text:
|Publication number
|Publication type
|Application number
|Publication date
|Aug 29, 2000
|Filing date
|Jun 28, 1999
|Priority date
|May 5, 1998
|Fee status
|Also published as
|Publication number
|Richard M. Kimes, Michael S. Mirizzi
|Original Assignee
|Kimes; Richard M., Mirizzi; Michael S.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (42), Non-Patent Citations (6), Referenced by (74), Classifications (15), Legal Events (5)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation of U.S. Ser. No. 09/072,925, now U.S. Pat. No. 5,974,692, filed May 5, 1998.
The present invention relates to an apparatus for loading a tubular graft, such as a stent, onto the distal end of a catheter assembly of the kind used, for example, in percutaneous transluminal coronary angioplasty (PTCA) or percutaneous transluminal angioplasty (PTA) procedures.
In typical PTCA procedures, a guiding catheter is percutaneously introduced into the cardiovascular system of a patient through the brachial or femoral arteries and advanced through the vasculature until the distal end of the guiding catheter is in the ostium. A guide wire and a dilatation catheter having a balloon on the distal end are introduced through the guiding catheter with the guide wire sliding within the dilatation catheter. The guide wire is first advanced out of the guiding catheter into the patient's coronary vasculature and the dilatation catheter is advanced over the previously advanced guide wire until the dilatation balloon is properly positioned across the arterial lesion. Once in position across the lesion, a flexible and expandable balloon is inflated to a predetermined size with a radiopaque liquid at relatively high pressures to radially compress the atherosclerotic plaque of the lesion against the inside of the artery wall and thereby dilate the lumen of the artery. The balloon is then deflated to a small profile so that the dilatation catheter can be withdrawn from the patient's vasculature and the blood flow resumed through the dilated artery. As should be appreciated by those skilled in the art, while the above-described procedure is typical, it is not the only method used in angioplasty.
In angioplasty procedures of the kind referenced above, restenosis of the artery may develop over time, which may require another angioplasty procedure, a surgical bypass operation, or some other method of repairing or strengthening the area. To reduce the likelihood of the development of restenosis and to strengthen the area, a physician can implant an intravascular prosthesis for maintaining vascular patency, commonly known as a stent, inside the artery at the lesion. The stent is crimped tightly onto the balloon portion of the catheter and transported in its delivery diameter through the patient's vasculature. At the deployment site, the stent is expanded to a larger diameter, often by inflating the balloon portion of the catheter. The stent also may be of the self-expanding type.
Since the catheter and stent travel through the patient's vasculature, and probably through the coronary arteries, the stent must have a small delivery diameter and must be firmly attached to the catheter until the physician is ready to implant it. Thus, the stent must be loaded onto the catheter so that it does not interfere with delivery, and it must not come off the catheter until it is implanted.
In procedures where the stent is placed over the balloon portion of the catheter, it is necessary to crimp the stent onto the balloon portion to reduce its diameter and to prevent it from sliding off the catheter when the catheter is advanced through the patient's vasculature. Non-uniform crimping can result in sharp edges being formed along the now uneven surface of the crimped stent. Furthermore, non-uniform stent crimping may not achieve the desired minimal profile for the stent and catheter assembly. Where the stent is not reliably crimped onto the catheter, the stent may slide off the catheter and into the patient's vasculature prematurely as a loose foreign body, possibly causing blood clots in the vasculature, including thrombosis. Therefore, it is important to ensure the proper crimping of a stent onto a catheter in a uniform and reliable manner.
This crimping is often done by hand, which can be unsatisfactory due to the uneven application of force resulting in non-uniform crimps. In addition, it is difficult to visually judge when a uniform and reliable crimp has been applied.
Some self-expanding stents are difficult to load by hand onto a delivery device such as a catheter. Furthermore, the more the stent is handled the higher the likelihood of human error, which is antithetical to a properly crimped stent. Accordingly, there is a need in the art for a device for reliably crimping a stent onto a catheter.
There have been attempts at devising a tool for crimping a stent onto a balloon delivery catheter. An example of such a tool comprises a series of plates having substantially flat and parallel surfaces that move in a rectilinear fashion with respect to each other. A stent carrying catheter is disposed between these surfaces, which surfaces crimp the stent onto the outside of the catheter by their relative motion and applied pressure. The plates have multiple degrees of freedom and may have force-indicating transducers to measure and indicate the force applied to the catheter during crimping of the stent.
Another stent loading tool design is comprised of a tubular member housing a bladder. The tubular member and bladder are constructed to hold a stent that is to be crimped onto a balloon catheter assembly. Upon placement of the stent over the balloon portion of the catheter, a valve in the loading tool is activated to inflate the bladder. The bladder compresses the stent radially inward to a reduced diameter onto the balloon portion of the catheter to achieve a snug fit. In this way, the stent is crimped onto the distal end of a balloon catheter with a minimum of human handling. The foregoing stent crimping tools are disclosed in, for example, U.S. Pat. Nos. 5,437,083 and 5,546,646 to Williams et al.
Yet another stent crimping tool is known in the art as the BARD XT, which is actually a stent loader. It is constructed from a rigid, tubular body with a ball at one end connected to a plurality of long, thin strips passing through the tubular body. An uncrimped stent is placed over the plurality of long, thin strips, which hold the stent in an expanded state. The balloon portion of a catheter is inserted into the cylindrical space formed by the plurality of strips. When the user pulls the ball while holding the tubular body against the stent, the strips are slid from beneath the stent and the stent is transferred onto the balloon portion.
Still another conventional stent crimping tool is manufactured by JOHNSON & JOHNSON and appears similar to a hinged nutcracker. Specifically, the tool is comprised of two hand operated levers hinged at one end and gripped in the palm of the hand at the opposite end. A cylindrical opening holding a crimping tube is provided through the mid-portion of the tool to receive therein a stent loaded onto a balloon catheter. The crimping operation is performed by the user squeezing the handle thereby pressing the crimping tube which in turn pinches the stent onto the balloon catheter.
While the prior art devices are suitable for crimping stents onto balloon catheters, they suffer from problems such as non-uniform crimping forces, resulting in non-uniform crimps. Consequently, they are unsuitable for use by physicians in a cath lab who desire to crimp the stent onto the balloon catheter.
Both PTCA and PTA procedures have become commonplace in treating stenoses or lesions in blood vessels and coronary arteries. In approximately 35% to 40% of the procedures, restenosis may develop requiring a further angioplasty, atherectomy or bypass procedure to return the patency of the vessel. Intravascular stents are now being deployed after PTCA and PTA procedures, and after atherectomies, in order to help prevent the development of restenosis. Importantly, such stents, mounted on the balloon portion of a catheter, must be tightly crimped to provide a low profile delivery diameter, and to ensure that the stent stays on the balloon until the balloon is expanded and the stent is implanted in the vessel. The present invention is directed to a crimping tool that can repeatedly provide a uniform and tight crimp to ensure the low profile diameter of the stent on the balloon portion of the catheter, and to ensure that the stent remains firmly attached until it is implanted in the vessel by expanding the balloon.
The present invention is directed to a method and apparatus to obtain consistent crimping of a stent on a balloon catheter independent of the balloon profile. This is accomplished by limiting the amount of force that is applied to crimp the stent by using a clutch that disconnects the applied torque at a predetermined level.
In particular, the present invention is directed to a tool for crimping a stent onto a balloon catheter, comprising a crimping section holding the stent and the balloon catheter therein; a shaft having an input end and an output end, engaging the crimping section at the output end, which shaft when rotated actuates the crimping section to crimp the stent; a detent formed into the input end of the shaft; a gripping member having an internal cavity to receive the input end of the shaft, wherein the cavity includes a hole proximate to the shaft; a stop member; a biasing member disposed in the hole and biasing the stop member into engagement with the detent; whereby applying a torque to the gripping member beyond a predetermined level overcomes the force of the biasing member and slides the stop member out of the detent to disengage the applied torque from the shaft.
Rotation of the shaft halts, and the magnitude of the crimping force encountered by the stent levels off or drops off due to resilience or backlash in the system. Damage to the stent from excessive crimping force is avoided.
In one exemplary embodiment, the crimping section comprises a housing having an internal chamber with an enclosed first end, and an open second end having threads, wherein the output end of the shaft is partially disposed within the internal chamber through the open second end of the housing, and wherein the input end of the shaft includes threads that engage the threads of the internal chamber; and an elastic tubing having a lumen, wherein the tubing is disposed within the internal chamber adjacent the enclosed first end, and the output end of the shaft is disposed adjacent the tubing. Accordingly, the stent and balloon catheter are positioned within the lumen and rotation of the shaft advances the shaft into the tubing, compressing the tubing, and crimping the stent.
In another exemplary embodiment, the crimping section comprises a rigid chassis having a hollow interior enclosed by a closed back end and leading to an open front end, wherein the back end includes a threaded opening; an end cap enclosing the open front end, the end cap including a central opening; an elastic tube disposed within the hollow interior adjacent to the front end and having a length less than a length of the hollow interior to define a chamber adjacent to the back end; a piston slidably disposed within the chamber; wherein the shaft passes through the closed back end of the chassis and the shaft includes threads engaging the threads of the back end, and the output end of the shaft engages the piston so that the shaft when rotated displaces the piston to compress the elastic tube; whereby the stent is loaded onto the catheter and is inserted through the central opening into the elastic tube, and the compressed elastic tube squeezes the stent radially onto the catheter.
In yet another exemplary embodiment, the crimping section comprises a base having at least first and second spaced apart supports, wherein the shaft is rotatably disposed on the second support with the output end of the shaft extending toward the first support; a coiled filament having an axial space and being attached to the first support and the output end of the shaft and extending between the first and second supports; whereby inserting the stent and catheter into the axial space of the coiled filament and rotating the shaft reduces the diameter of the axial space thereby crimping the stent onto the catheter.
In conclusion, it is clear that the present invention tool can be adapted to a variety of stent crimping sections that are operated by application of torque. The clutch of the present invention ensures that the amount of force applied during the crimping process is controlled. This is achieved by disconnecting the gripping member from the shaft at a predetermined level of torque. Doing so disrupts the transfer of torque to the crimping section of the tool, which in turn levels the amount of crimping force exerted on the stent.
With precise control of applied crimping forces, the present invention tool is capable of homogeneously crimping a stent onto a balloon catheter. Such a crimping tool is highly useful to cardiologists, for example. Such physicians are often concerned with proper deployment of the stent within the patient that it is desirable to have a consistently and reliably crimped stent. The present invention tool is further a time saver, because the stent crimping procedure can be performed fairly efficiently and quickly. These and other advantages of the present invention will become apparent from the following detailed description thereof when taken in conjunction with the accompanying exemplary drawings.
FIG. 1 is a side elevational view, partially in section, depicting a stent that has been crimped onto a delivery catheter and disposed within a vessel.
FIG. 2 is a sectional view of a preferred embodiment of the present invention, showing the clutch mechanism and the crimping section of the tool.
FIG. 3 is a cross-sectional view of an alternative embodiment of the present invention tool shown in FIG. 2.
FIG. 4 is a perspective view of an exemplary embodiment tool wherein the crimping section includes a coiled filament used to crimp the stent.
FIGS. 5 and 6 are simplified schematic diagrams depicting a stent crimping operation performed by the present invention tool.
FIG. 1 illustrates intravascular stent 10 which is mounted onto delivery catheter 11. Stent 10 generally comprises a plurality of radially expandable cylindrical elements 12 disposed coaxially and interconnected by members 13 disposed between adjacent cylindrical elements 12. Delivery catheter 11 has an expandable portion or balloon 14 for expanding stent 10 within coronary artery 15 or other vessel such as saphenous veins, carotid arteries, arteries, and veins. Artery 15, as shown in FIG. 1, has dissected lining 16 which has occluded a portion of the arterial passageway.
Delivery catheter 11 onto which stent 10 is mounted is essentially the same as a conventional balloon dilatation catheter for angioplasty procedures. Balloon 14 may be formed of suitable materials such as polyethylene, polyvinyl chloride, polyethylene terephthalate and other like polymers. In order for stent 10 to remain in place on balloon 14 during delivery to the site of the damage within artery 15, stent 10 is compressed onto balloon 14.
An optional retractable protective delivery sleeve 20 may be provided to further ensure that stent 10 stays in place on balloon 14 of delivery catheter 1 1 and to prevent abrasion of the body lumen by the open surface of stent 10 during delivery to the desired arterial location. Other means for securing stent 10 onto balloon 14 may also be used, such as providing collars or ridges on the ends of the working portion, i.e., the cylindrical portion of balloon 14.
In order to implant stent 10, it is first mounted onto inflation balloon 14 on the distal extremity of delivery catheter 11. Stent 10 is crimped down onto balloon 14 to ensure a low profile. The present invention addresses this crimping procedure.
The catheter-stent assembly can be introduced into the patient's vasculature through processes known in the art. Briefly, guide wire 18 is disposed across the arterial section where an angioplasty or atherectomy has been performed requiring a follow-up stenting procedure. In some cases, the arterial wall lining may be detached so that guide wire 18 is advanced past detached or dissected lining 16 and the catheter-stent assembly is advanced over guide wire 18 within artery 15 until stent 10 is directly under detached lining 16. Prior to inflation of balloon 14, optional delivery sleeve 20 is retracted to expose stent 10. Depending on the balloon and stent assembly, a delivery sleeve may be unnecessary. Balloon 14 of delivery catheter 11 is then inflated using an inflation fluid. Expansion of balloon 14 in turn expands stent 10 against artery 15. Next, balloon 14 is deflated and catheter 11 is withdrawn leaving stent 10 to support the damaged arterial section. As mentioned above, in order to ensure proper seating of stent 10 on balloon 14, and to ensure proper deployment of stent 10 at the site of the damage within artery 15, the stent crimping procedure is important.
FIG. 2 is a cross-sectional view of a preferred embodiment of the present invention stent crimping tool 22. Stent crimping tool 22 as shown preferably has crimping section 24 and actuation section 26. Actuation section 26 is rotated and torque is transmitted through shaft 28 to crimping section 24.
In order to limit the amount of torque transmitted to shaft 28 and to thus limit the amount of crimping force, the present invention includes a clutch mechanism. In the preferred embodiment, the clutch mechanism includes compression spring 30, ball bearing 32, and detent 34 located on shaft 28. As gripping member 36, which can be a knob, crank, knurled spindle, or the like, is rotated, torque is transmitted through a stop member, here ball bearing 32, to detent 34. Spring 30 which is positioned within hole 38 biases ball bearing 32 into detent 34 with sufficient force to maintain the transfer of torque from gripping member 36 to shaft 28. If, however, a predetermined amount of torque is exceeded, the axial force of compression spring 30 is overcome causing ball bearing 32 to slide out of detent 34 and to retract into hole 38. Of course, this predetermined amount of torque can be adjusted by modifying the spring force, depth of the detent, size of the ball bearing, and other parameters known in the art.
At that instant, the linkage between gripping member 36 and shaft 28 is broken because ball bearing 32 is free to rotate and slide along the outer circumference of shaft 28. The clutch mechanism thus limits the torque delivery through shaft 28 into crimping section 24.
In the exemplary embodiment shown in FIG. 2, detent 34 is a semi-spherical cut-out formed in the input end 40 of shaft 28. Input end 40 is also received within cavity 42 of gripping member 36. Gripping member 36 may be formed in a cylindrical shape for easy gripping as shown, or may take other grippable shapes known in the art. Furthermore, a resilient piece of material may be used to replace spring 30 to bias ball bearing into shaft 28. For example, a sponge-like material can be used that has compliance and a level of resilience needed to urge ball bearing 32 into detent 34 in order to transfer torque between gripping member 36 and shaft 28.
At the opposite end of shaft 28 is output end 44 which is preferably located adjacent resilient tubing 46. Shaft 28 further includes external threads 48 meant to engage internal threads 50 formed inside housing 52 of crimping section 24. Resilient tubing 46 fits within hollow interior 54 of housing 52, wherein the latter is sufficiently rigid to not expand or distort under pressure. At the opposite end of housing 52 is end cap 56 that encloses the back end.
Thus, as the user manually rotates shaft 28 through application of torque to gripping member 36, shaft 28 advances into and compresses resilient tubing 46. Within resilient tubing 46 is lumen 58 containing uncrimped stent 10 already loaded onto balloon 14 of catheter 11. End cap 56 has an optional central opening 60 in communication with lumen 58. Hence, delivery catheter 11 can be inserted through central opening 60 and advanced into alignment with uncrimped stent 10 inside lumen 58. As compression of the resilient tubing 46 takes place, the length of resilient tubing 46 is shortened thereby causing lumen 58 to collapse and simultaneously crimp stent 10 onto delivery catheter 11. After the crimping step, shaft 28 is rotated in the opposite direction to retract it away from resilient tubing 46, which regains its original shape. Thereafter, the crimped stent and catheter assembly can be withdrawn through central opening 60.
In an alternative embodiment, a through hole (not shown) can be formed through the length of shaft 28 and through gripping member 36. After the crimping step, the crimped stent and catheter assembly can be advanced over a guide wire (not shown), passing through the through hole, and out the opposite end of the tool. Therefore, in this alternative embodiment, the crimped stent and catheter assembly can be immediately advanced over the guide wire to the patient for implantation after the crimping step.
During the crimping step, if maximum torque is exceeded, as explained above, ball bearing 32 slides out of detent 34. On the other hand, if gripping member 36 is continuously rotated, ball bearing 32 can be reseated within detent 34 during a subsequent revolution of gripping member 36 about input end 40, thereby re-engaging the linkage between shaft 28 and gripping member 36. At that moment, torque can be reapplied by rotating the gripping member 36 in either direction to advance or retract shaft 28. By alternately advancing and retracting shaft 28, it is possible to repeat the crimping step and ensure a firm and consistent crimp of stent 10 on catheter 11. To be sure, it is also possible to rotate delivery catheter 11 during each cycle of the crimping step.
FIG. 3 is an alternative embodiment of the exemplary embodiment shown in FIG. 2. More precisely, FIG. 3 is a cross-sectional view showing crimping section 62 that is a modification of crimping section 24 from FIG. 2. As seen in FIG. 3, torque is transferred between gripping member 36 and crimping section 62 through threaded shaft 64. Crimping section 62 is similar to that disclosed in co-pending U.S. patent application entitled "Indeflator-Driven, Rubber-Compression Crimping Tool" by Stephen A. Morales, (ACS-42071) Ser. No. 09/063,905, filed Apr. 21, 1998, whose entire contents are incorporated herein by reference.
In this embodiment, crimping section 62 is constructed from cylindrical shape chassis 66 having open end 68 and closed end 70. Open end 68 is sealed closed with optional end cap 72 that is bonded to open end 68 using adhesive 74 of a type known in the art. Optionally, end cap 72 may be attached to chassis 66 using threads, snaps, clamps, or other mechanical means known in the art.
Within cylindrical shape chassis 66 is hollow interior 76 that contains elastic tube 78 that is coaxially disposed within chassis 66. Notably, elastic tube 78 has a length that is shorter than the length of hollow interior 76. Because of this difference in length, and because elastic tube 78 is disposed adjacent open end 68, chamber 80 is formed adjacent to closed end 70. Slidably disposed within chamber 80 is movable piston 82. Shaft 64 engages piston 82 as shown in FIG. 3.
End cap 72 includes central opening 84 that is aligned and in communication with axial space 86 of elastic tube 78. Central opening 84 allows the stent-catheter assembly to be inserted into crimping section 62 prior to undergoing the crimping procedure.
Leading up to the procedure, a user introduces stent 10 already loaded onto balloon portion 14 of catheter 11 into axial space 86 within elastic tube 78. In the exemplary embodiment, the inside diameter of elastic tube 78 is slightly greater than the outside diameter of the uncrimped stent 10, or uncrimped stent and balloon 10 and 14, respectively.
As gripping member 36 is rotated, torque is transmitted through spring 30 to ball bearing 32 and to the walls of detent 34 formed in shaft 64. Shaft 64 once in rotation advances piston 82 into elastic tube 78 as indicated by the arrow. As a result, elastic tube 78 is compressed axially or lengthwise. The elastic material of elastic tube 78 must maintain a constant volume due to its surface elasticity and containment within the confines of hollow interior 76. Continuous compression of elastic tube 78 by piston 82 causes the material of elastic tube 78 to displace axially and then radially into axial space 86, in effect collapsing that space. This decreases the diameter of axial space 86. In turn, stent 10 contained inside axial space 86 is compressed radially onto balloon portion 14 of catheter 11.
As in the previously described embodiment, exceeding a pre-determined torque on gripping member 36 disengages ball bearing 32 from detent 34 to disconnect the application of torque to shaft 64. On the other hand, insofar as gripping member 36 and shaft 64 are linked through the clutch mechanism, it is possible to rotate and counter-rotate shaft 64 to advance and retract, respectively, piston 82. Indeed, it is possible to cycle through the crimping step over and over as necessary.
In the various exemplary embodiments of the present invention crimping tool shown in FIGS. 2 and 3, the housing pieces, piston, shafts, gripping member, etc. can be made from a rigid, injection molded plastic material. Also, translucent and transparent materials can be used so that the task at hand can be visually monitored. The present invention design is well suited for fabrication from surgical steel, too. Resilient tubing 46 and elastic tube 78 of each embodiment can be made from rubber or other elastomers known in the art.
FIG. 4 is a perspective view of an alternative embodiment of the present invention tool. In this embodiment, stent crimping section 90 contains a filament used to constrict a stent onto a balloon catheter inserted within an axial space formed by the coiled filament. Torque is still applied through gripping member 36, which is connected to shaft 92. As best seen in this figure, the surface of gripping member 36 may optionally be contoured or knurled by pattern 94 to provide a better gripping surface.
Stent crimping section 90 is similar to that disclosed in co-pending U.S. patent application entitled "Stent Crimping Tool and Method of Use" by Stephen A. Morales, (ACS-42070) Ser. No. 08/962,632, filed Nov. 3, 1997, the entire contents of which are incorporated herein by reference. In FIG. 4, stent crimping section 90 includes base 96, first vertical support 98, second vertical support 100, wherein the two vertical supports 98 and 100 are spaced apart on base 96. Shaft 92 rotatably passes through an opening in second vertical support 100. Cam 102 is affixed on shaft 92 whereby the cam rotates with shaft 92.
Cam 102 optionally includes an obstruction which, in the preferred embodiment, are teeth 104 located at the circumference of cam 102 and are designed to engage pawl 106. Pawl 106 is positioned on base 96 and biased into teeth 104. Together, cam 102, teeth 104, and pawl 106 form a ratchet mechanism that permits rotation in one direction yet prevents rotation of shaft 92 in the opposite direction.
Attached to output end 108 of shaft 92 is one end of coiled filament 110. The opposite end of coiled filament 110 is connected to first vertical support 98. In the preferred embodiment shown in FIG. 4, coiled filament 110 is a coiled tension spring with its ends hooked to pins 112 and 114.
In FIG. 4, the present invention tool has fairly high extending vertical supports 98, 100, such that shaft 92 passes through second vertical support 100 rather than just resting upon it. Optional bearing 116 is located inside second vertical support 100 to minimize rotational friction between shaft 92 and second vertical support 100.
Also, through hole 118 is provided in first vertical support 98 and is in communication with axial space 120 that is defined by the collection of coils of coiled filament 110. When the tool is used, through hole 118 allows the stent-catheter assembly to be passed therethrough into axial space 120.
FIGS. 5 and 6 are simplified schematic diagrams of the preferred embodiment of the present invention shown in FIG. 4 to help explain the crimping operation. Specifically, FIG. 5 provides a side elevational view of the present invention whereby stent 10 and balloon 14 have been inserted within axial space 120. Optional sheath 122 is shown covering the stent-catheter assembly. Inside gripping member 36, ball bearing 32 has been biased by compression spring 30 into detent 34. Gripping member 36 can be rotated to apply torque through shaft 92 thereby twisting coiled filament 110 in order to constrict the stent-catheter assembly inside axial space 120.
FIG. 6 shows completion of the crimping step after coiled filament 110 has been twisted. Also shown in FIG. 6 is the instant when maximum torque has been exceeded so that ball bearing 32 has slid out of detent 34 and is riding on the outside diameter of shaft 92. At this very instant, the applied torque from gripping member 36 is disconnected from shaft 92 and from constricted coiled filament 110. The natural resiliency of coiled filament 110 at this moment tends to counter-rotate shaft 92. However, pawl 106 biased by spring 124 engages cam 102 to prevent the counter-rotation. Of course, disengagement of pawl 106 from cam 102 would permit free rotation of shaft 92 in either direction. At input end 126 of shaft 92, shaft 92 rotates independently of gripping member 36 until ball bearing 32 is again seated within detent 34 during one of the revolutions of shaft 92 relative to gripping member 36. Upon re-engagement, gripping member 36 is again linked to shaft 92 to control its rotation.
In the preferred embodiment, parts forming crimping section 90 are made from Nylon or a comparable polymer known in the art. Coiled filament 110 can be a metal tension spring, a resilient polymer ribbon made from Mylar, for example, formed into a coil. The coiled filament can have a flat, polygonal, or round cross-sectional shape.
The present invention is preferably sterilized and intended to be used in a cath lab by a trained technician or cardiologist. As will be appreciated by those skilled in the art, the present invention crimping tool is designed both for single use applications in a cath lab by a physician, or for multiple use applications in a sterile environment in a high volume manufacturing facility. In such a manufacturing facility where sterile conditions exist, the present invention stent crimping tool can be used repeatedly to crimp stents onto balloons until the mechanism wears out. Thus, repeated uses of the present invention are contemplated for controlled, sterile environments, as are single use applications when operated by cath lab personnel.
Furthermore, the present invention crimping tool can be used with any stent that is released without a delivery system. The crimping tool may also be sold alone, because its design is robust enough to undergo many uses.
Other modifications can be made to the present invention without departing from the scope thereof. The specific dimensions, procedural steps, and materials of construction are provided as examples, and substitutes are readily contemplated which do not depart from the invention.
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|Advanced Cardiovascular Systems, Inc.
|Assembly for crimping an intraluminal device or measuring the radial strength of the intraluminal device and method of use
|Nov 16, 2000
|Sep 16, 2003
|Scimed Life Systems, Inc.
|Bare stent ship and crimp device
|Nov 28, 2001
|Nov 25, 2003
|Advanced Cardiovascular Systems, Inc.
|Assembly for crimping an intraluminal device or measuring the radial strength of the intraluminal device and method of use
|Aug 2, 2000
|Jun 1, 2004
|Cordis Corporation
|Delivery apparatus for a self-expanding stent
|Aug 2, 2000
|Aug 10, 2004
|Cordis Corporation
|Delivery apparatus for a self-expanding stent
|Oct 1, 2001
|Nov 30, 2004
|Scimed Life Systems, Inc.
|Method and apparatus for contracting, loading or crimping self-expanding and balloon expandable stent devices
|May 23, 2003
|Jul 12, 2005
|Boston Scientific Scimed, Inc.
|Apparatus for contracting, loading or crimping self-expanding and balloon expandable stent devices
|Feb 6, 2003
|Jul 26, 2005
|Scimed Life Systems, Inc.
|Bare stent ship and crimp device
|Aug 20, 2003
|Aug 16, 2005
|Advanced Cardiovascular Systems, Inc.
|Intravascular stent
|Feb 25, 2002
|Jan 3, 2006
|Gore Enterprise Holdings, Inc.
|Method of producing low profile stent and graft combination
|Apr 16, 2004
|Apr 4, 2006
|Boston Scientific Scimed, Inc.
|Stent crimper
|Apr 4, 2003
|Aug 29, 2006
|Boston Scientific Scimed, Inc.
|Protective loading of stents
|Apr 16, 2004
|Dec 5, 2006
|Boston Scientific Scimed, Inc.
|Stent crimper
|Feb 26, 2004
|Apr 24, 2007
|Boston Scientific Scimed, Inc.
|Jan 12, 2004
|Oct 23, 2007
|Boston Scientific Scimed, Inc.
|Stent reducing system and device
|Jan 29, 2004
|Jan 8, 2008
|Boston Scientific Scimed, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|Jul 10, 2002
|Mar 18, 2008
|Boston Scientific Scimed, Inc.
|Method of making a medical device
|Jul 26, 2005
|Jun 24, 2008
|Abbott Laboratories
|Stent crimping system
|Mar 1, 2004
|Jan 27, 2009
|Boston Scientific Scimed, Inc.
|Automated marker band nest placement crimper
|Aug 31, 2005
|May 19, 2009
|Advanced Cardiovascular Systems, Inc.
|Intravascular stent
|Apr 24, 2007
|Aug 25, 2009
|Boston Scientific Scimed, Inc.
|Method of reducing a stent in cross-section
|Jun 23, 2005
|Sep 15, 2009
|Boston Scientific Scimed, Inc.
|Stent crimper
|May 22, 2007
|Dec 8, 2009
|Abbott Laboratories
|Stent crimping system
|Jan 8, 2008
|Dec 29, 2009
|Boston Scientific Scimed, Inc.
|Method for crimping and loading of intraluminal medical devices
|Sep 19, 2005
|Apr 6, 2010
|Gore Enterprise Holdings, Inc.
|Method of producing low profile stent and graft combination
|Jul 28, 2009
|Feb 15, 2011
|Boston Scientific Scimed, Inc.
|Dec 23, 2009
|Apr 19, 2011
|Boston Scientific Scimed, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|Aug 6, 2009
|Aug 9, 2011
|Boston Scientific Scimed, Inc.
|Crimping apparatus for reducing size of a stent
|Jun 27, 2005
|Jan 24, 2012
|Boston Scientific Scimed, Inc.
|Crimping and edge protection elements
|Mar 17, 2008
|Jul 10, 2012
|Abbott Laboratories
|Stent crimping system and method
|Apr 21, 2011
|Jul 17, 2012
|Abbott Cardiovascular Systems, Inc.
|Method for retaining a vascular stent on a catheter
|Apr 1, 2009
|Sep 4, 2012
|Advanced Cardiovascular Systems, Inc.
|Intravascular stent with a plurality of first and second peaks
|Mar 15, 2011
|May 14, 2013
|Boston Scientific Scimed, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|Jan 10, 2011
|Aug 27, 2013
|Boston Scientific Scimed, Inc.
|Jul 11, 2011
|Sep 17, 2013
|Boston Scientific Scimed, Inc.
|Method for contracting or crimping stents
|Aug 3, 2011
|Jun 3, 2014
|Abbott Cardiovascular Systems Inc.
|Crimping apparatus
|Jul 30, 2009
|Jul 1, 2014
|Intersect Ent, Inc.
|Methods and devices for crimping self-expanding devices
|Nov 13, 2008
|Oct 14, 2014
|Intersect Ent, Inc.
|Device and methods for treating paranasal sinus conditions
|Nov 15, 2013
|Mar 24, 2015
|Intersect Ent, Inc.
|Self-expanding devices and methods therefor
|Sep 25, 2009
|Jun 16, 2015
|W. L. Gore & Associates, Inc.
|Method of producing low profile stent and graft combination
|Sep 15, 2010
|Mar 7, 2017
|Intersect Ent, Inc.
|Device and methods for treating paranasal sinus conditions
|Feb 25, 2002
|Sep 26, 2002
|Armstrong Joseph R.
|Method of producing low profile stent and graft combination
|Feb 6, 2003
|Jul 24, 2003
|Scimed Life Systems, Inc.
|Bare stent ship and crimp device
|Jul 10, 2002
|Jan 15, 2004
|Jan Weber
|Medical devices and methods of making the same
|Aug 20, 2003
|Feb 26, 2004
|Gomez Andreina P.
|Intravascular stent
|Apr 4, 2003
|Oct 7, 2004
|Michael Austin
|Protective loading of stents
|Jan 12, 2004
|Jul 14, 2005
|Karen Larson
|Stent reducing system and device
|Jan 29, 2004
|Aug 4, 2005
|Scimed Life Systems, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|Feb 26, 2004
|Sep 1, 2005
|Scimed Life Systems, Inc.
|Mar 1, 2004
|Sep 1, 2005
|Scimed Life Systems, Inc.
|Automated marker band nest placement crimper
|Apr 16, 2004
|Oct 20, 2005
|Scimed Life Systems, Inc.
|Stent crimper
|Apr 16, 2004
|Oct 20, 2005
|Scimed Life Systems, Inc.
|Stent crimper
|Jun 23, 2005
|Oct 27, 2005
|Boston Scientific Scimed, Inc.
|Method and apparatus for contracting, loading or crimping self-expanding and balloon expandable stent devices
|May 13, 2005
|Dec 1, 2005
|Medtronic Vascular, Inc.
|Stent-reduction sleeve
|Sep 19, 2005
|Jan 19, 2006
|Armstrong Joseph R
|Method of producing low profile stent and graft combination
|Aug 31, 2005
|Mar 9, 2006
|Gomez Andreina P
|Intravascular stent
|Jun 27, 2005
|Dec 28, 2006
|Boston Scientific Scimed, Inc.
|Crimping and edge protection elements
|Aug 2, 2005
|Feb 8, 2007
|Boston Scientific Scimed, Inc.
|Protection by electroactive polymer sleeve
|Apr 24, 2007
|Aug 23, 2007
|Boston Scientific Scimed, Inc.
|Nov 20, 2007
|Jun 5, 2008
|Abbott Laboratories
|Stent crimping assembly and method
|Jan 8, 2008
|Jul 24, 2008
|Boston Scientific Scimed, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|Apr 1, 2009
|Jul 30, 2009
|Advanced Cardiovascular Systems, Inc.
|Intravascular stent
|Sep 25, 2009
|Jan 21, 2010
|Armstrong Joseph A
|Method of Producing Low Profile Stent and Graft Combination
|Jul 30, 2009
|Feb 25, 2010
|Abbate Anthony J
|Methods and devices for crimping self-expanding devices
|Dec 23, 2009
|Apr 22, 2010
|Boston Scientific Scimed, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|Aug 6, 2009
|Jun 24, 2010
|Boston Scientific Scimed, Inc.
|Method and apparatus for contracting, or crimping stents
|Sep 15, 2010
|Jan 6, 2011
|Eaton Donald J
|Device and methods for treating paranasal sinus conditions
|Jan 10, 2011
|May 5, 2011
|Boston Scientific Scimed, Inc.
|Mar 15, 2011
|Jul 7, 2011
|Boston Scientific Scimed, Inc.
|Apparatuses for crimping and loading of intraluminal medical devices
|May 2, 2011
|Aug 25, 2011
|Abbott Cardiovascular Systems Inc.
|Catheter assembly and method for treating bifurcations
|Nov 17, 2004
|Aug 4, 2005
|Boston Scientific Limited
|Stent reducing system
|Mar 10, 2006
|Nov 30, 2006
|Boston Scientific Limited
|Method and apparatus for reducing a stent
|Mar 14, 2014
|Nov 6, 2014
|Microtech Medical Technologies Ltd.
|Implantable device with bridge
|U.S. Classification
|29/280, 606/198, 623/1.11, 29/516, 29/282, 29/283.5
|International Classification
|Cooperative Classification
|European Classification
|Apr 24, 2001
|Certificate of correction
|Mar 1, 2004
|Fee payment
Year of fee payment: 4
|Mar 10, 2008
|Maintenance fee reminder mailed
|Aug 29, 2008
|Lapse for failure to pay maintenance fees
|Oct 21, 2008
|Expired due to failure to pay maintenance fee
Effective date: 20080829


text:
Peer Evaluations and the Skeptical Student
Peer evaluations encourage students to think critically and become active users in the feedback loop. With all the benefits peer evaluations provide, it is useful to learn how to tackle some of the main concerns that students have in relation to using peer evaluation in their coursework and how you can address and stop the skepticism before it even starts.
What skepticism?
These concerns are not pulled from thin air, we have analyzed feedback we have received from students after they have used Peergrade for one semester. Across students, we have seen that there are common concerns with peer grading and peer evaluation including: lack of teacher involvement, extra course work and feeling unprepared to give feedback. Below are three ways that these concerned can be addressed in the classroom.
1. Question of Integration
One of the main concerns students have had with using peer evaluation is related to the way it has been incorporated into their course work. If students already have a long list of assignments they need to complete for the course, then adding peer evaluation might feel like extra work, because it feels just like what is, an addition. If students are going to engage and put proper effort into peer evaluations, they need to feel that it is an important part of the course material.
2. Teacher Involvement
It is necessary to make sure that students know that peer evaluation does not mean that teachers are removing themselves from the task of teaching or grading. Students need to be assured that their teachers are equally involved in peer evaluation by being there to guide them, whether through clear evaluation rubrics or in class instructions and by bringing some of the discussions up in the classroom.
3. The Importance of Rubrics
Finally, we cannot write enough about the importance of rubrics, without clear guidelines and instructions, students are not able to offer constructive feedback to their peers. A good rubric takes time and consideration, but the time spent will pay off when students are able to fairly and reliably assess their peers and provide helpful feedback.
So where does that leave us?
The suitability of anything new in the classroom often comes down to how well its been implemented and integrated into the course work. This will determine both the usefulness of the new tool for the teacher and how well students will accept the change.
In order to effectively integrate peer grading into your course does require you to rethink the way you teach and assign projects to your students. But once you have taken the time to integrate it into your teaching, it will give you the possibility to use your time more constructively as well as offer your students the possibility to learn a valuable skill that can be used outside the academia.
Remember to click the little heart below if you enjoyed reading this article. For more great content like this follow us on Medium or sign up for our newsletter here. And don't forget to visit us at peergrade.io.

subset: commoncrawl


text:
2007 Toyota Camry - Consumer Review
Build Quality
Reliability Value
Build Quality
Reliability Value
7 of 10 people found this review helpful
2007 camry le
By enki1 on
Vehicle2007 Toyota Camry LE 4dr Sedan (2.4L 4cyl 5A)
ReviewHi, I bought my camry new from the dealership. The only problem I had its that at 70k miles started burning oil a lot, I brough the car to service dep and they told me that is a had gusket, and they fixed cause was under warranty, but the car still burned oil as much as the beginning. I brough back to Toyota and they were saying that the car is to old that's y is burning this much oil. I stop dealing with Toyota service dep. My camry now has 190k still runs good, it doesn't have the same pick up as it used to but still runs good. At 7 years I have changed tires twice, 2 batteries, struts once, a radiator, a lot of adding oil, and oil changes every 5k miles. my new car would be a camry again
Recommend (7) (3)
Are you the author of this review?Update Your Review
Comments (1) Post a Comment
By patel334
on 05/22/14 10:23 AM (PDT)
on 05/22/14 10:23 AM (PDT)
Consider putting in regular synthetic blend oil (5w-20, I believe), because I had the same issue with my car when I put the full synthetic (0w-20) oil. I now have 200k+ miles, and I would recommend trying that. This way, you'll save money and your car won't burn as much oil, either.Report it
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Tests & reviews
Outdoor Research - Verglas Gaiters Wo - Gaiters tested
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You have actually had one of these products? Tried and tested?
Other customers will be very happy to read your review – share what you know with them.
Reviews overview
Our reviews are 100% genuine. More info
This is what other customers say:
Nice looking, well made gaiters
Well made, quality gaiters. Not quite as tough as the men's Gore-tex variant and don't have the secondary velcro tab at the bottom to hold it in place, but a very good all round gaiter. Would probably want something a bit tougher for crampon use.
- Advantages
- Lightweight
- Robust
- Fit well
- Waterproof
- Recommended use
- Trekking
- Mountaineering
- Hiking
Yes, I would recommend this product to a friend
This is what customers from around the world say:


text: Ed Sheeran has a sweet new music video for "What Do I Know?" in honor of Red Nose Day. After visiting Liberia on behalf of Comic Relief's fundraising efforts, the singer created a video montage of his trip by piecing together different clips of the young men and women he spoke with alongside his latest track off his album Divide. Not only do the lyrics about love and positivity seem to fit perfectly, but Ed looks adorable while jamming out with all the children in a classroom.


text:
Style: 25641770 Color Code:
Leather satchel with two front zippered utility pockets. Two side zippered pockets. Top front of bag also has zipper opening. The top zips open into two compartments. Inside is fully lined and has one extra zipper pocket. Leather handles. Comes with removable and adjustable woven strap. Lots of space for organization!
Free People exclusive!
12" wide across front, 10" deep, 4" thick at bottom
9" handle drop, 19" long strap drop (can be made longer or shorter)


text:
Michael Roberts, Founder of Page1.me
Journalist & Licensed Private Investigator
Michael is a Licensed Private Investigator and a civil/criminal litigation support specialist (Digital & Social Forensics). He has used these gifts to analyze and, inasmuch as it is possible, reverse Read More
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Digital Marketer & Designer
Anna Brown is involved in different areas for Page1.me. With her background in Online Marketing & Communication she sets us on the map and writes Free Help Guides for everyone.
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William is our technical guru. With his knowledge of web programming and technical magic he can build and set up everything you can imagine. Thanks to William, our clients can Read More
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Dr. Alexander Vanderbilt has over decade of experience in the field of internet marketing. His areas of expertise include SEO, link building, and project management. He has launched a number Read More


text:
It only takes a minute to get started. Fill out our simple sign up form and login to the site.
This step is elective but will drastically boost your chances of your profile being viewed by others. Type a little about yourself, your interests and upload some good photos of yourself.
Use our website's state-of-the-art search to pinpoint members who meet your criteria. Or just flip through listings and pinpoint members that take your fancy.
Found someone who looks suitable? Send them a few words or just a wink and see what they say. With a little luck you'll be on your way to an amazing adventure.
It only takes a few clicks


text:
37377, TN Rent to Own Homes
|1 Listings Found
two Level upgraded brick house on cul-de-sac in Forest Park on Signal Mountain. 4 bedrooms rooms, three complete baths on 2 acres....
$384,500 - For Sale by Owner
Signal Mountain, TN 37377Details »
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text:
Friday, January 30, 2009
Serious Derby Colts in Action This Weekend at Gulfstream Park
South Ozone Park, NY, January 29, 2009--If you're based on the East Coast, Friday marks the traditional first step on the road to Triple Crown glory, first stop Churchill Downs on May 2.
As Yogi might say, Saturday comes early this year.
At Gulfstream Park, the old school Hutcheson Stakes is the first race out of the three-year-old blocks. Why old school? Seven furlongs, that's why.
"The Hutch" is back in its rightful place on the South Florida racing calendar--an important beginning, not the mid-meet after-thought it's been in recent years.
Old schoolers believe that seven furlongs is a great wake-up call from season-ending juvenile slumber, a spot to shake out the physical and mental cob-webs.
At the highest levels, seven-eighths might be the most demanding distance there is, requiring a blend of condition, speed and class.
Having the Hutch horses race on Friday gives accomplished runners their moment in the spotlight so that fans can assess where their favorites are developmentally even with three more months remaining in the prep process.
Saturday's featured Holy Bull at nine furlongs gives the more advanced sophomores a chance to get started for those trainers not wishing to turn their horses back into a sprint and getting them all speed crazy.
Actually, this is a great East Coast schedule that provides something for everyone, this weekend including supporting maiden and allowance races at meaningful distances that have attracted another serious horse or two.
In fact, a one-mile maiden race for three-year-olds on Saturday will mark the debut of Nicanor, the most hyped first time starter since The Green Monkey--and we all know how that turned out.
The well documented interest in Nicanor is because he's the late Barbaro's kid brother from the same human connections. If fact, Edgar Prado made a public pitch to ride the colt and will his wish from Michael Matz in Saturday's eighth at Gulfstream.
The race drew 13 entrants and Nicanor will break from post four at 4-1 on the early line. I'm as interested as anyone, but I'm not up to all the hype.
Maybe it's because of what tragically happened to his brother that I find the interest in him tinged with a certain ghoulish creepiness. Or maybe it's just me. But first thing's first.
Friday's Grade 2 Hutcheson attracted eight entrants of which three are serious Derby aspirants at this point in the season: Hello Broadway (5-2), Break Water Edison (3-1) and Capt. Candyman Can (3-1).
These are three very good colts and it will be interesting to note their progress throughout the spring.
When last seen, Break Water Edison and Hello Broadway finished 1-2 in the one-mile G3 Nashua Stakes. Both colts raced well and their Equiform performance figures were among the fastest posted by a juvenile going a mile or farther in 2008.
Each coming off a layup from November 2, Hello Broadway has worked eight times and appears the sharper of the two coming into the race. More of a forward factor, he has an edge over Break Water Edison, who's worked 10 times in the interim.
The bad news for BWE is that his rail draw likely means he'll need to be hustled early, something trainer John Kimmel would rather avoid. However, Kimmel and Barclay Tagg, trainer of the early line favorite, will need to keep tabs on Ian Wilkes' colt.
Capt. Candy Man has speed and stamina when he needs it, was toughened in three juvenile graded stakes, and arguably may be the most accomplished. A little closer to the race having finished second in the G2 Jockey Club Stakes at Churchill Downs Thanksgiving weekend, he might prove sharpest of the three.
Saturday's Holy Bull has also drawn a sizable field, 11, with early line choices West Side Bernie (3-1) and Beethoven (4-1) drawing posts 10 and 11, respectively.
West Side Bernie, a worthy runnerup in the Delta Jackpot, and Beethoven, winner of the Jockey Club Stakes, do not have the race to themselves, especially from out there in Big Brown land.
Danger To Society is undefeated in two starts, is well regarded by trainer Ken McPeek, who's 31 percent in 2009, nicely drawn inside and is already a nine-furlong winner over the track. Regular rider Robby Albarado is aboard the 5-1 early-line third choice.
Saturday's opener is interesting, too, as explosive Aqueduct maiden winner Well Positioned gets his season started for owner Paul Pompa Jr. and trainer Pat Reynolds. Pompa owned Big Brown before selling a major interest in the colt to IEAH Stable prior to the Derby campaign.
And so it's January 30, and it's Game On.
Written by John Pricci


text:
Feb 1713
Silver lining.
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text:
So I've known this guy for a really long time and we've been friends but never hungout... Then I asked him to go to the movies with me, which he did. He ended up paying for my movie and for the snacks. He seemed like he was having a good time. The thing is he never texts me first, I know he's really shy, but seriously? However, when I text him he always answers, usually within a few minutes. I just don't know what to think... Does it sound like he likes me? I was thinking about asking him out again, bad idea or nah?
Most Helpful Guy
Ask him out again. Since you initiate the texting first he waits for you to always do it since that seems to be the pattern. Im assuming he likes you if he didn't he wouldn't had payed for the movie and snacks.11|00|0
Thank you! So as a guy a girl initiating the dates wouldn't freak you out?
Your very welcome and no lol it wouldn't freak me out if a girl intiated dates.
Thank you very much for selecting my answer as the most helpful opinion.


text:
What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
Do I get a Free period with this subscription?Asked by DataMgrLou on October 16, 2015 at 01:39 PM
JotForm Support
Every account starts as a Free account. When you subscribe you are charged immediately upon creating the subscription. We do offer a 30 day money back guarantee. If at any point during the first 30 days of your subscription you would like a refund, let us know and we will be happy to refund your payment.


text:
Now Available Digital Download - YEAR A Liturgies, YEAR B Liturgies, YEAR C Liturgies, or all 3 Years in one complete digital download. These all include complete Orders of Service based on the Common Lectionary for The Liturgical Years in one download.
Prayer of Approach - Hymns - Prayer of Adoration and Praise - Readings from Old Testament - Epistle - Gospel - A Word with the Young - Prayer of Confession - Sermon - Prayers of Thanksgiving and Intercession - Offertory Prayer - Benediction
$9.00 for individual Year A, B or C Liturgies
Click here to purchase YEAR A Liturgies
Click here to purchase YEAR B Liturgies
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$25.00 for Complete 3 Years in one Digital Download.
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:: Instant Delivery via Digital Download Link ::
Holy God, we gather here to worship you with praise and thanksgiving for all you have done, are doing, and promise to do in the world and in our lives. We have done nothing to deserve such grace and goodness and so we cannot help but respond with joy and delight for being so loved by you and so precious to you. We rejoice because we no longer have to earn your love - only to accept it. You, O God, graciously revealed this love forever when you entered our world and our history in person - in Jesus Christ our Lord. He enters our very lives through the gift of the Holy Spirit. We pray that this time of worship may reveal the depth of our love for you and for this world you created, for we offer it in Jesus' name. Amen
We confess, O God, all the times when we are in special need of your help to overcome our weaknesses, our anger, our fear. We know that our quality of life is diminished when we find ourselves reacting to difficult situations, rather than acting to resolve them. This may mean looking at ourselves and our motives and pondering how differently we may act if we really believed the Apostle Paul's words that "the word is near you, on your lips and in your heart" and "if you confess with your lips that Jesus is Lord and believe in your heart that God raised him from the dead you will be saved."
When our lips gladly confess that Jesus is Lord but our actions do not reflect that belief, forgive us. When our need to promote our personal agendas becomes more important than promoting the Lordship of Christ, forgive us. When our apathy and prejudices undermine the gospel of love, forgive us. Merciful God, forgive us all our faults and fears, we pray. Renew our faith in the living Christ so that we can live joyously aware of his risen presence strengthening us to confess him as Lord and to make that confession visible in and through our lives. This we pray in Jesus' name. Amen
We would all agree that in recent years most countries of the world have moved from having industrialised economies to information economies. We receive information in ways which have not happened in our history before. We accept the fact that information is bounced off satellites from one part of the world to another. The stored deposit of information that each of us has covers vaster areas than our ancestors would have dreamed possible – so that – when we ask questions – we expect to receive some kind of rational answer or explanation. So – acknowledging this, how do we hear what today's gospel reading is saying?
Does the story of the miraculous calming of the storm by Jesus assault our rationalistic minds with its seemingly irrational account of the apparent suspension of natural laws? Or – do we ask the question – why is Matthew – and Mark, Luke and John – telling this particular story? Tagged on to that question is an equally important one – what does a story like this say to us today?
All the miracle stories are signs pointing towards something that they signify. In one way or another they signify aspects of the character of God - whether it be divine holiness and love or righteousness and faithfulness – they are signs of the presence of an unique and active love in this world. They point to the fact that the presence and power of God has broken into the history of the world in the person of Jesus Christ. The gospel writers set down their accounts of the miracles as they understood them - in the way they believed that they had happened. In putting the memory of the various miracles into words – they are proclaiming that God could be discerned in the works and deeds of Jesus, his suffering, dying and resurrection.
In this story today, then, the limits of human resources had been reached or passed and the miraculous happens – God is revealed as present and the awareness and belief of that reality changes despair back into hope. Its easy to see how the account of this particular event would have brought much needed comfort and strength to those early Christians whose faith would so easily have moved from hope to despair as they tried to witness in a society which was prevailingly hostile to the gospel. It was a society built on structures that benefitted from the rich and powerful and crushed the poor and powerless. The ever present danger and threat to life and property would have tested the most faithful of these Christians – Jesus therefore speaks through the story and says "don't be afraid" do not doubt that I am with you.
Click here to play COMING HOME - A short video recorded of Moira telling her story of faith and her journey through a divine encounter into full time ministry.
Digital Download - YEAR A - All Liturgies
$9.00 for all of Year A LiturgiesClick here to purchase YEAR A Liturgies
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text:
Fundamentals When You Desire To Learn How To Make Bio Diesel
January 4, 2012 by Vic Garland
Filed under Autos
Although the idea of bio diesel is not a new concept, it has gained a huge following recently. Actually bio diesel is as old as the diesel engine since the first compression-ignition engine was developed with peanut oil. This is an vital consideration when one wants to learn how to make bio diesel.
Bio diesel can therefore be described as a non-petroleum-based fuel produced from vegetable and animal fat. Although the fuel can be used alone, it cans also be blended with ordinary diesel to fire a diesel engine. This makes it a great option especially considering the increasing prices of fossil fuels.
Since the production process is quite easy, it makes it possible for one to learn from different sources. Considering the production materials, there is a very wide variety used in producing the diesel ranging from rapeseed, soybean oil and other feedstock. In some cases, it is also possible to extract the diesel from used vegetable oils from hotels. Animal fats such as chicken fat, tallow are also other viable sources. Apart from these oils, the diesel can also be extracted from algae although this is not feasible for commercial production.
The first step when you want to learn the art of making bio diesel is identifying the source oil. This is because the process varies slightly with different materials. Some of the materials will also necessitate the acquisition of special equipment like a bio diesel processor. Some of the cases however do not require such equipment like in the case of making the diesel from used cooking oil with methanol and sodium hydroxide. This method however, does not produce large amounts.
Once you have established the source the next step is usually testing it for properties such as water content and acidity. This is usually important as it helps determine the state of your end product. The level of acidity and water determine whether the resultant bio diesel will be perfect.
The best sources should be the ones providing relatively low acidic and dry oil as it makes the process much simpler. This means you need to learn how to test for water either by using the heating method or by using a water testing kit. The acidity is tested through titration where the oil is added to pH neutral alcohol.
Another major step when making bio diesel is filtration. This is done when using used vegetable oil and helps remove food particles and any other contaminants. Filtering is done mostly with drum filters which are very effective. You should learn about micron rating as it will help you select the most effective filter. The smaller the rating number, the smaller the holes in the filter will be.
Before you can embark of full production of bio diesel a test batch is very important. You should therefore learn how to make this using items obtained from the local grocery stores. You will also need to obtain the actual production equipment. Some of the equipments needed include oil collection containers, oil transfer and filtering capability, a bio diesel processor and bio diesel washing vessel. You also require storage containers, transfer pumps and a titration kit.
The intended production capacity will be one of the main determinants of the equipment you acquire. With these you should be prepared to learn how to make bio diesel.
Get those many choices for renewable energy by looking online. One choice you have will be biodiesel. To learn more about it go online now to learn those benefits.
categories: Renewable Energy,solar power,solar energy,renewable energy sources,algae,bio diesel manufacturing equipment,energy,fuel


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Gender Gap on Infertility Care
Men are less likely than women to seek medical help for infertility, a British study suggests.
Research published in Human Reproduction found that 57.3 percent of women sought help after at least one year of unsuccessful pregnancy attempts. In contrast, 53.2 percent of men sought care.
Researchers conducted a cross-sectional population survey from 2010 to 2012 among more than 15,000 men and women ages 16–74. Infertility was higher among women than among men surveyed: 12.5 percent vs. 10.1 percent.
Among factors associated with greater prevalence of infertility were higher socioeconomic status and later cohabitation. Factors associated with the decision to seek medical help for infertility included a higher level of education and occupations with higher status.
In the U.S., 18 percent of men younger than 45 who saw a fertility specialist were diagnosed with an infertility problem, a CDC study found.
Prostate Cancer Treatment Disparity
Even when they have more aggressive prostate cancer, Hispanic and black men in the U.S. are less likely to be treated than are Caucasian and Asian men, according to research in Urology. That disparity should be addressed, says senior author Willie Underwood III, MD, MPH, MSci, of Roswell Park Cancer Institute, which conducted the study with researchers from Vanderbilt University Medical Center.
Lower rates of treatment were discovered among black and Hispanic men who had a Gleason score of 7 or higher, indicating high-risk prostate cancer. Black men with low- or intermediate-risk disease were also less likely to receive definitive treatment, as were Hispanic men with intermediate-risk prostate cancer. Asian men received treatment at rates similar to those of Caucasian men.
The study evaluated data from about 328,000 men who had localized prostate cancer. Many of the men may have chosen a watchful waiting approach, researchers stated.
Approximately 26,000 American men died of prostate cancer in 2016, according to the American Cancer Society.
Zika May Harm Male Reproductive System
Pregnant women have been the primary focus of warnings regarding the Zika virus because of the danger that their babies will have microcephaly. However, research in Nature finds that male mice infected with Zika had reduced sperm counts and testosterone levels, as well as shrunken testicles.
Additionally, healthy female mice were roughly four times less likely to become pregnant when they mated with infected males than were those that mated with healthy males, according to the study, which was conducted by researchers at Washington University in St. Louis.
In light of the findings, some medical experts have called for monitoring of men who are infected to detect possible patterns of infertility.
Zika-infected men have reported blood in their urine as well as pelvic pain. Mosquito bites transmit the virus.


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The RelicNews Community Forums (also RelicNews Forums, in past: Relic Boards, Relic Forums) are the unofficial forums run by RelicNews and administered by Pike, Sorak, Dyntheos, ionfish, Delphy, Moe, Soulblighter and ceejayoz. Forums were known as Relic Forums, but on October 2007 they were renamed to RelicNews Forums, because of confusion that forums are run officially by Relic Entertainment.
The forums are a spinoff from the original fansite, Relicnews and are the primary mode of communication between members of the Homeworld fandom, as well as for fans of other games by Relic Entertainment.


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