text:
|Publication number
|Publication type
|Application number
|Publication date
|26 Oct 1999
|Filing date
|23 Jan 1996
|Priority date
|10 Nov 1993
|Fee status
|Also published as
|Publication number
|Harry G. Reimels, Raymond Morrison
|Original Assignee
|Mentor Corporation
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (34), Non-Patent Citations (39), Referenced by (90), Classifications (15), Legal Events (9)
|External Links: USPTO, USPTO Assignment, Espacenet
This is a continuation of application Ser. No. 08/150,925, filed Nov. 10, 1993, now abandoned.
This invention relates to bipolar electrosurgical instruments.
Some surgical procedures (such as severe retinal detachment repair and diabetic retinopathy) require the surgeon to insert surgical instruments into the posterior chamber of the eye. Because the eye should be maintained at a relatively constant pressure during the procedure, tubing to which fluid is applied from an elevated (such as by 2-3 feet) irrigation fluid bottle is inserted through the sclera, and the internal eye pressure is controlled by adjusting the height of the bottle.
The need for tightly controlling eye pressure dictates that the surgical instruments be as small as possible in cross-sectional diameter (to minimize leakage around the instruments and limit fluid loss during exchange of the instruments). Accordingly, an informal "standard" has evolved that surgical instruments used in the posterior eye chamber either be made from 20 gauge hypodermic tubing (which is 0.0355 inches in diameter) or be capable of passing through and sealing an opening equivalent to that created by a 20 gauge needle.
Frequent exchanges of the instruments tend to enlarge the puncture and increase fluid leakage, and are also frustrating for the surgeon and time consuming. It thus is desirable to design instruments which can perform multiple tasks. As the complexity of surgical procedures performed in the posterior chamber of the eye increases, the need for additional, intricate instruments increases as well. Basing the size of such instruments on the 20 gauge "standard" severely limits design options. (The need for limiting the size of the bore created by a surgical instrument and minimizing the number of instrument exchanges is not limited to ocular surgery--these goals also exist in other procedures, such as endoscopy and microsurgery on other areas of the body, such as the brain.)
Most extensive posterior surgery requires controlling hemorrhaging, which typically is done using bipolar radio frequency (RF) coagulation. In one coagulation method, two conductive instruments that are otherwise in use in the eye (e.g., an aspiration tube and a metal jacket of a fibre optic light source) are brought close together near the bleeding vessel while applying RF energy to the instruments. Current conducts in the region of closest spacing between the instruments and coagulates the vessel.
As an alternative, coaxial bipolar electrosurgical instruments (such as that described in U.S. Pat. No. 4,548,207, entitled "Disposable Coagulator," assigned to the present assignee and incorporated herein by reference) have been developed. In a coaxial bipolar instrument, an insulated wire is installed within a metal hypodermic tube, thereby providing a pair of electrodes whose distal tips are exposed and closely spaced to support current conduction therebetween. The exposed area limits the extent of the coagulation, which is advantageous in posterior chamber surgery. Variations on bipolar instruments include replacing the wire with an inner tube, which allows the instrument to be used for aspiration as well as coagulation.
This invention provides, in one general aspect, an electrosurgical instrument having a first electrode that includes an elongated, electrically conductive member and a second electrode that includes a layer of electrically conductive material adhered over at least a portion of the elongated member and separated therefrom by an insulator; a region of the electrically conductive layer is positioned adjacent to a region of the member disposed distally of the proximal end of the instrument to support current flow between the electrodes at the regions and apply electrical power to an object in the body.
In a related aspect of the invention, the second electrode is disposed over at least a portion of the end of the first electrode, is separated therefrom by an insulator, and is configured so that the outer diameter of the distal region is substantially the same as the outer diameter of the end of the first electrode. In a preferred embodiment of this aspect, the second electrode is a layer of electrically conductive material adhered on over the first electrode and separated therefrom by the insulator.
The electrosurgical instrument of the invention is significantly smaller than devices which employ a separate member--such as a tube disposed coaxially around the first electrode--as the second electrode. One result of this difference is that the dimension of the incision needed for the instrument can be made relatively small, so that a 20 gauge needle may be used for the first electrode, while maintaining the usefulness of the instrument for the dual purposes of coagulation and aspiration. This is particularly important in ophthalmic applications for which (as discussed above) an informal standard has developed that instruments no greater than 20 gauge be used in the posterior chamber of the eye.
Both electrodes are provided in a single instrument that is easily manipulated within the eye. This allows the surgeon to cauterize without performing awkward maneuvers--such as attaching wires from an RF source to a pair of instruments that are to serve as the electrodes, and manipulating the instruments close together with both hands.
Another aspect of the invention is a coaxial electrosurgical instrument one electrode of which has a reduced circumferential extent relative to another electrode to limit an area of current flow between the coaxial electrodes. This limits the size of the region in which cauterization occurs, thereby allowing the user (i.e., a surgeon) to control which body objects are subjected to electrical current more precisely than prior coaxial bipolar instruments in which the exposed distal tips of both electrodes are circular. As a result, damage to sensitive tissue (such as structures of the eye) can be avoided by appropriately directing the current away from these objects.
Preferred embodiments of one or more of these aspects of the invention include the following features.
The insulator is disposed over an exterior surface of the first electrode, and the layer of conductive material of the second electrode is adhered to the insulator and extends axially along the first electrode between the proximal end and the distally disposed region. The distally disposed region is preferably near the distal end of the instrument. The conductive layer is separated from the exterior surface of the first electrode by an insulator (such as a layer of plastic). The outer diameter of the first electrode is on the order of 20 gauge; by contrast, the thickness of the layer of conductive material is on the order of 3-5 microns (i.e., between 0.001 inches and 0.002 inches. Thus, the second electrode does not significantly add to the size of the first electrode. If desired, a second layer of insulation can be disposed over at least the layer of electrically conductive material for protection during handling.
The layer of conductive material extends over one half or less of the circumference of the first electrode, such as between one-third and one-half of the circumference, at least in the distal region. In a particularly useful example of this configuration, the first electrode is a hollow tube and the layer of conductive material is configured as an elongated strip that runs along the length of the tube between the proximal end and the distal region.
The tip of the tube at the distal region has a limited circumferential extent with respect to other portions of the tube, and the layer of electrically conductive material is circumferentially aligned with the tip. This provides even greater control over the areas to which the cauterizing current is applied. In one configuration, the circumferential extent of the layer is less than that of the tip. The distal region of the tube is beveled to provide the tip. The bevel affords the surgeon with an unobstructed view of the tip during cauterization. The tip includes a surface disposed transversely to the longitudinal axis of the instrument--that is, the tip of the bevel is blunt rather than sharp. A blunt tip helps avoid damage to tissue contacted by the instrument during operation.
In another embodiment, the layer of conductive material is disposed completely around the perimeter of the exterior surface in the distal region. Although the area to which current is applied is circumferential, this configuration is particularly useful in cauterizing incisions. In one example of this embodiment, the member is a cutting blade, and the distal end of the layer is disposed completely around a wide region of the blade proximally of the region of the blade that narrows to the tip. An incision cut by the blade is cauterized completely around its perimeter by advancing the blade to place the distal end of the layer adjacent to the incision while applying the bipolar power to the instrument to induce current flow between the blade and the layer.
In embodiments in which the member (i.e., the inner electrode) is a hollow tube, the tube is sized to provide an interior passage that is sufficiently large to slidably receive a device during use and allow the device to be advanced to at least the distal region of the tube. A 20 gauge needle is well suited for this purpose. Examples of such devices include an aspiration tube and a fibre optic cable. The interior passage (i.e., the bore) of a 20 gauge needle is sufficiently large so that such devices can be freely advanced and retracted therethrough without binding. Because the outer electrode is a layer of conductive material adhered to the exterior of the needle--rather than a smaller needle coaxially disposed within the 20 gauge needle--the entire diameter of the passage is available to receive the device. As a result, the risk of the device binding during use is significantly reduced.
Another aspect of the invention is a process for fabricating an electrosurgical instrument by providing a first electrode that includes an elongated, electrically conductive member, disposing an insulating material over at least a portion of a surface of the member, and forming a layer of electrically conductive material over the insulating material to provide a second electrode.
Preferred embodiments include the following features.
The layer is formed in any of the configurations discussed above--for example, in the shape of an elongated strip that extends between the proximal end and the distal region of the member, or completely around the circumference of the member.
The electrically conductive material is made from silver and is formed by vapor deposition. The silver layer is deposited to a thickness of between 3 microns and 5 microns. Materials other than silver (such as nickel, gold, palladium, platinum, tin, etc.) may alternatively be used. In addition, a second layer of conductive material may be deposited over the first layer of conductive material. This is particularly useful when silver or another material that tarnishes is used as the first layer of conductive material. Depositing a suitable metal (such as gold) over the silver avoids tarnishing.
Preferably, a sub-layer of electrically conductive material is applied over the insulating material before the layer of electrically conductive material of the second electrode is deposited. The sub-layer (which is, for example, titanium) serves as a primer to improve the adhesion of the silver or nickel. The insulating material preferably comprises a conformal insulating layer, such as a polymer (for example, parylene).
The bipolar electrosurgical instrument of the invention has a variety of applications in addition to coagulation. For example, the instrument is useful in intraocular diathermy to mark retinal breaks and assist the surgeon in locating the breaks as air enters the eye during fluid/gas exchange. Also, the aspiration tube that extends through the first electrode can be used as a brush to manipulate large retinal tears and to assist the surgeon in assessing the strength of vitreous strands near (and on) the retina. The amount by which the tube can be extended beyond the tip of the electrode determines the rigidity of the "brush."
Moreover, the aspiration tube allows pre-retinal blood or fluids so often encountered with proliferative diabetic retinopathy to be passively or actively aspirated from the eye. A drainage retinotomy can be achieved by cauterizing a spot on the retina, thinning the targeted tissue, and then applying suction via the extended tube. Subsequent extension of the aspiration tube through the retinotomy (or through a peripheral retinal break in eyes that have complex retinal detachments) achieves drainage of sub-retinal fluid (and hemorrhages). Likewise, the profile of bullous retinal detachments can be reduced at the start of vitreoretinal procedures in order to facilitate access to pre-retinal membranes.
Bubbles of air, gas, or silicone oil droplets which become trapped beneath the retina, or floating anterior, may be removed using active or passive aspiration with the tube extended through the first electrode. Moreover, the extended tube may be used for reflux.
Other features and advantages of the invention will become apparent from the following detailed description, and from the claims.
FIG. 1 diagrammatically shows a portion of an electrosurgical instrument according to the invention, in which one electrode is configured as a layer of electrically conductive material adhered on a metal tube, which serves as the other electrode of the instrument.
FIG. 2 is a perspective view of the surgical instrument of FIG. 1.
FIG. 3 shows a cross section of the surgical instrument of FIG. 1, taken along line 3--3.
FIG. 4 shows enlarged views of the distal region of the surgical instrument of FIG. 1 from the side and tip.
FIG. 5 shows a greatly enlarged view of a portion of the tip of the surgical instrument of FIG. 1.
FIG. 6 shows an assembly for bevelling the tip of the surgical instrument of FIG. 1.
FIG. 7 illustrates forming the electrode layer by vapor deposition.
FIGS. 8 and 9 are cross-sectional views showing additional features of the electrosurgical instrument of FIG. 1.
FIG. 10 illustrates the electrosurgical instrument of FIG. 1 in use.
FIGS. 11 and 12 show an the alternative configuration of the electrodes according to the invention.
Referring to FIGS. 1-5, an electrode assembly 10 of a bipolar electrosurgical instrument includes one electrode 12 made from a stainless steel, 20 gauge hollow needle and a second electrode 14 formed as a layer of electrically conductive material (such as silver or nickel) deposited over and adhered on an exterior surface 16 of needle electrode 12. A thin electrical insulator 15 separates electrodes 12, 14 along their lengths to avoid short circuiting.
Electrodes 12, 14 extend coaxially along a longitudinal axis 18 of the instrument from a proximal region at which bipolar electrical power is applied (from a source not shown) to a distal region 20 of electrode assembly 10. As explained in more detail below, tips 22, 24 (FIG. 5) of electrodes 12, 14 are closely spaced in distal region 20 so that when the instrument is energized, current flow is induced between electrode tips 22, 24 through an object in the body (such as a blood vessel or tissue within the eye) to perform cauterization and other procedures (such as tissue shrinking).
Electrode 14 extends over a limited portion of the circumference of electrode 12, rather than entirely around electrode 12. Moreover, as discussed below, electrode 12 is configured so to have a narrow tip 22 that is exposed to tip 24 of electrode 14 only at a face 23 at a distal tip 21 of the instrument. As a result, current flow between electrodes 12, 14 occurs over only the width W (e.g., 0.01 inches) of tip 22. It will thus be appreciated that current flow occurs over a relatively small portion of the circumference of electrode 12. This limits the area in the body that receives current, and provides the user (e.g., a surgeon) with a high degree of control as to where the current is applied. This is particularly advantageous in eye surgery, during which the electrodes are often used to cauterize bleeding blood vessels near sensitive tissue that may be damaged if subjected to electrical current.
As shown in FIG. 3, electrode 14 extends over an arc of approximately one half of the circumference of electrode 12, such as between 3/8 and 5/8 of the circumference. Electrode 14 is disposed symmetrically about an axis 26 that vertically bisects electrode 12 and terminates circumferentially in edges 28 that lie approximately on an axis 30 that horizontally bisects electrode 12. As discussed below, electrode 14 is formed by vacuum deposition, and thus the thickness of electrode 14 decreases from a maximum (such as 5 microns) at vertical axis 26 to zero as electrode 14 extends circumferentially toward axis 30. (Thus, edges 28 are "feathered" rather than being sharply defined.)
As shown in FIG. 4, distal region 20 is beveled to form a surface 25 oriented at an oblique angle (e.g., 45�) with respect to longitudinal axis 18. In addition, a pair of beveled surfaces 27 are formed in the half of electrode 12 on which electrode 14 is disposed (i.e., the lower half in the figures). Beveled surfaces 27 are oriented at an angle of 90� to each other and converge to form tip 21 at the extreme distal end of the instrument. Beveled surfaces 27 join with beveled surface 25 at edges 27b. Bevels 25, 27 are formed by a grinding process discussed below. Tip 21 is subsequently ground flat to form face 23, which is oriented perpendicularly to longitudinal axis 18 and is symmetrically disposed with respect to axis 26. Face 23 meets the beveled surfaces 27 at edges 27a. Electrode tips 22, 24 are coextensive at face 23. Thus, tip 21 is blunt, rather than sharp. The blunt nature of tip 21 helps avoid inadvertent damage to sensitive eye tissue during the surgical procedure.
Electrode 12 has a central passage 36 that is open at distal region 20. Because electrode 14 is adhered to exterior surface 16 of electrode 12, the entire diameter of passage 36 (which, for a 20 gauge needle, is 0.0305 inches) is available to slidably receive a device 40 used in conjunction with the instrument during surgery. Examples of device 40 are a hollow tube for aspirating irrigation fluid and other liquids from the eye, and a fibre optic cable for illuminating the surgical site (the site is viewed through the cornea with a microscope, not shown). Passage 36 of a 20 gauge needle is sufficiently large to allow such devices 40 to be advanced and retracted (in the direction of arrow 42) through electrode 12 without binding. Device 40 can be advanced so that its distal end 44 (shown in phantom in FIG. 1) extends distally beyond distal region 20, or not.
Referring to FIG. 6, the first step in fabricating electrode assembly 10 is to grind distal region 20 to form beveled surfaces 25, 27. Electrode 12 is placed in a collet-type indexing fixture 150, which is mounted on a sine plate 151 set at 45� to a mounting table 152 of a surface grinder. Pivot axis 153 of sine plate 151 is parallel to the direction of longitudinal travel of mounting table 152 (into and out of the page in FIG. 6). Grinding wheel 154 rotates about an axis 155 that is perpendicular to the direction of longitudinal travel of mounting table 152. Pivot axis 156 of indexing fixture 150 is perpendicular to pivot axis 153 of sine plate 151.
The complete cross section of electrode distal region 20 is ground at 45� with indexing fixture 150 set at 0�. This forms beveled surface 25 over the entire diameter of electrode 12. Grinding wheel 154 is then retracted and electrode 12 is rotated by indexing fixture 150 to a setting of +90�; and grinding wheel 154 is brought back into contact with electrode 12. Grinding wheel 154 is again retracted, and electrode 12 is rotated by indexing fixture 150 to a setting of +90�; grinding wheel 154 is then brought back into contact with electrode 12. The grinding procedure is repeated at the +90� and -90� fixture settings, with grinding wheel 154 lowered slightly during each repetition, until a point is formed at tip 21. Sharp edges and burrs are removed manually, e.g., using hard Arkansas stones and hand scrapers (hand honing and scraping can be eliminated by grinding electrode 12 using an electrochemical grinding process, or ECG).
Referring again to FIG. 2 and FIG. 3 (which shows the thicknesses of the various layers applied over electrode 12 greatly exaggerated for purposes of illustration), insulating layer 15 is formed on electrode 12 after grinding. Insulating layer 15 is made from Parylene C, a polymer commercially available from Union Carbide Corporation, and is applied by any suitable method, such as vapor deposition. During vapor deposition, a granular powder that comprises the insulating material is vaporized at an elevated temperature, and the resulting gas is deposited on electrode 12 in an ambient temperature deposition chamber (not shown). The insulating material is adsorbed on exterior surface 16 of electrode 12 as it polymerizes thereon, and also forms on tip 21 (which is a sharp point at this stage), and beveled surfaces 25, 27; some insulating material is also deposited on the interior surface of electrode 12.
Insulating layer 15 should be as thin as possible (for ease of fabrication and to keep electrode assembly 10 small), while serving its purpose of electrically insulating electrodes 12, 14 from each other. The total thickness of insulating layer 15 is between 0.0008 inches and 0.001 inches and thus adds insignificantly to the outer diameter of electrode 12 (which for a 20 gauge needle is 0.0355 inches). The proximal end of electrode 12 is masked to form a window (not shown) in insulating layer 15. The window provides an electrical contact point for a wire that delivers electrical current to electrode 12.
A layer 50 of titanium is then applied by ion vapor deposition in a high vacuum on insulating layer 15 over the portions of electrode 12 that will be covered by electrode 14. Thus, layer 50 is applied along the length of electrode 12 and extends over a limited portion (such as approximately 180�) of the circumference of electrode 12. Electrode 12 is masked to limit the portions of insulating layer 15 that are covered by the titanium. This process is discussed in more detail below with respect to the formation of electrode 14. Titanium adheres well to the insulating material of layer 15, and thus serves as a primer to improve the adherence of electrode 14. Layer 50 need not be very thick (e.g., less than 1 micron, or 0.00004 inches) to serve this purpose.
Referring also to FIG. 7, electrode 14 is then formed over titanium layer 50 by ion vapor deposition in a high vacuum. Silver has been found to be a suitable material for electrode 14 for several reasons. Silver is a good conductor of electricity, and it is also more compatible with the sensitive tissue of the eye than other metals (such as copper). In addition, silver is relatively soft and does not impose large stresses on underlying titanium layer 50 during deposition. A mask 52 shields portions of electrode 12 that are not to be covered by electrode 14 from the silver ions 54 emitted by a vapor deposition source 56. Mask 52 also covers the portions of electrode 12 disposed below electrode edges 28 (with respect to horizontal axis 30).
As will be appreciated from FIG. 7, silver ions 54 are deposited symmetrically with respect to vertical axis 26 so that the thickness of electrode 14 is greatest near axis 26 and tapers smoothly toward edges 28. Electrode 14 can be laid down to any suitable thickness such as between three microns and five microns, but electrode 14 should be sufficiently thick to conduct the level of current used during the operation of the instrument (which is typically 30 milliamperes). A thickness of 5 microns (i.e., 0.0002 inches) at vertical axis 26 has been found to work well under these conditions. The thickness decreases somewhat linearly as electrode 14 extends circumferentially toward edges 28. Silver ions 54 may also be deposited on beveled surfaces 25, 27. Because some insulation 15 is formed on the inner surfaces of electrode 12, no cauterization occurs at edges 27c (FIG. 2) of beveled surfaces 27.
Next, a clear plastic layer 58 (FIG. 1) is optionally formed over electrodes 12, 14. (Layer 58 is omitted from FIG. 3 for clarity.) Layer 58 helps protect electrodes 12, 14 from damage during handling and also serves as an insulating sheath for electrode 14 (and thus may be necessary in some surgical applications). Layer 58 is relatively thin (e.g., 0.0005 inches) and is made from Teflon�, although layer 58 need not be as rugged as the material used for insulating layer 15. Layer 58 ends slightly distally of the proximal end of electrode 14 so that electrical contact can be made to electrode 14 at the proximal end.
Referring again to FIGS. 2 and 5, after electrodes 12, 14 have been formed, the sharp point at tip 21 is honed perpendicularly to tube axis 18 using a hard Arkansas stone to form flat, relatively wide face 23. Honing continues until the desired width (W) of 0.01 inches (25 mm) of face 23 is obtained. In addition to flattening tip 21, the honing process also exposes tip 22 of electrode 12 and tip 24 of electrode 14. As a result, the width of coagulation of the instrument is determined by width W of face 23. Electrode assembly 10 is now ready to be mounted within the electrosurgical instrument.
Referring to FIG. 8, electrosurgical instrument 60 provides a plastic housing 62 for electrode assembly 10, as well as wiring for applying the bipolar energizing potential to electrodes 12, 14. Electrode assembly 10 rests in a cavity at the distal end 64 of housing 62. Distal end 64 is tapered for ease of use. A pair of wires 66, 68 are soldered to the proximal ends of electrodes 12, 14. Wires 66, 68 extend through a channel 72 in housing 62 and are soldered to a pair of pins 76, 78 at the proximal end 74 of housing 66. Pins 76, 78 serve as a plug to receive the bipolar energizing potential.
A silicone plastic aspiration tube 80 (i.e., one of the devices 40 discussed above in connection with FIG. 1) is selectively advanced and retracted within electrode assembly 10 through passage 36 by an actuator 82 that is mounted to slide with respect to housing 62. Specifically, a forward tongue 84 of actuator 82 slides within an elongated slot 86 in housing 62. A section 83 of TFE shrink tubing is disposed around the proximal end of electrode 12 and extends slightly proximally thereof. Tubing section 83 fits snugly around aspiration tube 80 and thus serves as a seal to help prevent fluid captured between electrode 12 and tube 80 from leaking into housing 62.
A hollow metal pipe 88 is rigidly mounted to actuator 82 and is snugly received within the interior bore of aspiration tube 80 (which is 0.012 inches in diameter). Pipe 88 extends almost completely through aspiration tube 80 and provides added rigidity to help tube 80 slide smoothly within passage 36. Pipe 88 is sufficiently long so that it remains within the proximal end of passage 36 even when actuator 82 is in the fully retracted position shown in FIG. 8. This helps avoid binding of aspiration tube 80 when actuator 82 is advanced. Pipe 88 terminates slightly proximally of the distal end of aspiration tube 80 (FIG. 9) to ensure that aspiration tube 80 does not become accidentally dislodged from electrode 12 and cast loose within the eye.
Pipe 88 extends upwardly through actuator 82 to a post 90, where pipe 88 is joined to an external tube 92 that passes rearwardly through a tunnel 93 on housing 62 to drain the aspirated fluid into a reservoir 94 (FIG. 10). A hood 96 secured to tube 92 fits snugly over post 90 and includes an aperture 98 that serves as a valve to allow the surgeon to regulate aspiration by selectively covering and uncovering aperture 98 with the finger. An enlarged bump 100 that can be felt through a surgical glove is positioned slightly behind aperture 98 to assist the surgeon in locating aperture 98 by feel. The surgeon can shut off aspiration by depressing bump 100 slightly; depressing bump 100 still further causes reflux to be applied through pipe 88 from a fluid reservoir (not shown) in housing 62. (Alternatively, a plug, not shown, may be inserted in aperture 98 if the surgeon prefers not to use his or her finger.)
Referring also to FIG. 9, the surgeon advances aspiration tube 80 through passage 36 simply by sliding actuator 82 (e.g., using the index finger of the hand) toward distal end 64 of housing 62 in slot 86. A shoulder 102 on housing 62 limits the forward travel of actuator 82. With actuator 82 positioned as shown in FIG. 9, the distal end of aspiration tube 80 extends beyond tip 21 of electrode assembly 10. This allows the surgeon to maintain electrode assembly 10 spaced away from the area of the eye being aspirated by tube 80, if desired. The surgeon retracts tube 80 from the surgical site into passage 36 by sliding actuator 82 rearwardly. A shoulder 104 on housing 62 (FIG. 8) limits the travel of actuator 82 to avoid withdrawing tube 80 from the proximal end of electrode 12.
Referring to FIG. 10, in operation during ophthalmic surgery, electrode assembly 10 is inserted into the eye 110 through a small incision 112 in the sclera. Light is applied through a trocar 114 inserted through a second incision, and irrigating fluid is introduced through tube 116 inserted through a third incision.
Because electrode 14 is formed as a layer adhered on electrode 12--rather than as a separate metal tube coaxially disposed around electrode 12--the outer diameter of electrode assembly 10 is substantially the same as that of electrode 12. For example, with a 20 gauge needle (which has an outer diameter of 0.0355 inches) used for electrode 12, the outer diameter of electrode assembly 10 (with layers 14, 15, and 50 having the thicknesses discussed above) is only 0.0024 inches. As a result, incision 112 need be only slightly larger than that needed for a 20 gauge needle, thereby minimizing eye trauma.
Moreover, disposing electrode 14 over exterior surface 16 of electrode 12 leaves the entire interior diameter of passage 36 open to receive aspiration tube 80. This is a distinct improvement over previous bipolar instruments that used a 20 gauge needle as the outer electrode and a smaller size needle (e.g., 25 gauge) within the outer needle as the second electrode, thereby sacrificing a portion of the diameter of the passage through the 20 gauge needle.
Instrument 60 is connected to a low voltage RF power source 120 via a power cord 122 and a socket 124 that mates with pins 76, 78 (FIG. 8) on housing 62. Low voltage RF source 120 is a Wet-Field� II Coagulator commercially available from Mentor O & O Inc., of Norwell, Mass. RF source 120 produces a relatively low bipolar output voltage (e.g., approximately 90 volts RMS under no-load conditions). A low voltage source 120 is preferred to avoid arcing between electrode tips 22, 24 which could damage the eye tissue.
Instrument 60 is advantageously used to cauterize bleeding blood vessels during ophthalmic surgery in the posterior chamber of the eye. The surgeon manipulates instrument 60 to place tip 21 against the bleeding vessel, and then performs cauterization by activating power source 120 with footswitch 126. The RF power level applied to electrodes 12, 14 is adjusted using, for example, controls (not shown) on the front panel of source 120. Current flow is induced through the area of the eye adjacent to the vessel between closely spaced electrode tips 22, 24, thereby cauterizing the vessel and stopping the hemorrhaging.
The beveled configuration of distal region 20 and the alignment of electrode 14 with tip 21 provides several advantages. For one, this configuration ensures that electrodes 12, 14 have closely spaced, exposed surfaces only at tips 22, 24--that is, at distal tip 21 of the instrument. As a result, cauterizing current is highly focused within an area defined by width W of tip 21. Moreover, the thickness of the silver is greatest at tip 21, thereby helping to ensure that electrode 14 will support the current levels needed during surgery. Put another way, current flow is highly localized with respect to the circumference of electrode 12. This allows the surgeon to precisely control the area in the eye to which the cauterizing current is applied by controlling the position of tip 21 (which, because it protrudes beyond the remainder of distal region 20, is easy to observe). Moreover, because beveled tip 21 is positioned on the underside of assembly 10 (as shown in, for example, FIG. 8) so that beveled edges 25, 27 face the surgeon through eye 110, tip 21 is left unobscured. This enables the surgeon to clearly visualize progress of the cauterization.
Other embodiments are within the scope of the following claims.
For example, electrodes 12, 14 can have many other configurations. One alternative is to expose electrodes 12, 14 to each other in regions other than tip 21. For example, one or more regions of layer 14 and underlying areas of insulator 15 may be removed (e.g., by filing) at any suitable location along axis 18 to expose electrodes 12, 14 to one another. Cauterization would occur in these regions.
The circumferential extent of electrode 14 can be further limited (e.g., to one-sixth of the circumference of electrode 12 or less), depending upon the degree of control desired over the size of the area to which current is applied. Alternatively, electrode 14 can extend around a greater portion of the circumference of electrode 12 in distal region 20 (or along other portions of the length of electrode 12). If electrode 14 is disposed completely around electrode 12 in distal region 20, the cauterization pattern will be annular.
Still other configurations of electrode 14 are possible. For example, multiple, circumferentially spaced strips may be provided in place of the single strip shown in FIG. 1. This would allow cauterization to occur at discrete locations around the periphery of electrode 12.
Face 23 need not be perpendicular to the sides of electrode 12. Instead, a portion (or all) of face 23 may be beveled, either in the same direction as bevels 25, 27, or in a retrograde manner. Beveling face 23 will, of course, affect the location of cauterization at tip 21.
Electrode 12 need not have both bevels 25, 27. Either may be used alone, or no beveling may be provided. If electrode 12 is not beveled and electrode 14 is formed completely around the circumference of electrode 12 at tips 22, 24, current flow would be present around the entire perimeter of electrode 12. This may be desirable in some applications and is certainly contemplated by the invention.
Electrode assembly 10 may have still other configurations. For example, electrode 12 need not be a 20 gauge needle, or a needle of any kind. Electrode 12 may be solid rather than hollow.
For example, referring to FIGS. 11 and 12, electrode assembly 170 is a cauterizing knife in which the inner electrode is a solid, stainless steel blade 172 that is coated over most of its length with metal layer 174 (which serves as the second electrode). Metal layer 174 terminates proximally of the sharp tip 176 of blade 172. More specifically, the distal end of metal layer 174 is coextensive with a diamond-shaped region 178 at which blade 172 begins to narrow from a relatively large diameter to tip 176 in four beveled surfaces 180.
During operation, tip 176 is used to cut an incision, for example, through the sclera of eye 110 (FIG. 10). As blade 172 is advanced slightly further into the eye, power source 120 (FIG. 10) is activated, and the incision is completely cauterized by current flow between layers 172, 174 in wide region 178. Thus, a relatively large, cauterized incision is quickly made.
In all of the embodiments discussed above, the insulator that separates the electrodes (e.g., layer 15, FIG. 3) need only be disposed over the portions of the inner electrode (e.g., electrode 12) that are covered by the outer electrode (e.g., electrode 14). Likewise, if outer insulating layer (e.g., layer 58, FIG. 1) is used, it can be disposed only over the outer electrode, if desired. The titanium primer (e.g., layer 50, FIG. 3) can alternatively extend around the entire circumference of the inner electrode, even if the outer electrode has a limited circumferential extent.
Mask 52 need not be used during the deposition of electrode 14. Instead, electrode 12 may simply be laid on a flat surface during deposition of electrically conductive layer 14.
Alternative materials may be used for electrodes 12, 14. For example, electrode 14 may be made from nickel, gold, palladium, platinum, tin, etc. Copper may also be used, particularly if outer insulating layer 58 is employed. Even if layer 58 is not provided, the use of copper may not be detrimental, given the short periods of time that electrode assembly 10 is typically in place in the eye. If silver is used for electrode 14, an additional metal layer (such as gold) may be deposited thereon to avoid tarnishing.
Other suitable insulators may be used. One possible substitute is teflon. Insulating layer 58 may be even more desirable if a relatively hard metal (such as nickel) is used for electrode 14 and teflon is used for insulating layer 15.
The bipolar electrosurgical instrument of the invention can be reusable or disposable.
Still other embodiments are within the scope of the claims.
|Cited Patent
|Filing date
|Publication date
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|14 Jul 1931
|Ende Frank M
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|4 Jul 1933
|Ende Frank M
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|Bernardo Goldenstein
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|Method of producing a composite electrode
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|International Classification
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|European Classification
|6 Mar 1996
Owner name: MENTOR OPHTHALMICS, INC., MASSACHUSETTS
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text:
STARRING: Philip Sayer Bernice Stegers,
Danny Brainin, Maryam d'Abo, Simon Nash, Peter Mandell, Anna Wing
1980, 82 Minutes, Directed by: Harry Bromley Davenport
Horror cheapie involving alien monsters that immediately made its way to the
video shelves.
Gory and unbelievable make-up
effects and some terrible soundtrack music makes for several bucks flushed
straight down the toilet.
Rather watch the tumble dryer
in action - it's more fun . . .

subset: commoncrawl


text:
The latest version of Adobe Flash Player is required to watch this video.
Please click on the link below to download the latest version. Thanks!
Three prominent newspapers will not be allowed on Sen. Barack Obama's plane during the final days before the election.
The New York Post, Dallas Morning News and Washington Times --all of which endorsed Sen. John McCain-- have until Sunday to move out so that Obama's campaign can make room for networks and other reporters.
"This feels like the journalistic equivalent of redistributing the wealth," Washington Times Executive Editor John Solomon said. "We spent hundreds of thousands of dollars covering Senator Obama's campaign, traveling on his plane, and taking our turn in the reporter's pool, only to have our seat given away to someone else in the last days of the campaign."
It is believed that some of the seats will go to Jet and Essence, two well-known African American magazines.
Obama's campaign said the decision on who to replace was "very hard" and that it had "absolutely nothing" to do with the papers' coverage.
The ousted reporters plan to fly commercial in order to continue campaign coverage.
Sources: Washington Times, Drudge Report
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text:
what kind of PP do you guys use ??
what kind of PP do you guys use ??
Check out my new blog at http://primalmom.blogspot.com
have to check mine when I get home now...
Know what contains fructose in my kitchen?
Muther effer.
great...not surprised though on the Shakeology!
The basic vanilla whey stuff from Whole Foods is good -- all whey, no sweeteners, but you really need to check those labels carefully.
Would love to do egg white protein, but it's quite expensive, as is this stuff: http://astronutrition.com/harmonized...a-flavour.html (stevia-sweetened plus kelp, dulse, flax & some other goodies.)
someone will probably say the fiber in it will help neutralize the effects...not sure though
so PO'd !!!
Check out my new blog at http://primalmom.blogspot.com


text:
TECH 3142 Statistical Quality Control -- 3 unit(s)
Application of quality concepts to manufacturing environment using statistics, sampling techniques, probability, and control charts. Calculation and interpretation of process capability, design of experiments, and continuous improvement.
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Zhe (Julie) Zhang, Associate Professor
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If two numbers are listed, undergraduate level class number is listed first, graduate level class number is listed second.
To enroll:
Click here to enroll through Continuing and Distance Education.
For more information:
Jacie Dahlstrom, Continuing and Distance Education
Phone: 800-648-3864 or 319-273-5970
Email: firstname.lastname@example.com


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A comprehensive, curated, printed guide to Detroit featuring 750 sites, attractions, and curiosities from the essential to the obscure.
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text:
Before he started dating girlfriend Selena Gomez, a 20-year-old female fan says Justin Bieber lost his virginity to her backstage and is the father of her 3-month-old child, according to new reports.
But the "Baby" singer, 17, dismissed the paternity allegations as "rumors" and "gossip."
"I'm gonna focus on the positives ... the music," he Tweeted Wednesday in reference to his Christmas album, Under the Mistletoe, released Tuesday.
The allegations are further complicated by the age gap between Bieber and Mariah Yeater, the fan making the claims. In California, the age of consent is 18, and the teen idol would have been 16 when the alleged sexual encounter occurred.
According to reports, Yeater says she was whisked away by a security guard to meet Bieber following an L.A. tour stop. "Immediately, it was obvious that we were mutually attracted to one another, and we began to kiss," the paternity suit alleges, according to papers obtained by a tabloid. "Shortly thereafter, Justin Bieber suggested that I go with him to a private place where we could be alone."
Yeater alleges Bieber told her he didn't want to use protection because it was his first time having sex.
She is seeking financial support from Bieber.
A rep for the pop star tells PEOPLE that his camp hasn't reviewed the lawsuit yet. "It's sad that someone would fabricate malicious, defamatory and demonstrably false claims," the rep says in a statement. "We will vigorously pursue all available legal remedies to defend and protect Justin against these allegations."
Meanwhile, a Bieber source says the woman's story just doesn't add up. "The kid is never alone. There's always someone with him," the source says. "He's never met this woman."
Justin Bieber Dismisses 'Rumors' He Fathered a Baby with a Fan
Kevin Winter/NBCUniversal/Getty
The Latest
Only on People.com


text:
NEW YORK — BrightFarms Inc. here has raised $4.3 million in financing that will go toward building hydroponic greenhouses at supermarkets. The company said the equity financing included investments from Emil Capital Partners, an investment fund operated by Christian Haub, the former chief executive officer of A&P, along with NGEN Partners and Ted Caplow, BrightFarms' founder. The company said its program would allow supermarkets to grow and buy locally sourced produce ...
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Gibraltar Ratchet Drum Key wrench
Sku #490774000000000
Drum Keys & Tuning Tools
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FREE SHIPPING on Almost Everything
The smart, fast way to tune or change heads.
This is a medium-weight ratchet-style drum key wrench with tighten and loosen tension-adjustment positions.
Essential gear for drummers. Order today.
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Reviewed by 1 customer
Comments about Gibraltar Ratchet Drum Key wrench:
not much I can say about this key other than its great!! I like it for reference if you want to tension all the rods the same, you can sight in quarter and half turns really easily no matter what position the rod is in.
the only thing I would improve would be the ratchet action itself...it needs more teeth inside the unit to make the action tighter and smoother, but thats just a little thing


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Selections from 30 Years of Illustration by I.B. Nelson — 7 a.m., BriarPatch Co-op, 290 Sierra College Dr, Grass Valley. I.B. Nelson has provided illustrative work for Sega of America (Pocket Arcade Games, 1994), King Features Syndicate (The New Breed single panel, 1989 to 2003), The University of California Cooperative Extension Master Gardeners (1982 on), San Jose Mercury, The Alta Sierran (2010-2013), and many more. He was an artist-in-residence in elementary and middle schools, participated in school career days, presented at children's art festivals, provided art work for library events including the Nevada County Library Walk for Literacy and Readdup Program. The BriarPatch show includes selected works from 30 years of published graphic work.
LeeAnn Brook: 'Light of Day' — noon, New Moon Cafe, 203 York St, Nevada City. New large format contemporary landscape paintings by Nevada City fine artist LeeAnn Brook. Her current body of paintings has been developed in her open studio over the past 12 years. Concentrating on large format contemporary paintings, her unique style of landscapes and abstracts resonate with her love of the natural environment. Showing in numerous one-woman shows and several group shows, her work has also included many commissioned pieces for residential and commercial venues. 530-265-6399
'Diversity' Paintings by Clay Platner — noon, Smith Vineyard Tasting Room, 142 Mill Street, Grass Valley. Smith Vineyard Tasting Room is showing a collection of original oil paintings by Clay Platner. The collection is diverse featuring cowboys, landscapes, portraits and a koi pond. The paintings are displayed during regular business hours of Smith Vineyard Tasting Room. Noon - 6 p.m. Monday, Wednesday, Thursday. Noon - 7 p.m. Friday and Saturday; and 2 p.m. - 5 p.m. on Sundays. (Closed Tuesday) 530-273-7032.
Nevada County Plein Air Painters Art For The Holidays Show — All Day, Foothill Flowers Art For The Holidays Sale, 102 W Main St, Grass Valley. Nevada County Plein Air Painters present: Art for the Holidays sale. Originals in Oils Pastes and Watercolors, prints and cards. Monday-Friday 8:30 a.m. - 5 p.m. Sat 8:30 a.m.-noon.
Artisans Festival — 10 a.m., Miners Foundry, 325 Spring St, Nevada City. For over 35 years, Thanksgiving Weekend in Nevada City has featured the Artisans Festival at Miners Foundry, hosting a small but select group of artists and craftspeople whose quality artwork has attracted a loyal and growing audience of admirers and patrons. The Artisans Festival will be Friday, through Sunday, from 10 a.m. 5 p.m. each day. Admission is $3 for each day or $5 for a weekend pass. 530-265-5040
Live Music — 10 a.m., Summer Thyme's Bakery & Deli, 421 Colfax Avenue, Grass Valley. There is live music every Saturday & Sunday morning from 10 a.m. to 1 p.m. 530-273-2904
Wine Tasting, Bistro & Live Music — noon, Naggiar Vineyards, 18125 Rosemary Lane, Grass Valley. See Friday's listing.
Original Oils by Clay Platner — noon, Smith Vineyard Tasting Room, 142 Mill Street, Grass Valley. See Friday's listing.
Flamenco del Oro — 6 p.m., The Old 5Mile House, 18851 State Highway 20, Nevada City. Flamenco del Oro music and dance of the heart of Andaluz, Spain featuring guitarist Gopal Slavonic, vocalist Leta Gibney, percussionist Roger Aiton, and dancer Kelly Rivera.
Live Music — 6:30 p.m., California Organics Market and Cafe, 135 Argall Way, Nevada City. Every Friday and Saturday, enjoy live music at the California Organics Cafe. www.californiaorganics.com/content/events.
Dream and the Dreamer — 6:30 p.m., Lefty's, 101 Broad St., Nevada City. Dream and the Dreamer plays hits from the '60s to today. Great food, drinks and fun music.
Frankie Tonini's Holiday Variety Show — 8:15 p.m., Off Broadstreet Cabaret Dessert Theatre, 305 Commercial Street, Nevada. In this musical comedy, Tony Lauria (Legends To Go) returns to OBS as 'Frankie Tonini,' a starry-eyed optimistic singing magician trying to promote laughter with his variety show in spite of the negativity and ineptitude of his two hired assistants (Kris Stepanian and Lyra Dominguez). When two dingy guardian angels (Jan Kopp and Nancy Keith) try to help, the situations becomes all the crazier. Friday and Saturday, $25, Sun $23. Call 530-265-8686.
Achilles Wheel — 9 p.m., Crazy Horse Saloon and Grill, 230 Commercial St, Nevada City. Nevada City's beloved psychedelic jam dynamos add to their legend tonight!. 530-265-4000
Kaminanda — 10 p.m., Haven Underground, 226 Broad St., Nevada City. Kaminanda's ever evolving sound is a playground of original deep Midtempo grooves, tribal rhythms, creative trip hop,complex Dub and lush downtempo textures. Playing live sets with guitar, keyboards, flutes, melodica, and vocals, Kaminanda's music is designed to take the listener/dancer on a journey traversing diverse landscapes reflecting the evolution of our collective consciousness. Having shared his creations at electronic music festivals such as Entheos, Shambhala, Symbiosis, Beloved, Rootwire, LIB,Burning Man and Earth Dance, as well as international festivals Envision, Boom and Eclipse Australia.
Nevada County Plein Air Painters Art For The Holidays Show — All Day, Foothill Flowers Art For The Holidays Sale, 102 W Main St, Grass Valley. See Friday's listing.
Convergence: New Collage Paintings by LeeAnn Brook — All Day, Szabo Tasting Room, 316 Broad St., Nevada City. See Friday's listing.
Craft Faire and Sandwiche Shoppe — 10 a.m., Nevada City United Methodist Church, 433 Broad St., Nevada City. See Friday's listing.
Wine Tasting — 11 a.m., Double Oak Vineyards and Winery, 14510 Blind Shady Rd, Nevada City. Wine tasting, tours and picnicking. Open Saturdays. (Open other days by appointment) Enjoy wine tasting featuring mountain grown fine wine, all estate grown and produced. Award winning wines include gold medal & best of class. Visit with the winemaker, tour the winery & learn about wine. Bring a picnic to enjoy in a charming area with a view of quarter-century old vineyards surrounded by oaks & pines. Groups are easily accommodated.
Wine Tasting — noon, Coufos Cellars, 10065 Rough and Ready Rd, Rough and Ready. Come to Coufos Cellars to enjoy tasting our award winning wines. Specializing in Rhone style wines (i.e. Syrah, Petite Sirah, Viognier as well as Rhone blends.) Five miles from Grass Valley in the historic town of Rough and Ready. Open Saturdays and Sundays and by appointment. For information call 530-274-2923.


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Getting firsthand information from an actual car owner is one sure way to get an idea of car performance once it leaves the lot. Autobytel features real consumer reviews that give the unbiased experience of a car.
This is an incredible truck. I have put over 105,000 miles on it and she still runs great as she did off the lot. Talk about tough - I ran it off the freeway and she came out with little damage.
Pros: Lots of power
Cons: crew cab not a 6 foot bedWhat a assume truck. It performs as good as it looks, which is excellent. 45K miles so far and not a one problem. I drive it 5 hours a day for work and every morning i look forward to driving it another 5 hours. need i say more?
mega cab 1500
Pros: Leg Room
Cons: Back LightsI bought it because of the leg room. I get 19-20 mpg for a 100 mile drive each day. San Diego to Orange County 4 days a week.
RAM 1500 Quad cab
Pros: Hemi
Cons: lifted a little high for my liking..Compared to Ford F150 it was really close it came down to best deal..Also love the sport version with the dual exhaust tucked into the bumper..Also the perfomrance of the Hemi is exceptional..Pulling my 21' boat is a breeze..The gas milage in ECO mode on the highway is hitting 22 to 23 miles per gallon..Not bad..The ride is impressive..
Pros: Spacious interior
Cons: N/AThis is my first pickup truck and I'll always have one. Should have got the HEMI.
Pros: the 4 doors and the rear seat has plenty of roomI like this truck very much it performes very well
Ram 1500 Quad Cab Hemi
Pros: Interior Room and Design
Cons: Gas MileageI bought this trick with the SLT and tow package. Simply put this truck has been fantastic. Of course you have to be willing to stomach the gas mileage, but other than that the Ram 1500 is a great choice. After 7 years of on the road driving and light towing, there have been no major mechanical problems. A few items have needed attention here and there like a door lock and automatic window switch, but other than that the RAM 1500 has been great. Oh and it is a mean looking truck!


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Tom Nozkowski and Joyce Robins are married, and I have admired the work of both for years. When I asked them to be the first "Beer with a Painter" subjects interviewed jointly as a couple, they were completely game.Continue Reading →
Thomas Nozkowski
HUDSON, NY — River Crossings, the recently opened show up at the historic Thomas Cole House and Olana, Frederic Edwin Church's architectural ode to Orientalism, over-promises and under-delivers.Continue Reading →
Simply titled Thomas Nozkowski, this is the artist's fourth solo exhibition at Pace Gallery since 2008, when he first joined the gallery, and this time he has pulled out all the stops.Continue Reading →
Thomas Nozkowski wasn't thinking about Philip Guston's "Untitled" (1980) while he was working on "Untitled (9-21)" (2012), but the number of formal attributes they share — from size to composition and imagery — has proven hard for me to ignore. It was while I was looking at Nozkowski's "Untitled (9-21)" at his exhibition at Russell Bowman Art Advisory (April 12 – June 15, 2013) in Chicago that a specific Guston work came to mind. Shortly after I got back to New York, I checked to see whether or not my memory had been playing tricks on me. It hadn't.Continue Reading →
The new paintings of Andrew Masullo, now at Mary Boone Gallery in conjunction with Feature Inc., outwit, defy, and make gallery-going fun again.Continue Reading →
Breaking the Postmodern Creed: Thomas Nozkowski's Unimaginable Paintings and Drawings
By 1974, Thomas Nozkowski had made two decisions – he would paint on widely available, 16 x 20-inch, prepared canvas boards, and everything he painted would come from personal experience.Continue Reading →
A Truly Subversive Artist Is Not Necessarily Someone Who Is Theatrical or Gimmicky
If there is one constant about Thomas Nozkowski that I would single out, it is his lifelong insistence on subverting conventions. In 1974 he began painting on canvas board measuring 16 by 20 inches. (Let's be clear here — Bill Jensen never painted on this small a surface because it had no historical precedence). He used an inexpensive, mass-produced product, the same kind that comes in "paint by number" kits and carries associations with "Sunday painters." No wonder his defiance went largely unnoticed, particularly when the '80s rolled around.Continue Reading →
I set out with the intention of seeing these shows, so I wouldn't call it synchronicity, but the simultaneous exhibitions of David Goerk and Martha Clippinger in the same building, just one floor apart, did get me thinking about art making that is concerned with the realm between painting and sculpture — from della Robbia's bas reliefs to early modernism (Hans Arp) to contemporary art (Stuart Arends, Ellsworth Kelly, Jim Lee, and Richard Tuttle).Continue Reading →
The owners of BravinLee aren't satisfied with simply selling art to hang on the walls. In a new initiative, they're expanding their inventory to include art to put underneath the coffee table.Continue Reading →
This month's Brooklyn Rail didn't just update me on the critical reception of the past months' art exhibitions, it also kept me well-informed about the state of vegetarian burritos, Indian call centers and the misunderstood G train! The November issue (my copy is elegantly covered in a Jonas Mekas lithograph of a hand cradling a flower bud) is a primer for anyone who hasn't necessarily seen all of the right shows and read all of the right books for the recent spat of cultural production. Taken as a whole, though, the weighty newsprint publication's most interesting articles lay in unexpected places and concern unexpected topics.Continue Reading →


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GENESEE COUNTY, MI – With the Aug. 5 state primary election quickly approaching and the Nov. 4 general election to follow, there are important dates and deadlines to note.
The Aug. 5 primary ballot will include state representative and state senator positions, county commissioner, and Genesee County judge positions.
There are also a few townships – Mundy Township, Mt. Morris Township, Richfield Township and Vienna Township – with partial board terms on the August ballot.
The November ballot will include the Democratic and Republican winners of each position, as well Genesee County school board candidates and any new ballot language for proposals that comes in.
Here are important dates to remember:
- July 17 by 4 p.m.: Deadline for candidates filing without party affiliation for the November election.
- July 22 by 4 p.m.: Deadline for school board and community college trustee candidates filing for the November election.
- July 25 by 4 p.m.: Deadline for write-in candidates for the August primary election.
- Aug. 5: After this date the minor party candidates for the November election will be announced.
- Oct. 6: Last day to register to vote in the November election.
- Oct. 24 by 4 p.m.: Deadline for write-in candidates for the November election.
To run for an open seat, each candidate must complete an affidavit of identity and either a nominating petition or pay a $100 fee. The affidavits of identity are available online at Michigan.gov/sos or at the elections division in the Genesee County clerk's office.
Every Genesee County school board has at least one position up for grabs. All school board candidates, except for those running for Flint, Atherton, Bendle or Bentley school boards, should file to run with the Genesee County Election Division.
Flint School Board candidates should file with the city of Flint and Atherton, Bendle and Bentley school board candidates should file with the city of Burton.
For a list of the candidates that will appear on Genesee County August ballots, click here.
For a list of proposals that will appear on Genesee County August ballots, click here.


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Top Definition
A blogivist is an online advocate of liberty and the principles of limited government—someone who isn't content with simply saying something about the need for greater liberty, but someone who does something about it.
Chicago blogivists contributed to the defeat of a $50 million tax increase, after they informed citizens about the issue.
po Sam Adams Alliance Фабруар 25, 2008
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Can you define these popular missing words?


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"It's a 2005 Chevy S-10 extended cab, 10 1/2 feet tall, 13 1/2 feet wide. 9,600 pounds, 1,500 horsepower. The paint job is red with flames. The tires are 66 inches tall."
Related quotes
"The GMT-900 version of the Chevy Tahoe is officially for sale now, but it is difficult to gauge how strong a start the vehicle is having. Nonetheless, early results will be highly scrutinized."
"I knew this AC Delco Chevy was really good in race runs. The guys had a good stop there on that last stop and got us a chance. What a good effort."
"The team did a great job putting the car together to the new Chevy Gen IV engine and we were very fast. That's the way it goes sometimes. I was really trying hard mostly because the team and engine company deserves it. That's the way it goes I crashed. I got loose. We were trying to free up the car and that was my first qualifying simulation. Maybe the tires weren't ready and maybe I pushed too hard. The fact is I got loose and crashed."


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Banquet 2013
On Saturday December 14th, 2013, Delta Chi Psi held its 9th annual banquet. Banquet is a time to reflect and celebrate all the accomplishments of the fraternity and its brothers over the past year. Thank you Dat "Kratos" Nguyen, Timmy "Onslaught" Tran, Lucky "Atlas" Lebrooy, Stephen "Riddler" Nguyen, and Thang "Prime" Van for coordinating a successful banquet and congratulations to all of the brothers who received awards for their dedication and hard work.
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A woman attending the Randolph County Schools bond call meeting in Harman Wednesday accused the superintendent of schools of promising to pay county school employees if they voted for the levy in November 2010.
Speaking to Dr. James Phares during his presentation, the woman said she was told he offered $500 to each employee if they voted to pass the $14 million excess levy. The woman, who refused to provide her name to The Inter-Mountain, was later identified by school personnel as Janie Ours.
"I was told you promised employees $500 each if they voted for the levy," Ours said. "After taxes, the employees got nothing (of the $500)."
Article Photos
The Inter-Mountain photo by Beth Christian Broschart
Randolph County Superintendent of Schools Dr. James Phares discusses the proposed Harman School additions and improvements Wednesday during a Randolph County Schools bond call meeting.
"That is not true," Phares said emphatically, then began to point to each school employee, one by one, gathered in the audience.
"Did I offer you $500 if you voted for the levy?" Phares asked each employee.
Each person Phares asked answered "no" and shook their heads.
Phares, who seemed visibly upset by the accusation, told those gathered that he would never offer people money for their votes.
"The accusation is a lie," Phares said.
The superintendent then told Ours to speak with The Inter-Mountain representative present and give her name and her comments.
"I want this in the paper," Phares said.
Earlier in the meeting, Ours said that people from Pocahontas and Marion counties, where Phares had previously been superintendent of schools, were complaining about him and accusing him of spending all of their tax money. Ours said the counties were glad to be rid of him.
Phares responded that people in the counties may hold differing opinions about his work there.
Also during the meeting, Alpena resident Terry Ogden asked about a list of board payments that appeared in the Sept. 28, 2011, issue of The Inter-Mountain.
"You paid the Greenbrier Hotel $870, Old Brick Playhouse $3,150, United Way $660 and Beverly Historic Commission $425," Ogden said. "I think our money should be spent on education, not wasted."
Phares told Ogden the board receives funds from Title 6 that are designated specifically for professional development and explained there are federal mandates on how the schools use those funds.
He also said the Old Brick Playhouse provides educational services for county schools.
Phares said he was not exactly sure what the specific funds were paid to the Greenbrier Hotel for, but he said no school employees stayed at the Greenbrier Hotel.
Ogden later told The Inter-Mountain that he was satisfied with Phares's answers, but he still wondered about tthe Greenbrier Hotel bill.
The total amount of proposed funds for Harman School additions and upgrades is $4,512,877. Improvements would include wall and ceiling finishes, HVAC, lighting, wiring, fire alarm, communication system, new restrooms, kitchen and cafeteria, sprinkler system, asbestos abatement, sitework grading and a new music room.
The total community schools projects cost, including the cost of bond issuance is $22,722,838. The bond call is for $13,500,000 with a state School Building Authority request for $9, 222,838. The SBA grant and the bond call will be contingent upon one another.
Combining the cost of the bond call and the existing levy, the average cost to the taxpayer for a $100,000 home and $50,000 worth of personal property is $367.60 per year, which is about $1.10 per day.
Information on the costs of all improvements and a tax calculator are available at www.informationonthebondcall.com.
Contact Beth Christian Broschart by email at firstname.lastname@example.com.


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Alderman Abshire announces he will not seek re-election
Rayne District 2 Alderman Jude "Butch" Abshire has announced his decision to not seek re-election at the end of his current term of office.
His full announcement follows:
"Today I am officially announcing my retirement from the Rayne City Council on December 31st of this year, which is the end of my current term in office. I am truly blessed to have been entrusted with the opportunity to serve the citizens of District 2 for the past 13 years. I have met many people who have become my friends while serving in this capacity. I would like to thank both the previous and current administration for always striving to do what is best for the people of Rayne. My job in oilfield sales now requires that I travel out of town frequently and I feel it is best to have an alderman that is more readily accessible for the people of Rayne.
"I would like to thank my wife Cyndi, along with my children Justin, Ashley and our late son Andrew for always supporting me throughout my role as your alderman. On behalf of my wife and family we also thank all the citizens of Rayne for their overwhelming heartfelt support as we continue to mourn the recent death of our son Andrew.
"Looking forward, I plan to spend more time with my family as I transition into this new chapter in my life. Although I am officially leaving public service at the end of 2014, I will continue to do all that I can to make Rayne a better city for everyone in the future.
"Several possible candidates have shown interest in running for the office that I am vacating and I am looking forward to assuring that a smooth transition occurs with whoever is elected by the citizens of District 2.
"Again, I want to say thank you to the people of Rayne, especially in District 2, for the opportunity to serve you. God Bless!"


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Best route map between Canton, TX and Galveston, TX. This route take about 275 Miles.
The distance and estimated time is placed on the right depending on the status of the road.
, 14:01
* You can see Canton, TX and Galveston, TX photos above. We provide this photos from Google Panoramio service.
* Canton, TX weather as celsius: °C
* Galveston, TX weather as celsius: °C
* Weather information on route, provide by Open Weather Map.
All Rights Reserved. © 2010 - 2016 About Feedback


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Best route map between Manchester, NH and Foxboro, MA. This route take about 80 Miles.
The distance and estimated time is placed on the right depending on the status of the road.
, 23:17
* You can see Manchester, NH and Foxboro, MA photos above. We provide this photos from Google Panoramio service.
* Manchester, NH weather as celsius: °C
* Foxboro, MA weather as celsius: °C
* Weather information on route, provide by Open Weather Map.
All Rights Reserved. © 2010 - 2016 About Feedback


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February 18, 2014
Sami al-Askari reveals the current move away from Iran and its relations with the Gulf of confidentiality and time-Sadr was hit in San Hakim al-Maliki and his withdrawal is less harmful than it is in the political work
Baghdad - Muqtada al-Sadr, leader of the Sadrist movement yesterday in his first comments since announcing the break with the politics and the withdrawal of his movement, a scathing attack on the Iraqi government, calling the president of the idol, but he called for a big post in the next elections.
For his part, said Sami al-Askari MP for the rule of law and the Adviser to the Prime Minister for the time that it is difficult to predict the positions of the chest This is not the first time that announcing his retirement from political action has already quit his I'tikaaf. But he added the military, but this time it seems more determined to retire from its predecessors.
He explained the military but not ruled out reversing his decision under other circumstances based on strategy and new direction.
He added in his statement for the military, saying the time may be part of the political game and the election.
He said the military's time that the second scenario, which runs on Muqtada al-Sadr and the jurisprudence that he has achieved a good result in the 2010 elections as a result of taking advantage of the Sadrists savvy to get the votes of supporters of Ibrahim al-Jaafari and the Supreme Council, but things are different now because of the repercussions of the situation in Syria and Anbar.
He added that al-Sadr does not want to personally bear the responsibility of the repercussions of these two modes. He added that there is no military again in his remarks against al-Maliki has built after traveling to Erbil withdrawal of confidence about him. He added that al-Sadr had seemed so near the time he was stronger than al-Maliki, but after the events of Anbar, the disintegration of the center rib or growl of his inconsistent.
The military said in a statement that the time line for Muqtada al-Sadr line differed from his father's chest, which recommended the first supporters of religion and doctrine but an alliance with Muqtada opponents yesterday Bcesp before him with al-Maliki and that was the subject of opposition supporters.
Askari said that prompted him to remain silent during the past two months, contrary to his habit. He said he uses a shock to return strongly in waiting demonstrations invites him to abandon retirement.
And about the existence of the fingers of the neighborhood or region in the decision to retire from Moqtada al-Sadr said the military form of a block of its own for the upcoming elections for the time I do not see any regional role or to neighboring countries, adding that his relationship with Iran has deteriorated and he has support unspoken of Qatar, Saudi Arabia and definitely two Sttdharan of his decision to retire.
In response to a question about the impact of the time to retire from the chest incision in the community said the military's time that Astmrah in political work is more dangerous to the community.
He said when he withdraws its impact will be less on the community.
He added that the military's biggest losers of the withdrawal of Muqtada al-Sadr are Ammar al-Hakim, who heads the Supreme Council and the united list, headed by Speaker Osama Najafi.
He added that they were allied with Muqtada al-Sadr, who was tongue and spearhead Ammar al-Hakim and al-Maliki to strike the state law, which is headed. Sadr said in a speech directly from Najaf channels reported Iraqi became policy Papa injustice and recklessness and the grievance and humiliation for sits dictator and tyrant Visult the money Uwenhbha, and on the necks Fikcefha, and the cities Faiharabha, and the communities Vivrgaha, and pronouns Victrea.
He added, in a reference to al-Maliki, the Shiite political force, which has ruled the country since 2006, that Iraq is governed by a group came from the back of the border have long awaited for free from dictatorship to adhere to the other chair on behalf of the Shiites and Shiism.
He said that the Maliki government is backed by Tehran and Washington no longer hear any sound of even one ref and his fatwa, and the voice of the partner and his complaint, supported by the East and the West, including all surprised by his wise and sane.
This is the first of the statements issued since announced in a surprise decision Sunday, and more than two months before the parliamentary elections scheduled for the end of April »April, his withdrawal from political work in the country and shut down offices of political resolve of his movement. Sadr has justified his decision by saying that he then came to preserve the reputation of al-Sadr to end ... Out of all the evils that have occurred or are likely to fall under the title ... and the exit door of AFCAC politicians and politicians. It is noted that Muqtada al-Sadr, who has political offices in most parts of the country and is his movement in parliament with 40 deputies of the 325 in the six government ministers, in mid-2012 was one of the prominent politicians who worked to overthrow Maliki to succeed without it.
He said al-Sadr in his speech yesterday Kotaiath with direct political work, saying that there were between you the voices of dishonest political or other Vltistmr but work independently or otherwise away from me and frameworks in general, adding that what was released from the decisions of my orders or not Tthmloha God forgave you and me, but I'm proud them to the Day of Judgment.
But Muqtada al-Sadr, who enjoys tremendous popularity among poor Shiites, especially in Sadr City, the densely populated in Baghdad, called on Iraqis, however, to participate in the upcoming elections.
He must participate in these elections, and significantly so as not to fall in the hands of the government is honest, and I will vote for me, I voted for each and Sadli Sharif wants to serve the people and I will stand with everyone at the same distance.
He continued, I hope that Iraqis participate in the elections and the only limit is short, this will be a betrayal of Iraq and its people.


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Other projects made by Marie Withrow:
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|Here are some details about my project:
|Yarn Weight
|Worsted (10 ply)
|Mod, Cute, Traditional, Classic
What materials did you use? Caron Simply Soft Yarn - a little more than one skein, 6 oz, 315 yards each skein.Crochet hook size IMop handle
What are you most proud of? The first yarn I tried was too thin and hard to handle. I bought a slightly thicker yarn and this one worked much better.
What advice would you give someone starting this project? Practice this stitch before trying to make something. You need to master the stitch and figure out how it will look so you can determine how many clusters to make across and how long to go. NOTE: Most of the images I found online make this stitch one row after the other - but I added two rows of single crochet as I think it stands out better and does not look quite so busy. You'll have to play with it and see what you like.
Beautiful stitches and color. I bet it looks very pretty on you!
Thank you! While this was a gift, I liked the color so much I do plan to make myself one after the holidays.


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About two months ago, I was opening the mail when I realized I got a check from a client. The client is a trade magazine I've written for about once a month for almost two years. It's not unusual to receive a check from them. What was unusual was that they didn't owe me any money at time. I remember staring at the check like it was a trick before deciding that cashing it would be a mistake.
First thing the next morning, I emailed my editor to report the money. A few hours later, I got an email back that said he was very sure that the payment was rightfully mine. I hung up and cashed the check because if he said he owed it, he owed it.
But the truth was I had no idea if that check was really mine or not.
My Non-Existent Invoicing System
Here is the part where I'd tell you about my invoicing system and how I developed it. Well, I never really developed it. From the very start of my full-time freelance career, I had monthly clients. The bulk of my income has always been from monthly invoices. Then I have between two and five one-offs each month.
Since I know exactly how much money those monthly clients are supposed to pay me, it's easy to say "Ok. Client B sent me a check but Client A didn't." Ditto with those one-offs. My entire process is just making a PDF invoice and emailing it off. It's an ok system…until it isn't.
Flash forward to now and it's just not working. That check wasn't the first time I lost sight of where my money is coming from and when it's supposed to be here. I once forgot to even invoice a client at all because I had so much going on. Fortunately, they were happy to pay for it the next month. But what if they weren't? Here's a joke I like to tell about the stupidity of that situation:
Q: What do you call a freelancer who forgets to invoice for their work?
A: A volunteer.
There Has to Be Something Better
Obviously, there has to be something better out there. There are so many options for freelancers and small businesses to keep up with their finances. Between PayPal and my bank statements, I have ways to keep track of what's coming in. But I'd like to use something that incorporates an invoicing system so I know what I have out at any given time.
So I've decided to try out some new things in the next couple of months and find something that works for my business. I'd love to find something that worked within Gmail and Google Calendar when applicable, but that's not strictly necessary. What is strictly necessary is an easy to use interface with customizable invoices. As long as I have that, I should be able to get the job done.
And if any of you have any suggestions for me to try, I'd love to hear them. Lay 'em on me in the comments section below.
Princess Jones
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