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subset: commoncrawl


text:
CONCORD, N.C. – The second round of the 2013 RLV Tuned Exhaust Products Gold Cup Series goes off this weekend with the Michigan Kart Supply Nationals at South Bend, Indiana's JET Karting, the popular sprint course formerly known as Michiana Raceway Park.
This year marks the second consecutive season the WKA Gold Cup Series has visited South Bend. Last year the track hosted the series' third race while this season JET Karting has the second Gold Cup of the year.
This weekend's Michigan Kart Supply Nationals marks the second straight weekend WKA national racing is in Indiana. Last weekend saw the Manufacturers Cup Series run at New Castle Motorsports Park. The Man Cup will also visit South Bend next month with the series' Grand Nationals being held June 28-30.
Approximately 30 national classes will go off between Saturday and Sunday. The weekend kicks off with Friday practice before a big Friday night Thunder Series, which features three main events after the conclusion of practice.
The Thunder Series will begin with a pair of 10-lap Shootouts for Sportsman Pro Gas Animal and Junior Pro Gas Animal. A three-lap qualifying run will be held for both classes to determine the starting lineup for each 10-lapper. Each winner will receive a new Briggs & Stratton Animal engine, posted by Briggs & Stratton Racing.
One of the most out-of-the-box money races in karting's history will conclude Friday evening's on-track action.
The Animal Heavy Money Race has attracted a good bit of attention since the $2,500 purse was announced. A new Animal engine will also go to the first Pro Gas Animal engine across the finish line, while second through 10th-place Pro Gas finishers are guaranteed at least $100 payback.
Methanol-powered Animal engines are encouraged to run this race, as well. Methanol-powered Animals are guaranteed 75 percent payback based on all the entries (Pro Gas and methanol) in the race.
Of course, Friday night's activities are only the beginning of an action-packed weekend of 4-cycle sprint racing in Indiana. A full lineup of national classes is on tap for Saturday and Sunday.
Pro Gas Animal, methanol Animal and Clone classes are offered for every age group. LO206 Kid Kart runs both days for the 5-to-7-year-old youngsters.


text:
Avery® Clip Style Badge Holders 2920, Clear, 2-1/4" x 3-1/2", Portrait, Box of 50Product Number: 2920
Help visitors and employees keep their name out front with these Clip Style Badge Holders. The badge holders feature a portrait orientation for easy insertion of 2-1/4" x 3-1/2" badge inserts. A strap fastens each badge holder to a convenient metal clip that enables the wearer to keep the ID visible at all times. The garment-friendly clip attaches snugly but won't damage fabric. ID badges are clearly visible through the translucent, flexible material so names and faces are on view at all times.
Product Description:
Reviewed by 9 customers
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This review is from Badge Holders - Landscape 2921:
Great product! I use this for all of our company meetings.
This review is from Badge Holders - Landscape 2923:
We use these badges for customer functions. The labels can be customized with logo or images.
They are very professional looking. The template is very easy to use.
This review is from Badge Holders - Landscape 2923:
I used these namde badges for a company event I was hosting. They were extremely easy to use. I had all my names in an excel list which i then merged into the template and voila! all my names appeared without me spending time re-typing them. I would definitely use this product again. My only complaint is that the quality of the buckles isn't the greatest and a few fell apart after use.
This review is from Badge Holders - Landscape 2923:
We use our badges for visitors, which means they get a lot f wear and tear. We ordered 100 last year and did not have to order replacements until this year. I believe the replacements are more because people forget to give back our badges when they leave. We very rarely have to throw away a badge because it is torn or the clip is broken off.
Thanks for a great product.
This review is from Badge Holders - Landscape 2921:
Our volunteers are given these for our annual fundraisers. The badge holders work great and the custom print inserts look very professional with our logo.
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text:
Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. Mechanical clips are implanted over the leaflets of a valve, e.g., in the heart, either alone or after thermal treatment to cause the valve to close more tightly. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. Alternatively, individual anchors with a tensioning element, like a suture, may be used to approximate the valves towards each other. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.
1. An assembly for treating tissue near a valve to modify flow through the valve, comprising:
a plurality of anchor members each having a distal end adapted for insertion into the tissue surrounding the valve and a proximal end defining an opening therethrough; and
a tensioning element for passage through each opening of the plurality of anchor members,
wherein the plurality of anchor members is aligned sequentially within a catheter whereby each anchor member is deployed sequentially with the tensioning element into the tissue through the catheter.
2. The assembly of
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22. The assembly of
23. The assembly of
24. A method of treating tissue near a valve to modify flow through the valve, comprising:
advancing a catheter to the tissue near the valve;
deploying a plurality of anchor members from a distal end of the catheter selectively around a perimeter of the valve, each of the anchor members being connected sequentially via a tensioning element passed through an opening defined in each member;
tightening the tensioning element such that the perimeter of the valve is approximated towards one another; and
securing the tensioning element such that the perimeter of the valve remains approximated.
25. The method of
26. The method of
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29. The method of
This application is a continuation-in-part of U.S. patent application Ser. No. 09/898,726 filed Jul. 3, 2001, now U.S. Pat. No. 6,626,899B2, which is a continuation-in-part of U.S. patent application Ser. No. 09/602,436 filed Jun. 23, 2000, now U.S. Pat. No. 6,669,687B1, which in turn claims benefit from U.S. Provisional Patent Application Ser. No. 60/141,077 filed Jun. 25, 1999, each of which is incorporated herein by reference in its entirety.
The present invention relates to treatment of tissue. More particularly, the present invention provides methods and apparatus for treating valvular disease with a catheter inserted into a patient's cardiac chambers, the catheter having an end effector for modifying cardiac structures, including valve leaflets and support structure.
Degenerative valvular disease is the most common cause of valvular regurgitation in human beings. Regurgitation is typically characterized by an expanded valve annulus or by lengthened chordae tendineae. In either case, an increase in the geometry of a valve or its supporting structure causes the valve to become less effective, as it no longer fully closes when required.
Loose chordae tendineae may result, for example, from ischemic heart disease affecting the papillary muscles. The papillary muscles attach to the chordae tendineac and keep the leaflets of a valve shut. Some forms of ischemic cardiac disease cause the papillary muscles to lose their muscle tone, resulting in a loosening of the chordae tendineae. This loosening, in turn, allows the leaflets of the affected valve to prolapse, causing regurgitation.
It therefore would be desirable to provide methods and apparatus for treatment of tissue that modify the geometry and operation of a heart valve.
It would also be desirable to provide methods and apparatus that are configured to thermally treat chordae tendineae, the annulus of a valve, or valve leaflets.
It would also be desirable to further provide methods and apparatus that are configured to mechanically modify the geometry and operation of a heart valve and annulus of a valve either alone or in addition to thermal treatment.
In view of the foregoing, it is an object of the present invention to provide methods and apparatus for the treatment of tissue that modify the geometry and operation of a heart valve.
It is another object of the present invention to provide methods and apparatus that are configured to thermally treat chordae tendineae, the annulus of a valve, or valve leaflets.
It is another object of the present invention to further provide methods and apparatus that are configured to mechanically modify the geometry and operation of a heart valve and annulus of a valve either alone or in addition to thermal treatment.
These and other objects of the present invention are accomplished by providing apparatus and methods for thermally or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner, thereby improving or restoring tissue function. Embodiments of the present invention advantageously may be employed to modify flow regulation characteristics of a cardiac valve or its component parts, as well as to modify flow regulation in other lumens of the body, including, for example, the urinary sphincter, digestive system valves, leg vein valves, etc., where thermal shrinkage or mechanical reconfiguration of tissue may provide therapeutic benefit.
In a first family of embodiments of the present invention, apparatus is provided having an end effector that induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve sufficient to cause shrinkage of the tissue, thereby reducing a diameter of the annulus and causing the valves to close more tightly. In a second family of embodiments, apparatus is provided having an end effector that selectively induces a temperature rise in the chordae tendineae sufficient to cause a controlled degree of shortening of the chordae tendineae, thereby enabling the valve leaflets to be properly aligned. In yet a third family of embodiments, apparatus is provided having an end effector comprising a mechanical reconfigurer configured to attach to a longitudinal member, such as the chordae tendineae. The reconfigurer forces the longitudinal member into a tortuous path and, as a result, reduces the member's effective overall or straight length.
Any of these embodiments may employ one or more expanding members that serve to stabilize the end effector in contact with the tissue or structure to be treated. In addition, where it is desired to preserve the interior surface of a lumen or structure, the instrument may include means for flushing the surface of the tissue with cooled saline. Where it is desired to achieve a predetermined degree of heating at a depth within a tissue or structure, the end effector may comprise a laser having a wavelength selected to penetrate tissue to the desired depth, or the end effector may comprise a plurality of electrically conductive needles energized by an RF power source, as is known in the electrosurgical arts. The end effector may alternatively comprise an acoustic heating element, such as an ultrasonic transducer.
In another aspect of the present invention, mechanical clips may be provided preferably made from shape memory alloys or superelastic alloys, e.g., Nickel-Titanium alloy (nitinol). Such clips may be delivered to the valve and annulus of tissue surrounding the valve in a variety of ways, e.g., intravascularly, endoscopically, or laparoscopically, either after the thermal treatment described above, or without the thermal treatment. During delivery by, e.g., a catheter, the clips may be compressed into a smaller configuration to facilitate transport. Upon exiting the catheter, the clips preferably expand to a second configuration for attachment to the valve tissue. The clips may be attached to the annulus of tissue surrounding the valve upon being urged out of the catheter distal end; they may be attached to opposing sides of the valve and preferably have a compressive spring force to draw or cinch the sides of the valve towards one another. The clips may be configured to traverse directly over the valve itself, but they are preferably configured to lie partially over the periphery of the valve to prevent obstruction of the valve channel. A central region of the clips may be formed in a variety of geometric shapes, e.g., semi-circles, arcs, half-ellipses, triangles, rectangles, and loops. Aside from clips, expandable meshes and grids may also be used to draw or cinch the valve edges together.
Moreover, the clips may be coated with therapeutic drugs, which may be time-released, or they may also be coated at least partially with a radiopaque coating to aid in visualization during implantation.
Aside from mechanical clips, individual anchors having a tightening element, such as a suture or wire, threaded through each anchor may alternatively be deployed around the valve. When desirably placed, the tightening element may be tightened to draw each of the anchors towards one another, thereby reducing the valve diameter.
Delivery catheters which may be used to deliver the clips may also incorporate sensors or energy delivery devices, e.g., transducers, on the distal ends. For example, they may be configured as a sensor to measure properties, e.g., ultrasound, Doppler, electrode, pressure sensor or transducer, etc., of the tissue prior to catheter withdrawal. Such sensors may also be used to measure properties such as flow rates, pressure, etc. for measurement pre-treatment and post-treatment. Alternatively, they may also be used as a transducer to deliver energy, e.g., RF, electrical, heat, etc., to the affected tissue or the surrounding area by, e.g., either as a separate device or directly through the clip itself.
Methods of using apparatus according to the present invention are also provided.
The above and other objects and advantages of the present invention will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference numerals refer to like parts throughout, and in which:
With reference to
The present invention therefore provides apparatus and methods for shrinking or reconfiguring tissue, such as annulus A or chordae tendineae CT. The present invention also encompasses optionally altering a shape of the valve through mechanical attachments. The mechanical attachments, as discussed in detail below, may be done either after the shrinking or reconfiguring of the tissue, or it may be done as a stand-alone procedure. Embodiments of the present invention advantageously may be employed to modify flow regulation characteristics of a cardiac valve or its component parts, as well as to modify flow regulation in other lumens of the body, including, for example, the urinary sphincter, digestive system valves, leg vein valves, etc., where thermal shrinkage or mechanical reconfiguration of tissue may provide therapeutic benefit.
Referring to
With reference to
The end effector of
Balloon 40 is substantially transparent to the laser energy, and coolant C may again serve to cool the surface of balloon 40, thereby minimizing damage at the surface of the treatment site. The circulating stream of coolant C maintains the temperature of surface tissue layers at a sufficiently low level to prevent thermal damage, and thus, to prevent formation of thrombus. Temperature sensor 46 optionally may also be provided.
As seen in
Referring now to
Collagen within annulus A shrinks and reduces a diameter of the annulus. Leaflets L are approximated towards one another, as seen in dashed profile in
End effector 34 stabilizes apparatus 30 against the wall of a body passageway. Once stabilized, a source of energy may be applied to the wall to thermally shrink the tissue contained in the wall. In addition to the application of
With reference to
Monopolar electrode 66 is electrically coupled to RF source 68, which is positioned outside of the patient. RF source 68 is, in turn, coupled to reference electrode 69. When RF source 68 is activated, current flows between monopolar electrode 66 and reference electrode 69, which may, for example, be attached to the exterior of the patient in the region of the treatment site. RF current flows into the wall of the treatment site, thereby effecting annular tissue shrinkage, as described previously.
Referring to
End effector 84 is advanceable with respect to catheter 82. When advanced distally, apparatus 80 assumes the expanded deployed configuration of
With apparatus 80 approximating annulus A, end effector 84 is distally advanced with respect to catheter 82, thereby selectively advancing electrodes 94 into the annulus. RF source 98 then provides RF current, which flows between electrodes 94 and reference electrode 99. The annulus of tissue shrinks, bringing valve leaflets into proper position and minimizing or eliminating regurgitation through the valve.
Catheter 82 insulates conductive shaft 92 from annulus A, thereby protecting surface tissue and only allowing coagulation at depth in treatment zones surrounding electrodes 94. To further ensure that coagulation only occurs at depth, a coolant, such as saline, may be introduced through central bore 86 and side bores 88 of catheter 82 to the surface of annulus A, thereby cooling and flushing the area where electrodes 94 penetrate the tissue. It is expected that such liquid infusion will keep the surface of the annulus clean and will prevent thrombus formation in response to thermal damage.
Referring now to
The size of treatment zones Z may be controlled to ensure that tissue remodeling only occurs at depth. Assuming a temperature T1, at which tissue damage is negligible, the magnitude of current passed through tissue T may be selected (based on the material properties of the tissue and the depth of insertion of electrodes 94 within the tissue) such that the temperature decays from a temperature T0 at a position D0 at the surface of an electrode 94 to the benign temperature T1 at a distance D1 from the surface of the electrode. The distance D1 may be optimized such that it is below the surface of tissue T. An illustrative temperature profile across a treatment zone Z is provided in
With reference to
Referring to
Fibers 152 may comprise any of a number of energy delivery elements. For example, fibers 152 may comprise a plurality of optical fibers coupled to a laser (not shown). The wavelength of the laser may be selected as described hereinabove, while the energy deposited by the fibers may be controlled responsive to the temperature recorded by sensors 150. Thus, for example, a controller (not shown) may be provided to switch off the laser once a preset temperature, for example, 45� C.–75� C., is attained, thereby ensuring that a sufficiently high temperature is achieved to cause tissue shrinkage without inadvertently damaging surrounding tissues.
Fibers 152 may alternatively comprise a plurality of multipolar electrodes. Each electrode may be capable of injecting RF energy into tissue independently. Alternatively, current may be passed between a pair of adjacent or non-adjacent electrodes to heat intervening tissue.
Referring now to
Referring to
Referring to
With reference to
With reference now to
A preferred use for apparatus of the second family is in treatment of mitral valve regurgitation. Mitral valve regurgitation has many causes, ranging from inherited disorders, such as Marphan's syndrome, to infections and ischemic disease. These conditions affect the macromechanical condition of the mitral valve and prevent the valve from closing completely. The resulting gap in the leaflets of the valve permit blood to regurgitate from the left ventricular chamber into the left atrium.
Mechanically, the structural defects characterizing mitral valve regurgitation include: (1) the chordae tendineae are too long due to a given disease state; (2) papillary muscle ischemia changes the shape of the papillary muscle, so that attached chordae tendineae no longer pull the leaflets of the mitral valve completely shut; (3) the annulus of the mitral valve becomes enlarged, resulting in the formation of a gap between the leaflets when closed; and (4) there is an inherent weakness in the leaflets, leaving the leaflets floppy and dysfunctional.
In accordance with the principles of the present invention, a temperature rise is induced in the support structure of the mitral valve to cause shrinkage that modifies the geometry of the valve to restore proper stopping of blood backflow and thereby regurgitation. This process is depicted in
Referring to
End effector 204 may be collapsible to a delivery configuration within catheter 202, and may expand to a delivery configuration beyond a distal end of the catheter. End effector 204 is configured to engage, heat, and shrink chordae tendineae. Various sources of energy may be used to impart heat to the collagenous tissue and thereby shrink it, including RF energy, focused ultrasound, laser energy, and microwave energy. In addition, chemical modifiers, such as aldehydes, may be used. For laser embodiments, a preferred laser is a continuous wave Holmium:Yag laser, with application of visible or infrared laser energy in the wavelength range of 400 nanometers to 10.6 micrometers.
With reference to
Referring to
End effector 204 is expanded to the deployed configuration distal of catheter 202. The end effector is steerable within left ventricle LV to facilitate engagement of chordae tendineae CT. End effector 204, as well as any of the other end effectors or catheters described herein, may optionally comprise one or more radiopaque features to ensure proper positioning at a treatment site. End effector 204 is capable of moving up and down the chordae tendineae to grab and selectively singe certain sections thereof, as illustrated in dotted profile in
When energy is transmitted through tissue utilizing one of the embodiments of this invention, the tissue absorbs the energy and heats up. It may therefore be advantageous to equip the end effector with temperature or impedance sensors, as seen in the embodiments of
This technique is illustrated in
Collagen within the tendineae shrinks, and chordae tendineae CT assumes the configuration seen in
An additional pair of bipolar electrodes optionally may be disposed on arm 230 b of the end effector to facilitate treatment in bands on opposite sides of chordae tendineae CT. The depth of shrinkage attained with apparatus 200 is a function of the distance between the electrodes, the power, and the duration of RF energy application. If, laser energy is applied, the wavelengths of energy application may be selected to provide only partial penetration of the thickness of the tissue. For example, continuous wave Holmium:YAG laser energy having a wavelength of 2.1 microns penetrates a mere fraction of a millimeter and may be a suitable energy source.
With reference to
Referring to
With reference to
Other embodiments of the third family in accordance with the present invention will be apparent to those of skill in the art in light of this disclosure.
Referring now to
Alternatively, various mechanical valve resizing systems and methods may be used in conjunction with the apparatus and methods discussed above. Optionally, the various mechanical valve resizing systems and methods, as discussed below, may be used as a stand-alone system. These mechanical resizing systems may generally entail the positioning, deployment, and securing of one or more clips to bring the annular edges of a valve, e.g., a heart valve, or opening together to correct for valvular regurgitation. This would typically result in the reduction of the effective diameter of the valve or opening. The clip is preferably made of superelastic or shape memory materials, e.g., Nickel-Titanium alloys, because of the ability of these types of materials to be easily formed, e.g., by annealing, into desirable geometries. Such materials are very strong and have the ability to be constrained into a reduced diameter size for deployment as well as being capable of providing a permanent compressive spring force.
The variations of clip geometries described herein may be manufactured in several ways. One method involves securing a wire, band, or other cross-sectioned length, preferably made of a superelastic or shape memory material, to a custom forming fixture (not shown). The fixture preferably has a geometry similar to the valve or opening where the completed clip is to be placed and the fixture preferably has a diameter which is smaller than the diameter of the valve or opening. The fixture diameter may be determined by the amount of closure by which the valve or opening may need to be closed or approximated to reduce or eliminate valvular regurgitation. The fixture, with a constrained clip placed thereon, may be subjected to a temperature of about 500� to 700� F. preferably for a period of about 1 to 15 minutes. Additional details about the processing and performance of superelastic and shape memory materials may be seen in U.S. Pat. No. 5,171,252 to Friedland, which is incorporated herein by reference in its entirety. The fixture and clip may then be removed and subjected to rapid cooling, e.g., quenching in cold water. The clip may then be removed from the fixture and the ends of the clip may be trimmed to a desired length. The trimmed ends may also be formed into a sharpened point by, e.g., grounding, to facilitate piercing of the tissue.
Another variation on a grid-type device is shown in
To maintain grid 360 or mesh 368 over the valve or opening, fasteners located around the valve or opening are preferably used for anchoring grid 360 or mesh 368. Fasteners are preferably made of a biocompatible material with relatively high strength, e.g., stainless steel or Nickel-Titanium. Biocompatible adhesives may also be used. A variation of such a fastener is shown in
Another variation on fasteners is shown in
Yet another variation on fasteners is shown in
Defined within shank 389, which may have a diameter, e.g., of at least 0.2 mm, of anchor 381 is eyelet or suture hole 387. Eyelet 387 may be defined along anchor 381 such that it rests either above the tissue surface, at the tissue surface, or even below it when anchor 381 has been positioned within the tissue. Eyelet 387 provides a hole through which a suture may be tied to or looped through to provide the desired anchoring points to draw the opposing sides of the valve towards one another.
Any of the anchor variations may be optionally coated with a therapeutic agent or antimicrobial agent to facilitate healing or to effect some other results, like timed drug delivery or to act as an anti-thrombosis agent. Alternatively, a radiopaque coating layer may be coated over either one, several, or all of the anchors for deployment to facilitate visualization during deployment and/or placement using any conventional visualization techniques. The coatings may vary and may include, e.g., Nickel-Titanium alloy, Platinum, Palladium, Gold, and/or Tantalum.
Another variation on a biasing clip device is shown in
A further variation of the clip is shown generally in
Another variation is seen in
The curved anchoring members above are shown as being curved in a semi-circle such that they face in apposition to one other. But any geometry may be used, e.g., arcs, half-ellipses, hooks, V-shapes or triangles, and generally any type of end geometry that would facilitate tissue insertion yet resist being pulled or lodged out.
The shape of the clip itself may range from a wide variety of geometries. Such geometries may include circles, semi-circles, rectangles, triangles, or any combinations thereof.
Any of the above-described clips or any other clip geometry in the spirit of this invention may be coated with a variety of substances. For example, a clip may be coated with a hydrophilic (which may be used, e.g., for surface lubricity), anti-thrombosis agent, therapeutic agent, or any other drug coating to prevent, e.g., thrombosis, or to act as a drug delivery mechanism. Such drug coatings may be applied during the clip manufacture or just prior to deployment. Also, the clips may be made to become more radiopaque by coating them with, e.g., Nickel-Titanium alloy, Platinum, Palladium, Gold, Tantalum, or any other biocompatible radiopaque substance. Such a coating could be applied, e.g., by sputter coating or ion deposition. Moreover, the coating is preferably applied in a thin enough layer such that it would not affect the physical properties of the clip material.
The clip may be delivered and placed over or around the valve using a variety of different methods, e.g., endoscopically, laparoscopically, or through other conventional methods such as open-heart surgery. A preferable method and apparatus is to deliver the clip through the vasculature using a delivery catheter and/or guidewire.
Clip 444 may be disposed in lumen 440 within catheter section 436; as seen, clip 444 is preferably in a compressed configuration to fit within lumen 440 during delivery. The clip 444 may be loaded into catheter section 436 through delivery port 442, or alternatively, through the proximal end of delivery lumen 440 and advanced towards the distal end of catheter section 436. Reinforced liner 446 may surround the area where clip 444 is loaded to allow structural reinforcement to catheter body 438. Liner 446 may also allow constrainment of clip 444 while allowing forward movement of the clip 444 during deployment. Liner 446 may be made from a thin-walled superelastic or shape memory tube and may also have a lubricious coating to reduce the amount of force required for deployment of clip 444. Catheter section 436 may be guided within the vasculature via a conventional guidewire (not shown), or it may be steered through the vasculature via steering lumen 452 which may contain steerable components, e.g., wire 453, disposed within to steer catheter section 436. Wire 453 may be a pull-wire, leaf spring, or other steering-type device.
Once catheter section 436 has reached the target site, clip 444 may be advanced through delivery port 442 by plunger 448. Plunger 448 is preferably attached to a distal end of stylet 450, which may run through the full length of catheter body 438 to allow manipulation from the proximal end. Plunger 448 may be advanced towards the distal end of catheter section 436 to urge clip 444 out of delivery port 442 by manipulating the proximal end of stylet 450. Stylet 450 may be advanced manually like a guidewire, or by attaching it to an advancement mechanism, e.g., a thumb-slide. Stylet 450 may also be passed through a hemostatic valve located within catheter body 438, either at a distal or proximal end, to prevent backflow into lumen 440 during insertion and delivery through the vasculature. The advancement mechanism, discussed further below, may be controlled by an indexed linear movement mechanism, e.g., a screw, ratchet, etc., located on a handle at the proximal end of catheter body 438. Once plunger 448 and stylet 450 is advanced completely, clip 444 may be urged completely through delivery port 442, where it may then expand or form its deployed configuration.
Delivering and placing the clip over the desired tissue, valve, or opening may be accomplished by several different methods. As shown in
Then, as shown in
The variations described above may incorporate a variety of sensors or transducers in the delivery catheter to ensure adherence or optimal clip performance. For instance, as seen in
Distal end 480 may also incorporate a grasping and/or releasing mechanism (not shown) to aid in clip release and implantation. Such a mechanism may be incorporated on the plunger or stylet, or a separate catheter may be inserted in conjunction with catheter 478. The grasping and/or releasing mechanism may also be used to temporarily provide an electrical connection to the clip.
In a further variation for delivering and placing the clip, it may be deployed through one or more delivery ports located in the side of the catheter rather than from the distal end. Delivering from the catheter side may be accomplished in much the same manner as described for
Once proper orientation has been determined, a first clip 498 a, which may be compressed in catheter 490 may be urged out of delivery port 492 a by a plunger and stylet, as described above or twisted out, and pushed through a wall of the coronary sinus 398 and through the adjacent heart tissue 392, as shown in
Aside from the use of clips to engage the valve tissue, indented anchor 395, as shown above in
The anchors 395 may be pre-threaded with a suture 506 or other tensioning element, e.g., a wire, prior to loading or delivery into tissue 392. Alternatively, anchors 395 may be first placed into tissue 392 and subsequently threaded with suture 506. In either case, suture 506 is preferably positioned such that it surrounds the periphery of the valve 402, as shown. After the individual anchors 395 are positioned around the valve 402, suture 506 may be tightened by pulling on the proximal end of suture 506 through catheter 508 and drawing suture 506 through a crimp or other adjustable fastener. This tightening will approximate the opposing sides of valve 402 to draw or close the opening of valve 402. Once the desired degree of approximation has been effected, suture 506 may be cut by crimping one of the anchors 395, as described above, or by severing suture 506 with a crimp adapted to cut suture 506, and the tools may be removed from the region.
When the anchors 381 are loaded within cartridge 512, the tensioning element or suture 506 is preferably pre-threaded through anchors 381. The suture 506 is threaded through the first anchor 381 and through each successive anchor 382 until it is threaded through the last one. Then the suture is threaded alongside anchors 381 and brought back to approximate the other end of the suture 506 to form a loop. The two suture ends are threaded through fastener 507 for final tightening/crimping and cutting.
Although fastener 532 may be configured to allow suture 506 to pass freely therethrough, fastener 532 is preferably designed to allow for the unidirectional travel of suture 506 through the fastener 532. This allows suture 506 to be tightened through the anchors but prevents suture 506 from slipping back and releasing the tension within the anchors and the valve tissue.
Any of the fastening devices described above may be made of biocompatible metals, e.g., stainless steel, nickel and/or titanium alloys, etc., or they may be manufactured from biocompatible plastics, e.g., PTFE, etc.
Some of the fasteners above incorporated a tapered or sharpened edge to sever the suture when completely tightened. An alternative design is shown in
In addition to the fastening elements, the anchoring elements may be further modified.
Another alternative anchor mechanism is shown in
All of the above mentioned methods and apparatus may be delivered not only intravascularly through catheters, but also through conventional procedures such as open-heart surgery. Moreover, all of the above mentioned methods and apparatus may also be used in conjunction with flow-indicating systems, including, for example, color Doppler flow echocardiography, MRI flow imaging systems, or laser Doppler flow meters. Application of energy from the end effector may be selected such that regurgitation stops before the procedure is completed, as verified by the flow-indicating system. Alternatively, the procedure may be "overdone" to compensate for expected tissue relapse, without compromising the ultimate outcome of the procedure.
Additionally, all of the foregoing apparatus and methods optionally may be used in conjunction with ECG gating, thereby ensuring that tissue is at a specified point in the cardiac cycle before energy is deposited into the tissue. ECG gating is expected to make treatment more reproducible and safer for the patient.
Although preferred illustrative embodiments of the present invention are described above, it will be evident to one skilled in the art that various changes and modifications may be made without departing from the invention. For instance, variations of the present invention may be used as permanent or temporary localized tissue retracting devices. Moreover, modified variations may also be used to mechanically expand or dilate tissue, e.g., for use in maintaining open nasal passages. It is intended in the appended claims to cover all such changes and modifications that fall within the true spirit and scope of the invention.
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Lyn Saga's CD Release Show
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Sunday, January 13, 2013 at 8:30 PM (PST)
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|56 posts found
Novice Member
Joined: 1/07/04
Every year, it is our goal to take a look at the major MMORPGs. Today, we take a peek at one that slipped through the cracks when it first launched. Final Fantasy XI is now available on the PS2, XBOX360 and PC. This review is for the PC version, although all three do exist in one world.
The full review is here.
Dana Massey
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Novice Member
Joined: 5/19/04
Great review! FFXI is not newbie friendly and the lower level trials can destroy a persons intrest in this game. I suggest BYOG(bring your own group) for this game otherwise expect to spend alot of time working your way from lvl 1-30 where the game really picks up.
Novice Member
Joined: 7/06/06
We,ve and I do say that we (son and I) have been experiencing FFXI since July '06. I,being new to the FF series as well as rpg/mmorpg and my son, a pro. No online gaming experience is ever perfect but much of the problems that we have experienced have been minimal. We play using the 360 but I am considering using the pc and the graphics are a concern (I will miss the hd experience that the xbox allows) as I have encountered many players that have used their pc for years and complain that installing the expansion packs are a bit of a problem since they are playing with the original and second is the graphics since they are playing with this older version. Rescuing a dormant account is another gripe ,one player who capped at lvl 75 mage left for 6 months and now has to start all over again,he doesn't gripe so much as is a tad bit disgruntled. The players make the game. More team work and less in ls fighting would be appreciated and shame on the mercenary ls that dare to charge newbs and advancing members for assisting in quests,pls and raises. All the flaws that you have correctly pointed out are a concern but they really don't truly detract from the beauty of the graphics, the entrancement of gameplay nor the team work involved and that is one that our particular linkshell prides ourselves on....I do have one sore spot here and that is the inability to conversate with other players using ps2 and pc this is a feature that 360 has and can only be used with others that have a 360; the translator feature for German and French as well as Japanese players is still a mystery for us 360 users. All over a great game but SE....as a player to you are you listening?
Novice Member
Joined: 7/30/06
small error detected, you said PS3
I think that people are forgetting how to get the 2048x2048 textures, you just adjust the two registry keys under square enix and i think the two numbers are meant to be 800 and 800 then you have 2048x2048 textures. the game looks much nicher. also if you have a HD tv then you can plug your computer into your TV I have a HDMI enabled graphics card and can run it at 1080i and 1080p (almost 2000 pixels width!!! cant remember the height though)
The sounds are gradually being fixed. In the review it mentions the graphics but to be honest that would take absolutly months!!! remodelling the characters for the smoother looking bodies so that the upgraded textures look right on it as well. then of course there is the incredibly massive world that would need retexturing! and finally think of the weapons and armour that would have to be rebuilt. This would be great but I would rather have more options for changing the characters looks (like face and torso)
The communuity is great and I find that at level 20 I can solo just fine. It is good when you get into the game!
Novice Member
Joined: 8/03/06
Square Enix should stick with RPG's on the next-gen consoles.
Novice Member
Joined: 1/07/04
Good eye, fixed.
Dana Massey
Novice Member
Joined: 9/09/04
Freedom of choice
The game sounds like lot of horse crap , thanks for good rewiev!
"Before this battle is over all the world will know that few...stood against many." - King Leonidas
The game was definitely memorable, but too much of a timesink. Everything in the game was tedious, and not really fun, but the atmosphere and everything was awesome. I want to go back to it every now and then, but I just can't do it, especially since all my characters have been deleted now and I don't wanna start over.
The thing that really screwed the game up for me -- and it relates to customer service -- was that on two different occasions, they charged me twice for one account. My cousin and I both played, and we had an account for each of us (we live in the same house, and are charged on the same credit card), and for some reason, my account was charged twice and his once, two different times. Called customer service and asked them what to do, and they said to fax it over to them and they should fix it. Long story short: they never fixed the problem, I quit, and I will never trust another asian company, and thus, refuse to pay monthly for any of their MMO's from that point on.
Novice Member
Joined: 6/05/05
It's my job to be objective, it's my right to have an opinion.
I'm glad to be seeing some positive feedback =]
Waiting for something fresh to arrive on the MMO scene...
Novice Member
Joined: 10/08/06
I played the game from 2003-2006. I made some amazing friends that even a year after I quit this past january, I still talk to them. The game itself survives off of the friendships made in-game until after the 4th or 5th job to 75 you're paying for a very ornate and beautiful chat room. It is not a game for end-gamers. It is a game for adventurers.
I very much agree with the review and, sadly, feel the mediocre rating is deserved and earned.
I played FFXI from its NA launch on PC and I have seen the game go from one that I once considered the greatest game ever to one that I've finally decided to walk away from for good, overwhelmingly in disappointment of what it's become.
I *especially* agree with the part about the community. The community in FFXI used to be one of its strongest qualities, in my opinion. However, over time the game has been reduced to a literal grind-fest as everyone follows the same step-by-scripted-step treadmill to the "end-game" to farm Sky/Sea or Dynamis/Limbus, etc. etc. Experimentation and exploration are not embraced as you are expected to stick to a very limited handful of leveling spots at any given level-range; suggestions to try other spots are met with incredulity and scorn - how dare you suggest going off the beaten path! Need proof? Ask most players what they think of Valkurm Dunes, or Garlaige Citadel... then watch their faces distort into all manner of disgust. Then, offer an alternative spot to try out instead... and watch their faces distort into expressions of disbelief and disapproval at the very suggestion, as they rattle off the mantra "no.. you're supposed to level there at levels x-y!". Players have reduced progress in FFXI down to near cook-book rigidity. So, very very much of the expansive world created by SE goes unused.. a mere place to get through on the way to somewhere else.
The heavily party-centric gameplay would be wonderful - were the mentality of most players compatible with it. The gameplay/quests/missions in FFXI are built around people maintaining a degree of selflessness and embracing the sense of "team" and helping each other achieve common goals. Sounds wonderful, don't it? However, the ugly truth is that the mentality of too many players is oil to SE's water...
You can almost make a theme song of the self-centered, opportunistic attitude that pervades a large portion of FFXI's player-base...
Sing along, the words are easy...
"Me me me... mine mine mine.. me me me. No time for you.. It's all about me me me".
To a very large degree, people are only interested in their own progress with little time for, nor interest in helping anyone else. The back-stabbing and deceit the reviewer mentions starts well before the end-game. I, personally, have been stabbed in the back by my own linkshell mates. I've got a novel's worth of stories about such behavior in that game.
Not to make this all negative, the game *does* have beautiful environments and an amazing sense of atmosphere. The earlier ones are, perhaps, the most "mundane" - well, except for the Ronfaure region.. they've captured the feel of a "misty morning forest" better than any other game I've ever played. And as you get farther into the game, the areas become more interesting, more beautiful and, in some cases, alot wierder. The artists and world designers on the FFXI team are *extremely* talented and I give them all kudos for that. In the music department, I agree with the review as well. Some of the tunes in that game are very addictive and often beautiful. Sanctuary of Zi'tah has an amazing theme.
I have many, many fond memories of FFXI from "back in the day". And those are the ones I'll keep going forward. The game has gone very much down-hill in many ways.
Perhaps SE's next MMO will bring a breath of fresh air - for a while.
Novice Member
Joined: 7/24/03
I r0x j00 r0x we all r0x
Great Review, for once.
Novice Member
Joined: 6/05/05
It's my job to be objective, it's my right to have an opinion.
By the way...for the final edits on my article, on the Graphics section it says ''MMP'' instead of ''MMO'', and in the community section, towards the very bottom, it says ''game make'' instead of ''game makes''
Sorry...I'm a raging grammar nazi =]
Waiting for something fresh to arrive on the MMO scene...
Novice Member
Joined: 10/14/06
I would suggest having someone who has played since 03 do the rating for this game. And also; the rating categories are a joke.
Novice Member
Joined: 7/30/06
but anyway I heartly recommend this game to anyone that enjoys a good mmorpg. I started in March 2006 and the game was good but bored me, so I quit in the may, I restarted in august and the ammount of updates and new things was AWESOME. I am on FFXI quite a bit now if anyone on the fenrir server wants to party.
Novice Member
Joined: 1/20/04
word of warning to any body that wants to try this game. its a good year and a half to 2 years of grinding to lvl up your first 2 jobs. also make sure to look up the excepted job combos our you will never get a group. people are very very picky in this game and most of them would rather sit around and wait then go out with a job combo they think sucks.
Apprentice Member
Joined: 10/14/06
My girlfriend and I have been playing this game since the NA PS2 release. We enjoy it greatly and look forward to logging in. She plays on the PC, I play on the PS2.
Some things I should point out:
1. Your account is not deleted after 3 months. Your character data is saved for a year and can be reactivated for the entire year. This was changed during the "Return to VanaDiel" campaign.
2. There are no player guilds in the game. Linkshells take their place.
3. There are usually 4 or 5 role-playing linkshells per server. If you enjoy role-playing, you can find like-minded individuals fairly easily. There are linkshell listings on the Playonline Linkshell Community for every server
4. Chocobo raising and breeding has been in place for about 50 or so days now.
I recommend this game to everyone. SE did a great job of creating a world to explore. The NPC's have personalities that set them apart from the usual "hail fellow well met! Bring me 12 octopus tentacles and a clove of garlic." questing that I have seen in other games. The world is beautiful, most of the people you meet are helpful and nice, the ones that aren't you can blacklist and never see or hear a thing they do ever again. You can change your job at any time with no penalty. Be a thief one day and a white mage the next. Spend your day fishing, riding the ferry or the manaclipper, clamming, harvesting, excavating, logging, xping, whatever you decide.
The quests range from very easy to very hard. The missions are graded in difficulty by rank and they do get harder as you increase your rank but all them them are doable before you reach level 69, much less the level cap of 75. Although most of the missions are team-based, there are a few that you can get through solo with sneak and invisible.
Sure, you can decide that you want to get to 'endgame' really fast and do nothing but level if that is how you want to play the game. I know a few people who did that in a couple of months. It's all up to you!
edit: too early in the am, I can't spell.
Amen to that. I was gonna touch on that in my response (above), but figured it was negative enough :-).
Part of the rigidity and "script-like" treadmill the players have introduced is exactly what bountydog says. There are a total of 300 or so possible job combinations in FFXI. Only a relative handful are "accepted".. or, rather, "demanded".
In the same vein as trying different places to hunt and gain xp, don't dare try any job combination not on that "approved" list, you know.. to experiment, or perhaps get something more out of the game than what everyone else does and expects you to do. You will be called "noob", you will be berated and lectured and shunned from parties and told you don't know how to play. It happens all the tme.
You might notice that 90% of my disappointment with FFXI is related to the player-base, not the game itself. With a different, less egocentric player mentality pervading it, FFXI would be a drastically different experience, and likely still the most amazing MMO I'd ever played.
Apprentice Member
Joined: 10/14/06
"when thiers nothing left to burn, one must set its self on fire"
-a random band i heard once
this game is awsome, even though im not a level seventy five this game is alot of fun...... also wat is great about this game is that the community is generaly nice and helpful. i tried to play maple story and ppl rip u off try to cheat u and wont help, and ussaly discourage u, but in ffxi that seldom happens. Characters are ussally helpful and can help u do stuff. I hav a high level linkshell and thier really kind and will help me on tedious missoins. If u ask politly almost all the time a person will help u or do it for u o think this game is great
i got shot ten times in the head
Novice Member
Joined: 6/05/05
It's my job to be objective, it's my right to have an opinion.
Sogoro, I've played since release. Thank you for your consideration though =]
Zyrs, when this was originally written, the balance patch and chocobo breeding had not yet been implemented. So it's slightly dated now...but not by too much. Another person also wrote me in about the character deletion thing, my mistake there.
WSIMike, I'm generally in agreement with you on many aspects regarding FFXI. I honestly enjoyed the game a great degree, it's the people who detracted from the overall experience. HNM linkshells, NM botters, gilsellers, bossy elitists, greedy players, and dramaqueens definitely deteriorate from the Community as a whole. Honestly, had I written this game in the first few months of playing, maybe up to even the first year of player, my review would be rather different, and likely much more positive overall. However, I've seen the good, the bad, and the ugly over the years....and I think it's important to make potential players aware of what they'll be getting themselves into with FFXI.
To all those who read the review, I hope you're not getting overly discouraged from even giving it a try, but please consider that FFXI really is a committment. If you're not willing to dedicate a good month of solid playtime to it...FFXI isn't for you. I know of very few people who logged on for 1 day for 1 hour and decided to play the game for years. Generally, it's the person who logs on for a couple times for a couple hours, despite initial frustrations, and sticks with it. Those are the people you'll see at the end-game.
Waiting for something fresh to arrive on the MMO scene...


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Courses: Sociology of the Arts (MUSCH257B01)
Spring 2011
An introduction to sociological perspectives on the arts. Topics include the relationship between art and social structure, the social sources of aesthetic meaning, the social consequences of artistic classifications and representations, the use of art to construct and undermine social boundaries, the social relations of creating, producing, evaluating, and consuming art, the functions of art in everyday life, and the potential for art to promote social change.
Fulfills: SO I Limit:25
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Teacher in theft case placed on leaveApril 22,2013Teacher in theft case put on leave
RICHFORD An elementary school teacher who police say embezzled about $3,500 while serving as treasurer of the Richford Parent Teacher Organization has been placed on paid leave from her teaching duties.
Vermont State Police said 35-year-old Shawna Steinhour embezzled the money from October 2011 to March 22.
Franklin Northeast School Superintendent Jay Nichols told The Burlington Free Press that Steinhour will be on an indefinite paid leave from the school while the matter is being investigated.
The newspaper said attempts to reach Steinhour or her husband, who serves on the town School Board, have been unsuccessful.MORE IN This Just InBy Kathleen Phalen Tomaselli Full StoryBennington College and Middlebury College both top a list for most entrepreneurial colleges in... Full StoryWas the response to an alleged assault at College of St. Full Story
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- RICHARD'S POOR ALMANACK: On this day 1739, 'Richard Palmer' identified in prison at York Castle as the notorious outlaw DICK TURPIN; IN 1836, Battle of the Alamo begins near San Antonio de Bexar, Texas; 1896, the Tootsie Roll invented by LEO HIRSCHFELD.
- RICHARD'S POOR ALMANACK: On this day in 1472, Orkney, Shetland islands put up as collateral by Norway to Scotland in lieu of dowry for MARGARET OF DENMARK on her marriage with JAMES III, king of Scotland; 1962, JOHN GLENN first American to orbit Earth.
- TOMORROW'S HEADLINES TODAY: City mayoral candidates debate campaign issues; Hartford, Conn., woman still missing; Neal Goswami reports attempts to legislate suicide; local woman loses 100 pounds through TOPS program.
- RICHARD'S POOR ALMANACK: On this day in 1878, JOHN TUNSTALL murdered near Lincoln, New Mexico, by the outlaw JESSE EVANS; in 1930, ELM FARM OLLIE first cow to fly in aircraft, first to be milked airborne; 1955, nuke test WASP; '79, snow in Sahara.
- TOMORROW'S HEADLINES TODAY: Rutland Herald News Editor Alan J. Keays and staff writer Gordon Dritschilo discuss stories planned for the February 18, 2015, edition of the newspaper: Winter budgets maxed, legal marijuana, Springfield bank job, USPS slowdown
- RICHARD'S POOR ALMANACK: On this day in 1249 AD, ANDRE of LONGJUMEAU is dispatched by LOUIS IX of France to meet the KHAGAN, ruler of the Mongol Empire; in 1804, during 1st Barbary War, STEPHEN DECATUR scuttles the pirate-held USS Philadelphia in Tripoli.


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Service with a Smile
Nora Beach Resort & Spa offers a full range of services to ensure that guests are able to relax and take home only happy memories of their visit. Everything, from laundry and flight bookings to baby-sitting services and Wireless Internet access services, is available to all. Transportation is a breez with limousine services and complimentary daily shuttle to Chaweng Beach. Nora also offers a venue for theme meetings, weddings and cocktail functions.
Large Swimming Pool, Pool Bar and Fitness
It is down on the beachfront that Nora comes into its own as the ideal holiday destination for people of all ages. A stunning view of one of Samui's most charming beaches, restaurants and bars serving delicious food and drinks and the island's newest and most unique spas combine, to ensure that there is never a dull moment at Nora.
The pool has its own Jacuzzi as well as a swim-up bar. Why not lie around on a sun lounger and read a favorite novel or simply take in the wonderful view of the Thai Gulf and the nearby island of Koh Pak Som? The pool area also stages many different activities and events so Nora's guests can enjoy anything from southern Thai dancing and cultural displays to even an on-site floating market.
More active holidaymakers might want to use Nora's fully-equipped and air-conditioned gym, where Nora's personal trainer helps guests to devise a work out program to suit them.
Or why not take a swim in the warm waters or go snorkeling and admire some of the beautiful fish and colorful coral just offshore.
Anodas Spa
Discover a sanctuary of pure bliss and tranquility when you visit The Anodas Spa signature. The Anodas spa signature offers a contemporary range of both East and West spa favorites. The secrets of the Asian beauty are unveiled in an exquisite range of spa delights that is supported.
By tradition and modern science. Our extensive range of spa treatments from both East and West traditions will ensure that your every need is catered to. Feel your stress and strain slip away. Your complete relaxation our only aim.
Enjoy with premier spa product with world class import "ANNE SIMONEN"and centuries of Thai World-Class product, ERB is an invitation to look at life a fresh, from the perspective of Thai beauty secrets. Self - indulgence is the core of the Anodas Spa Premier. Our products provide answers to radiant skin with down-to-earth solutions for those who want to maintain purity, nurture their skin and rejuvenate their souls.
In the selection of our products we commit to create a truly unique global spa experience for our guest with a discerning eye for beauty and excellence.
Inspired by an Asian blend of healing and therapeutic remedies, Ytsara holistic spa programs and treatments offer an original and global approach to age-old rituals and native Asian holistic healing practices for modern use.
Samui's Style Wedding
Nora is proud to be the leading wedding planner on the island. We cherish the unison of two hearts that have found each other and are looking forward to spend the rest of their lives together. Nora provides the perfect venue for you and your partner to begin forever at.
You can begin your walk together as one from Thai wedding ceremony or a tropical beach wedding. The Thai wedding ceremony begins with a spiritual binding common to all Buddhist ceremonies and proceeds to the exchange of ring and prayers and blessings from monks. Experience the best day of your lives in the exotic paradise island. Sparkling wine, candle lit dinners and breath taking themes are bound to make this special day memorable and an experience of a lifetime.


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The SwimWays® Sea Squirts™ Life Jacket is a U.S. Coast Guard certified Type III PFD (Personal Flotation Device).
Features include:
- Buoyancy Technology helps kids achieve greater control and stability in the water.
- Quality neoprene cover and fabric liner for extreme comfort.
- Fins are water-tight, and fold flat so a child can sit comfortably when not in the water.
- Heavy duty zipper, straps and clips.
- Fun Orca Whale, Blue Dolphin, Pink Dolphin, or Clown Fish designs kids will love to wear.
- Large size fits children with a chest measurement of 25-29 inches & weighing 50-90 pounds. (Also available in Small or Medium.)
Wearing a life jacket has never been more fun!


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Friday, June 21, 2013
A freshening breeze cooled the grounds at The Woodlands Thursday afternoon as Maite Murphy was sworn in to the Circuit Court of South Carolina, at large Seat 15.
S.C. Chief Justice Jean Toal presided over the special convening of the court and administered the oath. Murphy was joined by her husband Rep. Chris Murphy and their two sons, Austin and Jackson.
The occasion included remarks from Rep. Jenny Horne, Circuit Court Judge Diane Goodstein, and Toal, who praised Murphy's ability as a jurist. Sen. Sean Bennett led the Pledge of Allegiance.
Murphy thanked all who had helped her along the way, singling out Horne and Goodstein as being crucial to her success as a judge – first as a magistrate, more recently as Dorchester County Master-in-Equity and now the circuit court.
Horne spoke of the importance of having the at-large seat awarded to someone from Dorchester County, and in particular to Murphy. She spoke of Murphy's expertise as an attorney and a judge. She also spoke of Murphy as a close friend, mother and wife.
Horne noted that there are now nine women among the 49 circuit court judges in South Carolina and that until the mid-1980s there were no women in the circuit court.
Goodstein echoed those sentiments, speaking directly to the Murphy children about how exceptional their parents are. Following the swearing-in, Goodstein gave Murphy her Judge's robe.
The investiture ceremony was followed by a reception inside the Woodlands mansion and a party at the Woodlands Pavilion.
See more photos from the event at journalscene.com
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Details and Shopping
Customer Favorite
Pieced-together lace tunic with daisy chain crochet trimming around straps and upper bust. Bottom portion has double layers. Bottom layer has sheer lace inserts. Straps are adjustable.
*100% Rayon
*Hand Wash Cold
*Hand Wash Cold
Measurements for Small:Length: 24"= 61 cm
Bust (all around): 33"= 84 cm
Front Strap Length: 9 1/4"= 43 cm
Rated 4.1 out of 5Â by 49 reviewers.
Rated 3 out of 5Â by MarilynMeow Not for a larger chest I waited for this to come back in stock and was really excited to get it in the mail today. It completely flattens my chest (32 E). Normally FP slips are so roomy that this isnt a problem but this one is unforgiving of a larger bust. So sad! 5.13.2013
Rated 4 out of 5Â by giulia_tata Gosh, I am so in love with this dress. Honestly, I think I'm obsessed. I was so excited, but a little apprehensive, to receive this in the mail. I wasn't sure if the dress would fit properly! There were so many other reviews saying that the dress was way too big, so I went ahead and ordered a size smaller than I usually wear ( I usually wear a large but ordered a medium). I'm about 145 lbs, not very well endowed in the chest area, but fairly well proportioned otherwise. It's a good thing I ordered a size down or else it probably would have been way too big. The chest area fits snugly, but sits well on me, and the amount of drapery on the dress is absolutely divine. I think this dress could make any body shape look good. The fabric is very thin, however you can tell that it is well made. It is just so feminine and pretty.. ahh I love it :) 8.15.2013
Rated 4 out of 5Â by lapozolera Great layering piece I am 5'5", a size 36B to C-ish bra and wear a U.S. 12 or large. I wear a medium to large in Free People, depending on the cut of the garment. I bought this slip in a medium. I usually order the medium with Free People because their pieces tend to run large and I am a little too curvy for the super oversized stuff to look very flattering on me. I ordered the medium and it fit like a glove. I'd say that anyone that is my size, but that has a bigger cup size than I do, (like a large C and above), might want to stick with the large as the chest is the tightest area on this garment. The medium fits my 36B to C-ish chest perfectly. The skirt of the slip is totally open and flowy so you don't have to worry about it accentuating your gut (if you have one like I do...actually, let's not call it a gut, let's call it a snuggly womb or something more inviting). Anyhow, I can definitely see how people would be disappointed with the sheer lace panel in the front if they bought this with the intention of wearing it alone. I bought this with the intention of wearing it as a layering piece though, so I don't mind the sheer panel. This can easily be pulled off over a pair of cute bloomers or one of the Free People Intimates layering skirts to provide that extra length and coverage. Or, it can be layered over a longer slip or cut off shorts. I noticed that several people also complained that the straps looked "juvenile". I actually really like the straps. As someone who is old enough to truly remember the 90s (I'm 32), I really appreciate how the bodice and the little floral straps are reminiscent of those 90s slip dresses that I always wore. Since I bought this to wear under shorter tunics and dresses, I don't think anyone will get to see the cute straps and bodice anyway (unfortunately). AT 5'5", the shortest part of the medium comes to about 2 or 3 inches below my butt/crotch (so, too short to wear all alone but, like I said, that's not why I buy slips). The longer parts (on the sides) are about knee length. So, long story short, size down one size unless you are more well endowed in the chest area, in which case, stick to your normal size and don't buy this with the intention of wearing it all alone. Expect to have to wear it layered over/under something longer. 6.10.2013
Rated 2 out of 5Â by swanghost pretty enough to keep even once it breaks this is an obviously lovely slipdress. i got the wisteria color which is beautiful and unique. not even a week after receiving it in the mail, and only twice after wearing it, the strap broke even though there was no pressure on the strap. of course, i have to say that i 100% expected something like this to happen as this is just the way free people makes their clothing. and as always, i am *really* annoyed that even though i paid so much for a slip, it broke after such a short amount of time. but, like all my other free people dresses, i will fix it myself and go on wearing it because i love it so much. 5.30.2013
Rated 2 out of 5Â by EmmaMonster What. Given that I am short, at around 5'2", with a short torso, I decided to give this slip a chance and ordered it in an XS to wear as a dress. Yes, I was wary of the length mentioned in other reviews, but I figured on my small frame it wouldn't be an issue. For me, the length would have been perfect and I would have loved to have worn this as a light summer dress...if it weren't for the see through panel right in the middle of the crotch!! In the online photos, you can see the lace part, but it is not apparent that it is completely sheer. I mean, what is that? Who in the world thought it was a good idea, other than someone who likes flashing their unmentionables around? Other than that, this slip is really beautiful. It has gorgeous, fluttery lace detailing, and is very flattering on. In person, the sand color is a really nice creamy rose. Unfortunately for me, this isn't enough to save it, so I will be returning. If this doesn't bother you, or you envision wearing this as with leggings or shorts, then feel free! 5.16.2013
Rated 1 out of 5Â by free_spirited HUGE I loved the look of this dress online, but was disappointed when it arrived. I am 5"5, 110 lbs and ordered an xs in the sand color. The dress is huge around the bust and waist, and hangs on me like a bag. It is also short to the point that I would worry about showing my undies. I really wish it would have fit true to size and been longer because it is a beautiful dress otherwise. 3.21.2013
Rated 4 out of 5Â by Justpeachy242 Great for a romantic night out They say this dress is lingerie, but I disagree. I think it's a great little date night dress. I'm 5 3 curvy/athletic & it fits me exactly like the picture. I highly recommend getting the bra in the picture or the something to go under this dress because it is LOW CUT. 2.28.2013
Rated 4 out of 5Â by jessielove77 Undecided I bought this dress in the raspberry color in an xs. I am 5'2" - 32 a/b chest. The material is really beautiful and the dress is certainly unique!! BUT I am short and the layering hits me right in the hips, making me look wider in the hips than I already am. (the front of the dress is short and has lace, so it is see through - you would have to wear some sort of cute undies or leggings underneath - FP makes plenty of those so not to worry). It is in my closet for now but not so sure it will stay there :-/ 2.26.2013
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So if I find myself in an emergency situation and pick up one of the new phones at the Odell Weeks track, will ADPS know how to locate me or will I have to give them directions and hope that I survive the 20-minute wait for them to arrive?
Nursing homes
Nursing homes need to follow along with SRS, instead of paying employees for their time.
Strange indeed
Its strange indeed that SRNS was told after the election to take a vacation. Strange indeed.
The only thing good that came out of that compassionate speech of Obama to the people of Hurricane Sandy was it got him some votes. He could really care less.
Tax hack
I, too, have frustration about our taxes being hacked. I, too, tried many days to get on the website, and it didnt work. I called the number to get instructions again. By some miracle I got someone on the phone and gave them my information. He gave me Protect ID direct, which is (866) 252-0121. I hope that helps the rest of you.
This is a message for Nikki Haley. She ran all over the country with Mitt Romney trying to make him the president, now the states credit is in jeopardy. We need a new governor, one who stays in the state and doesnt run behind a loser.
It was good presentation on the plans for the lane expansion of the Hitchcock Parkway 118 bypass, but I fail to see any inclusion of sidewalks or street lighting or bicycle lanes or anything like that.
Good job
Im calling to thank the three students we had at Precinct 44 with our voting Tuesday, and want to let them know what a wonderful job they did and how proud we are that students are getting involved in elections at a young age.
Nice people
There are still nice people left in the world. My daughter and I were at Walmart and we went over $30 on our groceries and this nice couple gave us $30 so we wouldnt have to put back our things. I just want to thank them so much, may God bless them. Theyre so wonderful.
Unfair light
I agree with the TalkBack on the East Gate Drive light. Sometimes traffic backs up on the roundabout. This light setting is very unfair.
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Philip D.
A Positive Spin
When I'm 74
July 30, 2013
"Hey Babe, listen to this headline," as I sipped my morning dose of java and viewed the week's top stories on TheBody.com. "There are some more people that have been cured of HIV."
My Inner Critic Takes a Holiday
April 12, 2013
Since 2007, my inner critic has been extra busy. Sure, he's always been a really, hard worker but since HIV moved in, he's been pulling extra shifts. First one in, last one out, and rarely takes a sick day. In fact, he does his job with such consistency and dedication that most of the time he goes unnoticed. Until recently, that is. My newfound awareness, after observing him in action, has brought me to the conclusion that it's time for him to take a much-needed vacation.
My Canine Confidante
February 16, 2013
As she sleeps, I hear her snoring softly. To me, there is no sound more comforting; and is, quite possibly, the thing I will miss most. My dog, Wilma, has cancer and it's spreading inside her. With the wisdom of my trusted vet, I've decided not to pursue surgery or other procedures to prolong her life. She is resting comfortably now with the help of painkillers and steroids. I know in my heart that her ball fetching days are over. I am mentally preparing for life without her and making arrangements to have her euthanized in our home and to be buried in the country.
Happy Anniversary, HIV. I Hate You.
January 10, 2013
If you are an adult American, it is nearly impossible to forget where you were the morning of September 11th. If you are HIV positive, it is unlikely you can forget the moment you were first told that the deadly virus lives and replicates inside of you. I heard the news five years ago today. It changed the way I felt about myself and in some ways, how I viewed the world. Although I have already blogged here about that pivotal moment, I still wanted to post something to mark "our" anniversary.
Worry Your Way to Longevity
June 9, 2012
There may be hope for me yet. According to a book I read recently, those who worry in moderation appear to outlive their overly cheerful counterparts. If that's really true, I may be around to blog for a very long time.
I Will Survive
April 12, 2012
I am tattoo free. Saying that, along with having little or no desire to visit Facebook (never say never) can make me feel like the odd man out, at any given San Francisco event. (not an easy thing to do, if you've ever attended the Folsom Street Fair). But recently I have entertained the idea of permanently marking some of my skin with ink. Although you might be sporting full sleeves or a Komodo dragon that envelops your entire back, I'm thinking something a bit more discreet. I'm not completely decided on its placement but it's really just for me and it's really just one word. Not so much a statement but a personal reminder.
Just Fine
December 9, 2011
I know it's been quite some time since I posted an entry here. Admittedly, the content of my previous post was a bit on the gloomy side but the experience of writing it evolved into something surprisingly cathartic. I'm lucky to have lived to tell the tale and I am forever grateful that my days of running from the Devil are behind me.
Running From The Devil
June 1, 2011
I first read about the new gay cancer in the summer of 1982. Barely 18, my hormones are continually escalating and men are really starting to notice me. There are so many things I want to try with them but it isn't worth dying over.
Liquid Gold: The Secret Life of Essential Oils, Part Two
March 17, 2011
After my previous post on essential oils, I received more inquiries on the topic than any other, by far. This made me feel hopeful for the HIV-positive community. Many of us are so bound to to Pharma that sometimes it's refreshing to have somewhere else to turn to support our compromised health and complement what modern medicines have to offer us.
Liquid Gold: The Secret Life of Essential Oils
February 17, 2011
In my opinion, it's a travesty what Advertising has gone and done with the word Aromatherapy. The powerful chemistry found within a single drop of essential oil -- inhaled from a warm washcloth, a steamer, a carrier oil or right on your wrist -- has such a profound, almost instantaneous and usually beneficial effect inside our bodies and minds; to cheapen it by putting inferior quality imitations into room sprays and Glade Plug-ins and calling it Aromatherapy is a crying shame.
A Positive Spin
Philip D.
After testing HIV positive in 2007, I promised myself that I would make something "good" from all that I was handed. From the very beginning, each time I was presented with an obstacle or challenge, I also received some help. Usually in the form of a person, sometimes an opportunity; but I have grown so much, it has made it impossible for me to call the past few years "bad." Although I've never written much of anything before, I have been so incredibly fortunate, I feel like I must pay it forward somehow. Maybe by sharing my experience, it will help those starting later in the game, on the fast track to HAART, or anyone that's feeling a bit isolated or "stuck" with their diagnosis.
Subscribe to Philip's Blog:
Recent Posts:
July 30, 2013 - When I'm 74: A Blog Entry by Phillip D.
April 12, 2013 - My Inner Critic Takes a Holiday: A Blog Entry by Philip D.
February 16, 2013 - My Canine Confidante: A Blog Entry by Philip D.
January 10, 2013 - Happy Anniversary, HIV. I Hate You. A Blog Entry by Philip D.
June 9, 2012 - Worry Your Way to Longevity: A Blog Entry by Philip D.
A Brief Disclaimer:
The opinions expressed by TheBody.com's bloggers are entirely their own, and do not necessarily reflect the views of TheBody.com itself.


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Ashe County saw two players receive all-conference honorable mention for their play this past season.
Aspen Domske and Sloan Elliott were selected to the Mountain Valley Athletic Conference Honorable Mention team.
Starmount's Ashton Gregory was named MVAC Player of the Year and Starmount head coach Jon Symons received MVAC Coach of the Year honors. The Lady Rams finished the season with a perfect 16-0 conference record.
MVAC All-Conference players:
Erin Barr (Starmount)
Laken Blevins (Alleghany)
Leah Bishop (West Wilkes)
Hannah Cardwell (West Wilkes)
Jackie Denny (North Wilkes)
Makenzie Dudley (Forbush)
Jessica Funk (Forbush)
Ashton Gregory (Starmount)
Cassidy Gregory (East Wilkes)
Haley Hartman (Starmount)
Ashley Hayes (East Wilkes)
Josie Matthews (Starmount)
Lakyn Rutledge (West Wilkes)
Mika Sprinkle (Alleghany)
Whitney Weaver (Alleghany)
Taylor Wyatt (North Wilkes)
MVAC Honorable Mention players:
Meredith Boles (Forbush)
Jessica Bumgarner (West Wilkes)
Raegen Bumgarner (North Wilkes)
Kasey Caudill (Alleghany)
Mallory Choplin ( Forbush)
Samantha Crabb (East Wilkes)
Aspen Domske (Ashe)
Sloan Elliott (Ashe)
Natasha Hamm (Alleghany)
Martha Mastin (Wilkes Central)
Lauren Miller (Wilkes Central)
Brooklyn Osborne (North Wilkes)
Adrian Pardue (East Wilkes)
Kaitlyn Pierce (West Wilkes)
Cayley Shoemaker (Elkin)
Rachel Wagoner (Starmount)
Lindsey Williams (Forbush)


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Jean E. Krom, 77, a former resident of Tri-Lakes and widow of Lewis E. Krom, passed away at 8:51 p.m. Saturday, Sept. 10, 2011 at Lutheran Hospital in Fort Wayne.
She had been taken to the hospital from the Englewood Health & Rehabilitation Center in Fort Wayne, where she had been a patient for the past five years.
Mrs. Krom was born Jan. 9, 1934 in Fort Wayne, a daughter of Fred and Frances (Nix) Alles, and spent her formative years there.
As an adult, she had lived in Florida for ten years, before returning to this area in 1978.
On Nov. 20, 1980 she was married to Lewis E. Krom. The couple spent their married lives at Round Lake, and she assisted her husband in the operation of Sweet Pea Septic Service for many years.
Mr. Krom preceded her in death on Aug. 28, 1997.
She was a member of the Good News Baptist Church in Churubusco.
The surviving relatives include her twin brother Eugene "Pete" (Charlotte) Alles and another brother John Alles, both of Fort Wayne.
In addition to her parents and husband, she was preceded in death by an infant son Scotty Reed; and by a brother Carl Alles.
Funeral services will be held at 10 a.m. Wednesday at the Sheets & Childs Funeral Home in Churubusco with Rev. Edward A. Thompson, pastor of Good News Baptist Church, officiating.
The family will receive friends at the mortuary from 5 to 7 p.m. on Tuesday.
Interment will be in the Christian Chapel Cemetery, Merriam.
For those who wish, memorials may be directed to Good News Baptist Church, 812 W. Anderson Road, Churubusco, IN 46723
To leave an online condolence for the family in Mrs. Krom's memory, log on to www.sheetsandchilds.net.