the community the evil spirits who created divisions between neighbours and sickness in man and beast. They were also designed to bring good weather and blessing and fertility to the fields....The sense of unity on such occasions was very strong. Processions from neighbouring parishes which happened to converge might come to blows, in part because they believed that the rival procession was driving its demons over the boundary into their parish. Those who absented themselves from such processions...were seen as bad neighbours. George Herbert, writing in 1630, exactly captured this dimension: "Particularly [the country parson] loves procession, and maintains it, because there are contained therein 4 manifest advantages: first, a blessing of God for the fruits of the field; secondly, justice in the preservation of bounds; thirdly, charity and loving walking and neighbourly accompanying one another, with reconciling of differences at that time, if there be any; fourthly, mercy in releeving the poor by a >liberall distribution and largesse, which at that time is or ought to be used. Wherefore he exacts of all to bee present at the perambulation and those that withdraw and sever themselves from it he mislikes, and reproves as uncharitable and unneighbourly."
There we are then! What more encouragement do we need to join in this year's procession and beating of the bounds.
Chuchyard Tree Felling
On 3rd March, an old oak tree was felled in the churchyard. This was necessary because the tree had died and was becoming hazardous. The work was quite delicate because of the tree's proximity to the church, the road, and to overhead power lines. For this reason, the tree had to be felled in sections and the individual pieces carefully lowered to the ground. The work was expertly carried out by Jamie Dyer and his team.
The following photo gallery records the event. Photographs by kind permission of John Jefford.
Buses are Good for us!
|Clott's bus service in the 1930's - from Chesham to Beaconsfield and back, all day long
Unless we make a conscious decision to do so, we rarely think about public transport when planning our travel. The default is simply to get in the car and drive. Fortunately, most of us in Coleshill have enough money to own and run a car and are not in that sense dependent on a public transport system. But this is by no means true of everyone in our local area and, from personal observation, it is quite clear to me that a large number of people in Amersham and around (many of them elderly or infirm in some way) rely entirely on the bus service to go shopping, visit their friends or whatever. They do not have the money to run a car or the ability to walk very far and, without a bus, would find themselves confined indoors a lot more. The bus, in a strange but heartening way, provides their social life.
I say all this because, in today's economic environment, local authorities find themselves having to make large budgetary cuts and the subsidy provided to bus companies for local bus services – a number of which will not pass a profitability test but still perform an essential social function – will undoubtedly be looked at extremely carefully. Routes carrying few passengers, which would include the 73 through the Village, may well disappear.
My plea, therefore, is for us all to consider using the service we have before it suffers the same fate as the local shop and Post Office and is forced to close for lack of custom. It is all very well to bemoan the loss of something previously valued but nevertheless not supported in any practical sense. Once the decision is taken to close something, it is usually too late to resurrect it. The 73 passes through Coleshill three/four times a day and the timetable allows a good hour's shopping time in top Amersham before returning. You can also go on to Chesham, though the timetabling for the return journey becomes slightly more complicated in that case. And venturing further afield (the world's your oyster), the A30 will pick you up once an hour from Amersham Station and you'll be at Heathrow in 50 minutes.
I haven't even mentioned the environmental benefits but this is probably enough of the polemic! It would just be good if we could all think more about the bus as a possibility when we want to go somewhere. Obviously, it will not always be a realistic option but, where it is, let's choose it more than we do at the moment. We might regret it if we don't.


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|Publication number
|Publication type
|Application number
|Publication date
|Mar 29, 2011
|Filing date
|Nov 21, 2003
|Priority date
|Nov 22, 2002
|Fee status
|Also published as
|Publication number
|Dusan Pavcnik, Clay D. Fette, Jason A. Mead, Joseph F. Obermiller, Fred T. Parker
|Original Assignee
|Oregon Health & Science University, Cook Incorporated, Cook Biotech, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (11), Non-Patent Citations (2), Referenced by (15), Classifications (18), Legal Events (2)
|External Links: USPTO, USPTO Assignment, Espacenet
This application claims priority of provisional application Ser. No. 60/428,640, filed Nov. 22, 2002.
This invention relates generally to medical devices and, in particular, to a stent and tissue graft prosthesis and to a delivery system for delivering the prosthesis to an implantation site such as, for example, an aneurysm in the vascular system of a human or animal patient.
As background, submucosa tissues have been suggested and used as tissue graft materials. For example, U.S. Pat. No. 2,127,903 to Bowen describes various tubes for surgical purposes which may be constructed of the submucosa layer of animal intestinal tissue. Bowen teaches constructing the tubes using a multiplicity of tissue ribbons or threads which are wound over a tubular form and dried.
U.S. Pat. No. 3,562,820 to Braun describes the use of submucosa or serosa tissues to form prosthesis devices. In one embodiment, Braun describes preparing a tubular prosthesis by drawing submucosa over a tube and drying the tissue. Braun teaches that this procedure may be repeated until the desired wall thickness is obtained.
U.S. Pat. No. 4,956,178 to Badylak et al. teaches tissue graft compositions comprising the tunica submucosa of a segment of small intestine of a warm-blooded invertebrate, wherein the tunica submucosa is delaminated from the tunica muscular and at least the lumenal portion of the tunica mucosa. Badylak et al. teaches creating tubular constructs by manipulating a sheet of the tissue graft composition to define a cylinder and suturing or otherwise securing the tissue longitudinally.
U.S. Pat. No. 6,358,284 to Fearnot et al. describes the preparation of a tubular graft from a purified submucosa sheet, wherein a first and second opposite edge of the sheet are overlapped, and wherein layers in the overlapped region are fixed to another. The Fearnot et al. patent also discloses the potential of having a second layer of submucosa tissue overlying the first layer.
WO 01/10355 published Feb. 15, 2001 describes tubular grafts of biomaterial, such as submucosa, having lumen walls which present no seam edge traversing the entire length of the lumen, for example, wherein the lumen walls present a discontinuous seam. As described, such a device can be made using a biomaterial sheet having a plurality of extensions and a plurality of corresponding apertures. The sheet can be configured as a cylinder and the extensions extended through the apertures in the formation of the tubular medical device.
WO 01/82836 A2 published Nov. 8, 2001 describes an endovascular stent graft with a stent frame having a plurality of stents connected together with a monofilament line. A covering of collagen having an extracellular matrix (ECM), such as small intestine submucosa (SIS) is disposed through the inside and over the outside of the stent frame. The covering is affixed to the stent frame such as by being sutured onto the stent frame at the ends of the stent frame and also at the connections of the stent bodies, such as at eyelets.
U.S. Pat. No. 5,693,085 to Buirge et al. describes a stent with collagen in which the collagen is applied to the outside surface of a vascular stent.
U.S. Pat. No. 5,916,264 to Von Oepen et al. describes a stent graft having two coaxially arranged, radially expanded stents and a flexible, stretchable material layer arranged between the stents. Both stents are directly connected with one another in their end regions and the material layer is formed as a fabric band wound around an inner stent. The material layer is composed of a foil or a fabric from a body compatible material or of a biological fabric. The biological material can include an autologous or homologous vein or artery.
endoluminal exclusion of an abdominal aortic aneurysm (AAA) by Transluminal implantation of stent grafts has in selected cases become an attractive alternative to open surgical aneurysmal repair. Endoluminal exclusion has been done on an elective basis after detailed preoperative visualization and measurements have been made of the aneurysmal and adjacent arterial anatomy. Stent graft systems for both elective and emergency AAA exclusions have been typically constructed with conventional surgical synthetic materials such as DACRON or polytetrafluoroethylene (PTFE) supported by typically metallic expandable stents.
Conventionally, stent grafts placed within the vascular system include one or more stents of affixed graft material including biological materials in addition to the conventional synthetic materials. As previously suggested, these biological materials can include tissue which is affixed to one or more longitudinally positioned stents using, for example, sutures which are affixed to folded over tissue at the ends of the stents and similarly along the lengths of the stents. As suggested by the Von Oepen patent, stents can be used to sandwich a stretchable material layer arranged longitudinally between the two stents. However, the stents are directly connected with one another at their end regions making the end regions significantly more rigid thereat than the intermediate portion therebetween. Abrupt transitions between the stented and unstented portions can cause significant trauma and undesirable intimal hyperplasia with consequent narrowing of the vessel. This consequence is typically referred to as "edge effect." Attachment sutures or other attachment configurations allow for a leakage of blood through the covering material, thus producing undesirable and/or life-threatening endoleaks. Furthermore, simply covering a stent with a layer of tissue without any attachment thereto allows for the tissue material to be pulled back or everted over itself when a delivery catheter is pulled back over the stent graft at the implantation site. This eversion creates a significant problem in that the aneurysm is no longer excluded and in that the stent graft with its everted tissue material presents a significant problem in its removal.
The foregoing problems are solved and a technical advance is achieved in an illustrative embodiment of a stent and tissue graft prosthesis in which a tissue graft is disposed on a first or inner expandable stent and an outer tubular member such as a second or outer expandable stent is disposed over the tissue graft and around the first expandable stent for retaining advantageously the tissue graft disposed on the inner stent. As a consequence, holes through the tissue graft are advantageously minimized, if not eliminated, and the probability of endoleaks are significantly lessened. In this preferred illustrative embodiment, the ends of the inner and outer stent along with that of the tissue graft are advantageously aligned to coincide with each other. This alignment further advantageously allows host tissue coming in contact with the tissue graft to remodel and become incorporated into the prosthesis when the tissue graft includes, for example, an extracellular matrix material (ECM) such as small intestine submucosa.
Other embodiments of the present invention include extending the inner expandable stent beyond the end of the tissue graft. However, the outer tubular member is still positioned at least entirely over the tissue graft or extends beyond the ends of the tissue graft so as to advantageously prevent undesirable eversion or displacement of the tissue graft during, for example, placement of the prosthesis and, in particular, when withdrawing a delivery catheter from the prosthesis. Keeping the ends of the inner expandable stent coincident with the ends of the tissue graft prevents the tissue graft from everting or folding into the passage of the inner expandable stent. As a result, the tissue graft is prevented from narrowing the passage or lumen of the vessel and/or creating an edge, shelf, and the like for thrombus and the like to build up on or adhere to. Since the stent tissue graft prosthesis is typically placed in an arterial vessel, pulsatile blood flow can cause the eversion of the tissue graft over either end of the inner expandable stent, which is advantageously prevented when the ends of the inner expandable stent are coincident with or extend beyond the ends of the tissue graft.
The outer tubular member of the tissue stent graft prosthesis can advantageously assume one of several different configurations. In one embodiment, the tubular member includes a perforated tube or sleeve of a polymer material such as polyethyleneteraphalate (PET). The size of the perforations is advantageously selected so as to promote contact with and remodeling of the host vessel tissue therethrough. In the preferred embodiment of the stent tissue graft prosthesis, the tubular member includes a second or outer expandable stent, which can be self-expanding, balloon expandable, or a combination of both. Furthermore, the inner expandable stent can also be self-expanding, balloon expandable, or a combination of both. In the preferred embodiment, the inner and outer expandable stents each include a plurality of circumferential segments and a plurality of tie bars longitudinal interconnecting the circumferential segments. The circumferential segments advantageously include a serpentine configuration and preferably a zigzag pattern of generally straight struts interconnected by a plurality of bends. The zigzag pattern advantageously provides for a compressed stent diameter, which facilitates loading into a delivery system for delivering the prosthesis to an implantation site. When released, the zigzag pattern can typically expand six or more times its compressed diameter to bring the tissue graft between the inner and outer expandable stents in contact with the vessel wall.
The inside and outside diameters of each of the inner and outer expandable stents in a relaxed condition is selected to retain the tissue graft disposed on the inner stent and at the same time apply sufficient outward pressure to maintain the tissue graft in contact with the vessel wall without causing damage to either the tissue graft or the vessel wall. In addition, the diameters can be selected to accommodate different loading procedures and whether the tissue construct is hydrated, lyophilized or a combination of both during the loading procedure.
In a preferred embodiment, the outside diameter of the inner stent is selected to be greater than the inside diameter of the outer stent. This embodiment helps facilitate the loading of a stent and lyophilized tissue graft prosthesis into an introducer or delivery system. This is also applicable to hydrated tissue. The lyophilized tissue graft is preferably selected to have a diameter in between the dimensions of the inner and outer stents and is thus advantageously disposed and retained on the inner stent and in direct contact with the vessel wall.
In another embodiment using a hydrated tissue graft, the outer diameter of the inner stent is selected to be less than the inner diameter of the outer stent. Again, the tissue graft is preferably selected to have a diameter in between these two inner and outer stent dimensions. Such an embodiment provides for the loading of a hydrated tissue graft over the inner stent while providing sufficient tolerance for loading the outer stent over the hydrated tissue graft without causing injury or damage thereto. When positioned in an introducer system, there is always sufficient pressure between the inner and outer stent so as to retain the tissue graft disposed on the inner stent. Typically, it is preferred to oversize the prosthesis approximately 10% to 20%, preferably 10% to 15%, and more preferably 10% with respect to the vessel lumen diameter so as to maintain sufficient outward force on the tissue graft and stents to eliminate or minimize migration of the prosthesis in the implanted vessel. Oversizing the stent tissue graft prosthesis to more than 20% of the vessel diameter can cause trauma to the vessel wall and, in particular, migration of the stent through the vessel wall.
In a preferred and best mode embodiment, the outside diameter of the inner stent is greater than the inside diameter of the outer stent as previously described. However, a dry, laminated, tubular tissue graft construct is inserted into the outer stent, which is preferably nitinol and in a fully martensitic and expanded state. The dry construct is preferably formed by vacuum pressing the water therefrom; however, lyophilization can be utilized to remove the water as well. The inner stent, which is preferably nitinol and in a fully martensitic and compressed state, is inserted into the dry tubular construct with the outer stent therearound. The combination tissue graft construct with the stents therearound is rehydrated and loaded onto the delivery system cannula. The rehydrated construct is compressed, frozen and loaded into the sheath of the delivery system. While frozen or at least still rehydrated, the tissue graft in the delivery system is freeze-dried or evaporative cooled. This tissue graft construct and stent combination is advantageously loaded into a delivery system without tearing the tissue or causing pin holes therein, which can occur when simply loading a lyophilzed or dried tissue construct into a delivery system.
In yet another embodiment, the inside and outside diameters of the inner and outer expandable stents are selected to be equivalent to exert more compressive force on a hydrated tissue graft or less compressive force on a lyophilized tissue graft.
In another aspect of a preferred embodiment of the stent tissue graft prosthesis of the present invention, the tissue graft preferably includes at least one seamless tube of tissue, tissue including extracellular matrix material and more preferably a seamless tube of small intestine submucosa for advantageously remodeling host tissue coming in contact therewith. In the preferred illustrative embodiment, the tissue graft includes a multilayer tissue construct including a plurality of seamless tubes of tissue including extracellular matrix material. The construct advantageously includes at least an inner and an outer seamless tube of porcine small intestine submucosa of different nominal diameters, which is typically harvested from at least two different weight juvenile contributors. To advantageously add further strength to the multilayered construct, a sheet of tissue from mature porcine small intestine submucosa tissue will be used. Thus, one preferred construct will include an inner tube of juvenile porcine small intestine submucosal tissue. Next, at least one sheet of mature porcine small intestine submucosal tissue is advantageously wrapped around the inner seamless tube one or more times to add further strength to the construct. In addition, an outer seamless tube of juvenile porcine tissue is disposed over the wrapped sheet of mature porcine tissue. To further bind the construct together, a fibrin and/or fibrinogen glue is applied to the layers of the construct during formation thereof to further bind the layers and construct together. Another preferred method of laminating the construct together is vacuum pressing the ECM layers together. The hydrated construct is then lyophilized to further advantageously concentrate and/or compress the layers of the construct to form a rehydrated wall thickness that is less than the initial hydrated thickness of the pre-lyophilized tissue construct. This advantageously produces a tissue graft that further reduces the wall thickness of the construct and the overall thickness of the stent tissue graft prosthesis of the present invention.
To address and avoid potential pinhole leaks in juvenile porcine tissue, at least one sheet of mature porcine tissue is wrapped around a mandril to form preferably a four layer laminated tissue construct. A minimum of one mature porcine tissue sheet or layer is contemplated, but a tissue construct of six or more laminated layers of mature porcine tissue is also contemplated at the other end of the range of tissue layers. However, a construct comprising four layers of mature porcine tissue represents the preferred, best mode embodiment of the present invention.
A further advantage of the stent tissue graft prosthesis of the present invention is that the ends of the inner stent and the outer tubular member and, in particular, the outer expandable stent are preferably not affixed to one another. Although such fixation would initially appear to better contain the tissue graft therebetween, the added stiffness of the end portions of the inner stent and outer member would further traumatize the tissue immediately adjacent and extending beyond the ends of the prosthesis. Such trauma can be minimized by staggering the ends of the inner stent and outer tubular member as previously suggested; however, the tissue graft must not extend beyond the ends of the inner stent and the outer tubular member should fully cover the tissue graft so as to prevent undesirable eversion during the delivery procedure.
The distal and proximal tubular or outer stent ends 55 and 56 are disposed coincidentally with the respective distal and proximal ends of the inner expandable stent and the tissue graft. The ends of the tubular member or outer stent are coincident with the tissue graft so as to preferably prevent eversion or fold-over of the tissue graft during withdrawal of a delivery catheter that is used to place the prosthesis at the placement site in a vessel. Should the outer tubular member or stent not be positioned over the entire length of the tissue graft, there can be sufficient adhesion between the tissue graft and delivery catheter so as to evert, fold over or pull back the tissue graft over itself and the inner stent as the delivery catheter is pulled back from the prosthesis. The outer tubular member or stent prevents such eversion, fold over or pull back of the tissue graft particularly at the ends and further maintains the uniform wall thickness of the prosthesis along its entire length.
Inner expandable stent 21 is similar to outer expandable stent 44 and includes a plurality of circumferential cell segments 65 including distal end cell segment 63, flexible interconnection cell segment 64, and hoop cell segment 42 (not shown). As previously suggested, the circumferential segments 65 and 57 of respective inner and outer expandable stents 21 and 44 each include a serpentine zigzag pattern of straight struts 51 interconnected by a plurality of bends 52. This well-known and commercially available zigzag pattern was first developed in a stent commonly known as the Gianturco Z-stent as described in U.S. Pat. No. 4,580,568 and incorporated herein by reference. The inner and outer expandable stents are also known as ZILVER� stents and commercially available from Cook Incorporated, Bloomington, Ind. One or more eyelets 66 extend from the ends of the inner and outer expandable stents and include a radiopaque material such as gold to provide radiographic visualization of the stent's position when placed in the vessel of a patient. As also previously suggested, the expandable stents can be either self-expanding, balloon expandable, or a combination of both. Self-expanding stents are typically formed from a spring-like metal such series 316L stainless steel or a shape memory alloy such as nickel titanium commonly referred to as nitinol. However, any spring-like biocompatible material is suitable so as to provide outward radial force to keep the tissue graft in contact with the vessel wall. Similarly, balloon expandable stents can be formed from stainless steel or other biocompatible materials. Either the self-expanding or balloon expandable materials can be formed from a tube or cannula or formed from a filament of spring-like material having, for example, a circular, triangular or other suitable cross-sectional shape. It is also contemplated that any expandable stent can be used with this invention and that the invention is not limited to serpentine.
In a preferred embodiment of the tissue construct, a first or inner most seamless tube of juvenile SIS tissue 32, a second or intermediate seamless tube of juvenile SIS tissue 67 and an outermost seamless tube of SIS tissue 68 constitute a plurality of seamless tubes of tissue 34 that would typically have a wall thickness equivalent to that of one layer of mature porcine SIS tissue. By way of example, each seamless tube of SIS tissue 32, 67, and 68 has an average thickness of approximately 100 microns and ranges in thickness from 80 to 125 microns. The thickness of a sheet of mature porcine SIS tissue material has an average thickness of approximately 250 microns and ranges in thickness from 200 to 300 microns. Thus, a tissue construct comprising three seamless tubes of juvenile porcine SIS tissue should have more than sufficient strength to withstand nominal blood pressures of typically 120 mm of mercury. This embodiment including a lyophilized three-layer tissue construct is relatively easy to load into a delivery system. However, assembly and loading of the prosthesis 20 using inner and outer stents of various diameters and a lyophilized tissue construct of three tubes of juvenile porcine SIS tissue can cause pin holes or tears in the tissue construct unless extra care and special attention is given during the assembly and loading process. However, a vacuum pressed method of assembly can also be used on this, as well as other constructs of the ECM construct, to minimize, if not eliminate, pinholes or tears during prosthesis assembly.
Accordingly, to provide further strength to the tissue construct and minimize, if not eliminate, fluid leaks, tissue construct 33 of the embodiment of
In addition, a description of a preferred extracelluar matrix material such as small intestine submucosa is described in U.S. Pat. No. 6,206,931 B1, entitled "Graft Prosthesis Materials," which is incorporated by reference herein in its entirety. The SIS material harvested from porcine for use in the present invention as described therein includes disinfecting and then stripping the various layers of the small intestine to produce an extracelluar matrix SIS material that has extremely low endotoxin levels. Tissue construct 33 is formed per the No. 60/408,914 disclosure, using for example, fibrin or fibrinogen glue to adhere the various layers of the construct together. In addition, when the construct is lyophilized, a construct typically having an initial hydrated wall thickness of approximately 800 microns reduces in thickness when re-hydrated to a thickness of approximately 500-600 microns.
In a best mode embodiment, one or more hydrated sheets of mature SIS tissue are wrapped around a mandrel to form a laminated construct with preferably four layers of the tissue sheet. The number of hydrated sheets is dependent on the size and, in particular, the circumference of the construct. The SIS tube is manufactured as follows: Sow weight SIS is obtained in hydrated form. This material is laid down with the longitudinal axis aligned horizontally. A rigid rod or mandrel is then placed onto the SIS at the top edge. The top edge of the SIS is then carefully pulled over onto the rigid mandrel and made as smooth and straight as possible. The material is then rolled onto the mandrel in overlapping fashion until the desired number of layers is obtained. Multiple pieces of SIS can be used to obtain the desired number or layers or thickness of material. After the material has been rolled onto the mandrel, this system (mandrel plus SIS) is placed into a commercially available vacuum pressing apparatus. One such vacuum pressing apparatus is commercially available from Zip-Vac East, Incorporated, Kennesaw, Ga. The vacuum pressing apparatus is a flexible chamber that has a vacuum drawn on it, which pulls the flexible boundaries of the chamber onto and around the mandrel/SIS. Due to the vacuum, the water is removed from the SIS, while the sides press against and around the SIS. This results in a dry, well-laminated tube of SIS material. The SIS tube is then removed from the mandrel, and the edges are trimmed to the desired length.
Further processing is required to manufacture an abdominal aortic aneurysm (AAA) stent-graft. The dry SIS tube is inserted into the desired diameter ZILVER (or other design) stent. Another stent is then deployed inside of the SIS tube. Resultingly, there is a stent on the inside, a dry SIS tube, and a stent on the outside. This construct is then rehydrated in high purity water for at least 10 minutes. The now rehydrated construct (stent/SIS/stent) is then loaded onto a delivery system cannula. It is then compressed with uniform radial force. While still compressed, the construct is frozen. After freezing, the construct is loaded into the sheath of the delivery system. While still frozen, or at least while still rehydrated, the entire system is then freeze-dried (lyophilized or evaporative cooled). This freeze-dried system is then sent to sterilization and once sterile is ready for distribution. When assembling the tissue graft construct and stents, it is preferred to have, for example, nitinol stents in a fully martensitic state so as not to introduce stress-induced martensite in the nitinol material. This is easily accomplished by placing the stent in liquid nitrogen to cool the nitinol below its martensitic final temperature. The temperature of the stents can be raised above 0� C. but below austenite start temperature so as to load hydrated SIS laminated constructs therein or therearound.
In addition, a larger diameter tube can possibly be manufactured by using tube-form SIS material. If the desired diameter of SIS tube is similar to the diameter of the tube-form SIS material, pieces of tube-form SIS can be placed onto a rigid mandrel. Multiple pieces of tube-form material can be added until the desired number of layers or thickness of the SIS device is obtained. After all of the tube-form SIS has been placed onto the mandrel, the mandrel and SIS is vacuum pressed as described before. Other manufacturing processes after vacuum pressing are identical to that listed above. The advantage of using tube-form SIS material is that a seamless inner lumen will result.
Also, an AAA stent graft can be manufactured using only one ZILVER (or other) stent, and one tube of SIS. This system would require the SIS to be affixed to the stent, for example, by glue or suture.
Also, an AAA stent graft can be manufactured by vacuum pressing the SIS component directly onto one stent. After drying, this construct can be rehydrated and compressed, loaded, and freeze dried. It is also possible to vacuum press the SIS material between two stents, further reducing the profile of the resultant device.
Returning to
To load prosthesis 20 into delivery system 73, inner tube 76 of the delivery system is positioned in the lumen or longitudinal passage of prosthesis 20 that has been radially compressed. The length of inner tube 76 extends into the passage of the prosthesis without distal tip portion 78 affixed thereto. After the inner tube is positioned in the compressed prosthesis, the proximal end of the prosthesis is pushed into the lumen of delivery catheter 24 until it reaches engagement portion 81 of the inner member. After the prosthesis is fully positioned in the delivery catheter and around intermediate portion 80 of the inner member, the length of inner tube 76 is then trimmed so as to permit distal tip portion 78 to be inserted over the distal end of the inner tube as indicated by the arrow. A transverse hole or aperture 85 is positioned in the distal tip portion to allow a commercially available, biocompatible medical grade glue 86 to be inserted therein and thus cement the distal tip portion to the inner tube. As depicted, radiopaque marker 84 is positioned at the distal end of delivery catheter 74 so as to radiographically mark the distal end of the delivery catheter.
In another method of assembling prosthesis 20 and loading it into prosthesis delivery system 73, self-expanding inner stent 21 is selected to have an inside diameter of approximately 9.0 mm, and multilayered tissue construct 33 is selected to have an inside diameter of approximately 9.5 mm. The inner stent is compressed and inserted into the hydrated multilayered tissue construct and expanded to engage the hydrated construct. The inner stent and the hydrated tissue construct are then compressed to a diameter for insertion into the delivery catheter. Compressing the inner stent and hydrated tissue construct minimizes, if not eliminates, damage to the hydrated tissue construct. The compressed inner stent and hydrated tissue construct are then frozen into a compressed diameter cylindrical solid. The outer stent 48 is then compressed around the solid, and the combination loaded into the delivery catheter over the inner tube as previously described. The distal tip portion of the inner member is then attached to the inner tube. After the prosthesis has been loaded into the delivery catheter including the compressed diameter solid, the prosthesis delivery system is placed in a vacuum chamber to complete the lyophilization of the frozen tissue construct.
Thus, it should be apparent that the stent tissue graft prosthesis of the present invention can be configured into a number of different embodiments to meet the anatomical needs of a patient by various combinations of the inner stent, multilayered tissue construct and outer stent. Multiple inner and outer stents can be used to form combination prosthesis with portions of the stent covered and uncovered to again meet the needs of the patient. As further depicted, occluders such as previously detailed as well as a square stent adapter can be utilized to form bifurcated versions of the stent tissue graft prosthesis. By way of example, a square stent adapter is described in detail in U.S. Pat. No. 6,220,336, entitled "Multiple-Sided Intraluminal Medical Device," and published U.S. Patent Appl. No. 2001/0039450 entitled "Implantable Vascular Device," both of which are incorporated herein by reference in their entirety.
For ease of understanding, a list of elements used in the description and drawings of the present invention is included herewith. However, this element list is not to be construed to limit the present invention, but is only being provided for illustrative purposes and not to restrict the scope of the invention.
It is to be understood that the above-described tissue graft prosthesis and method of assembly and use are merely illustrative embodiments of the principles of this invention. However, the invention should not be construed as limited to the particular embodiments discussed. Instead, the above-described embodiments should be regarded as illustrative rather than restricted. For example, as mentioned above, outer tubular member 24 has been described as an outer expandable stent 44. Other embodiments of the tubular member may include a polymeric tubular member in which perforations are formed therein by, for example, laser cutting and the like, for allowing host tissue to come in direct contact with the multilayered tissue construct for remodeling host tissue. This tubular member may be formed from any biocompatible material and is contemplated that such a tubular sleeve is fully within the limits of the claimed invention as follows.
|Cited Patent
|Filing date
|Publication date
|Jun 6, 1995
|Nov 5, 1996
|Parodi; Juan C.
|Graft to repair a body passageway
|Nov 7, 1995
|May 13, 1997
|Corvita Corporation
|Self-expanding endoluminal stent-graft
|Dec 29, 1995
|Feb 2, 1999
|Ramus Medical Technologies
|Method and apparatus for forming vascular prostheses
|Apr 11, 1997
|Apr 6, 1999
|C.R. Bard, Inc.
|Non-migrating vascular prosthesis and minimally invasive placement system therefor
|Mar 26, 1998
|Jun 29, 1999
|Jomed Implantate Gmbh
|Stent graft
|Aug 24, 1995
|Apr 10, 2001
|Impra, Inc., A Subsidiary Of C. R. Bard, Inc.
|Covered endoluminal stent and method of assembly
|Oct 8, 1999
|Jan 1, 2002
|Advanced Cardiovascular Systems, Inc.
|Stent cover
|Jun 2, 1999
|Mar 19, 2002
|Med Institute, Inc.
|Tubular grafts from purified submucosa
|Dec 27, 1996
|Jul 10, 1997
|Ramus Medical Technologies
|Method and apparatus for forming vascular prostheses
|May 4, 2001
|Nov 8, 2001
|Oregon Health Sciences University
|Endovascular stent graft
|Mar 13, 2002
|Nov 14, 2002
|Bionx Implants, Inc.
|Bioabsorbable stent-graft and covered stent
|International Preliminary Examination Report for PCT Application No. PCT/US0337365 dated Feb. 25, 2005.
|International Search Report for PCT Application No. PCT/US0337365 dated Feb. 25, 2005.
|Citing Patent
|Filing date
|Publication date
|Sep 27, 2011
|Cook Medical Technologies Llc
|Method of producing a radially expandable prosthesis
|Nov 26, 2008
|Jun 5, 2012
|Cook Medical Technologies Llc
|Method and device for vascular therapy
|Sep 11, 2012
|Jun 11, 2013
|Cook Medical Technologies Llc
|Prosthesis coupling device and method
|Sep 17, 2014
|Jul 28, 2015
|Cook Medical Technologies Llc
|Emergency vascular repair prosthesis
|Oct 31, 2012
|Nov 17, 2015
|Covidien Lp
|Wing bifurcation reconstruction device
|Dec 24, 2014
|Jan 19, 2016
|Fettech, Llc
|Tissue-based compositions
|Mar 10, 2010
|Mar 22, 2016
|Cook Medical Technologies Llc
|Blood perfusion device
|Dec 6, 2011
|May 31, 2016
|Covidien Lp
|Vascular remodeling device
|Jan 29, 2008
|Jul 31, 2008
|Cook Incorporated
|Method of producing a radially expandable prosthesis
|Aug 31, 2007
|Mar 5, 2009
|Cook Incorporated
|Barbed stent vascular occlusion device
|Nov 26, 2008
|Jun 4, 2009
|Cook Incorporated
|Method and device for vascular therapy
|May 12, 2011
|Nov 15, 2012
|Theobald Elizabeth A
|Emergency vascular repair prosthesis
|Sep 11, 2012
|Jan 10, 2013
|Cook Medical Technologies Llc
|Prosthesis coupling device and method
|Jul 15, 2013
|Nov 14, 2013
|Abbott Laboratories Vascular Enterprises Limited
|Stent graft
|Nov 16, 2012
|May 22, 2013
|Cook Medical Technologies LLC
|Silane bonded medical devices and method of making same
|U.S. Classification
|623/1.13, 623/1.16
|International Classification
|Cooperative Classification
|European Classification
|Apr 14, 2010
Owner name: OREGON HEALTH & SCIENCE UNIVERSITY,OREGON
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Owner name: COOK INCORPORATED, INDIANA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:PAVCNIK, DUSAN;MEAD, JASON A.;PARKER, FRED T.;AND OTHERS;SIGNING DATES FROM 20070731 TO 20070803;REEL/FRAME:024232/0214
Owner name: COOK BIOTECH, INC., INDIANA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:PAVCNIK, DUSAN;MEAD, JASON A.;PARKER, FRED T.;AND OTHERS;SIGNING DATES FROM 20070731 TO 20070803;REEL/FRAME:024232/0214
|Aug 25, 2014
|Fee payment
Year of fee payment: 4

subset: commoncrawl


text:
Lajo releases "dock friendly" exoflp case for iPod
Today Lajo released a new addition to his lineup of silicone cases named the exoflp. The exoflp features button and wheel protection (like the exo3), a back slit which makes the exoflp dock friendly, and is designed to fit tight with anti tear rings at each end. Exoflp can be found at xskn.com, click just released or enter exoflp into the search engine. "Lajo designs iPod cases with the philosophy that no on design, or color, or pattern will meet every one's needs and as a result his exo series for 3rd gen iPod has four case, over 50 colors, a variety of interchangeable accessories including screen protectors in a variety of colors and his just release SWVclip which can be color coordinated with you exoflp to make you the talk of the town." The exoflp costs $21.50 (case only) plus $5 shipping to anywhere in the world.
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text:
Former President Bill ClintonBill Clinton100 days to go in volatile race Romney: Trump victory 'very possible' What does Bill think of Hillary's Chris Wallace interview? MORE and former Secretary of State Hillary ClintonHillary Rodham ClintonClinton hammers Trump for criticizing retired general Trump draws backlash for comments on slain soldier's father Clinton's court shortlist emerges MORE will travel to South Africa to participate in memorial events honoring Nelson Mandela, sources close to the couple say.
Bush's father, former President George H.W. Bush, was also invited to join the Obamas but declined. The elder Bush was hospitalized earlier this year after fighting severe bronchitis-like symptoms and has limited his public appearances since then.
The White House announced earlier Friday that the Obamas would make the trip, but press secretary Jay Carney told reporters that details had not been finalized.
"We hope to have it fairly quickly, and when we do, we'll be able to provide it to you," Carney said.
Pressed specifically on whether former presidents would be invited to accompany Obama aboard the presidential plane, Carney said he did not want to get ahead of logistical planning for the trip.
"All I can say at this point is that President Obama and the first lady will go to South Africa next week to pay their respects to the memory of Nelson Mandela and to participate in memorial events," Carney said.
South African President Jacob Zuma announced earlier in the day that Mandela would be buried on Dec. 15, following 10 days of national mourning at his ancestral home in the Eastern Cape.
There will also be a Dec. 10 memorial service for the anti-apartheid leader at Johannesburg's Soccer City Stadium, the site of the 2010 World Cup final.
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text:
Star Tracks
Alicia Keys gets the night started. Plus: Nick Lachey, Katie Holmes, Scarlett Johansson and more
Credit: London Entertainment/Splash
Updated: Monday Feb 07, 2005 | 06:00 AM EST
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text:
Food and Drink
Let Me Be Frank
Posted by Becca Z
19. Jul, 2012
The Commons Cafe has just reopened as Let Me Be Frank , the latest offshoot of the South Melbourne stalwart Cafe Zappa.
But I digress.
Let Me Be Frank is located in the South Melbourne Commons Project, a partnership between Friends of the Earth, The Father Bob Maguire Foundation and some local parishes. Think Abbotsford Convent and CERES combined and compacted.
While my friend's Feta and Avocado mash on toast ($12) was slightly bland, 'Rocco's amazing chilli' served on the side provided the zippy pick-me-up. My quinoa batone served with smoked salmon, capers, dijon aioli and fresh tomato from the Commons garden ($12.50) was well toasted, crispy and struck the right balance of bread and filling.
As we ate a range of people passed through: students discussing their new project, the little old lady drinking tea, a Sex in The City girly catch-up and a family whose kids were kept busy with the cafe's toy and book collection.
This new cafe is well on its way to to catching up to big brother Zappa, proving it can one day be Frank.
217-239 Montague St, South Melbourne
Open every day, 8am – 4pm
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Our interview with Dr. David McInnis on ACMI showcasing Shakespeare On Film on the 400th anniversary of the Bard's death.


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linda mccartney
If It's Hip, It's Here: The Astounding Range Of Creative Talent Known As Rankin.
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My Vintage London | Battersea Power Station in all its Art deco glory
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Jude Law & Ewan Mcgregor.
audrey hepburn
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Bond, James Bond.
George Clooney
London, UK / photo by Jack Waldren
Monet with his Waterlilies in the background
its a puppy in a cup
tumblr_lv41d94Jlu1qdrmfeo1_1280.jpg (605×453)
fass for gq
Sweet storm that rolled through Nebraska on August 7th.
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☆one of the most beautiful places I've visited!!!!! The crazy cliff-side dwellings of Ronda, Spain - beautiful, but scary ☆
Self Portrait of Helmut Newton in Hotel Bijou, Paris (1973)


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The fishing boat sank not far from a Chinese oil rig, which has set off a territorial row between the two countries. Each side has blamed the other over the sinking.
Vietnam has said the rig is in its 200-nautical mile exclusive economic zone and on its continental shelf. China - which claims almost the entire South China Sea - says the rig is operating within its waters.
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Japanese shipping company Mitsui O.S.K. Lines, has, through its wholly-owned subsidiary Lakler S.A., agreed to conclude a charter contract with Gas Sayago, for
The bodies of 21 women and one man were brought ashore to Sicily on Friday as fellow migrants described scenes of panic and violence when water poured into their dinghy.
Keppel Offshore & Marine Ltd (Keppel O&M)'s wholly owned subsidiary Keppel Singmarine Pte Ltd (Keppel Singmarine) has secured contracts from Jan De Nul Group to
Southeast Asian nations were thrown into disarray after Cambodia on Saturday blocked them from issuing a statement referring to an international court ruling against
Petroleum Facilities Guard has blocked terminals for months. Ras Lanuf, Es Sider terminals damaged by fighting.
Libya's Petroleum Facilities Guard (PFG) will
U.S. Secretary of State John Kerry will urge Southeast Asian nations in meetings in Laos next week to find diplomatic ways to launch talks with China on easing
For the first time, AWI scientists have found evidence of living, potentially pathogenic vibrions on microplastic particles.
With increasing water temperatures
Ithaca Energy Inc. reports that the "FPF-1" floating production facility has completed the required inclination test as planned and departed the Remontowa shipyard in Gdansk, Poland.
Royal Boskalis Westminster N.V. (Boskalis) has been awarded the Offshore Balance of Plant contract by Vattenfall for the construction of Aberdeen Offshore Wind Farm,


text:
Waiter / Waitress games
Group DescriptionThe goal of these games is to take orders and deliver food or drinks in a timely fashion so that your customers don't get upset.
|Viewing Page 1 of 2
|(items 1-25 of 38)
Selected Covers
Front cover for Cake Shop
Front cover for Tropix 2! Quest for the Golden Banana
Front cover for Diner Dash: Seasonal Snack Pack
Front cover for Restaurant Rush
Front cover for Burger Restaurant 2
Selected Screenshots
Screenshot from Cake Shop
Screenshot from Tropix 2! Quest for the Golden Banana
Screenshot from Restaurant Rush
Screenshot from Burger Restaurant 2
Game group created by Riamus (8124), additional games added to group by Cantillon (13806), Patrick Bregger (156068), Tien Thuy Le Nguyen (2123), Sciere (373264), Pirou Julien (2878), Martin Smith (62961), Scaryfun (13562), Indra is stressed (19945) and Macs Black (77759)
Screenshot from Success Story
Screenshot from Success Story


text:
server room service jobs near Phoenix, AZ
Refine your searchClear Filters
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Team Member - Service Crew
Cafe Rio Mexican Grill - Phoenix, AZ
Work alongside fellow service crew, including cashiers, servers, greeters and expeditors to meet daily goals....
Dining Room Server
The Oaks, A Merrill Gardens Community - Gilbert, AZ
Dining Room Servers are responsible for the smooth operation of the dining room, providing exceptional service, and delighting our residents!...
Director of Devops and IT
BillingTree - Phoenix, AZ
This is a hands-on position, which will transform the way we configure, deploy and scale our servers and applications on our operating systems....
Server / Waiter
Senior Lifestyle - Scottsdale, AZ
Assists in bussing, resetting tables, and room services as needed. This server position reports to the Dining Services Manager or any other staff person...
Restaurant Expeditor
Grand Canyon University - Phoenix, AZ
Ability to learn the structure and function of all hotel departments, facilities, rooms, activities, services and hours of operation of hotel....
Software Engineer
BillingTree - Phoenix, AZ
Minimum 2+ years .Net or JAVA coding experienceExperience working with HTML, JavaScript, CSS, DHTML, AJAX, XML/XSLT/XSL-FO,J-Query, responsive design and...
Software Engineer - Hotel Team -Bangkok C#, Scala, Javascript
Big Wednesday Digital - United States
SQL Server, Cassandra, Redis, ZeroMQ. Create APIs and backend services to monitor and update hotel information....
RA Sushi - Phoenix, AZ
Oversees dining room activity to ensure guest seating efficiency. Relays guest seating and information to servers and bus persons....
Test automation Engineer
BillingTree - Phoenix, AZ
Bachelor's Degree in Computer Science or related Engineering degree2+ years hands-on test automation through scripting (Selenium with C# in Visual Studio...
Software Development Engineer- Relocation Opportunity
A2Z Development Center, Inc. - United States
Digital and Devices Customer Service Technology team owns critical applications and backend services. 3+ years of Mobile applications development or server...


text:
Brain & Nervous System Health Center
Neurosyphilis - Topic Overview
Neurosyphilis refers to the infection of the brain and spinal cord by the syphilis bacteria. This can lead to destruction in many areas of the nervous system, causing loss of function of a person's arms or legs, loss of vision, and altered mental abilities. Neurosyphilis can affect many different body systems and may develop over an extended period of time. Symptoms of neurosyphilis usually include:
- Personality changes, such as confusion and irritability.
- Hearing loss.
- Vision problems.
- Decreased ability to concentrate.
- Memory loss.
- Difficulty speaking or understanding speech.
- Tremor of the fingers and lips.
- Mild headaches.
- Disorderly appearance.
Other symptoms may include:
Recommended Related to Brain & Nervous System
Concussion (Traumatic Brain Injury)
The most common and least serious type of traumatic brain injury is called a concussion. The word comes from the Latin concutere, which means "to shake violently." According to the CDC, between 2001 and 2009, an estimated 173,285 people under age 19 were treated in hospital emergency rooms for concussions related to sports and recreation activities. Other causes include car and bicycle accidents, work-related injuries, falls, and fighting. How can you tell if you have had a concussion? Is it always...
Read the Concussion (Traumatic Brain Injury) article > >
- A wide gait.
- Numbness or tingling of the hands or feet.
- Muscle pain.
- Joint destruction because of lack of sensation (Charcot's joint).
- Inability to control urine or stool (urinary or fecal incontinence).
Most forms of neurosyphilis take years to develop and can be life-threatening. People who are also infected with human immunodeficiency virus (HIV) tend to develop signs of neurosyphilis sooner.
Antibiotic treatment cures the syphilis infection and stops the progress of neurosyphilis. But the damage that has already occurred may not be reversed.
In this article
WebMD Medical Reference from Healthwise


text:
Latest Lord Street Calendar, School Holidays Events
- Summer Holiday29Jul2016
- Summer Holiday30Jul2016
- Summer Holiday31Jul2016
- Summer Holiday01Aug2016
- Summer Holiday02Aug2016
Welcome to Lord Street Primary School
Dear Parents, Guardians and Visitors,
Welcome to the Lord Street Primary School website. This is a new site which will be much easier for you to negotiate. We are populating it with information about the school, ways to help your child and key dates and forms you might need. It will take us a couple of weeks to finish this but it will be done soon. Please let us know if there is anything we have missed that you think would be helpful!
If there is anything else that you need to know then you are most welcome to phone us (01282 865597) or to call in at school if you would rather. Guests are always most welcome, whether you are an ex pupil who wishes to rekindle old school day memories or you have a child who you would like to enrol at the school.
Come and visit us. Our staff and children will always give you a warm welcome.
KS2 SAT results
The tests our year six children have taken this year have a scaled score result instead of a grade. We have put these on reports. Since they are a new system we would like to direct you to the information leaflet from the DFE. This tears tests have been reported as being significantly harder than those used in the past and so it is hard to draw comparisons. I am happy to say that all our children worked very hard and tried their best.
If, after reading the document , you are still unsure then please come in and talk to our year six team.
KEY STAGE 2 SPORTS DAY IS ON. We will see you at 1.30 pm


text:
Cashing Out: The 5 Highest Paid Swiss CEOs
Feb. 28 (Bloomberg) -- What would it cost for you to walk away? (Source: Bloomberg)
Most Recent Videos
Soylent: The Food of the Future?
27:08 - Rob Rhinehart, Soylent's chief executive officer, discusses the company's quest to disrupt the food industry. He speaks with Bloomberg's Emily Chang on "Bloomberg West." (Source: Bloomberg)


text:
Even though we ARE Nikon lovers,we are NOT affiliated with Nikon Corp. in any way.
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Florence, US
75 posts
"RE: Help please, what did I do?"
Thank you Sherri. I thought that was the way it was supposed to work.The manual is less than helpful with options for manual mode scattered all over the place. The Mastering D700 is a Nook copy and I cant just check the index or table of contents and page around or at least I havent figured that out either. One thing I havent seen in either book is how to move the little focus point thingy in the viewfinder. Mine has moved over to the right and I cant figure out how to get it back.Thanks for all the help
Visit my Nikonians gallery.
Visit my Nikonians gallery.


text: UFSB-KIMY Back UFSB-KIMY Bra / SS 2013 EUR 45,00 49% off EUR 23,00 Info UFSB-KIMY Bra SS 2013 About 91% Nylon, 9% Elastane FREE SHIPPING OVER € 200 Place an order of € 200 or more and receive it for free within 2-4 working days. FREE RETURNS Don't love it? Return it for free within 14 days from the date of receiving the order. Discover more Featured in Recently viewed Also like


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2520 Stanwell Drive Suite 160
Concord, CA 94520
785 Oak Grove Rd
Concord, CA 94518
4481 Clear Creek Ct
Concord, CA 94521
Very pleased. My daughter has been going to this facility since July 2011 and I am pleased. While the teacher turnover in one...
I used to take sailing lessons from this company a couple of years ago.Not anymore, because my job now doesn't allow me too much...
This little shop has been around for many, many years now and, not only sells products for your specialty baking needs, but gives...
©2016 Cox Search, Inc. All rights reserved. Data provided in part by Localeze and Valpak.


text:
How many rights should we give the people? Hella
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text:
FBI car for Grand Theft Auto: Liberty City StoriesHome / Playstation 2 /
This page contains Grand Theft Auto: Liberty City Stories Hints for Playstation 2 called "FBI car" and has been posted or updated on Sep 23, 2006 by pearl3145.
- Developer: Rockstar Leeds
- Publisher: Scea
- Genre: Action Adventure
- Release: Jun 6, 2006
- ESRB: Mature
FBI car
Get a five star wanted level. FBI cars will appear. As soon as you see one, enable the "Wanted level disabled" code and quickly get in an FBI before it leaves. When you are driving the FBI car, turn on the siren. All of the other cars will move out of the way. It also has good speed and handling.
Please Submit a Problem for any incomplete, non-working or fake cheat listed above.
If you know other secrets, hints, glitches or level guides, then please Submit your Cheats and share your insights with other gamers.
Stuck in this game? Set a specific, clearly defined question and let other gamers answer your question or view answers to previously asked questions. If you think you are an expert then please try to help others with their questions.
From: Jaf
Posted on: 06-03-2014
From: Arsh
Posted on: 11-28-2012
From: Razor
Posted on: 06-30-2011
From: hhhh
Posted on: 11-15-2010
Grand Theft Auto: Liberty City Stories - Drunk driving skillz
- Jun 6, 2014, Views: 60
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AN ACCOUNTANT and tax adviser who worked for a string of actors and celebrities has been jailed for five years yesterday after being found guilty of evading more than £6m in tax.
Dennis Christopher Carter Lunn, known as Christopher, ran his own Sussex-based accountancy firm Christopher Lunn & Co, whose clients included newsreader Fiona Bruce, actress Sadie Frost and Gotham star Sean Pertwee.
In 2010, the business was investigated by HM Revenue & Customs and Lunn was subsequently arrested. The tax authority uncovered a string of offences at Lunn's premises including the inflation of accountancy fees and the fraudulent use of trading losses, measures which were undertaken to help Lunn's clients evade tax.
Lunn was convicted at Southwark Crown Court in December 2015 on four counts of cheating the public revenue.
A few days before Lunn was sentenced, his lawyer Geoff Cox QC made the case for Lunn to only payback £65,000 of the £6m he owed, arguing that the prosecution picked out 15 examples of fraudulent accounting that involved celebrities to 'prove a course of conduct'.
Cox added that Lunn had been "a decent, law abiding man' of 'good character" whose health and finances have deteriorated significantly as a result of the case against him.
Lunn was sentenced for five years and HMRC has now started confiscation proceedings to strip Lunn of any financial gain he made as a result of his criminal activity.
None of Lunn's clients are under investigation and are understood to have known nothing about the crimes that took place. HMRC has given Lunn's clients a chance pay any tax and interest due, with the taxman hoping to recover as much as £40m in evaded tax once all of his clients have settled.
Rebecca Busfield, partner at Watt Busfield Tax Investigations, believes that HMRC will want to display that they are rewarding ex Lunn clients who came forward promptly.
She said:"HMRC are keen to show that they are prosecuting more cases of tax fraud and treating accountants more seriously because they have positions of responsibility and trust. However, cases should be reviewed on a case by case basis and the standard of reasonable care expected varies from person to person."
Jennie Granger, HMRC's director general for enforcement and compliance, said that Lunn's arrest was the product of "hard work from HMRC officers across the department".
"Lunn believed he could make up fraudulent claims to benefit both himself and his clients. This long-running investigation has already recovered £20m as Lunn's former clients settle their tax liabilities, with more to come."
"I hope this result serves as a reminder to those who try to cheat the public purse – particularly those in the tax profession – that no one is above the law and that HMRC will relentlessly pursue tax evaders to bring them before the courts."
Lunn's son, Christopher Jonathan Lunn (Jon), who also worked at the firm, was convicted in December 2014 on six counts under the Fraud Act, after he had sent false invoices to HMRC to try to cover up the fraud in the practice.
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Why are student numbers among the professional accountancy institutes declining?
Student numbers among the main professional bodies have declined over the past four years. Simon Wright at CareersinAudit.com looks at why this might be happening and the call to action for the profession


text:
Ambulance Service-India
Himachal Pradesh
Ambulance Service-Himachal Pradesh
Latest Ambulance Service news in Himachal Pradesh
June 19, 2016 17:29:05 IST
GVK EMRI service hits bumpy road in Chhattisgarh
The GVK's EMRI (Emergency Management and Research Institute) service in Chhattisgarh had landed in controversy with allegation that the state government floated the norms to award contact to the company. Popularly known as 108 ambulance service, ...
HC restrains ambulance staff from going on strike
The HP High Court today restrained the HP 108 and 102 Ambulance Service, Contract Workers Union from going on strike. While issuing the restraining order a division bench comprising the Chief Justice Mansoor Ahmad Mir and Justice Sandeep Sharma has ...
HT Spotlight: Ambulance racket shames Chandigarh's PGIMER
Can you be fleeced after death? Yes, you can if youre unfortunate enough to end up in a body bag awaiting an ambulance at Chandigarh's Post Graduate Institute of Medical Education and Research (PGIMER). Unsuspecting relatives, already under the ...
Explore Himachal Pradesh
Local News around Shimla
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Local News around Sirmaur


text:
Marketers agreed that the Facebook-Bing deal should make the phones ring a bit more often in the companies' ad sales department. ClickZ reached out to agencies last week to gauge their reactions to the social-and-search marriage forged Oct. 13.
Two immediate consensus opinions: Brands will want to increase their "likers" via Facebook.com ads or other measures, as such Facebook users will be appearing in socially contextualized Bing search results. And companies with large Facebook presences – such as Coca-Cola (14.2 million "likers"), Red Bull (9.6 million), and Wal-Mart (1.7 million) – will be inclined to increase their Bing paid and organic search efforts.
Reggie Bradford is CEO of Vitrue, a social media company that made waves in April when it valued the earned media $3.60 per Facebook "liker." He said the Bing deal extends the reach of "likers" into the search realm and likely raises their dollar-value worth.
"We haven't had the chance to look at it in that context yet, but certainly from an earned media standpoint…that should put a multiplier on [the $3.60] number," he said. "It only enhances the value."
Interestingly, the CEO also pointed to research by The Nielsen Company, which found that Facebook.com ads appearing with users' friends outperformed promos on the social site without them. "Advertising is more impactful and gets a higher click-through rate when you see that your friends have 'liked' a brand," Bradford said. "It's a real reason to drive [brands] to get more people to 'like' them.
Here is what four other marketers had to say about the Facebook-Bing deal:
Chris Tuff, social media director at ad agency 22squared: "Those with an existing Facebook presence are more likely to concentrate efforts and media dollars on Bing. To those brands without Facebook presence, Bing will be seen as an area on which they need to concentrate. The reason why many brands invest time and money in Facebook is because they [or their agencies] understand the power behind 'friendsourcing' purchase decisions and brand opinions. This deal brings the same mentality to search…Given the direct and timely effect this deal will have on social search, Facebook ads will become a higher priority for brands in 2011."
Kevin Barenblat, CEO of social marketing company Context Optional: "Including 'like' buttons in search results certainly makes search and social more complementary, and Facebook may see a bump in spend from search marketers as a result of its influence on search engine optimization. That said, media buying is only one of the many ways that brands gain [likers]. Sophisticated social marketers also run [liker]-only promotions through Facebook, add 'like' buttons to content on their site and leverage Facebook social channels to grow their fan base, all of which become increasingly important in a world where search and social discovery intertwine."
Harry Gold, CEO of Overdrive Interactive and a ClickZ columnist: "I am not sure in the short term this is really a thing that will have a direct impact on paid media. It is more a case where 'likes,' 'tweets,' and 'shares' are becoming more and more the 'popularity score' of the Web and a particular page…So instead of keyword density or links driving a page to the top of Bing results – the amount of 'likes' and/or that page's popularity with your particular friends will drive that page to the top of the results. So now there will be double value in Facebook engagement ads that get people to 'like' your fan page and your content out on the web because it will build both social connections and SEO octane in Bing."
Mike Lazerow, CEO at digital agency Buddy Media: "This is another step in Facebook's efforts, similar to Facebook Connect, to make the Web more social by expanding its reach beyond Facebook.com, and a big step in terms of Facebook's search strategy. For marketers, social search will increase the reach of the sharing and connecting that occurs on Facebook.com by allowing Bing users to see how their friends have interacted with the brands or products they are searching for. This could make Facebook marketing initiatives and related ad spends even more appealing to brands."
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text:
Filtering by selection
Filtering by selection
Filter by Selection is the fastest way to locate Records in your Table or Form that match your criteria. Open up to your Customers form and let's say I want to see how many restaurants and stores I have in California. Find an example of CA in the State field, highlight it and then go up to the Home ribbon to the Sort and Filter group, find the Selection button and drop it down. I have four options, Equals "CA", Does Not Equals "CA" Contains "CA" and Does Not Contain "CA". I'll click on Equals California (Equals "CA") and now I can see that I have two customers in California.
To bring all my records back I can see the Toggle Filter is highlighted so I'll click on it, and now all my records return. Let's highlight California again and go back to that Selection button and this time choose Does Not Equal "CA"-- now you can see all of your customers except those in California, and I'll click the Toggle Filter button...
Filtering by selection provides you with in-depth training on Business. Taught by Alicia Katz Pollock as part of the Access 2010 Power Shortcuts
- Subject:
- Business
- Software:
- Access
- Author:
- Alicia Katz Pollock
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Rim, supporting ring and assembly thereof
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United States Patent #5787950
An integral rim intended for mounting a tire having at least two beads and including, when viewed in meridian section, at least a first rim seat, a second rim seat, and a rim base which is without a groove. The first rim seat slopes downwardly towards the outside. The second rim seat has a generatrix, the axially inner end of which is on a circle of diameter at least as great as the diameter of the circle on which the axially inner end of the first rim seat is located. The assembly formed by such a rim and a supporting ring for the thread.
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