text:
|Publication number
|Publication type
|Application number
|Publication date
|Feb 14, 1989
|Filing date
|Oct 23, 1987
|Priority date
|Oct 23, 1987
|Fee status
|Publication number
|Ronald P. Grunwald, Robert J. Todd
|Original Assignee
|Research Medical, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (13), Referenced by (106), Classifications (15), Legal Events (5)
|External Links: USPTO, USPTO Assignment, Espacenet
The present invention relates generally to cannulation of the superior and inferior vena cavae and more particularly to cannulation of the superior and inferior vena cavae using a single bifurcated cannula.
In prior surgical techniques wherein the patient's blood circulation system is diverted through an extracorporeal heart-lung circuit, it has been common to use a pair of venous return cannulas inserted in the neighborhood of the appendix of the right atrium of the heart. The auricular appendix is convenient for clamping purposes and is also conveniently located for cannulation. However, double cannulation is not easily accomplished through the appendix of the atrium, since there is insufficient space to insert the two cannula tubes.
The double incisions required for the above form of cannulation technique requires placement of two separate snare sutures for the cannulas surrounding the two individual incisions. This takes preparation time and increases the trauma to the area due to the two separate incisions. Furthermore, the two cannulas, once inserted, often obstruct the area and further delay the surgical process.
In the typical two cannula arrangement, a third cannula is used for infusion of blood from the heart-lung machine. This cannula is typically inserted into the aorta. The two drainage tubes and the infusion tube often hinder positioning of the heart to facilitate aortocoronary bypasses, valve implants, etc. In addition, the several tubes hinder direct access by the various surgical instruments used in such operations.
It becomes desirable, since the venous drainage cannulas lead to the same phlebotomy line of the extracorporeal circuit to use a single cannula inserted through a single incision in the atrial appendix.
U.S. Pat. No. 4,309,994 to Grunwald, co-inventor in this application, discloses a bifurcated cannula and internal obturator that are now in common use as a solution to the double cannulation problems indicated above. The cannula includes resilient branches at an inward end, one that is receivable within the superior vena cava and the other for descending the inferior vena cava. Both branches diverge from the central axis of a single tube. An obturator having a cross-sectional configuration matching the cross-sectional shape of the cannula is slidably received within the tube. The obturator includes relatively straight bifurcated legs that are used to hold the cannula branches together along the tube axis during initial insertion. The obturator legs also enable the cannula branch ends to separate within the atrium following initial insertion. the obturator is shaped along its full length to slidably engage the internal configuration of the cannula and branches to hold the cannula straight with the branches together to facilitate insertion of the cannula into the atrium and to prevent reflux of blood through the cannula by close frictional engagement of the obturator along the cannula. While this assembly has operated effectively, some difficulty has been experienced in insertion of the cannula and separation of the branches due to frictional resistance to axial movement of the obturator within the cannula.
U.S. Pat. No. 4,248,224 to Jones discloses a double venous cannula that makes use of a bifurcated cannula tube having an external obturator in the form of a second tubular member. The external obturator is received axially over the length of the primary cannula tube and includes an end that is used to cam the bifurcated cannula branches together and apart to facilitate insertion and removal of the cannula branches into the superior and inferior vena cavae. The cannula branches in this version extend from a crotch of the tube that remains exposed outwardly of the incision site. The incision is closed by purse sutures about the two separate branches of the cannula. The tissues engaged about the two individual branches may not be adequately gathered about the two tubes, especially in areas adjacent to the tangential points of contact of the two tubes. Interstices are therefore formed between the tubes and the adjacent tissues at the incision site. Unless these areas are otherwise plugged, the interstices will permit reflux of blood.
A double cannula arrangement is shown in U.S. Pat. No. 3,903,895 to R. D. Alley, et al. This patent shows a venous return line of an extracorporeal circuit with a double tubular end, one cannula end being inserted through an incision in the atrium and extending upwardly into the superior vena cava, while the remaining cannula is inserted through a second incision to descend into the inferior vena cava. The two branches extend outwardly of the heart to connect with converging lines to the heart-lung circuit.
U.S. Pat. No. 3,835,863 to Goldberg discloses a "T" tube that is used as a drainage catheter for implantation in an internal duct. Transverse arms of the "T" tube are slotted longitudinally to enable folding over one another to the diameter of the main tube branch. The tubes can thus be folded onto one another and inserted through an incision in the associated duct. Upon insertion, the two branches may spring apart, opening into the duct. Withdrawal of the tube is accomplished simply by pulling the tube outwardly. The transverse branches of the tube will fold together at the incision as the tube is pulled outwardly.
The Goldberg "T" tube may have beneficial use in the drainage of internal ducts such as bile ducts in abdominal surgery. However, such a drainage tube would not be functional for use as a venous return cannula due to the open slots formed along the two branches. Furthermore, the open tubes would not lend themselves easily to operation with an obturator by which the branch ends would be guided upon insertion or withdrawal through a single incision.
The preferred embodiments disclosed herein provide distinctive improvements that are not shown or suggested by the known prior art. The disclosed cannula and obturator include provisions that significantly ease insertion of the cannula and that facilitate placement of the cannula branches within the superior and inferior vena cavae with minimal manipulation.
Preferred embodiments of the invention are illustrated in the accompanying drawings, in which:
FIG. 1 is a diagrammatic view illustrating a heart with a bifurcated cannula in its operative position;
FIG. 2 is an elevation view of the cannula;
FIG. 3 is a view of the cannula and an obturator assembly with the branches of the cannula being drawn together by legs of the obturator;
FIG. 4 is a view of an exemplary obturator;
FIG. 5 is an enlarged sectional view taken substantially along line 5--5 in FIG. 3;
FIG. 6 is an enlarged sectional view taken substantially along line 6--6 in FIG. 3;
FIG. 7 is an enlarged view of an obturator hub with the obturator rod and legs broken away;
FIGS. 8 and 9 are operational diagrams illustrating initial steps of insertion of the cannula and a sliding leg type obturator;
FIG. 10 is a view of a double rod and leg obturator;
FIG. 11 through 14 are progressive operational diagrams illustrating insertion of the cannula using the obturator form shown in FIG. 4;
FIGS. 15 through 21 illustrate various obturator leg configurations; and
FIGS. 22 through 24 illustrate operation of a curved branch obturator and its use for inserting a cannula.
The following disclosure of the invention is submitted in compliance with the constitutional purpose of the Patent Laws "to promote the progress of science and useful arts" (Article 1, Section 8).
The present invention is exemplified by a cannula assembly including a cannula 12 and an obturator 10.
The cannula assembly, including the cannula 12 and obturator 10, are intended for use in cannulation of the right atrium (A), connecting blood flow from the superior vena cava (SVC) and the inferior vena cava (IVC) to the phlebotomy line of a conventional extracorporeal heart-lung system (not shown) for cardiovascular bypass. Use of the cannula 12 in accomplishing this function is illustrated diagrammatically by FIG. 1 of the drawings. The cannula is there shown extending through a single incision (I) in the appendix of the right atrium with bifurcated branches of the cannula extending respectively up the SVC and down the IVC. FIG. 1 also illustrates an infusion cannula (C) (not a component of the present invention) inserted into the aorta.
The cannula 12 includes an elongated hollow body 11 having an open outward end 13 with a central axial lumen 24 leading from end 13 to a bifurcated inward end 14 forming a "T" configuration. The bifurcated end 14 is characterized by a pair of branches 15, 16 that lead from a crotch 17 of the body 11 to blunt apertured tips 18, 19, respectively, at free open tube ends. The apertured tips are shown in detail by FIGS. 2 and 3 and substantially diagrammatically in the remaining Figures.
The central lumen 24 opens at the outward end 13 for connection to a phlebotomy line. The lumen 24 is formed by an internal tube wall along a central longitudinal axis of the tube body 11 and leads into integral smaller bore lumen 25, 26, formed through the respective branches 15, 16.
A preferred external diametric measurement of the main branch is 51 French (one French equaling 0.0131 inches). It is preferred that the two branches 15, 16 include exterior diametric dimensions totaling between approximately 51-72 French. The above dimensions are given for a range of branch sizes, with smaller sizes being used for small children and larger sizes for adults. A cannula with the above dimensions facilitates superior drainage capability over a standard venous cannula while minimizing the incision length required for insertion.
The cannula may be produced with internal branch lumen of different diameters. For example, the SVC branch 15 is advantageously 32 French while the IVC branch measures 36 French for average size adult patients. A smaller version may include an IVC branch 16 measuring 32 French and a SVC branch 15 measuring 28 French. A large size might include a 32 French for the SVC branch 15 and a 40 French for the IVC branch 16.
The cannula branch size is related to the relative amount of blood flow through the IVC and SVC. Approximately 70 percent of the total flow through the two cavae flows through the IVC while 30 percent flows through the SVC.
Another important feature of the cannula is noted in FIG. 3. The SVC branch 15 is shorter than the IVC branch 16. It is advantageous that the shorter SVC branch 15 be approximately one inch less in length than the longer IVC branch 16. This results in a staggered longitudinal relationship of the branch ends (FIG. 3) when the branches are brought together for insertion through the single incision. Upon insertion, the longer branch will progressively dilate the incision site for acceptance of the shorter branch end.
It is also desirable to utilize varying length cannula branches 15, 16 due to the nature of the SVC and IVC. The IVC is capable of receiving a cannula of substantial length since there are no significant venous branches within the IVC directly adjacent to the heart. The SVC, on the other hand, includes venous branches that are in relatively close proximity to the heart. It is therefore advantageous that the shorter cannula branch 15 be utilized for insertion within the SVC with its open end situated below any significant venous branches thereof and that the longer cannula branch 16 be situated within the IVC. Actual length of the SVC and IVC cannula branches may vary with the size of the patient. Small patients may utilize a cannula having 23/4 and 31/8 inch branch length, medium size patients may utilize a cannula having 31/2 and 41/2 inch branch lengths, while larger patients may utilize a cannula having 41/2 and 51/2 inch branch lengths.
The cannula branches are resilient, normally diverging from the main cannula body to form a "Y" configuration (inverted in FIG. 2). To facilitate this feature, a preferred material for forming the cannula is dip mold plastisol formed of finely ground polyvinyl chloride mixed in a suspension with a plasticizing agent. Such material is acceptable for surgical use and includes a "memory" to facilitate resilient, normal separation of the cannula branches 15, 16, to their normally diverging configuration. This resilient material also enables manipulation of the branches to the closed configuration as shown by example in FIG. 3 to permit insertion and retraction of the cannula through a single incision. Other materials known to those skilled in the art, for example, polyurethanes or silicone, elastomers and others, either singly or in combination may also be utilized.
The cannula 12 may include a reinforcing spring 21 along its main tubular body 11. It may also include similar reinforcing springs 22 along the branches 15, 16. These springs may be embedded within the resilient cannula material to enhance resiliency of the material and to prevent the associated lumen 24, 25, 26 from collapsing or crimping when in use.
FIG. 4 illustrates a first preferred form of the present improved obturator 10. Other preferred forms of the present obturator are shown in FIGS. 10 through 24. All the various obturator forms shown include similar important features. Similar features for each of the obturators shown in the drawings will therefore be referred to collectively, and by the same reference numerals.
Obturator 10 includes an elongated rod 30 extending along an axis from a top handle end 31 to a hub 32. The hub 32 mounts a pair of axial obturator legs 34, projecting from the hub opposite to the rod 30. It is advantageous that one of the legs 34 be integral with the rod 30.
Means is provided along the obturator 10 for minimizing frictional resistance to movement of the rod 30 and legs 34 within the cannula. To this end, it is significant to note the cross-sectional dimensions of the rod 30 and legs 34, in comparison to the cannula lumen 24-26. As may be noted in FIG. 6, the cross-sectional dimension of each leg 34 is substantially less than the similar cross-sectional dimension of the adjacent branch lumen 25, 26. It may also be noted in FIG. 5 that the cross-sectional dimension of the rod 30 is substantially less than that of the central cannula lumen 24. The reduced leg and rod cross-sectional dimensions thus facilitate substantially free, low friction movement of the obturator axially within the cannula.
To further facilitate minimal frictional resistance to axial movement, the obturator legs include facing curved gripping surfaces 35 that tangentially contact wall surfaces of the branch lumen 25, 26 as shown in FIG. 6. The legs 34 will effectively hold the branches together, but their gripping surfaces 35 will slide relatively freely in axial directions to facilitate axial insertion and removal of the obturator into and out from the cannula and the cannula branches.
The small diameter obturator rod and legs may be formed of a substantially rigid material such as stainless steel having sufficient stiffness even in the small cross-sectional dimensions shown to selectively spring the cannula branches to a closed position for insertion as shown in FIG. 3. Other materials including reinforced thermoplastic may be substitued by those skilled in the art.
The small diameter rod 30 and legs 34 will permit relatively free passage of blood within the cannula. Blood reflux through the cannula, however, is minimized through provision of the hub 32. It may be formed to include an annular wiping edge 40 (FIG. 7) that is just slightly smaller in cross-sectional dimension than the cross-sectional dimension of the main lumen 24 (see FIG. 5). The edge 40 slidably obstructs the main lumen 24 of the cannula to prevent reflux of blood beyond the hub 32 upon insertion of the cannula. The axial extent of the edge 40 is insufficient to produce significant frictional drag against the walls of the central lumen as the obturator is moved therein.
The hub 32 may be formed of injection molded plastic, formed about rod 30 and legs 34. The rod 30 and one or both of the legs 34 may be permanently anchored by the hub 32. For example, in the obturator shown in FIGS. 3 and 4, and partially in the operative positions shown in FIGS. 11-13, the hub 32 mounts both legs 34 in a parallel stationary relation. In other obturator versions shown and described below, the hub 32 may include a release means 46, augmenting the means for reducing frictional resistance by enabling selective movement of one obturator leg relative to the other.
The release means 46 is provided for selectively moving one of the obturator legs 34a relative to the other leg 34 between a release position wherein the obturator legs are spaced apart by first distance and a gripping position wherein at least portions of the obturator legs are spaced apart by a second distance that is less than the first distance. Several examples of the release means 46 are shown in FIGS. 8, 9 and 15-21 where the first and second distances are indicated by respective dashed and solid lines. In these versions it is preferred that one of the legs 34a be integral with the rod 30 so that movement of the rod 30 will cause corresponding movement of the attached leg 34a.
The release means 46 includes features of the hub and at least the obturator leg 34a that facilitates motion of the one leg 34a relative to the other leg 34. As an example, a bore 43 is formed in the hub that will permit rotation of leg 34a relative to the other. An annular recess 42 (FIGS. 15-19) may be provided about the joined rod 30 and leg 34a within the hub. The recess 42 receives a complementary shaped portion 42a of the hub to allow rotation of the rod and leg yet prevent relative axial movement of the hub and rod-leg unit.
The rotatable leg 34a preferably includes a bend or angled section along its length, examples of which are shown in FIGS. 15 through 24 as a part of the release means 46. The bends will radially space the associated gripping surfaces 35 from the axis of the hub bore 43 so that the surfaces 35 will move between open release positions (dashed lines) and closed gripping positions (solid lines). The rods 30 may thus be rotated to selectively move the legs 34a and their gripping surfaces 35 to gripping positions (solid lines) to securely grip the cannula branches together as shown in FIG. 3, and to release positions (dashed lines) where the cannula branches are allowed to initially separate as indicated in FIG. 23.
Another example of the release means 46 is shown in a sliding leg obturator version by FIGS. 8, 9 and 21. Here, the hub 32 includes a relatively smooth open bore 45 (FIG. 21) extending through the hub to facilitate both axial motion and rotation of the rod and obturator leg 34a relative to the other leg 34. Beads 50 or other appropriate abutments may be positioned along the length of the movable leg 34a to act as stops, preventing axial movement of the leg beyond fully extended and retracted positions.
Axial separation of the leg ends in the sliding leg obturator is shown in FIGS. 8 and 9. FIG. 8 shows the obturator legs in a gripping position with their ends closely adjacent one another to clamp corresponding branches of the cannula closely together for insertion into the atrium. The sliding obturator leg 34a may also be moved axially outward, to the position shown in FIG. 9 where the leg ends are spaced apart axially in a "release" condition to allow separation of the cannula branches within the atrium.
With the above axially movable "slidable" leg obturator, separation of the legs between the first (FIG. 9) and second (FIG. 8) distances occurs axially as opposed to substantial radial or lateral separation of the leg ends with the rotatable obturator leg versions.
A combination of both movable obturator leg release features (rotatable and axially movable obturator legs) may be available in the example indicated in FIG. 21. There the obturator leg 34a is capable of both axial motion and rotational motion in relation to the remaining obturator leg 34. The gripping surface 35 of leg 34a is radially spaced from the axis of rotation for the rod (as defined by the hub bore) so rotation of the rod will result in rotation of its gripping surface 35 in a circular path toward or away from the remaining leg 34. The hub bore will also allow the rod 30 to slide, axially moving the leg 34a between axially extended and retracted positions.
A double obturator rod is exemplified in FIG. 10 which may incorporate features of the release means including the axial sliding obturator leg features and rotatable leg features along with a double rod and handle to permit maximum manipulation of the cannula branches by use of the obturator. One of the rods 30a and its associated obturator leg 34 may be axially affixed to a hub 32 but may remain free to rotate, while the remaining rod 30 and leg 34a will both axially slide and freely rotate within the hub. Both obturator legs 34, 34a can thus be selectively moved axially or rotated, or both by manipulation of their handle ends.
A handle 48 may be provided for slidably guiding the outward ends of the two rods and providing a hand hold against which the individual rods can be actuated.
Operation of the cannula and obturator combination shown in FIGS. 3 and 4 is shown diagrammatically by FIGS. 11 through 14. The obturator and cannula are initially assembled as shown in FIG. 3 with the obturator extended fully into the cannula and with the obturator legs 34 received within the branches of the cannula. The curved gripping surfaces 35 of the relatively straight fixed obturator legs 34 slide axially along the length of the cannula branches camming the cannula branches together, and firmly clamping them in the closed position shown in FIG. 3 for insertion into the atrium. The relatively small areas of tangential contact between the obturator leg surfaces 35 and the contacted branch lumen surfaces facilitates relatively free, low friction axial motion of the obturator relative to the cannula.
The assembled cannula branches and obturator legs may be initially inserted through a single incision formed through the appendix of the right atrium as shown in FIG. 11. Insertion is facilitated by the staggered length cannula branches. The tip 19 of the longer branch 16 first enters through the incision, dilating the incision and facilitating reception of the tip 18 of the second, shorter cannula branch 15. Insertion of the cannula to the extent illustrated in FIG. 11 is therefore accomplished in a smooth and nearly effortless manner.
Insertion of the cannula may continue with the obturator being held stationary with the leg ends situated just inside the atrium (FIGS. 12 and 13). The resilient branches progressively spread as they slide from contact with the gripping surface 35 of the obturator legs.
It is pointed out that axial movement of the cannula in relation to the obturator is accomplished with relatively little frictional resistance between the two components. The surgeon can hold the obturator stationary while pushing the cannula inwardly, or slightly retract the obturator while simultaneously pushing inwardly on the cannula. In either manner, the cannula will slide inward with little frictional resistance and the branches 15, 16 will separate axially from the obturator leg ends and diverge within the atrium.
Insertion is made with the branches oriented such that the shorter cannula branch 15 bends upwardly to be received in the SVC and the lower, longer branch 16 is received downwardly within the IVC.
Blood reflux is prevented in the above steps by the wiping edge 40 along the hub 32. The wiping edge 40, and rounded surfaces 35 of the obturator legs are substantially the only surfaces that need be in frictional engagement with the cannula lumen, so resistance to motion within the cannula is held at a minimum. Such minimal contact permits low friction, axial motion of the obturator within the cannula, without hesitant, jerky motions that could adversely influence guidance and reception of the cannula branches within the respective SVC and IVC.
Once the cannula branches fully separate due to their natural resiliency and are received within the SVC and IVC, and when the crotch of the cannula is situated well within the atrium, the obturator may be fully removed from the cannula. Purse string sutures may then be tightened about the cannula and appropriate connections may be made with the extracorporeal heart-lung machine. If desired, appropriate tapes (FIG. 1) may be used to secure the tips of the cannula branches within the vena cavae.
Removal of the cannula may simply involve insertion of the obturator through the outward cannula end to bring the obturator legs into the atrium. The obturator is then held axially stationary in this position as the cannula is withdrawn. The legs of the obturator will cam the cannula branches together just inside the incision site to avoid stretching or tearing of the tissues at the incision site as the cannula branches are withdrawn. The hub 32 and its wiping edge 40 act to minimize withdrawal of blood along with the cannula branches as the cannula is withdrawn. Complete withdrawal may follow as the cannula is drawn fully over the obturator and the otherwise divergent branches are again progressively clamped by the obturator legs as the cannula is retracted. The cannula branches may then be fully withdrawn from the atrium so the incision may be closed.
Operation of the sliding leg obturator and cannula may be understood with reference to FIGS. 8 and 9. Insertion of the obturator into the cannula is made in basically the same manner as described above, with the rod 30 being axially received along the full length of the cannula and with both obturator legs 34, 34a being received within respective cannula branches. The obturator leg surfaces 35 cam against the cannula branches, drawing them together for insertion through the single incision in the atrium. Bead 50 prevents leg 34a from sliding too far forward during insertion.
Insertion of the cannula branch ends is shown in FIG. 8 where the longer branch 16 of the cannula has been inserted into the atrium, followed by the shorter branch 15. The staggered branch lengths facilitate insertion by progressively dilating the incision as noted above.
Once both cannula branches are inserted partially within the atrium, the obturator rod 30 may be held stationary with the end bead 50 in the vicinity of the incision site as insertion of the cannula and the remaining branch 34 continue. This action allows the cannula branch 15 to resiliently diverge at least partially toward its normal outward orientation as indicated in FIG. 9. The slidable obturator leg 34a will ultimately withdraw (with respect to the other leg 34) only to the point where the bead 50 on the obturator leg 34a engages the hub 32. Further pull along the obturator rod 30 or inward thrust of the cannula will cause the remaining obturator leg 34 to retract axially from the cannula, withdrawing from the remaining cannula branch 16. That branch will then begin its outward migration, seeking out the adjacent IVC.
It is pointed out that the example illustrated shows the short cannula branch 15 receiving the sliding obturator leg 34a while the long cannula branch 16 receives the relatively fixed obturator leg 34. However, this arrangement could be reversed if it is desired to initially start the longer branch 16 down the IVC. Such motion could be accompanied by tilting the obturator and cannula as shown in FIG. 22 to further assist placement of the long IVC branch 16.
Full retraction of the obturator following initial retraction of the sliding leg is facilitated with minimal frictional resistance due to the separate operation of the individual obturator legs in moving apart from the closed, gripping condition shown in FIG. 8 to the substantially open, release position shown in FIG. 9. Full retraction of the obturator from within the cannula results in full separation of the two cannula branches and their reception within the SVC and IVC as substantially shown in FIG. 14.
Removal of the cannula using the sliding leg obturator is accomplished in a manner similar to that described above.
Operation of a double-curved rotatable release leg obturator and cannula combination is illustrated in FIGS. 22 through 24. With this arrangement, both obturator legs are bent or angled in a similar direction while one leg 34a is rotatable. The cannula and obturator may be angled on insertion as indicated at FIG. 22 to facilitate reception of the longer cannula branch 16 downwardly toward the IVC. This may be done to avoid accidental reception of the longer cannula branch 16 through the adjacent tricuspid valve (not shown).
Following initial insertion (FIG. 22), the obturator rod 30 may be rotated, along with the attached curved obturator leg 34a outwardly to the release position shown in FIG. 23. The curved leg 34a, rotated to this position, initiates the bend necessary for the short cannula branch 15 to follow when being directed upwardly for reception in the SVC. Following rotation, the obturator rod may be held stationary as the cannula is pushed on inwardly thereby allowing the IVC cannula branch 16 to diverge against the distal wall of the IVC, clearly avoiding the tricuspid valve. Next, the entire assembly may be tipped back to the position shown by FIG. 24. The surgeon may now continue to push the cannula inwardly to complete insertion. As this happens, the outwardly turned obturator legs influence divergence of the cannula branches until they are fully received within the SVC and IVC (FIG. 24). The surgeon may now rotate the rod 30 back, bringing the curved obturator leg 34a back to the closed position (shown by dashed lines in FIG. 24), at which time the obturator may be pulled axially from the cannula. Alternatively, the surgeon may gently pinch the cannula tube as shown in FIG. 24 adjacent the incision to assist inward springing of the curved obturator legs as the obturator is withdrawn.
Removal of the cannula using this version may be accomplished as discussed above with the possible exception that the rotatable leg 34a may be rotated to a neutral position (between gripping and open) to facilitate retraction of the cannula.
A combination of the steps indicated above for operation of the sliding leg obturator and the rotatable leg obturator are available with the release exemplified in FIG. 21, or in the double rod obturator arrangement illustrated in FIG. 10. Both of these versions, used separately or with variations including features of both, may be utilized to enable still further manipulative control of cannula branch separation within the atrium.
For example, a bend along the leg 34a may be rotated following insertion to initially move ends of the cannula apart to an initial, release orientation. Then the same leg 34a may be axially withdrawn to further facilitate motion of the adjacent cannula branch to its open, normal orientation. This movement could be followed by final retraction of the obturator from the cannula or by rotation and similar retraction of the remaining obturator leg when utilizing the double rod configuration shown in FIG. 10. Retraction of the cannula using either of the above obturators may involve steps similar to those used with the rotatable leg obturator described above. Of course, it is preferable that the cannula be retracted while both obturator legs are fully axially extended.
The several obturator configurations and cannula in the operations described above facilitate maximum manipulative capabilities within the atrium. Each form described includes features similar to the above versions, that facilitate low friction axial movement of the obturator within the cannula to selectively control divergence and convergence of the cannula branches.
In compliance with the statute, the invention has been described in language more or less specific as to structural features. It is to be understood, however, that the invention is not limited to the specific features shown, since the means and construction herein disclosed comprise a preferred form of putting the invention into effect. The invention is, therefore, claimed in any of its forms or modifications within the proper scope of the appended claims, appropriately interpreted in accordance with the doctrine of equivalents.
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|Apr 3, 2003
|Oct 2, 2007
|Medtronic, Inc.
|Oval-shaped cardiac cannula
|Feb 21, 2003
|Jul 1, 2008
|C. R. Bard, Inc.
|Multi-lumen catheter with separate distal tips
|Jun 15, 2007
|Jul 13, 2010
|Interrad Medical, Inc.
|Anchor instrumentation and methods
|Apr 26, 2011
|Interrad Medical, Inc.
|Temporary retention device
|May 3, 2011
|Interrad Medical, Inc.
|Temporary retention device
|Jul 5, 2011
|C. R. Bard, Inc.
|Reinforced multi-lumen catheter
|Sep 13, 2011
|Interrad Medical, Inc.
|Anchor device and method
|Sep 13, 2011
|Interrad Medical, Inc.
|Anchor device and method
|Sep 20, 2011
|C. R. Bard, Inc.
|Split tip dialysis catheter
|Jul 16, 2008
|Oct 18, 2011
|Interrad Medical, Inc.
|Anchor systems and methods
|Oct 17, 2008
|Nov 29, 2011
|C. R. Bard, Inc.
|Split-tip catheter including lateral distal openings
|Oct 31, 2008
|Jan 10, 2012
|C. R. Bard, Inc.
|Catheter assembly including triple lumen tip
|Mar 27, 2012
|Interrad Medical, Inc.
|Anchor instrumentation and methods
|Sep 21, 2007
|Apr 10, 2012
|C. R. Bard, Inc.
|Multi-lumen catheter with separate distal tips
|May 1, 2012
|Medtronic, Inc.
|Oval-shaped cardiac cannula
|Oct 31, 2008
|Jun 26, 2012
|Bard Access Systems, Inc.
|Methods and apparatus for inserting multi-lumen split-tip catheters into a blood vessel
|Jun 27, 2008
|Aug 7, 2012
|Interrad Medical, Inc.
|System for anchoring medical devices
|Mar 25, 2011
|Aug 28, 2012
|Interrad Medical, Inc.
|Temporary retention device
|Aug 3, 2005
|Sep 4, 2012
|Medtronic, Inc.
|Cannula system and method
|Mar 30, 2009
|Oct 23, 2012
|C. R. Bard, Inc.
|Solid-body catheter including lateral distal openings
|Dec 11, 2012
|Interrad Medical, Inc.
|System for anchoring medical devices
|Jan 1, 2013
|Interrad Medical, Inc.
|Systems and methods for anchoring medical devices
|Apr 30, 2013
|C. R. Bard, Inc.
|Reinforced multi-lumen catheter
|Sep 8, 2011
|May 21, 2013
|Interrad Medical, Inc.
|Anchor systems and methods
|Oct 2, 2008
|Aug 6, 2013
|Bard Access Systems, Inc.
|Manufacture of split tip catheters
|Oct 22, 2012
|Sep 24, 2013
|C. R. Bard, Inc.
|Solid-body catheter including lateral distal openings
|Jan 10, 2013
|Nov 12, 2013
|Interrad Medical, Inc.
|Anchor systems and methods
|Apr 12, 2012
|Dec 3, 2013
|Bard Access Systems, Inc.
|Methods and apparatus for inserting multi-lumen split-tip catheters into a blood vessel
|Jul 5, 2012
|Jan 14, 2014
|Interrad Medical, Inc.
|System for anchoring medical devices
|Nov 11, 2011
|Apr 15, 2014
|C. R. Bard, Inc.
|Split-tip catheter including lateral distal openings
|Jul 18, 2012
|May 6, 2014
|Interrad Medical, Inc.
|Temporary retention device
|Aug 17, 2011
|Jul 8, 2014
|Interrad Medical, Inc.
|Anchor device and method
|Oct 18, 2007
|Aug 19, 2014
|C. R. Bard, Inc.
|Multi-lumen catheter with separate distal tips
|Dec 16, 2011
|Nov 25, 2014
|C. R. Bard, Inc.
|Catheter assembly including triple lumen tip
|Feb 27, 2012
|Dec 30, 2014
|Interrad Medical, Inc.
|Anchor instrumentation and methods
|Feb 17, 2012
|Jan 13, 2015
|Interrad Medical, Inc.
|Anchoring an intravenous cannula
|Sep 15, 2011
|Jan 20, 2015
|Interrad Medical, Inc.
|System for anchoring medical devices
|Dec 5, 2012
|Feb 17, 2015
|Interrad Medical, Inc.
|Systems and methods for anchoring medical devices
|Nov 9, 2012
|Mar 10, 2015
|Interrad Medical, Inc.
|System for anchoring medical devices
|Nov 15, 2012
|Mar 24, 2015
|Interrad Medical, Inc.
|System for anchoring medical devices
|Jun 9, 2004
|Mar 31, 2015
|Bard Access Systems, Inc.
|Splitable tip catheter with bioresorbable adhesive
|Nov 1, 2013
|Jun 16, 2015
|Interrad Medical, Inc.
|Anchor systems and methods
|Dec 18, 2012
|Oct 27, 2015
|Cardiacassist, Inc.
|Dual lumen cannula
|Sep 20, 2013
|Nov 3, 2015
|C. R. Bard, Inc.
|Solid-body catheter including lateral distal openings
|Mar 19, 2014
|Jan 5, 2016
|Interrad Medical, Inc.
|Temporary retention device
|Apr 14, 2014
|Jan 12, 2016
|C.R. Bard, Inc.
|Split-tip catheter including lateral distal openings
|Dec 19, 2013
|Mar 15, 2016
|Interrad Medical, Inc.
|System for anchoring medical devices
|Oct 11, 2012
|Apr 19, 2016
|Interrad Medical, Inc.
|Systems and methods for anchoring medical devices
|May 3, 2013
|Jul 5, 2016
|Interrad Medical, Inc.
|Systems and methods for anchoring medical devices
|Jan 12, 2015
|Jul 5, 2016
|Interrad Medical, Inc.
|Systems and methods for anchoring medical devices
|Jun 2, 2014
|Jul 5, 2016
|Interrad Medical, Inc.
|Anchor device and method
|Jul 10, 2014
|Jul 12, 2016
|C.R. Bard, Inc.
|Multi-lumen catheter with separate distal tips
|Feb 13, 2013
|Aug 16, 2016
|Interrad Medical, Inc.
|Systems and methods for anchoring medical devices
|Apr 3, 2003
|Oct 9, 2003
|Medtronic, Inc.
|Oval-shaped cardiac cannula
|Dec 11, 2002
|Jun 17, 2004
|Applied Materials, Inc.
|Low temperature process for passivation applications
|Feb 21, 2003
|Aug 26, 2004
|Zawacki John A.
|Multi-lumen catheter with separate distal tips
|May 10, 2004
|Oct 21, 2004
|Zawacki John A.
|Split tip dialysis catheter
|Sep 8, 2003
|Mar 10, 2005
|Joanna Graft
|Split-tip catheter divider
|Mar 18, 2005
|Aug 25, 2005
|Rosenberg Michael S.
|Temporary retention device
|Jun 9, 2004
|Dec 15, 2005
|Anand Pj
|Splitable tip catheter with bioresorbable adhesive
|Dec 29, 2004
|Jan 4, 2007
|Patterson Ryan C
|Reinforced multi-lumen catheter
|Jun 27, 2005
|Jan 11, 2007
|Venkataramana Vijay
|Methods of implanting an aorto-coronary sinus shunt for myocardial revascularization
|Jun 27, 2005
|Jan 11, 2007
|Venkataramana Vijay
|Implantable aorto-coronary sinus shunt for myocardial revascularization
|Aug 3, 2005
|Feb 15, 2007
|Joseph Katherine R
|Cannula system and method
|Sep 1, 2006
|Apr 12, 2007
|Medtronic, Inc.
|Oval-Shaped Cardiac Cannula
|Nov 22, 2006
|May 10, 2007
|Interrad Medical, Inc.
|Temporary retention device
|Mar 9, 2006
|Sep 27, 2007
|Rosenberg Michael S
|Anchor device and method
|Aug 16, 2007
|Feb 7, 2008
|Briscoe Roderick E
|Oval-shaped cardiac cannula
|Mar 14, 2008
|Sep 4, 2008
|Spire Corporation
|Splitable tip catheter with bioresorbable adhesive
|Jun 15, 2007
|Dec 18, 2008
|Interrad Medical, Inc.
|Anchor instrumentation and methods
|Oct 17, 2008
|Apr 30, 2009
|C.R. Bard, Inc.
|Split-tip catheter including lateral distal openings
|Oct 31, 2008
|May 7, 2009
|Spire Corporation
|Methods and apparatus for inserting multi-lumen split-tip catheters into a blood vessel
|Oct 2, 2008
|Aug 13, 2009
|Spire Corporation
|Manufacture of split tip catheters
|Oct 2, 2008
|Aug 13, 2009
|Spire Corporation
|Catheters with enlarged arterial lumens
|Oct 2, 2008
|Aug 20, 2009
|Spire Corporation
|Manufacture of fixed tip catheters
|Oct 2, 2008
|Aug 20, 2009
|Spire Corporation
|Fusion manufacture of multi-lumen catheters
|Sep 3, 2009
|Dec 31, 2009
|Interrad Medical, Inc.
|Anchor Device and Method
|Jun 27, 2008
|Dec 31, 2009
|Interrad Medical, Inc.
|System for anchoring medical devices
|Feb 2, 2010
|Jun 3, 2010
|C.R. Bard, Inc.
|Reinforced multi-lumen catheter
|Aug 12, 2010
|Interrad Medical, Inc.
|System for anchoring medical devices
|Mar 24, 2011
|Navilyst Medical, Inc.
|Branched catheter tip
|Jul 14, 2011
|Interrad Medical, Inc.
|Temporary Retention Device
|Jul 21, 2011
|Cornell Research Foundation, Inc.
|Detection of nucleic acid sequence differences using the ligase detection reaction with addressable arrays
|Aug 11, 2011
|C. R. Bard, Inc.
|Reinforced multi-lumen catheter
|Feb 8, 2013
|Jan 26, 2016
|C. R. Bard, Inc.
|Multi-lumen catheter tip
|Nov 21, 1995
|Jun 13, 1996
|Heartport, Inc.
|Cardioplegia catheter system
|Jan 21, 1999
|Jul 29, 1999
|Medtronic, Inc.
|Flexible cannula obturator
|U.S. Classification
|604/6.16, 604/284, 604/27
|International Classification
|Cooperative Classification
|European Classification
|Oct 23, 1987
Owner name: RESEARCH MEDICAL, INC., 1847 W. 2300 SOUTH, SALT L
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNORS:GRUNWALD, RONALD P.;TODD, ROBERT J.;REEL/FRAME:004786/0486;SIGNING DATES FROM 19870930 TO 19871009
Owner name: RESEARCH MEDICAL, INC., 1847 W. 2300 SOUTH, SALT L
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:GRUNWALD, RONALD P.;TODD, ROBERT J.;SIGNING DATES FROM 19870930 TO 19871009;REEL/FRAME:004786/0486
|May 18, 1992
|Fee payment
Year of fee payment: 4
|Sep 24, 1996
|Maintenance fee reminder mailed
|Feb 16, 1997
|Lapse for failure to pay maintenance fees
|Apr 29, 1997
|Expired due to failure to pay maintenance fee
Effective date: 19970219


text:
We seem to want a moment, but we don't want to totally roll the dice.
Unemployment Compensation Reform Joint Committee says solution lies in balance.
Stops planned for Youngstown and Cleveland.
State voted to legalize recreational pot in 2014.
Kerry's meeting with Russian foreign minister makes progress, but details remain
Vice president will visit Youngstown area, Cleveland.
Activities are to include phone banking, voter registration, signing up volunteers, and more.
Report: Total cost is $27.30 an hour despite year-old hiring freeze.
Some contain information about and references to Benghazi attack.
Says Democratic nominee isn't interested in 'tinkering around the margins with TPP.'

subset: commoncrawl


text:
Import and Sales of TOP quality, reasonably priced friesian horses. call janna 415-272-2112
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We just have mostly fun horses. That are normaly all arround horses you could do anything with. And i would gladly take horses in for training in…
Horseback riding lessons for beginners and all levels of riders. Lesson horses available or bring your horse. Youth and adults welcome, ride for…
Jamestown, TN


text:
AIMU has compiled a list of regulations that affect U.S. marine insurers, reinsurers and the international trade community.
AIMU EDUCATION CALENDAR – 2016 Upcoming Opportunities!
View here »
Friday 7 October 2016
08:30 am - 3:00 pm
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Only employees of AIMU Member Companies can be added to the email list. Check the list of members here. Any questions, contact Elvira Rodin email@example.com


text:
Stronghold is defined as "a place where a particular cause or belief is strongly defended or upheld". This inspired our name, and continues to inspire us when approaching design.
We are united, in building brands and defending design.
Identity Design
Logo conceptualization, logo design, brand guidelines, icon design, illustration.
Brand strategy, print and packaging design, photography, branded spaces.


text:
Auto Components
Company Overview of Acoustex (Pty) Ltd
Executive Profile
Alfred Anthony da Costa B.Com. (Hons.)
Non Executive Chairman, Acoustex (Pty) Ltd
|Total Calculated Compensation
|This person is connected to 6 Board Members in 6 different organizations across 6 different industries.
See Board Relationships
Corporate Headquarters
Bennett StreetPhone: 27 41 407 4111
Port Elizabeth, Eastern Cape 6001
South Africa
Fax: 27 41 451 1494
Board Members Memberships
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Non Executive Chairman
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Non-Executive Director and Member of Audit & Risk Committee
Non-Executive Chairman and Member of Audit Committee
EducationThere is no Education data available.
Other Affiliations
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text:
Belvedere Suspends Operations At Hitura In Face Of Low Nickel Prices 0 commentsMay 23, 2013 1:10 PM
Shares of Belvedere Resources (CVE:BEL) lost ground Thursday after the company announced that it is suspending mining operationgs at its Hitura nickel mine in Finland in response to continued low nickel prices.
Further to its announcement in January, the company told investors today that it has now initiated a two-week notice period for the start of temporary layoffs, of up to 60 of the 69 people employed at the mine.
The layoff period will continue for up to 90 days for each employee. The company added that key staff will stay on to manage the care and maintenance of the mine and mill facilities during the suspension.
"The continuing weakness in the nickel prices, in conjunction with permitting delays, has left the company with little option but to suspend nickel operations and commence temporary lay-offs," said CEO David Pym in a release Thursday.
"During the lay-off period the company will continue to concentrate on the metallurgical, environmental and engineering studies involved with assessing the viability of processing the nearby Kopsa gold copper ores through the Hitura mill."
The Finland-based operator made a net profit of €1.3mln (€2.6mln) over the whole of 2012, but was in the red in the final three months due to poor nickel prices and grades. Full year revenues were €27.9mln, up from €24.7mln while the amount of nickel produced rose to 2,282 tonnes against 2,157 tonnes.
Belvedere was trading at 4.5 cents on Thursday, down 10 per cent.
Disclosure: I have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours.Back To Proactive Investor's Instablog HomePage »
Instablogs are blogs which are instantly set up and networked within the Seeking Alpha community. Instablog posts are not selected, edited or screened by Seeking Alpha editors, in contrast to contributors' articles.Full index of posts »
Copper North Closes Oversubscribed Flow Through Portion Of Financing, Raises Almost $0.6mln $CPNVF http://seekingalpha.com/p/24uzt Dec 24, 2014
MZI Resources Commences Development Of The Keysbrook Project http://seekingalpha.com/p/24rah Dec 22, 2014
Legend Mining Completes Survey Over Its Fraser Range Project http://seekingalpha.com/p/24r9x Dec 22, 2014
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Disney After Dark (Hardcover)
Email or call for price
Special Order
When Disney comes looking for five teenagers to serve as actors for a new technology-Daylight Hologram Images, or DHIs-there is more to it than meets the eye. Strange things have been happening inside the Florida park: parts from one ride are found mysteriously moved to another; in the Fantasmic! show, the dragon unexplainably triumphs over Mickey; little blips in story lines and "offstage" antics by characters trouble managers. Finn Whitman, a middle-schooler, goes to sleep one night and has the dream of a lifetime: he "wakes up" inside Disney World as his DHI character, a glowing hologram. He meets an old man there, Wayne, who claims to be one of the original Imagineers and explains to Finn that he "and your friends" have a mission to save the park from forces that humans can neither see nor hear. Not believing his dream, but not totally discounting it, Finn, back in real life, sets out to find the four other kids who were chosen to be DHIs and in doing so he learns an eerie fact: he is not alone in this "dream." The others have had similar experiences. What if this is for real?
About the Author
Ridley Pearson is the award-winning author of multiple adventure series for (young-ish) readers, including The Kingdom Keepers, Steel Trapp, and with Dave Barry, Peter and the Starcatchers. Ridley is also a best-selling crime novelist of more than 25 titles. Pearson was the first U.S. citizen to be awarded the Raymond Chandler/Fulbright Fellowship in Detective Fiction at Oxford University. In 2013, Ridley was awarded Missouri's Quill Award and inducted into that state's Writers Hall of Fame. As a "full time dad and husband," Ridley, along with his wife, Marcelle, live with their two teenage daughters in St. Louis, MO.


text:
PyNaMiteProject reference: 298831
Funded under :
Mode of action and selectivity of pyrethroids on economically important mites and ticks
Project details
Total cost:EUR 278 807,4
EU contribution:EUR 278 807,4
Coordinated in:United Kingdom
Topic(s):FP7-PEOPLE-2011-IEF - Marie-Curie Action: "Intra-European fellowships for career development"
Call for proposal:FP7-PEOPLE-2011-IEFSee other projects for this call
Funding scheme:MC-IEF - Intra-European Fellowships (IEF)
There are over 45,000 species of mites/ticks (class: Arachnida, taxon: Acari). Amongst these are a number of important agricultural, horticultural, domestic animal and human pests. Economic losses inside the European Union caused by several of these species can reach hundreds of million euros every year. In the UK, mites have been reported in 72 % of farm stores, 81 % of commercial grain stores, 89 % of animal feed mills and 89 % of oilseed rape stores. The damage caused by a mite infestation can lead to direct financial loss through the deterioration of food quality, downgrading of products, customer complaints and rejection of stock.
Synthetic pyrethroid compounds are frequently used as acaricides to control tick/mite infestations in agricultural, veterinary and domestic (home/garden) settings, and command a large market share. Understanding their mechanism of action and selectivity on mites/ticks is clearly important for the design of next generation compounds. Selectivity may be highly desirable in situations where there is a need to target one species only, leaving a second species unharmed - a good example being the control of varroa mites on honeybees.
This proposal entails the characterization of pyrethroids interactions with tick/mite Na channels at the molecular level since it is important to be able to establish why certain pyrethroid acaricides are more lethal than others, and why some have differing effects on different species. In addition, as resistance development in pest populations threatens the long-term success of currently effective compounds, it is urgent to screen field populations of ticks/mites to identify novel resistance mutations. Eventually, with the information generated from the screening performed, it will be feasible to develop rapid, high throughput DNA-based assays for diagnosing the presence/absence of resistance mutations in field populations of ticks/mites.
Related information
EU contribution: EUR 278 807,4
West Common
United Kingdom
Tel.: +44 1582 763133
Fax: +44 1582 762595


text:
September 26, 2008 — A poll released Sept. 22 by the Associated Press suggests that racial prejudice could cost Democratic presidential candidate Barack Obama up to 6 percentage points of support in the election, spurring yet another round in months of discussion about the role of race in the 2008 vote.
One more such discussion took place Thursday evening at the University of Virginia's Miller Center of Public Affairs, where a roundtable panel of U.Va. professors who study race and gender expressed optimism about the declining impact of race in American politics.
Panelist Lynn Sanders, a politics professor, explained that the so-called "Bradley effect" — in which voters tell pollsters they will support a non-white candidate, but end up pulling the lever for the white candidate — has been well-documented in past American gubernatorial and Congressional elections. It was named for former Los Angeles mayor Tom Bradley, a black candidate who lost the 1982 California governor's race despite being ahead in voter polls.
But the Bradley effect has been steadily declining over the years, according to Sanders' close study of numerous polls. Discounting the recent AP poll, she predicted that the Bradley effect will only be 1.5 to 2 percent in this election, and "may soon be nonexistent."
Panelist and fellow politics professor Vesla Weaver was quick to point out that even a 1 or 2 percent effect could be enough to swing the election to Republican John McCain.
This fall's election is like Christmas for scholars of race and gender in politics, with Republican vice presidential candidate Sarah Palin, the second woman to be nominated by a major party, running opposite the biracial Obama, who himself defeated Hillary Clinton, the most successful female presidential contender in history, said panelist Paul Freedman, a professor of politics who studies political ads.
Sanders said she was dismayed by the pessimistic tone of much of the public discussion of race and politics, which has focused on findings such as AP polls that find that four in 10 Americans agree with certain statements that reflect resentment toward blacks. Even that rate is way down from seven or eight in 10 in the past, she noted.
"There are still honest bigots," Sanders said. "But there are also people who are sincere egalitarians, and those are some of the people who have moved us to a situation where we can be open to the possibility of having a new type of president that we've never had before."
Identifying what Americans really think and feel about race is challenging, the panelists agreed. Psychology professor Brian Nosek discussed his study of implicit cognition, the thoughts and feelings outside of our control and awareness.
He noted that people can't observe their own mental operations. "Our conscious experience really is just a sliver of what is actually going on that influences our everyday perception, judgment and behavior," he said.
Nosek co-developed an online test, called the Implicit Association Test, to measure people's unconscious associations with race by measuring, in fractions of a second, how quickly they match positive or negative words with black or white faces. About 80 percent of the 500,000 people who have taken the test, including many who espouse egalitarian values, demonstrate a stronger association of black faces (including Obama's) with negative words than they do for white faces, he said.
Our unconscious attitudes play a role in our decision-making, and results of the Implicit Association Test are predictive of people's votes, Nosek said. But the extent of that role is unknown.
Political ads always carry implicit messages in addition to their explicit content, Freedman said. We cannot choose whether or not we receive various implicit messages, Nosek added.
American politics has a long history of ads with implicit messages that reinforce racial prejudices, Weaver said.
She pointed to a McCain ad that links Obama with another black politician, former Detroit mayor Kwame Kilpatrick, who recently pleaded guilty to several criminal charges. If you watch the ad without sound, she explained, it scrolls words like 'perjury' and 'obstruction of justice', interspersed with images of Kwame and Obama's faces, conveying the message that "blacks equal crime, and Obama equals crime."
Similar messages have appeared in various forms for decades, but what's new this time around is that when the Obama campaign drew attention to the racial undertones of the ad, the McCain campaign responded by accusing Obama of "playing the race card."
Attempting to dismiss the attention to racism as trivial is a new tactic in American politics, Weaver said.
How, politics professor Nick Winter asked, do we sort out the effects of our implicit associations and our explicit commitments to egalitarianism that are also real?
He reported new research findings that when people are not paying attention or not motivated to think carefully about a topic, implicit attitudes have more power. But when people are prompted to think carefully about an issue, such as this fall's public discussion about race and equality, explicit thoughts about equality can outweigh implicit attitudes.
"We aren't slaves to our automatic minds," Nosek agreed. Our conscious minds can override the inclinations of our unconscious minds, he added, and the Civil Rights Movement has caused true change in people's explicit feelings.
Moderator Douglas Blackmon — Atlanta bureau chief for the Wall Street Journal and author of the new bestseller "Slavery By Another Name" — asked if societal self-awareness about racial issues blunts the effectiveness of the implicit racial messages in some political ads.
"I don't know. It may," Freedman said. But that's one of the important questions that we'll be looking at after the election.
The forum was sponsored by U.Va.'s Arts & Sciences magazine, following up a recent article that examined four of the panelists' research on race and gender.


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Effort to tie local Republicans to Trump backfiring
Democratic strategists have found that tarring down-ticket Republicans with the scarlet T may hurt Clinton.
Bjorn Lomborg
Counterpoint: If solar and wind are competitive, why all the aid?
The $100 billion in subsidies they receive now will still be needed for another 24 years.


text:
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Celtic OdysseyDouble Dragon Publishing 2012; US$ 5.99
This sequel to Prehistoric Journey: The First Expeditions picks up where the first expedition left off. Something tore apart the lifeboat of The Atlantic Mermaid and the crew panicked. Captain Colin Limmerick, a steam-punk version of Indiana Jones, knows that the creature that did this was from a prehistoric time. He is convinced that Dr. Sasha Dimitrikov?s... more...
Refugees on UrloonKensington 2012; US$ 2.99
Two weary refugees, two moons and a life-changing fertility festival. Watch out for a whole lot of sensuality. Under normal circumstances, Svana, non-military maintenance crew, and Captain Liam Ringel, a highly respected military instructor, would never have crossed paths. A sudden anomaly, however, thrusts them into deep space where they are rescued... more...
Clockwork LivesECW Press 2015; US$ 15.99
Some lives can be summed up in a sentence or two. Other lives are epics.In Clockwork Angels, #1 bestselling author Kevin J. Anderson and legendary Rush drummer and lyricist Neil Peart created a fabulous, adventurous steampunk world in a novel to accompany the smash Rush concept album of the same name. It was a world of airships and alchemy, clockwork... more...
The League of Illusion: LegacyCarina Press 2013; US$ 2.99
London, 1851 Former thief Jovan Davenport is the black sheep in a family of powerful sorcerers. But when his dying fatherhead of the League of Illusionreaches out for help, Jovan has no choice but to accept. He must find his missing brother Sebastian and stop the power-hungry Hawthorne family from taking control of the council. If only they'd appointed... more...
The League of Illusion: ProphecyCarina Press 2013; US$ 2.99
Book two of the League of Illusion London, 1851 With his brother Sebastian missing, illusionist Rhys Davenport is running out of time and leads. He knows only that Sebastian disappeared into Stonehenge and that an incomplete map is the key to finding him. And that the missing piece is in the possession of the unnervingly attractive psychic... more...
The League of Illusion: DestinyCarina Press 2013; US$ 2.99
The conclusion to the League of Illusion trilogy Five years ago, Sebastian Davenport tried to go back in time to reverse a fatal mistake, but found himself trapped in another reality. Unaware of the jeopardy facing his family and the League of Illusion, he gave up his magic for a quiet life as a blacksmith. Quiet, until a monstrous three-headed... more...
Prehistoric ClockCarina Press 2012; US$ 2.99
1908. Somewhere over the English Channel� Verity collapsed her brass telescope and winced as the pyre of yet another British airship blazed on the rough waves. The odds of surviving this suicidal folly dwindled with each crimson flash. She shielded her face from the sting of lateral rain. All around her, metal warped and canvas groaned as the storm... more...
Ministry Protocol: Thrilling Tales of the Ministry of Peculiar OccurrencesScribl 2013; US$ 1.79
From the Creators of the award-winning steampunk Ministry of Peculiar Occurrences series ( Phoenix Rising and the Janus Affair) comes a collection of new adventures from around the world. The Ministry of Peculiar Occurrences investigates the bizarre and unusual, and protects the citizens of the Empire from forces of darkness. Every agent knows that... more...
Phoenix RisingHarperCollins 2011; US$ 2.99
Co-authors Pip Ballantine and Tee Morris ingeniously reimagine England?s Edwardian Era in Phoenix Rising ?a hilarious, rip-roaring steampunk fantasy romp that the voracious fans of New York Times bestseller Gail Carriger will eagerly devour with great relish. In this outrageous, non-stop adventure, Ballantine and Morris introduce us to Agents Books... more...
The Janus AffairHarperCollins 2012; US$ 5.99
Hang onto your bowler hats, agents Books and Braun of Britain?s top-secret Ministry of Peculiar Occurrences are back in The Janus Affair . In their second wildly imaginative, utterly fantastic steampunk adventure, authors Pip Ballantine and Tee Morris carry readers back to an alternate history Edwardian England, where suffragettes are inexplicably... more...


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*Position: Physical Design Engineer / RTL Design Engineer* *Client : Nvidia, Bay Area.*
*Requirements:* - RTL Design, Verification, Synthesis, DFT, FPGA Prototyping, Emulation - - Physical design and implementation of GPU and other ASICs targeted at the desktop, laptop, workstation, and mobile markets - - Physical design, flow automation, floorplan, power/clock distribution, chip assembly and P&R, timing closure - - Static timing analysis, power and noise analysis and back-end verification *TOTAL EXPERIENCE :* *RELEVANT EXPERIENCE :* *OFFICIAL NOTICE PERIOD :* *CURRENT RATE PER HOUR :* *VISA STATUS :* *EMAIL ID :-* *up2datec...@gmail.com <up2datec...@gmail.com>* -- You received this message because you are subscribed to the Google Groups "Android Developers" group. To unsubscribe from this group and stop receiving emails from it, send an email to android-developers+unsubscr...@googlegroups.com. To post to this group, send email to email@example.com. Visit this group at https://groups.google.com/group/android-developers. To view this discussion on the web visit https://groups.google.com/d/msgid/android-developers/4a0724a1-7421-460b-88ee-969c51aee9b5%40googlegroups.com. For more options, visit https://groups.google.com/d/optout.


text:
Job Seekers
Recruitment specialists supplying the resources and engineering sectors in Perth, Brisbane and throughout Australia
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Programmed Professionals is the recruitment agency of choice in the Australian resources sector. Find the candidate or position you have been looking for today.Read More


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Dacula, GAUSA
Hometown: Talent, OR
September 13, 2011
I am something else. A software developer with an interest in games. Especially on mobil platforms.
Wednesday and Friday evenings are normally good for me. But the weekends can work too.
I'm a software developer that loves to play boardgames and have developed one of my own boardgames. Would love to get feedback on my game to see if it's a plausible idea, or just a passing fad.
Meetup members, Log in
By clicking "Sign up" or "Sign up using Facebook", you confirm that you accept our Terms of Service & Privacy Policy


text:
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Average rating: 4.9


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know what i noticed?
know what i noticed?
Jul 22, 2005 11:39PM PST
the average life span of a member on 1up is like a month...
haha!! a month ago this place was jumpin' now it seems a little outdated. anyone else agree?
my reccomendation is to get an account on www.myspace.com you can personalize it a HELLuv a lot more... and there are thousands more people... who also like games!! :) just a thought...
haha!! a month ago this place was jumpin' now it seems a little outdated. anyone else agree?
my reccomendation is to get an account on www.myspace.com you can personalize it a HELLuv a lot more... and there are thousands more people... who also like games!! :) just a thought...
Comments (19)
I'll take a look at it.Posted: Jul 22, 2005 12:00AM PST by Pappagiorgio
I am always looking for more stuff to do while I am at work.
Looks fairly interesting..Posted: Jul 23, 2005 12:00AM PST by dem0nstorm
I made a page over there already, its cool they give you a "default" friend so you dont feel like a total noob.. hehe
I was on myspace...Posted: Jul 25, 2005 12:00AM PST by Adriel
but I cancelled the site for the same reason that you're talking about. I knew no one, it was getting old, and the people that were on it (with the exception of you and my lovely girlfriend) smelled like 3 day old milk. I'm happy where I am but I know what you mean about the lifespan on 1up.
its cool cuz*Posted: Jul 25, 2005 12:00AM PST by crodriguez
im such a "personalizer" kinda person... you can make it your own... ya, some people on there are ~dry~ but hey, what ya gonna do? ;) gotta make the most of everything, ya know? hahaha!!!
A lot of that going on...Posted: Jul 25, 2005 12:00AM PST by Twin Tiger
I hear a lot of people talking about 1up members dropping like flies. This place was jumping during E3, though.
well...Posted: Jul 25, 2005 12:00AM PST by CyberAthlete
it could be due to the fact it's summer, not too many people spending days on end sitting in front of a computer...
i did sign up on my space a long time ago, but i prefer the simplicity of 1up.
dittoPosted: Jul 27, 2005 12:00AM PST by angel_in_disguise
hey sis. yeah, the only reason im on this computer is because im at millersville university right now. their computers are awesome, but they still wont let me update my page....i cant upload pictures or anything, which kind of sucks, and i wish i had a disk or something that i could download them to, but i have to run, because my first class is in a few minutes. im so spazzed. my french is getting so much better, and the councelors are awesome, but they wont speak english, and we get fake money for speaking french with our friends. we were playing cards the other day, and we were playing in french, and franc yelled "merde" and one of our councelors was there behind him, but he thought it was funny. (we were playing bs)
but anyway,. i cant really upload any pictures to my web page from home either, because theres so much crap on the computer. so yeah, we seriously need to get a new computer. this thing seems to be older than i am.
oh crap, gotta run. i hate being late.
ahhhhhhhhhhhhPosted: Jul 27, 2005 12:00AM PST by fanboyhater67
I have an account here and on myspace....I dont really like my myspace that much(I have been using it more latly though) But I still would rather have my 1up.
miaouPosted: Jul 28, 2005 12:00AM PST by angel_in_disguise
thats how the french spell. meow. last night, we had french cheeses and wine, and learned how you're supposed to drink wine, and a drinking song (a bunch of the guys were ticked that the wine had alcohol removed) and it was really interesting. there were three different types of wine
oopsPosted: Jul 28, 2005 12:00AM PST by angel_in_disguise
and the first kind was this white wine, and it was rather bitter, and i didnt like it, and then there was the white zinfindell (or however you spell it) amd that was reallly goood, and then there was this really bitter red wine, and my friends and i were like "une, doux, trois, GOUTE!" (1,2,3, drink) because it tasted so bad. and then the cheese was really good. but i didnt lke the brie. ever had laughing cow (i forgot how you say that in french). well, its really.
both are great sights...Posted: Aug 12, 2005 12:00AM PST by liquid_sword
i use one for marketing - the other for the latest in gamedom!!...one to two hours on the net is enough for me ...rather be talking to my woman(3%)hehee
meh..Posted: Aug 16, 2005 12:00AM PST by CrazyFishsticK
I ahve an account also on Myspace.I like how you can personalize your page and what not...a lot better than 1up, but I"m still not a big fan of Myspace..it seems more of a music thing..and while I love music...I love gaming more.I also hate the search engine on Myspace.It's horrible,when I"m searching for someone specific,it shows a whole bunch of people who even have the persons name in there profile..its annoying.So you have to sit there and search for hours just find someone.I also don't like the fact that its just a big advertising thing right now.And you can thank that Tom guy who made Myspace for selling it to Fox.
I've neverPosted: Aug 17, 2005 12:00AM PST by Crystal__Method
checked out Myspace but 1up takes up enough of my time.
I"m herePosted: Aug 23, 2005 12:00AM PST by Xian042
I'm on the computer all day at work and I"m a huge gamer so I have a lot of time to sit here and play with 1up. I just started a myspace, I like 1up's page setup better, no you cant do as much but myspace pages get too crazy. Although you can find a LOT more ppl on myspace. BUT everyone on here is a gamer and thats what I am so I can actually find more people that are into what I like. Most myspacers are into making spectacles of themselves or talking about how "OMG tat BoI iz sooooooooo HAWT!!!!"
So if you wanna keep up with a regular drop me a message or a blog comment!
you!Posted: Sep 25, 2005 12:00AM PST by dem0nstorm
you denied my add at myspace
you snob !!


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"From early on, very early on, I understood that art is not about what you say. It's about these other things that you don't say."
"Now I approach a picture out of a collection of information that comes to me, and through the experiment of projecting information and working with the language, the mark-making, painting the color and texture, and whatever other elements that I want to bring into the work."
-Julie Mehretu


text:
interhome property
Size70 m²
Floor No.0
- Kitchen
- Lockable room
- Pets allowed
- Balcony/terrace
- Washer/dryer
- Smoking allowed
- Air conditioning
|18010 Granada, Andalusia, Spain
|Property type
|Property ID
|Acceptance rate
|Response time
|A few hours
|Calendar updated
|Check-in after
|On arrangement
|Check-in before
|On arrangement
|Check-out before
|On arrangement
|Cancellation Policy
|View Details
We can only recommend the location, the view, perfect. As described. Very friendly contact. Love to be proven, thank you!
Können wir nur weiter empfehlen, die Lage, die Aussicht, Perfekt. Wie beschrieben. Sehr freundlicher Kontakt. Gerne wider, Danke!
When You get the place You will really enjoy it to be there - but it´s not easy to find it. It is some steps up... it´s not possible to go by car right before the house.
We got some help to carry our cases up :-)
We enjoyed it to be that close to the Alhambra, having a nice look from the sleeping room - a good variation of Jazz & classic CD´s - great paintings make a good atmosphere and the private terrasse.
Beautiful view of the Zugspitz from a private patio. Pleanty of room for two couples with 2 bedrooms. Beds very comfortable. Clean with friendly service.
A group of five girls stayed here and it was fantastic! The views were spectacular the location was spot on couldn't fault the apartment it was spotless and the finishing touch of the towels made up as swans on each bed with small toiletries was a lovely touch. We picked up the keys early from the interhome office the lady was extremely helpful. Would highly recommend we will be using this apartment again on our next visit to benidorm. Thank you
perfect!! the host were so accomodating...nice flat with a private pool...100% coming back!
A little romantic house near lake como. It's a historic stone house, which has been restored beautifully. Perfect for two persons, but also possible with two kids.
Beautiful, comfortable flat with a magnificent view over plage du sillon
Very nice and cosy little appartment. It's small but has everything one needs, the hosts are very friendly, and the location is both quiet and beautiful. Even the dog loved the stay!
I was total satisfied - everything went smoothly. The house was clean and well equipped. Host was very nice and friendly. Nice view and environment. Great places in the neighborhood - worth to visit.
A Nice small apartment in a very nice neighborhood in Venice, few tourists but still good restaurants and very nice people. The host don't speak english but is still very nice and polite. The only thing we missed at the apartment was a AC system because the apartment gets very hot during the summer.
- Quality assured accommodation
- Every host is verified by telephone
- Secure payment via SSL encryption


text:
MILAN — Giorgio Armani has taken on another project — Emporio Armani fine jewelry.
This story first appeared in the July 31, 2002 issue of WWD. Subscribe Today.
The first collection of 60 pieces includes rings, earrings, bracelets and chains and will bow in November. It will be available in the company's 114 Emporio Armani boutiques, plus about 500 jewelry stores worldwide.
"This linear and graphic collection is made with beautiful materials and implicit references to different cultures," said Giorgio Armani. "It features small treats for young people to add a unique and personal touch to their appearances and their identity."
The jewels blur the line between modern and ethnic style, with silver taking the lion's share, followed by yellow and white gold and ebony. Some pieces are jazzed up with colored quartz.
For the production of the debut collection, Armani has collaborated with Fossil, the watch manufacturer that already makes Emporio Armani watches. The line is made in Italy. Retail prices start at $100 for a silver band and climb to $2,000 for a gold necklace.
"I approached the world of jewelry as a question of light and decoration, one step at a time, and with this line I'm offering a more eclectic line to a wider public," said Armani.


text:
Travel to Sherwood Forest and hide from the Sherriff of Nottingham with Robin Hood,
Maid Marian, and the Merry Men as they steal from the rich to give to the poor!
Sep 30 - Oct 2
Friday at 8:00 PM
Saturday and Sunday
at 1:00 PM & 4:00 PM
Bridget's summer becomes an eye-opening adventure when
she discovers her Nana has been running a lingerie boutique for
the sexy senior out of her rent-controlled apartment!
Sep 2 - Sep 11
Friday and Saturday at 8:00pm
Sunday at 2:00pm
Thursday - Saturday at 8:00pm
DCP Theatre Upcoming Auditions
Thanks for auditioning for our 2016 shows!
Check back soon for the audition dates for our 2017 season!
Visit our Auditions page for more info!
DCP Theatre | (215)234-0966 | 795 Ridge Road, Telford, PA
Copyright © 2011. All Rights Reserved.
DNN Skins created with Artisteer by Mike Addice.


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A watertight solution
Business Continuity
Business continuity management is changing. The swine flu threat is already being taken far more seriously than previous pandemic scares. It has reversed the temptation for businesses to cut spending, while the wider economic crisis is providing more lessons for business continuity planning (BCP). The interconnectivity between banks uncovered during the financial crisis led to unforeseen exposure between financial counterparties. A similar trend can be identified in BCP. Firms are broadening their...
More on Operational Risk
7 days in 60 seconds
Margin problems, liquidity tests and passporting
The week on Risk.net, September 16–22, 2016Receive this by email
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text:
Plyometrics is defined as a high-velocity movement that relies on power generated through what is called the "stretch-shortening cycle." A muscle that is stretched before an explosive contraction will contract more forcefully and more rapidly. A common example is the "squatting down" just prior to a vertical jump. By lowering your center of gravity, the muscles involved in the jump are stretched before the powerful leap up.
No matter your goal, plyometrics should be part of your training arsenal.
Explosive exercises will increase your speed and lessen your chance of injury.
To maximize your power output during some leg exercises, stick to body weight.
The traditional low-weight, high-reps approach to lifting weights may not be the best.
Race performance improves after 6-week program.
Explosive power in the legs helps even with distance running.
Jumping exercises improve balance, power, strength, and flexibility.
These short bursts encourage optimal muscle recruitment
Use these exercises to become a more powerful runner.


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Recluse Walter Samaszko Jr.'s gold coins, found after his death, brought in more than $3.5 million in a Carson City, Nev., auction.
A total of 9,644 coins were auctioned at the Carson Courthouse, the majority of the lots obtained by Carson City coin dealer Allen Rowe.
Howard Herz said he has appraised other collections after an owner's death, but never one this large.
"It's a very well-managed investment in gold," he said.
The rest of the coins will be auctioned or sold at a later date, the newspaper said.
Get more Reality TV World! Follow us on Twitter, like us on Facebook or add our RSS feed.


text:
Two days after a spectacular four-alarm fire gutted a Ukrainian Orthodox church in East Oak Lane, the smell of burned wood still lingered over a scene filled with workers and heavy equipment, federal and city officials were still trying to determine the cause of the blaze, and church leaders were pondering their next move.
The scope of the fire at St. Mary Protectress Ukrainian Orthodox Church made determining its cause difficult, Steven Bartholomew, a spokesman for the federal Bureau of Alcohol, Tobacco, Firearms and Explosives, said Tuesday.
"It's a long process," the special agent said. "It's slow and methodical. You have to be thorough to make sure it's done correctly."


text:
(678) 804-8319(678) 804-8319
2713 Chastain Meadows Parkway, Marietta, GA 30066
So I got a flat on my way home the other day, and I dont have a spare on my truck. I got a tow from the guys with AAA, and I came here instead of my house, I got a plug on the flat, and I now have that as a spare, and I got new tires for a good price.
Posted: 3/25/2013 • Link to this review
Reviews: 1
I found them after having a bad experience with Goodyear. The guys are awesome, honest and will not perform any work you do not approve. I have begun taking ALL my company vehicles there. Recently, after my dealership tried to charge me $300 for basic work I called them and they were able to do the work for $100.
Posted: 1/22/2011 • Link to this review
Reviews: 13
I signed up online for a specific set of tires at a specific price. I received a call from the store stating the tires were in Texas. The sales agent wanted me to pay the shipping at $13/tire. I told them to cancel the order and I'd go elsewhere. I received a call back a few minutes later stating the manager would pay for the shipping. The outcome was good, but it seemed to be bait and switch to me. I'm still going somewhere else for the tires.
Posted: 12/01/2009 • Link to this review
I went here for an oil change and they got to my car within 3 minutes of me walking in the store. Very friendly staff!
Posted: 11/07/2007 • Last edited: 6/01/2009 • Link to this review
Reviews: 1
Kauffman tire offers lower than average prices for its tires (because the price also includes services for which most dealers charge extra, for example valve stems and lifetime free rotation). However, service was slow, possibly because I did not have an appointment. Also, the sales person was not knowledgable of the product ratings, such as treadwear, temperature, and traction. Do your own reasearch to know if you're getting the quality you want!
Posted: 6/24/2007 • Last edited: 6/01/2009 • Link to this review


text:
|32 Reviews
|Property type
|Minimum Stay
|3 nights
When you book through the HomeAway checkout, your booking is backed by our Book with Confidence Guarantee™ offering comprehensive payment protection.Learn more
Lovely room with beautiful garden just outside the door in Montecito. King size bed, old fashioned claw foot tub, desk, wireless internet, flat panel TV, basic cable, gated property, laundry, fridge, microwave and toaster oven. Bed linens and towels provided as well. Peaceful garden area and use of pool and spa. Washer & Dryer in unit. E-mail for more info and please include your phone number.
$500 fully refundable deposit and weekly & monthly rentals require a one time $100 cleaning fee.
10% Bed Tax applies to all rentals of 30 days or less.
Holidays extra
Ask about our other rentals.
Keywords: Santa Barbara Vacation Rental, pool, Montecito,
Montecito is just about my favorite place on earth. You can't beat the year round weather and I just love the peaceful environment.
Comfortable, quiet and the grounds are still beautiful despite the drought. We always feel very welcome at Carla's. The dogs consider this their home away from home. We are currently booking our 5th stay for next year as we do no wish to stay anywhere else!
Thank you Carla
Stayed at Carla's Cottages for 4 nights while attending a workshop in Santa Barbara. Had a wonderful stay in the Sweet Studio. The bed was comfortable & cozy. Loved the little kitchenette. Reverse osmosis water on the premises so I could fill my water bottles up every day...that was a treat. Carla was incredibly accommodating and super helpful. It was truly like a home away from home. I look forward to returning when in the area again.
My wife, myself and our 2 Golden's always receive a warm welcome from Carla. My wife hails from Santa Barbara so it is always a whirl wind of visiting relatives and friends. An efficient comfortable and very clean place to stay is a must. A block away is a nice neighborhood to walk the dogs and the beech is a mere 6 minutes by car. This was our third stay and we have already booked for next year! Carla always goes the extra mile to make us feel welcome. Thank you Carla!
My wife, myself and our 2 Golden's always receive a warm welcome from Carla. My wife hails from Santa Barbara so it is always a whirl wind of visiting relatives and friends. An efficient comfortable and very clean place to stay is a must. A block away is a nice neighborhood to walk the dogs and the beech is a mere 6 minutes by car. This was our third stay and we have already booked for next year! Carla always goes the extra mile to make us feel welcome. Thank you Carla!
Carla's cottage was amazing, especially the location in Montecito. It's just a few minutes from the freeway (101 and what a beautiful drive! We stayed 3 nights and thouroughly enjoyed our time, definately WAY better than a hotel experience. Carla is on top of her appointments and was super friendly and informative. She truly reflects the laid back Santa Barbara lifestyle and will make you feel right at home. The ammenities were great and all the neighbors were great too. Definately give her cottages a go next time you're in SB, you will be very happy :)
My husband and I had the pleasure of staying at Sweet Cottage this past week end. It was quite a last minute arrangement on our part, but to our delight, Carla's sweet cottage was available. It was indeed one of the best experiences. The cottage is charming, quiet, peaceful and extremely clean! Carla greeted us upon arrival, showed us around, instructed us on the use of the wonderful amenities…and then we never saw her again!!! but we knew she was only a text away if we needed her! She was such a good hostess. We brought our own coffee pot and fruit and snacks and we were delighted to have everything there that we needed. The setting is simply heaven, and while our week end was super busy visiting our grandson at UCSB; we couldn't wait to get back to the peace and quiet of our cottage each evening. I simply did not want to leave and I told Carla I would be returning as soon as I could!
Golf, Shopping, Antique Shops, Fine Dining, Polo, Beach, scuba diving, island cruises, whale and dolphin watching, hang gliding, glider rides, vineyards, wineries, cafes, opera, symphony orchestra, farmers markets, sunday beach walks/artisan fair, road bike friendly town.
|Rate Period
|Weekend Night
|Monthly *
2016 High Season
May 1 2016 - Sep 30 2016
3 night minimum stay
2017 High Season
May 1 2017 - Sep 30 2017
3 night minimum stay
My Standard Rate
3 night minimum stay
|Cleaning Fee
|Refundable damage deposit
|Tax Rate
3 night minimum stay. Weekly and monthly rentals have a $100 cleaning fee
* Approximate monthly rate. Actual rate will depend on the days of the month you stay.