text:
|Publication number
|Publication type
|Application number
|Publication date
|Apr 10, 2008
|Filing date
|Jun 5, 2007
|Priority date
|Aug 31, 1998
|Publication number
|David Hardin, Kulwinder Dua, Gregory Skerven
|Original Assignee
|Wilson-Cook Medical Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Referenced by (31), Classifications (4), Legal Events (1)
|External Links: USPTO, USPTO Assignment, Espacenet
This application claims the benefit of U.S. provisional patent application 60/811,647, filed Jun. 7, 2006; this application is also a continuation-in-part of U.S. patent application Ser. No. 11/341,970, filed Jan. 27, 2006, which is a continuation-in-part of U.S. patent application Ser. No. 10/208,736, filed Jul. 29, 2002 and issued as U.S. Pat. No. 7,118,600, which is a continuation-in-part of U.S. patent application Ser. No. 09/876,520, filed Jun. 7, 2001, which issued as U.S. Pat. No. 6,746,489, which claims priority to U.S. Provisional Application Ser. No. 60/211,753, filed Jun. 14, 2000, and is a continuation-in-part of U.S. patent application Ser. No. 09/386,173, filed Aug. 31, 1999, which issued as U.S. Pat. No. 6,302,917, and which claims priority to U.S. Provisional Application Ser. No. 60/098,542, filed Aug. 31, 1998. This application also claims priority to U.S. Provisional Application Ser. Nos. 60/309,107, filed Jul. 31, 2001 and 60/648,744, filed Jan. 31, 2005. All of the above-referenced patents and patent applications are hereby incorporated by reference in their entirety.
The present invention relates to implantable medical devices. More particularly, the invention relates to drainage stents comprising a bioactive, including drainage stents adapted for use in the biliary tract.
Endoluminal medical devices can be implanted to treat various conditions. For example, a biliary stent can be implanted within a biliary duct to treat conditions associated with compromised drainage of the biliary tree, such as obstructive jaundice. Implanted biliary stents can provide for the palliation of malignant biliary obstruction, particularly when surgical cure is not possible. Biliary stenting treatment approaches can also be used to provide short-term treatment of conditions such as biliary fistulae or giant common duct stones. Long term implantation of biliary stents can be used to treat chronic conditions such as postoperative biliary stricture, primary sclerosing cholangitis and chronic pancreatitis.
Biliary stents may be configured as a tubular structure housing a drainage lumen. The biliary stent may be sufficiently flexible to be advanced on a delivery catheter or through an endoscope along a path that may include sharp bends, before being placed in a bile duct. The biliary stent may also be sufficiently strong to resist collapse and to maintain an open drainage lumen through which digestive liquids can flow into the digestive tract. The biliary stent also should maintain its intended position within the bile duct without migrating from that position.
Once implanted, biliary stents can become occluded within a bile duct, as an encrustation of amorphous biological material and bacteria ("sludge") accumulate on the interior surface of the stent, gradually obstructing the lumen of the stent. Biliary sludge is an amorphous substance often containing crystals of calcium bilirubinate and calcium palimitate, along with significant quantities of various proteins and bacteria. Sludge can deposit rapidly upon implantation in the presence of bacteria. For example, bacteria can adhere to plastic stent surfaces with pili or through production of a mucopolysaccharide coating. Bacterial adhesion to the wall of a drainage lumen can result in occlusion of the drainage stent, as the bacteria multiply within a glycocalyx matrix of the sludge to form a biofilm over the sludge within the drainage lumen of an implanted drainage stent. The biofilm can provide a physical barrier protecting encased bacteria within the sludge from contact with host white blood cells and antibodies, and diminishing the penetration of antibiotics into the stent sludge. With time, an implanted biliary stent can become blocked, thereby restricting or blocking bile flow through the drainage stent. As a result, a patient can develop symptoms of recurrent biliary obstruction due to restricted or blocked bile flow through an implanted biliary stent, which can be complicated by cholangitis and sepsis. Often, such conditions are treated by antibiotics and/or endoscopic replacement of an obstructed biliary stent.
In addition to clogging, another post-implantation challenge after the implantation of a biliary stent may be reducing or preventing undesired retrograde fluid flow through the drainage lumen. Retrograde fluid flow through a biliary stent may create a risk of migration of bacteria into the drainage lumen, which could lead to infection or obstruction of the drainage lumen.
Therefore, there exists a need for an endoluminal medical device, such as a drainage stent, that desirably reduces retrograde flow through a body vessel while simultaneously preventing or reducing bacteria, biofilm and sludge deposition inside the drainage lumen of implantable medical device. Promising approaches for preventing biofilm and sludge deposition have involved systemic administration of antibiotics, such as fluoroquinolone agents, that achieve high concentrations in bile and are effective against enteric Gram-negative bacteria. However, systemic treatment approaches may not allow penetration of the antibiotic agent through the glycocalyx matrix of biofilm that can insulate bacteria from contact with the antibiotic.
What is needed is a medical device having a drainage lumen adapted to regulate antegrade and/or retrograde flow through the drainage lumen in response to the fluid flow within a body vessel, while delivering one or more bioactive agents that prevent or mitigate the deposition of bacteria or other material that can lead to blockage of a drainage lumen in the medical device.
The present disclosure relates to endoluminal medical devices, such as drainage stents, comprising a drainage lumen with a valve means for regulating fluid flow through the drainage lumen, and a releasable biodeposition-reducing bioactive agent. The drainage lumen is defined by an interior surface of the drainage stent, and may extend longitudinally from an inlet to an outlet along the axis of the drainage stent. The valve means is preferably configured as a sleeve in communication with the drainage lumen. A portion of the medical device contacting the fluid flow can contain a releasable biodeposition-reducing bioactive agent. Preferably, the sleeve contains the biodeposition-reducing bioactive agent, although the biodeposition-reducing bioactive agent can also be positioned on the surface of the drainage lumen.
In one embodiment, the endoluminal medical device is a drainage stent comprising a collapsible sleeve comprising a releasable biodeposition-reducing bioactive agent attached to the outlet of a tubular drainage stent, such as a biliary stent, to advantageously prevent reflux of intestinal contents and the associated bacteria into the drainage lumen of the stent. The biodeposition-reducing bioactive agent may be an antibiotic or antimicrobial agent, to prevent formation of biofilm within the drainage lumen of the medical device, which can lead to occlusion of the drainage lumen. The sleeve can define a collapsible lumen that is preferably positioned in fluid flow communication with the drainage lumen of a biliary stent. The collapsible lumen of the sleeve can be positioned within the drainage lumen of a drainage stent or may extend longitudinally from the drainage lumen of the drainage stent.
Preferably, one end of the sleeve material circumferentially encloses the outlet end of a biliary stent. The sleeve material is preferably configured as a tube of flexible material, and may have any suitable thickness. Advantageously, the sleeve is long enough to permit shortening the sleeve length to accommodate variation in individual anatomy. Depending on the anatomical size of the human or veterinary patient, the sleeve can extend from the outlet end of the tubular drainage stent for any suitable length, for example up to about 20 cm (about 7.9 inches), preferably in a range of 5 to 15 cm (about 2.0 inches to 5.9 inches), and most preferably approximately 10 cm (about 3.9 inches) in a human patient or 8 cm (3.1 inches) in a veterinary patient. The sleeve material can be formed from any biocompatible material that is flexible and acid resistant, preferably expanded-polytetrafluoroethylene ("ePTFE"). The sleeve can also be formed from polyurethane, silicone, or polyamides (including a nylon material).
The sleeve may function as a valve by collapsing or inverting to block fluid flow in a retrograde direction, into the outlet of a drainage stent. The sleeve may be configured as a flexible tube defining a collapsible lumen, and having an exterior surface. Fluid flow in the antegrade direction may provide a first pressure against the collapsible lumen of the sleeve in the antegrade direction, effective to expand the collapsible lumen of the sleeve and permit fluid to flow through the sleeve from the outlet of the drainage stent. However, fluid flow in the retrograde direction may exert a second pressure against the sleeve effective to collapse the sleeve. The sleeve may collapse when the second pressure is greater than the first pressure, thereby blocking fluid flow into the drainage lumen of the drainage stent. The pressure needed to collapse or invert the sleeve can be a function of the sleeve material, thickness and length measured from the distal end of a tube of a drainage stent. The thickness of the sleeve can vary as a function of distance from the outlet of the biliary stent. Desirably, the sleeve material is thicker at the portion attached to the drainage stent, and progressively thinner moving away from the drainage stent outlet. For example, the sleeve may desirably have a thickness of about 0.0050-inch (about 0.0127 mm) through about 0.0080-inch (about 0.0203 mm) at the portion attached to the drainage stent outlet, but a decreasing thickness in a range of about 0.0040-inch (about 0.1016 mm) to about 0.0015-inch (about 0.0381 mm), preferably approximately 0.0020-inch (about 0.0508 mm), at the sleeve portion distal to the portion attached to a drainage stent outlet.
A drainage stent configured as a biliary stent is desirably placed in the biliary tree for maintaining patency of the bile or pancreatic duct and the Papilla of Vater. Preferably, the biliary stent is positioned so that the sleeve can extend down into the duodenum to provide a one-way valve for the flow of bile. When bile is not being secreted, the sleeve advantageously collapses to prevent backflow of material from the duodenum, which might otherwise occur in a biliary stent without a valve means. Alternatively, the sleeve may be located completely within the lumen of the drainage stent with one end of the sleeve being bonded or otherwise attached to the interior wall of the biliary stent. Alternatively, the drainage stent can also be configured for placement in the ureters or urethra, and can include a sleeve extending from one end of the drainage conduit to permit urine flow and prevent retrograde flow or pathogen migration toward the kidneys or bladder.
In yet another aspect of the present invention, a method of treating a subject comprises implanting a medical device at a point of treatment, such as within a biliary duct, wherein the medical device comprises a tubular member and a sleeve.
The following detailed description and appended drawings describe and illustrate various exemplary embodiments of the invention. The description and drawings serve to enable one skilled in the art to make and use the invention, and are not intended to limit the scope of the invention in any manner.
The invention provides medical devices for implantation in a body vessel, methods of making the medical devices, and methods of treatment that utilize the medical devices.
As used herein the terms "comprise(s)," "include(s)," "having," "has," "contain(s)," and variants thereof, are intended to be open-ended transitional phrases, terms, or words that do not preclude the possibility of additional acts or structure.
The term "effective amount" refers to an amount of an active ingredient sufficient to achieve a desired affect without causing an undesirable side effect. In some cases, it may be necessary to achieve a balance between obtaining a desired effect and limiting the severity of an undesired effect. It will be appreciated that the amount of active ingredient used will vary depending upon the type of active ingredient and the intended use of the composition of the present invention.
As used herein, the term "body vessel" means any body passage that conducts fluid, including but not limited to biliary ducts, ureteral passages, esophagus, and blood vessels such as those of the human vasculature system.
As used herein, the term "implantable" refers to an ability of a medical device to be positioned at a location within a body, such as within a body vessel. Furthermore, the terms "implantation" and "implanted" refer to the positioning of a medical device at a location within a body, such as within a body vessel.
As used herein, the term "biodeposition-reducing bioactive agent" refers to a material that reduces the rate of biodeposition within the lumen of a drainage stent. Biodeposition can include the deposition of components of the biofilm or glycocalyx matrix on the interior surface of the drainage stent, such as calcium bilirubinate, calcium palimitate, proteins and bacteria. Biodeposition-reducing bioactive agents are preferably antibiotic or antimicrobial agents, although any other suitable materials can be used.
As used herein, "endolumenally," "intraluminally" or "transluminal" all refer synonymously to implantation placement by procedures wherein the medical device is advanced within and through the lumen of a body vessel from a remote location to a target site within the body vessel. Endolumenal delivery includes implantation in a biliary duct from an endoscope or catheter.
A "biocompatible" material is a material that is compatible with living tissue or a living system by being medically appropriate for a given treatment. Preferably, a biocompatible material does not induce an undesirable level of toxicity, injury or immunological rejection upon implantation for a desired therapeutic outcome. Biocompatibility tests may include tests and standards set forth in International Standards Organization (ISO) Standard No. 10993 and/or the U.S. Pharmacopeia (USP) 23 and/or the U.S. Food and Drug Administration (FDA) blue book memorandum No. G95-1, entitled "Use of International Standard ISO-10993, Biological Evaluation of Medical Devices Part-1: Evaluation and Testing."
The invention relates to medical devices for implantation in a body vessel. More specifically, various embodiments of the invention relate to a medical device comprising a sleeve formed from a flexible material, the sleeve attached to a drainage stent and having a lumen extending longitudinally there through and communicating with a drainage lumen extending through the drainage stent. The sleeve desirably comprises ePTFE containing one or more biodeposition-reducing bioactive agents. The sleeve preferably defines a collapsible lumen in communication with the outlet of a biliary stent. The sleeve may be configured to open in response to a fluid flow out of the outlet of the biliary stent. The fluid flow from the biliary stent may apply a first pressure on the sleeve in a first direction, opening the sleeve lumen to permit the fluid flow to pass the fluid through the sleeve lumen. However, movement of the sleeve in response to fluid flow in the opposite direction, toward the outlet of the biliary stent, can collapse the sleeve lumen to at least substantially close the lumen of the sleeve, and block retrograde flow into the biliary stent outlet. The sleeve may be configured to collapse in response to either a fluid applying a second pressure in a second direction or the absence of the fluid applying a first pressure in a first direction.
Medical Device Configurations
The drainage lumen 12 is defined by an interior surface of the medical device 10. The inlet 63 is adapted to receive the fluid or other material that is moving under a first, antegrade direction 17 at a first pressure. The collapsible sleeve 13 is preferably in fluid flow communication with the drainage lumen 12, meaning that fluid flow may pass through the drainage lumen 12 before, during or after passing through the collapsible sleeve 13. The outlet 62 of the tubular drainage stent 60 may be circumferentially enclosed by the sleeve 13, or the sleeve 13 may be positioned within the drainage lumen 12. The sleeve 13 may be a tube of flexible material extending from a first end 67 to a second end 68. The second end 68 is preferably positioned around the outlet 62 of the drainage stent 60, for example by a retaining ring 66. The sleeve 13 may be adapted to function as a collapsible one-way valve to prevent or reduce fluid flow in a retrograde direction 19 into the outlet 62 and through the drainage stent 60.
Preferably, the medical device comprises a means for anchoring the device within a body passage. The means for anchoring the biliary stent may include flaps extending from the exterior surface of the tubular member 11. The number, size and orientation of anchoring flaps can be modified to accommodate the migration-preventing requirements of the particular medical device to be implanted, the site of implantation and the desired function of the device. For example, the drainage stent 60 comprises an outlet array 64 and an inlet array 65 of radially extending flaps extending from the exterior surface of the drainage stent 60, proximate the outlet 62 and the inlet 63, respectively. The outlet array 64 and inlet array 65 of flaps can have any suitable number, size and configuration of flaps selected to anchor drainage stent 60 within a biliary duct. For example, the outlet array 64 and the inlet array 65 may comprise one row of four flaps each. The arrays of anchoring flaps 64, 65 can be formed by slicing small longitudinal sections in the distal or proximate ends of the tubular member 11 and orienting the sliced sections radially. Preferably, the slice incisions are made in the exterior surface of the tubular member 11 in a shallow manner so as to not create holes in the drainage stent 60. Alternatively, the drainage stent 60 may also include an anchoring means, such barbs, pigtail loops, etc. positioned proximate the outlet 62 and/or the inlet 63.
The sleeve 13 is preferably configured to act as a one-way valve permitting substantially uni-directional fluid flow through the drainage lumen 12 of the drainage stent 60. Referring to
Preferably, the sleeve 13 is mounted around outlet 62 of the drainage stent 60 and extends longitudinally therefrom. The range of sleeve thickness for the illustrative embodiment in
The sleeve 13 may be made of a biocompatible material that will not substantially degrade in the particular environment of the human body into which it is to be placed. Possible materials include expanded polytetrafluoroethylene (ePTFE), Dacron, PTFE, TFE or polyester fabric, polyurethane, silicone, nylon, polyamides such as other urethanes, or other biocompatible materials. It is important that the sleeve material be selected appropriately. For example, in the illustrative embodiment, the sleeve is typically made of a tubular piece of ePTFE which may be more resistant to the caustic bile than would a sleeve of polyurethane. The ePTFE tube may be extruded into a thin wall tube having sufficient flexibility to collapse and seal against the ingress of fluid, while having sufficient integrity to resist tearing.
The second end 68 of the sleeve 13 may be attached about the outlet 62 of the drainage stent 60, which can be a ST-2 SOEHENDRA TANNENBAUM� stent, a COTTON-LEUNG� stent or a COTTON-HUIBREGTSE� stent (Cook Endoscopy Inc., Winston-Salem, N.C.), by an attachment means, such as an illustrative crimped metal retaining ring 66. This retaining ring 66 can be made radiopaque to serve as a fluoroscopic marker. Other methods of attachment could include suture binding, selected medical grade adhesives, or thermal bonding, if appropriate for both the sleeve and stent polymers. An alternative method of attaching the sleeve to a tubular drainage stent 60 is depicted in
The drainage stent 60 may be configured as an elongate, closed tubular member housing a drainage lumen 12 providing a fluid drainage conduit adapted to be placed within a bodily passage, such as the bile duct, pancreatic duct, urethra, etc. to facilitate the flow of fluids therethrough. Alternatively, the drainage stent 60 may be configured as a tubular drainage catheter. A drainage stent 60 is commonly implanted either to establish or maintain patency of the bodily passage or to drain an organ or fluid source, such as the liver, gall bladder or urinary bladder. The drainage stent 60 is desirably formed from plastic or metal, and is typically non-expanding.
For example,
In another embodiment, the medical device is a medical device comprising: a tubular portion having a passage (e.g., a stent or drainage catheter) extending longitudinally therethrough; and a sleeve disposed around and extending at least partially along said tubular portion, said sleeve extending from an end of said tubular portion and having a lumen extending longitudinally through the sleeve and communicating with said lumen of the tubular portion. The sleeve is preferably configured to collapse in response to a fluid applying a first pressure in a first direction passing the fluid through said lumen of the sleeve, said sleeve collapsing in response to a fluid applying a second pressure in a second direction.
In one embodiment, the medical device includes a tubular member having a passage extending longitudinally therethrough; and a sleeve extending from an end of the tubular member and having a lumen extending longitudinally therethrough and communicating with the passage of the tubular member. The sleeve may be configured to permit the passage of a fluid through the lumen in a first direction in response to the fluid applying a first pressure to the sleeve in the first direction. The sleeve is typically collapsible so as to substantially close the lumen in response to a fluid applying a second pressure to the sleeve in a second direction. The sleeve may also include a proximal portion and a distal portion, and wherein the distal portion comprises a modification with respect to the proximal portion for increasing resistance to being inverted through the tubular stent in response to the second pressure. The sleeve may be normally closed in the absence of the fluid applying the first pressure to the sleeve in the first direction. Optionally, the sleeve may include a proximal portion and a distal portion wherein the distal portion includes an inversion inhibition means for preventing the sleeve from being inverted through the tubular stent in response to the second pressure. The sleeve may optionally include a portion having increased resistance to being inverted through the tubular stent in response to the second pressure; wherein the sleeve may extend through the passage of the tubular member in response to a third pressure that is applied to the sleeve in the second direction, said third pressure being significantly greater than the second pressure; and wherein the sleeve comprises a proximal portion extending from said tubular stent and a distal portion, said distal portion comprising a thickness that is greater than a thickness of said proximal portion for increased resistance to being inverted.
In another embodiment, the medical device may be a drainage stent or catheter for placement in a patient comprising a tubular portion having a passage extending longitudinally therethrough and a sleeve extending from an end of the tubular portion. The sleeve typically defines a lumen extending longitudinally therethrough and communicating with the passage of the tubular portion, the sleeve permitting the passage of a fluid through the lumen of the tubular portion in a first direction in response to the fluid applying a first pressure to the sleeve in the first direction, the sleeve being collapsible so as to substantially close the lumen in response to a fluid applying a second pressure to the sleeve in a second direction. The sleeve may include a portion having increased resistance to being inverted through the tubular stent in response to the second pressure; wherein the sleeve extends through the passage of said tubular portion in response to a third pressure that is applied to the sleeve in the second direction, said third pressure being significantly greater than the second pressure. The sleeve optionally includes a proximal portion extending from said tubular portion of the medical device and a distal portion, said distal portion comprising a material having stiffness that is greater than a stiffness of a material of said proximal portion for increased resistance to being inverted.
Drainage Stent Structure
The drainage stent 60 can be made from any biocompatible material that is resiliently compliant enough to readily conform to the curvature of the duct in which it is to be placed, while having sufficient "hoop" strength to retain its form within the duct. The drainage stent 60 can be formed from any suitable biocompatible material. Preferably, the drainage stent 60 is formed from a thermoformable material such as a polyolefin. One preferred type of material is a metallocene catalyzed polyethylene, polypropylene, polybutylene or copolymers thereof. Preferably, the drainage stent 60 is formed from a biocompatible polyethylene. Other suitable materials for the drainage stent 60 include: vinyl aromatic polymers such as polystyrene; vinyl aromatic copolymers such as styrene-isobutylene copolymers and butadiene-styrene copolymers; ethylenic copolymers such as ethylene vinyl acetate (EVA), ethylene-methacrylic acid and ethylene-acrylic acid copolymers where some of the acid groups have been neutralized with either zinc or sodium ions (commonly known as ionomers); polyacetals; chloropolymers such as polyvinylchloride (PVC); fluoropolymers such as polytetrafluoroethylene (PTFE); polyesters such as polyethyleneterephthalate (PET); polyester-ethers; polyamides such as nylon 6 and nylon 6,6; polyamide ethers; polyethers; elastomers such as elastomeric polyurethanes and polyurethane copolymers; silicones; polycarbonates; and mixtures and block or random copolymers of any of the foregoing. Examples of specific preferred materials for forming the drainage stent include: polyethylene, polyurethane (such as a material commercially available from Dow Corning under the tradename PELLETHANE), silicone rubber (such as a material commercially available from Dow Corning under the tradename SILASTIC), and polyetheretherketone (such as a material commercially available from Victrex under the tradename PEEK). These materials are non-limiting examples of non-biodegradable biocompatible matrix polymers useful for manufacturing the medical devices of the present invention.
A preferred drainage stent 60 structure having a straight configuration (
A stent or delivery device may comprise one or more radiopaque materials to facilitate tracking and positioning of the medical device, which may be added in any fabrication method or absorbed into or sprayed onto the surface of part or all of the medical device. For example, referring to
A marker band may be formed from a suitably radiopaque material. The degree of radiopacity contrast can be altered by altering the content of the radiopaque marker band. Radiopacity may be imparted by covalently binding iodine to the polymer monomeric building blocks of the elements of the implant. Common radiopaque materials include barium sulfate, bismuth subcarbonate, and zirconium dioxide. Other radiopaque elements include: cadmium, tungsten, gold, tantalum, bismuth, platinum, iridium, and rhodium. In one preferred embodiment, iodine may be employed for its radiopacity and antimicrobial properties. Radiopacity is typically determined by fluoroscope or x-ray film. Imagable markers, including radiopaque material, can be incorporated in any portion of a medical device. For example, radiopaque markers can be used to identify a long axis or a short axis of a medical device within a body vessel. For instance, radiopaque material may be attached to a tubular drainage stent or woven into portions of the valve member material.
Methods of Manufacture
The medical devices can be formed in any suitable manner that provides a structure having a sleeve attached to a drainage stent. The sleeve preferably comprises a expanded PTFE and a bioactive agent.
When the term "expanded" is used to describe PTFE, i.e. ePTFE, it is intended to describe PTFE which has been stretched, in accordance with techniques which increase the internodal distance and concomitantly porosity. The stretching may be in uni-axially, bi-axially, or multi-axially. The nodes are stretched apart by the stretched fibrils in the direction of the expansion. Methods of making conventional longitudinally expanded ePTFE are well known in the art.
In one aspect, a billet comprising a PTFE resin is mixed with a bioactive agent. A billet can have a solvent level of about 10 to 30% by weight, to yield an extrudate suitable for the stretching process. Moreover, it is desired that the preformed billet is extruded to a reduction ratio of about 200 to 1. An additional parameter which has a significant effect on the resulting extrudate property upon being stretched is the extrusion pressure. Suitable extrusion pressures to practice the present invention include pressures of about 5,000 PSI to about 10,000 PSI.
The extrudate can be stretched under conditions capable of yielding a layer which is uniform over a large portion of its length. Stretching conditions are given in terms of stretch rate and stretch ratio. Stretch rate refers to the percentage change in length of the extrudate per unit time. Preferably, the stretch rate may be about 7 to about 8 inches per second (about 17.7 to 20.3 cm per second). The percentage change is calculated with reference to the starting length of the extrudate. In contrast, stretch ratio is not time dependent but refers to the ratio of the final length of the stretched extrudate to that of the initial length of the unstretched extrudate. With respect to a bioactive-containing sleeve, the stretch ratio can be about 2.5 to 1. Moreover, stretching is preferably conducted at a temperature of about 250� C. and the extrudate can be placed in tension during the stretching process.
An ePTFE sleeve can have enhanced axial elongation and radial expansion properties of up to about 600% or more by linear dimension. The physically modified ePTFE tubular structure is able to be elongated or expanded and then returned to its original state without an elastic force existing therewith. Additional details of physically-modified ePTFE and methods for making the same can be found in commonly assigned Application Title "ePTFE Graft With Axial Elongation Properties", assigned U.S. application Ser. No. 09/898,418, filed on Jul. 3, 2001, published on Jan. 9, 2003 as U.S. Application Publication No. 2003-0009210A1, the contents of which are incorporated by reference herein in its entirety. Preferably, the sleeve is formed from ePTFE having pores of an internodal distance from about 5 to about 10 microns. After the extrudate sleeve has been stretched, the sleeve can be sintered by heating it above its crystalline melting point while under tension. This allows the microstructure of the material to be set properly.
Optionally, the ePTFE tube can be coated with an adhesive solution of from 1%-15% C
Optionally, the sleeve material can be formed from two or more layers of ePTFE bonded together to form a composite sleeve structure. The expansion and sintering of an outer sleeve layer over an inner sleeve tube serves to adherently bond the interface between two tubes, resulting in a single composite structure. A composite ePTFE sleeve structure may be formed by expanding a thin wall PTFE inner tube at a relatively high degree of elongation, on the order of approximately between 400 and 2,000% elongation and preferably from about between 500% and 600%. An inner tube is expanded over a cylindrical mandrel, such as a stainless steel mandrel at a temperature of between room temperature and 645� F., preferably about 500� F. The inner tube is preferably, but not necessarily fully sintered after expansion. Sintering is typically accomplished at a temperature of between 645� F. and 800� F., preferably at about 660� F. and for a time of between about 5 minutes to 30 minutes, preferably about 15 minutes. The combination of the inner ePTFE tube over the mandrel is then employed as a substrate over which a second layer. The interior diameter of the second tube is selected so that it may be easily but tightly disposed over the outside diameter of the inner tube. The composite structure formed between the two tubes is then sintered at preferably similar parameters. A bioactive agent can be incorporated in one or more layers of the multilayer structure.
Biodeposition-Reducing Bioactive Agents
Preferably, the sleeve comprises a bioactive agent selected to reduce or eliminate the deposition of sludge on the sleeve or within the drainage lumen of the drainage stent. The bioactive agent preferably includes one or more antimicrobial agents, antibiotic agents and antifungal agents.
One or more biodeposition-reducing bioactive materials can be incorporated in or coated on a sleeve by any suitable method. In one aspect, a dry, finely subdivided bioactive agent may be blended with the wet or fluid ePTFE material used to form the sleeve before the ePTFE solidifies. Alternatively, air pressure or other suitable means may be employed to disperse the bioactive agent substantially evenly within the pores of the solidified ePTFE. In situations where the bioactive agent is insoluble in the wet or fluid ePTFE material, the bioactive agent may be finely subdivided as by grinding with a mortar and pestle. Preferably, the bioactive agent is micronized, e.g., a product wherein some or all particles are the size of about 5 microns or less. The finely subdivided bioactive agent can then be distributed desirably substantially evenly throughout the bulk of the wet or fluid ePTFE layer before cross-linking or cure solidifies the layer. Alternatively, a bioactive agent can be incorporated into the ePTFE sleeve in the following manner: mixing a crystalline, particulate material (e.g., salt or sugar that is not soluble in a solvent used to form the extrudate) into an extrudate used to make the ePTFE sleeve; casting the extrudate solution with particulate material; and then applying a second solvent, such as water, to dissolve and remove the particulate material, thereby leaving a porous ePTFE. The ePTFE may then be placed into a solution containing a bioactive agent in order to fill the pores. Preferably, a vacuum would be pulled on the ePTFE to insure that the bioactive agent applied to it is received into the pores. Alternatively, the drug may be coated on the outside surface of the ePTFE. The drug may be applied to the outside surface of the ePTFE such as by dipping, spraying, or painting.
The bioactive agent may include antimicrobial or antibiotic agents. Suitable antibiotic bioactive agents include ciprofloxacin, vancomycin, doxycycline, amoxicillin, metronidazole, norfloxacin (optionally in combination with ursodeoxycholic acid), ciftazidime, and cefoxitin. Bactericidal nitrofuran compounds, such as those described by U.S. Pat. No. 5,599,321 (Conway et al.), incorporated herein by reference, can also be used as a bioactive agent. Preferred nitrofuran bioactive agents include nitrofurantoin, nitrofurazone, nidroxyzone, nifuradene, furazolidone, furaltidone, nifuroxime, nihydrazone, nitrovin, nifurpirinol, nifurprazine, nifuraldezone, nifuratel, nifuroxazide, urfadyn, nifurtimox, triafur, nifurtoinol, nifurzide, nifurfoline, nifuroquine, and derivatives of the same, and other like nitrofurans which are both soluble in water and possess antibacterial activity. References to each of the above cited nitrofuran compounds may be found in the Merck Index, specifically the ninth edition (1976) and the eleventh edition (1989) thereof, published by Merck & Co., Inc., Rahway, N.J., the disclosures of which are each incorporated herein by reference. Antibiotic agents also include cephalosporins, clindamycin, chloramphenicol, carbapenems, penicillins, monobactams, quinolones, tetracycline, macrolides, sulfa antibiotics, trimethoprim, fusidic acid and aminoglycosides. Antifungal agents include amphotericin B, azoles, flucytosine, cilofungin and nikkomycin Z.
Other suitable bioactive agents include bactericidal agents that inhibit bacterial DNA-dependent RNA polymerase activity such as rifampin, and antibiotic agents derived from tetracycline that inhibits protein synthesis such as minocycline, and agents that inhibit bacterial protein and nucleic acid synthesis, such as novobiocin. The bioactive agent can also be a combination of bioactive agents, such as those discussed in U.S. Pat. No. 5,217,493 (Raad et al.). Rifampin is a semisynthetic derivative of rifamycin B, a macrocyclic antibiotic compound produced by the mold Streptomyces mediterranic. Rifampin is available in the United States from Merrill Dow Pharmaceuticals, Cincinnati, Ohio. Minocycline is a semisynthetic antibiotic derived from tetracycline. It is primarily bacteriostatic and exerts its antimicrobial effect by inhibiting protein synthesis. Minocycline is commercially available as the hydrochloride salt which occurs as a yellow, crystalline powder and is soluble in water and slightly soluble in alcohol and is available from Lederle Laboratories Division, American Cyanamid Company, Pearl River, N.Y. Novobiocin is an antibiotic obtained from cultures of Streptomyces niveus or S. spheroides. Novobiocin is usually bacteriostatic in action and appears to interfere with bacterial cell wall synthesis and inhibits bacterial protein and nucleic acid synthesis. The drug also appears to affect stability of the cell membrane by complexing with magnesium. Novobiocin is available from The Upjohn Company, Kalamazoo, Mich.
The sleeve 13 can also comprise one or more antimicrobial agents. The term "antimicrobial" refers to inhibition of, prevention of or protection against microorganisms such as, bacteria, microbes, fungi, viruses, spores, yeasts, molds and others generally associated with infections such as those contracted from the use of the medical articles described here. The antimicrobial agents include antiseptic agents selected from the group consisting of silver, chlorhexidine, triclosan, iodine, benzalkonium chloride and other like agents. Examples of suitable antimicrobial materials also include nanosize particles of metallic silver or an alloy of silver containing about 2.5 wt % copper (hereinafter referred to as "silver-copper"), salts such as silver citrate, silver acetate, silver benzoate, bismuth pyrithione, zinc pyrithione, zinc percarbonates, zinc perborates, bismuth salts, various food preservatives such as methyl, ethyl, propyl, butyl, and octyl benzoic acid esters (generally referred to as parabens), citric acid, benzalkonium chloride (BZC), rifamycin and sodium percarbonate.
Optionally, materials with antimicrobial properties can be mixed with or applied to the surface of the sleeve 13. One example of a suitable antimicrobial material is described in published U.S. patent application US2005/0008763A1 (filed Sep. 23, 2003 by Schachter), incorporated herein by reference. The sleeve 13 can be combined with a siloxane binder and divalent metallic (M2+) ions, such as, for example, Cu2+, Zn2+, Ca2+, Co2+, and Mn2+. Upon curing, the siloxane binder can form a silsesquioxane, e.g., methyl silane sesquioxide or CH3SiO3/2. The siloxane oligomeric binder can be synthesized, for example by hydrolysis of precursors such as, for instance, monomethylalkoxysilane, e.g., methyltrimethoxysilane (CH3Si(OCH3)3) to form a partial condensate of methyl trisilanol. The monomethylalkoxysilane also can be provided in a mixture with copolymerizable silane monomer(s). A copolymer may be formed from cohydrolyzed silanol, RSi(OH)3, of which methyl trisilanol comprises at least about 70% by weight, preferably at least about 75% by weight, and wherein R is a non-reactive organic moiety, such as, for example, e.g., lower alkyl, e.g., C1-C6 alkyl, especially C1-C3 alkyl, e.g., methyl, ethyl or n- or iso-propyl, vinyl, 3,3,3-trifluoropropyl, γ-glycidyloxypropy, γ-methacryloxypropyl, and phenyl. When only methyl silanol (from methyl trialkoxysilane) is used, the amount of metal cation, (M2+) added can be based on the amount of silanol. When mixtures of silanol are used the molar silane sesquioxide equivalent of the remaining silane mixture can be converted to the molar equivalent of methyl silane sesquioxide. In one example, the composition includes, on a weight basis of the total composition, from about 28% to 71%, preferably from about 31% to 71% silanol (of which at least about 70% is methylsilanol), from about 29% to about 39% water, from 0 to about 31%, preferably from about 15 to about 30%, isopropanol or other volatile organic solvent, and an M2+ ion or a mixture of such M2+ ions, within the range of from about 0.5 to 3 millimoles (gram x millimoles), preferably about 1.2 to 2.4 millimoles, per molar equivalent of the partial condensate calculated as methyl silane sesquioxide. The pH of the mixture is adjusted to mildly to slightly acidic, such as between 2.5 and 6.2, preferably 2.8 to 6.0, more preferably 3.0 to 6.0. More particularly, the aqueous coating composition can include a dispersion of divalent metal cations (such as Ca2+, Mn2+, Cu2+, and Zn2+) in a solution of water/lower aliphatic alcohol of the partial condensate of at least one silanol of the formula RSi(OH)3 in which R is a radical selected from the group consisting of lower alkyl, vinyl, phenyl, 3,3,3-trifluoropropyl, γ-glycidyloxypropyl and γ-methacryloxypropyl, at least about 70 weight percent of the silanol being CH3Si(OH)3, acid in an amount sufficient to provide a pH in the range of from about 2.5 to about 6.2, and said divalent cations in an amount of from about 1.2 millimoles to about 2.4 millimoles per molar equivalent of the partial condensate, calculated as methyl silane sesquioxide.
Optionally, the bioactive agent or drug may be encapsulated in microparticles, such as microspheres, microfibers or microfibrils, which can then be incorporated into or on the ePTFE sleeve. Various methods are known for encapsulating drugs within microparticles or microfibers (see Patrick B. Deasy, Microencapsulation and Related Drug Processes, Marel Dekker, Inc., New York, 1984). For example, a suitable microsphere for incorporation would have a diameter of about 10 microns or less. The microsphere could be contained within the mesh of fine fibrils connecting the matrix of nodes in the ePTFE sleeve. The microparticles containing the drug may be incorporated within a zone by adhesively positioning them onto the ePTFE material or by mixing the microparticles with a fluid or gel and flowing them into the ePTFE sleeve. The fluid or gel mixed with the microparticles could, for example, be a carrier agent designed to improve the cellular uptake of the bioactive agent incorporated into the ePTFE sleeve. Moreover, it is well within the contemplation of the present invention that carrier agents, which can include hyaluronic acid, may be incorporated within each of the embodiments of the present invention so as to enhance cellular uptake of the bioactive agent or agents associated with the device. The microparticles embedded in the ePTFE sleeve may have a polymeric wall surrounding the drug or a matrix containing the drug and optional carrier agents. Moreover, microfibers or microfibrils, which may be drug loaded by extrusion, can be adhesively layered or woven into the ePTFE.
Methods of Delivery and Treatment
A drainage stent can be delivered to a point of treatment within a body vessel in any suitable manner. Preferably, the drainage stent is delivered percutaneously. For example, a biliary stent can be inserted into a biliary lumen in one of several ways: by inserting a needle through the abdominal wall and through the liver (a percutaneous transhepatic cholangiogram or "PTC"), by cannulating the bile duct through an endoscope inserted through the mouth, stomach, and duodenum (an endoscopic retrograde cholangiogram or "ERCP"), or by direct incision during a surgical procedure. A preinsertion examination, PTC, ERCP, or direct visualization at the time of surgery may be performed to determine the appropriate position for stent insertion. A guidewire can then be advanced through the lesion, a delivery catheter is passed over the guidewire to allow the stent to be inserted. In general, plastic stents are placed using a pusher tube over a guidewire with or without a guiding catheter. Any suitable guidewire may be used for delivery of the device, such as a 0.035 inch wire guide for stent placement (such as the FUSION short guide wire or long guide wire systems, available from Cook Endoscopy, Winston-Salem, N.C.), which may be used in combination with an Intra Ductal Exchange (IDE) port. Delivery systems are now available for plastic stents that combine the guiding and pusher catheters (OASIS, Cook Endoscopy Inc., Winston-Salem, N.C.). Optionally, the diameter of the pusher catheter can be reduced at the distal end, which is positioned behind the drainage stent, permitting the sleeve to enclose the pusher.
The biliary stent may be placed in the biliary duct either by the conventional pushing technique or by mounting it on a rotatable delivery catheter having a biliary stent engaging member engageable with one end of the stent. Typically, when the diagnostic exam is a PTC, a guidewire and delivery catheter may be inserted via the abdominal wall. If the original exam was an ERCP, the biliary stent may be placed via the mouth. The biliary stent may then positioned under radiologic, endoscopic, or direct visual control at a point of treatment, such as across the narrowing in the bile duct. The billiary stent may be released using the conventional pushing technique. The delivery catheter may then be removed, leaving the biliary stent to hold the bile duct open. A further cholangiogram may be performed to confirm that the biliary stent is appropriately positioned. Alternatively, other drainage stents can also be delivered to any suitable body vessel, such as a vein, artery, urethra, ureteral passage or portion of the alimentary canal.
The invention includes other embodiments within the scope of the claims, and variations of all embodiments, and is limited only by the claims made by the Applicants. Additional understanding of the invention can be obtained by referencing the detailed description of embodiments of the invention, below, and the appended drawings. It is to be understood that the above described anti-reflux biliary prostheses 10 is merely an illustrative embodiment of this invention. The present invention can also include other devices and methods for manufacturing and using them may be devised by those skilled in the art without departing from the spirit and scope of the invention. The invention also includes embodiments both comprising and consisting of disclosed parts. For example, it is contemplated that the entire tubular drainage stent can be coated with the sleeve material. Furthermore, the sleeve material extending from the distal end of the tubular member can be formed with different material from that covering the tubular drainage stent. It is also contemplated that the material of the stents can be formed of other materials such as nickel titanium alloys commercially known as nitinol, spring steel, and any other spring-like material formed to assume a flexible self-expanding zig-zag stent configuration.
|Citing Patent
|Filing date
|Publication date
|Aug 29, 2008
|Aug 9, 2011
|Cook Medical Technologies Llc
|Medical implant having improved drug eluting features
|Feb 17, 2009
|May 15, 2012
|Spiracur Inc.
|Devices and methods for treatment of damaged tissue
|Apr 1, 2010
|Jul 3, 2012
|Metamodix, Inc.
|Modular gastrointestinal prostheses
|Jul 9, 2010
|Oct 9, 2012
|Metamodix, Inc.
|External anchoring configurations for modular gastrointestinal prostheses
|Dec 25, 2012
|Spiracur Inc.
|Devices and methods for treatment of damaged tissue
|Jan 7, 2010
|Jan 29, 2013
|Spiracur Inc.
|Reduced pressure therapy of the sacral region
|Sep 26, 2011
|Sep 10, 2013
|The Board Of Trustees Of The Leland Stanford Junior University
|Reduced pressure therapy devices
|Mar 11, 2010
|Dec 10, 2013
|Cook Medical Technologies Llc
|Stent geometry
|May 30, 2012
|Apr 1, 2014
|Olympus Medical Systems Corp.
|Medical stent of resin material
|Jan 7, 2011
|Apr 22, 2014
|Metamodix, Inc.
|Gastrointestinal prostheses having partial bypass configurations
|Aug 6, 2012
|Apr 22, 2014
|Metamodix, Inc.
|External anchoring configurations for modular gastrointestinal prostheses
|Jul 29, 2009
|May 6, 2014
|Covidien Lp
|Multilayer medical devices having an encapsulated edge and methods thereof
|Mar 4, 2010
|May 20, 2014
|Spiracur Inc.
|Devices and methods to apply alternating level of reduced pressure to tissue
|Sep 26, 2011
|May 20, 2014
|Spiracur Inc.
|Controlled negative pressure apparatus and alarm mechanism
|Aug 10, 2011
|Jun 17, 2014
|Spiracur Inc.
|Controlled negative pressure apparatus and alarm mechanism
|Jul 1, 2011
|Aug 5, 2014
|Spiracur Inc.
|Alarm system
|Sep 26, 2011
|Oct 14, 2014
|Spiracur Inc.
|Controlled negative pressure apparatus and absorbency mechanism
|Aug 27, 2010
|Dec 30, 2014
|Thomas W. Rickner
|Anti-refluxive and trigone sparing internal ureteral stent
|Sep 13, 2012
|Jan 6, 2015
|Spiracur Inc.
|Devices and methods for treatment of damaged tissue
|Feb 3, 2011
|Feb 24, 2015
|Spiracur Inc.
|Devices and methods for treatment of damaged tissue
|Oct 2, 2013
|Mar 24, 2015
|Artventive Medical Group, Inc.
|Bodily lumen occlusion
|Jun 29, 2010
|Apr 28, 2015
|Artventive Medical Group, Inc.
|Reducing flow through a tubular structure
|Apr 3, 2014
|Jun 2, 2015
|Metamodix, Inc.
|Gastrointestinal prostheses
|Mar 14, 2013
|Aug 4, 2015
|Artventive Medical Group, Inc.
|Methods and apparatuses for blood vessel occlusion
|May 19, 2014
|Aug 18, 2015
|Artventive Medical Group, Inc.
|Blood vessel occlusion
|Oct 16, 2009
|Apr 22, 2010
|Boston Scientific Scimed, Inc.
|Shape memory tubular stent with grooves
|Dec 23, 2009
|Jun 24, 2010
|Dean Hu
|Device for delivery of reduced pressure to body surfaces
|Feb 3, 2011
|Nellcor Puritan Bennett Llc
|Multilayer medical devices having an encapsulated edge and methods thereof
|Mar 11, 2010
|Sep 15, 2011
|Wilson-Cook Medical Inc.
|Stent Geometry
|May 30, 2012
|Dec 27, 2012
|Olympus Medical Systems Corp.
|Medical stent and production method of medical stent
|Dec 20, 2012
|Jun 20, 2013
|Douglas Bates
|Apparatus and method for treating occluded infection collections of the digestive tract
|U.S. Classification
|International Classification
|Cooperative Classification
|European Classification
|Dec 20, 2007
Owner name: WILSON-COOK MEDICAL, INC., NORTH CAROLINA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:HARDIN, DAVID M;DUA, KULWINDER S;SKERVEN, GREGORY J;REEL/FRAME:020277/0575;SIGNING DATES FROM 20070727 TO 20071211


text:
Reviews - Bedingfeld Arms4
Swaffham Road, Oxborough, PE33 9PS
Price From £55.20View Rooms
Customer Reviews
Our reviews are from genuine LateRooms.com customers. We verify that the customer has stayed before leaving a review.
Very Good
97% would recommend it to a friend
Customer service
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Room quality
Simply excellent
Only stayed 1 night.
Wanted to stay longer.
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Lovely and relaxing
The only disappointment we had eaten before arriving as they had a promotion on bugger night the food looked fabulous a lovely coach inn of the Beaton track would definetly go again
Excellent value for money and superb quality food and accomodation
Very friendly staff, excellent value for money, great menu, room clean, comfortable and great nights sleep.
Looking forward to my next stay.
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Short stay
Friendly staff, fantastic service, great remote location if you want to get away from the daily stress of normal life.
Great value for money.
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Excellent customer service, accommodation, setting and room quality.
This is a beautiful place to stay .
Relaxing with excellent staff and room quality. Would gladly recommend to others. Very good value for money. Accommodation was of high quality and very inviting. The staff were warm and friendly and nothing was to much trouble.
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Bedingfeld Arms
Wonderful, last minute booking but will now book again and recommend.
We were really pleased overall with the overnight stay.
The evening meal was lovely and the full english breakfast had not one bit of grease on the plate. The room outside in the annex was cosy and we were both really impressed. Will definitely stay there again as mum lives in Downham Market. Again we were really impressed at the quality for the price we paid.
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Lovely location, but Extremely slow service
This hotel was ideally located and offered a very peaceful and scenic break.
The room nicely furnished and decorated, and the bed was very comfortable. Unfortunately the service was extremely slow, both at dinner and at breakfast (I appreciate a 'cooked to order' full English breakfast but don't expect to wait 40 minutes). So, book early for dinner and dont expect to have a quick breakfast and check out, otherwise you may be disappointed.
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Hidden away
Really pretty setting in a often overlooked part of Norfolk.
Lovely building and cosy rooms.
V helpful staff and excellent food at a decent price.
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Bedingfeld Arms
Lovely pub, very friendly and helpful staff.
Delicious dinner and comfortable bed - a great stay.
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subset: commoncrawl


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Meet our bloggers...CEO, Bill Nye, Emily Lakdawalla, Bruce Betts, Mat Kaplan, Casey Dreier, and a host of expert and entertaining voices from throughout our vast space community.
Browse Recent Blog Posts
In Pictures: Russian Spacecraft Ends Streak of Station Supply Mishaps
Posted by Jason Davis on 2015/07/05 07:30 CDT | 2 comments
Following back-to-back space station resupply failures, a Russian Progress vehicle pulled into port this morning at the International Space Station.
Pluto's progression: Third-to-last Pluto day before encounter
Posted by Emily Lakdawalla on 2015/07/03 08:49 CDT | 6 comments
Only two days remain until New Horizons' historic encounter with Pluto....two Pluto days, that is. Pluto and Charon rotate together once every 6.4 days, so as New Horizons has approached the pair over the last week, we've been treated to one stately progression of all of their longitudes.
The Senate Appropriations Committee's FY 2016 CJS Bill
Posted by Jason Callahan on 2015/07/02 11:34 CDT
Congress has made good progress so far this year in moving the annual appropriations bills that fund the government. However, a looming budget battle over the sequestration and budget caps threaten to sideline progress until Congress and the White House reach agreement. Here's the current situation.
Mars Exploration Rovers Update: Opportunity Phones Home after Conjunction Healthy, Ready to Rove
Posted by A.J.S. Rayl on 2015/07/02 12:12 CDT | 1 comment
After three weeks of being in a communications blackout on the other side of the Sun during the Earth-Mars solar conjunction, Opportunity phoned home, reporting that she is healthy and ready to continue her mission.
LightSail Project Manager Passes Torch
Posted by Jason Davis on 2015/07/01 04:02 CDT
LightSail project manager Doug Stetson, who helped bring the program from a storage shelf to low-Earth orbit, is passing the torch.
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Dawn is continuing to unveil a Ceres of mysteries at the first dwarf planet discovered. Mission Director Marc Rayman gives us an update.
5 Steps to Preventing Asteroid Impact
Posted by Bruce Betts on 2015/06/30 12:33 CDT | 2 comments
For Asteroid Day, Bruce Betts reviews 5 steps needed to prevent asteroid impact, as well as how The Planetary Society is involved in those.
Posted by Jennifer Vaughn on 2015/06/29 12:57 CDT | 1 comment
It's really happening. We're leaving our home of five years on South Grand and heading to our new home just two miles east on South Los Robles.
SpaceX Rocket Breaks Apart En Route to International Space Station
Posted by Jason Davis on 2015/06/28 09:48 CDT | 6 comments
A SpaceX Falcon 9 rocket broke apart over the Atlantic Ocean during today's flight to the International Space Station.
Of Course I Still Love You, Falcon: New SpaceX Ship Ready to Catch Rockets
Posted by Jason Davis on 2015/06/25 02:13 CDT | 3 comments
SpaceX is gearing up for its seventh paid cargo run to the International Space Station, and the third attempt to catch the first stage of its Falcon 9 rocket on a drone ship in the ocean.
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Trade24 makes sure to follow all the rules according to Halacha of which one can invest and lend money.
Posted on: August 2nd, 2015InDepth → Op-Eds
Reports of a dead baby, a devastated family, and indications of a gloating attacker.
Posted on: July 31st, 2015Blogs → This Ongoing War
In all the years (and this week it's exactly 14 years) since our daughter was murdered, we have not found a single Arabic-language post, article, tweet or speech condemning that attack in the center of Jerusalem or the killings.
Posted on: July 22nd, 2015Blogs → This Ongoing War
Shalit Deal advocates: "Israel must do whatever it takes" to free Gilad; This proved deadly nonsense
Posted on: May 13th, 2015Blogs → This Ongoing War
The targets: Ordinary unarmed Israeli civilians, preferably sleeping.
Posted on: December 21st, 2014Blogs → This Ongoing War
BBC GUIDELINES ON TERRORISM: The word "terrorist" itself can be a barrier rather than an aid...
Posted on: November 25th, 2014Blogs → This Ongoing War
Australian Ambassador to Israel ran to the hospital in J'm to visit the wounded and to donate blood
Posted on: October 12th, 2014Blogs → This Ongoing War
It's very bad news indeed that the idea of terrorist release is once again under discussion.
Posted on: June 29th, 2014Blogs → This Ongoing War
The Palestinians remain below the age of responsibility; the source of their behavior always in Israel's actions.
Posted on: June 27th, 2014Blogs → This Ongoing War
Our daughter Malki was murdered, because she was Jewish,, by unrepentant Arab terrorists.
Posted on: June 23rd, 2014Blogs → This Ongoing War
Tragedies continue emanating from the decision to release 1000+ terrorists from Israeli prisons.
Posted on: June 2nd, 2014Blogs → This Ongoing War
A rocket from Gaza failed to make it over the fence. It crashed somewhere on the Hamas-controlled side.
Posted on: May 20th, 2014Blogs → This Ongoing War
UNRWA's numbers mean half the refugees in the world are Palestinian Arabs.
Posted on: May 11th, 2014Blogs → This Ongoing War
Mrs. Obama, our daughter's murder by another Islamist terror group - Hamas - was also unconscionable.
Posted on: May 4th, 2014Blogs → This Ongoing War
To commemorate Remembrance Day, Netanyahu has, so generously, dealt us yet another blow.
Posted on: April 27th, 2014Blogs → This Ongoing War
The grandaughter of an Auschwitz survivor was murdered in a terrorist massacre in Jerusalem.
Posted on: April 24th, 2014Blogs → This Ongoing War
The State Department is said to want the court to intervene on Arab Bank's behalf for foreign policy reasons.
Posted on: April 17th, 2014Blogs → This Ongoing War
World Council of Churches expresses solidarity with "Palestinians" 'languishing' in Israeli prisons.
Posted on: April 9th, 2014News & Views → News Briefs
Gazans are among the principal victims of the terror-addicted Hamas Islamists.
Posted on: March 30th, 2014Blogs → This Ongoing War
The EU pretends it doesn't know the PA pays terrorists and murders using EU funds.
Posted on: March 23rd, 2014Blogs → This Ongoing War
Abbas attacked and embraced the same Obama plan in 24 hours.
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Spending months in MEXICO CITY/OAXACA working with FREE RADIO COLLECTIVES to create an illustrated cross-border manual for MICRO FM. Read more
Funding Unsuccessful
This project's funding goal was not reached on July 16, 2011.
Spending months in MEXICO CITY/OAXACA working with FREE RADIO COLLECTIVES to create an illustrated cross-border manual for MICRO FM.
About this project
Our goal is to produce a book, titled WAVE MANUAL, that bridges the gap between the theoretical and practical advantages of Free Radio. The book will unfold along three sections:
* First, a theoretical engagement with Micro FM broadcasting by working through the texts of thinkers like Felix Guatarri and veteran Free Radio activists such as Stephen Dunifer of Free Radio Berkeley, and Tetsuo Kogawa. In particular, we will focus on Micro FM as a social activity that raises questions about the relationship between media, democracy, pedagogy, and local politics.
* Secondly, we will elaborate upon the history of Free Radio and its involvement in various social movements around the globe. In particular, we will focus on the 2006 Oaxaca, Mexico uprising in which local media outlets were seized by protestors for the purpose of (1) quickly disseminating information to protestors, such as police and military repression, and (2) challenging Mexico's mainstream media which demonized and manipulated the intents and purposes of the uprising. The fact that these citizen-run media outlets became such an important target for police and military raises questions about the importance of media for maintaining control over civilian populations.
* Thirdly, and most importantly, we will present a pedagogical framework that serves as an adaptable manual for teaching the creation of Micro FM stations in a community classroom setting. The goal of this section is to provide educators and community members with the tools to construct and maintain a Micro FM station as well as a radically democratic space that calls for and develops community participation.
WAVE MANUAL will not be your standard, run-of-the-mill textbook. We intend to approach the book as a work of art that includes graffiti, paintings, flyers, broadcasts, and collaborative community projects that have taken place both within the Free Radio movement and in the construction of our text.
WAVE MANUAL will not simply be a theoretical exercise but a documentation of our complete immersion into the Micro-FM movement that includes travel to Mexico and around the U.S. to work with and interview participants of various Free Radio collectives.
Your donations go to travel expenses, the procurement of materials, and the publishing costs of WAVE MANUAL. We are extremely excited about the potentials of this project and we thank you for your donations.
Your Friends,
Steven Rodriguez and James Goebel
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WAVE MANUAL SIGNATURE MICRO FM TRANSMITTER KIT- A Tetsuo Kogawa style MICRO FM transmitter kit. Comes with all components (including microphone jack) and instructions for your own micro FM radio transmission. With WAVE MANUAL logo artwork printed on circuit board! These Micro FM kits are currently completely unavailable anywhere online.Less
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Fifth Harmony aren't playing with their second album. The girl group has called on hitmaker du jour Max Martin.
Selena Gomez worked with some of the hottest producers and songwriters in the game on Revival. Find our more after the jump.
Ellie Goulding spills the beans on the lead single from her third album. Find out more after the jump.
Selena Gomez hit the studio with super producer Max Martin for new LP Revival. Find out more after the jump.
The Weeknd hits #1 for the first time.
Robin Thicke attempts to stage a comeback with the Max Martin-produced song.
The Weeknd is the subject of a revealing 'NYT' profile.
As always each Friday evening, it's time to sift through the creme de la creme…and the shade de la shade!
Looks like The Weeknd is aiming to have a big summer.
Tinashe enlists the super-producers and aims for a #1 hit.
We look back at all of the chart-topping smashes Max had a hand in and rank them accordingly.
Hear the once-elusive Canadian crooner's pop power play.
Max Martin won his eighth ASCAP Pop Songwriter Of The Year award last night (April 29). See the full list of winners after the jump.
Find out the winners of the 2015 Swedish Grammis Awards.
Sure, you saw about nine statues handed out during last night's overly-long telecast of the 57th annual Grammy Awards, but that was really just a drop in the bucket with regards to all the hardware that was passed over to musicians.
After making the leap from YouTube stardom to buzz artist with a major label deal, Tori Kelly showed the full scope of her vocal ability and songwriting prowess on 2013 EP Foreward. It was a great introduction to the 22-year-old but didn't have the radio-friendly hit needed to take things to…
Usher is plotting what sounds like a grand return to form next year — and he's got all the cooks in the kitchen to help him whip up a smash or two.
Following the lukewarm success of cuts like "Good Kisser" and "She Came To Give It To You" with…
We didn't really need another reason that underscores the ways in which Sweden is the coolest corner on the planet, but here's one anyway: Robyn is getting her own postage stamp. And Max Martin. And "Pistols At Dawn" singer Seinabo Sey, First Aid Kit and, yes, even Avicii. Scandinavian postal company PostNord will…
Pop super-producer Max Martin hints that Katy Perry and Drake may soon appear in a song together. MTV notes that the official website for his production company Maratone now lists a version of Perry's song "Legendary Lovers" featuring Drake among his credits. Martin wrote and produced the song with the chanteuse, her longtime…
Bebe Rexha's no stranger to a mean pop hook: The burgeoning singer-songwriter is most famously responsible for penning Eminem and Rihanna's hit "The Monster" among other pop gems, as well as supplying her distinctive vocals on Cash Cash's inescapably catchy club smash, "Take Me Home."
But Bebe's got even more exciting things still…


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October 4, 2015
Knoxville, Tenn. (WVLT) -- The Creative Expressions Ministry of Erin Presbyterian Church announces the staging of The Steppin' Up Cruise. It's the 22nd production of Sonshine Company Children's Theatre Workshop.
Show times are April 5 at 7p.m. and April 6 at 2p.m. at 200 Lockett Road in Knoxville.
Tickets are $10 for adults, $8 for seniors and children 12 and under, and a $30 family maximum.
The original book was written by workshop directors Cynthia House and Kelly Boyd. Several students including Lauren Gahan and Konnor Stump were involved in the writing process also.
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Maybe it's because I have kids, but I definitely think of my garden as playground central. Barbara Butler thinks that way too--you can tell by the elaborate play structures she creates. This one, for Will Smith and Jada Pinkett-Smith's children, is called the Storybook Playhouse. It is elaborately hand-carved with a menagerie of delightful creatures that frolic and play on all four walls, and you can choose your own color palette and one of three sizes. On Barbara's web site you can also buy plans for garden play houses--but you need a carpenter or carpentry skills to build them.
The leading outdoor design magazine!
- Established in 1985
- Quarterly, ad-free, and "book-like"
- Rich garden photography, collector worthy
- Plant-rich, idea-filled gardens
- Local ideas: plants, furnishings, decor
- Plant, design, product, and travel advice


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Dr. Lara Traeger is a psychologist in the Cancer Center and the Behavioral Medicine Service at the Massachusetts General Hospital, and an Assistant Professor of Psychology in the Department of Psychiatry at Harvard Medical School. She received her Ph.D. in clinical psychology from the University of Miami, and completed her pre-doctoral and post-doctoral fellowships at the Massachusetts General Hospital.
Dr. Traeger's clinical practice focuses on optimizing health and quality of life for adults with chronic medical conditions. Her research focus is on behavioral strategies to reduce disease- and treatment-related complications in patients with cancer. Dr. Traeger has over 50 published works, including peer-reviewed publications and book chapters. She has been the principal investigator of funded grants from the NIH/National Cancer Institute and the American Cancer Society, and serves as an ad hoc reviewer for peer-reviewed journals such as the Journal of Clinical Oncology, Cancer, The Oncologist, and Psycho-Oncology. Dr. Traeger supervises and mentors trainees in the Behavioral Medicine Service and the Cancer Outcomes Research Group.
Phone: 617-724-5600
Fax: 617-724-8690
Phone: 617-724-5600
Fax: 617-724-8690
Call the Massachusetts General Hospital physician referral service at 800-711-4644.
Mass General accepts most health insurance plans. Find out what you need to know before coming to Mass General.
Driving to Mass General? Get driving directions or locate a parking lot on the hospital's main campus.


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Hello Darling, I'm Melissa Danielle.
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If you answered yes to more than one of these questions, then my wellness club is right for you.
What is Integrative Nutrition Health Coaching?
Integrative Nutrition Health Coaching is a dynamic partnership between a trained coach and their client that recognizes the client's own ability to transform and heal their relationship with food, practice mindfulness, and create new habits. As an Integrative Nutrition Health Coach, I will support you in making gradual and sustainable lifestyle changes without dieting, deprivation, or willpower.
During your coaching experience, you will...
- set and accomplish goals in a way that is empowering and exciting
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While they're very popular, I do not offer cookie-cutter "solutions", quick-fix diets, detoxes, or cleanses (but I can offer supportive guidance should you choose to do one). I don't believe you need to restrict major food groups or starve yourself in order to clean up your diet and feel better in your body. My coaching supports you where you are and guides you towards long-term changes you will actually stick with.
Become a Member!
Membership renews annually and you can cancel at anytime. Please review your membership options below.
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I'm a graduate of Institute for Integrative Nutrition and a Kundalini Yoga KRI Level I Instructor with studies in compassionate communication, improvisational technique, and workshop facilitation. As a health coach, I've enjoyed a thriving practice offering community food education, farm and farmers market tours, and outdoor adventures. I have over ten years experience in coaching and facilitating individuals and groups, supporting clients towards self-determined transformation and healing. Learn more about my health coach training here.


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ping of the treasure which had so long flowed to Rome, the rich plunder of religious foundations, were tempting advantages to every sovereign. Why, then, it may be asked, did they not operate with equal force upon the princes of the House of Austria? What prevented this house, particularly in its German branch, from yielding to the pressing demands of so many of its subjects, and, after the example of other princes, enriching itself at the expense of a defenceless clergy? It is difficult to credit that a belief in the infallibility of the Romish Church had any greater influence on the pious adherence of this house, than the opposite conviction had on the revolt of the Protestant princes. In fact, several circumstances combined to make the Austrian princes zealous supporters of popery. Spain and Italy, from which Austria derived its principal strength, were still devoted to the See of Rome with that blind obedience which, ever since the days of the Gothic dynasty, had been the peculiar characteristic of t
Cara Devon has always suffered curiosity and im... Read more
When the economic downturn ends Matty Cruzs co... Read more
A telekinetic teenager. A telepathic child. A p... Read more
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Tamara Mellon's cream stretch-wool piqué pants are a modern classic. Cut with a straight-leg fit, flattering slant pockets and a mid-rise waist, this pair is fully lined to ensure an impeccably sleek shape. Complete the suit with the matching blazer.
Cream stretch-wool piquéSlant pockets, pressed creases, fully linedZip and hook fastening at front96% wool, 4% spandex; lining: 100% BembergDry clean
Product code: 417260 - Need help? Contact us


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Tim Fox - Page 2
Montana Attorney General's Photo Used in Online Dating Scam
KGVO Morning News for Friday July 11 [VIDEO]
Montana Attorney General Tim Fox Praises Supreme Court's Hobby Lobby Decision
The Affordable Care Act took a hit today, June 30, when the Supreme Court decided in its Burwell v Hobby Lobby decision that small corporations did not have to follow the law's insurance contraception mandates, or pay a fine, if there were certain moral objections. Montana Attorney General Tim Fox was pleased with the decision.
Montana Attorney General Fox Delivers Closing Arguments in Wyoming Water Trial [AUDIO]
On Thursday, May 1, Montana Attorney General Tim Fox presented the state's closing arguments in the Montana v.Wyoming water trial.
Montana Landboard Unanimously Decides to Extend Bull Mountain Coal Mine Operation
Lawsuit Filed Against Montana Attorney General's Office Over Fracking Documents
An environmental group called the Montana Environmental Information Center(MEIC) is taking Montana Attorney General Tim Fox's office to court over what MEIC argues is the unconstitutional non-disclosure of documents pertaining to fracking...
Montana to Receive Over $15,000 After Whistleblower Lawsuit Settlement
The Montana Attorney General's office is announcing a successful settlement in a multi-state, whistleblower lawsuit against the medical equipment company CareFusion.
Attorney General Tim Fox Requests Tamper Proof Lids for Pain Killers
Candidates for Montana Healthcare Foundation Board Named [AUDIO]
When Blue Cross, Blue Shield of Montana was purchased by Health Care Service Corporation, one of the requirements from Montana officials was the creation of a non-profit foundation to improve healthcare in the state.


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Tribune Photo of the Day - May 14, 2014
Published May 14, 2014 11:16 pm
This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Steve Griffin | The Salt Lake TribuneCitizens fill the auditorium at the Main Library in Salt Lake City, during a town hall meeting about who should control Utah's public lands Wednesday, May 14, 2014. Read more
Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting "Flag comment as inappropriate". If you've recently registered with Disqus or aren't seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account.comments powered by Disqus
See more about comments here.
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Rick Perry
The GOP's Jeb Bush Flirtation Is a Big Rebuke of the GOP
April 14, 2014
It's almost like his establishment backers think a guy who's been out of office for seven years is more attractive than all the supposed rock stars the party has in place today...
Jeb Bush Joins a Long List of Conservatives Who Got in Trouble for Saying Compassionate Things About Immigrants
April 08, 2014
A few Republicans who have acknowledged the moral urgency of immigration reform.
Texas Republicans Keep Moving Right
March 06, 2014
Dewhurst loses, Abbott wins, and the Texas GOP keeps moving right.
The Huge Obamacare Story You Aren't Reading
November 10, 2013
Today it's a few hundred thousand people. By next year, it will be at least a few million. Their health insurance status is changing dramatically: What they have in 2014 and beyond will look nothing like what they had in 2013 and before.
Rick Perry Just Boosted His Intellectual Reputation
October 14, 2013
The secret meaning of Rick Perry's glasses
The One Big Question Where Americans and Rick Perry Agree
August 22, 2013
It's official: Texas is America's least favorite state.
It Sure Looks Like Wendy Davis Is Running for Governor
August 05, 2013
Addressing the National Press Club in its wood-paneled ballroom on Monday, Texas state Senator Wendy Davis fended off the same question before she even started her speech, the moment she finished it, and (disguised in different wording) at regular in
The Five Worst Things About Texas's Abortion Law—and Three Ways to Fight It
July 18, 2013
All eyes were on Texas last month when hundreds of orange-clad women flooded Austin to protest an omnibus abortion bill, and state Senator Wendy Davis stayed on her feet for thirteen hours to filibuster it out of existence.
Meet the Next Gun-Loving Governor of Texas
July 16, 2013
When Rick Perry, who has been the governor of Texas for over a decade, announced last week that he wouldn't run again, he set off a flurry of speculation about who would replace him next year.
The Weekly Standard's Strange Rick Perry Fetish
July 15, 2013
Understandably, Republicans are anxious to show that they can do better among Hispanic voters without immigration reform. The problem is that there aren't many recent examples of Republicans doing well among Hispanics.


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Good morning. I am in the middle of an experiment.
Susan and I watched a 60 Minutes segment that I commented on a few weeks ago about sleep deprivation and the detrimental effects it has on our lives. Lately, we have noticed that due to the TMP alarm having a mind of its own and our bad habit of watching Jay and Dave, then Iron Chef before bed, we probably average 6 hours of straight sleep most nights. We both often return to sleep after the run is over for another few hours.
Do those extra few hours in the morning, or an afternoon nap make up for the loss of sleep at one time, at night?
I had dialysis as usual on Thursday night with no interruptions. Friday was my usual night off and we took it, but instead of staying up late, I went to sleep at 11:15 . The experiment started yesterday, Saturday, during the day when Susan hooked me up around Noon . Eight hours (and a couple of DVDs and a nap) later I was finished. We passed a pleasant evening and went to sleep at 11:30 .
I got a full 8 hours on Friday and Saturday night.
Today, Sunday, I will dialyze during the day again abd hopefully get 8 more hours sleep tonight. Tomorrow is Monday and my next day off so I am hoping for a fourth night in a row of 8 hours sleep before dialyzing on Tuesday night.
Will I feel the difference? Will Susan? Stay tuned!


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This video is from one of the Masters who passed recently. I loved this guy. Thank you Jim Rohn. You will be missed.
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All Posts Tagged Tag: 'Ask Jeeves'
Ask Jeeves Co-founder Takes Leadership Role at Interesting News Site
How Important is Natural Language to the Future of Search?
Where Google is a search engine, and Bing is a "decision engine," Ask.com seeks to be an answer engine. Ask thinks the future of search is in questions and answers. This means, you should be able to ask a direct question and get a specific answer, rather than pages of results, which can lead you to finding the answer on your own.
Ask.com Gets New U.S. Leadership
On Friday Ask.com announced that it has promoted Doug Leeds to President of Ask.com U.S. In addition, Tony Gentile has joined the company as Senior Vice President, Product Management.
Leeds has been with Ask Networks since early 2006, where he has held several different positions. Most recently, he has been President of the company's Dictionary.com and Chief Operating officer of Ask Networks. Now as President, he will oversee the US business for Ask.com and lead the development, launch, and execution of Ask's strategy in the U.S.
Ask Brings Back Jeeves
The search engine formerly known as Ask Jeeves, which has more recently gone by Ask.com has decided to bring the beloved butler back, at least in the UK (though his look is slightly updated). The company says that it knows from research that customers "love Jeeves and strongly associate him with providing answers. "
If you ask Jeeeves why he's back, he'll tell you:
Ask Shows Off Its Advanced Semantic Search
Remember Ask? You know, the search engine with the Butler. While the company doesn't get brought up in the discussion as much as it once did, it has not surrendered to Google and it's other competitors just yet.
Ask has now announced some advances in its semantic search technology. If you're unfamiliar with the concept of Semantic Search, Wikipedia explains it:
Ask Man and Answerbag on Yahoo Answers Model
I'd never heard of Answerbag before today's news that Ask Jeeves co-founder, David Warthen, has joined the company.


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I have tried it in several threads after finding it not working on a post I really liked, the option to hit Yes after Did you appreciate this post? takes you to page not found.
Printable View
I have tried it in several threads after finding it not working on a post I really liked, the option to hit Yes after Did you appreciate this post? takes you to page not found.
Was going to edit the title to be 'new format issues' but it was not letting me edit the title. Can we no longer edit titles?
The post reply button at the bottom still does not work well, you have to hit a very small sweet spot to make it work, like it was during the test period.
ETA - I figured out how to edit the title. Use the Go Advanced option.
ETA2 - The New Posts (now called Todays posts) option now includes everything from off topic and the menagerie. In the past New Posts did not include these sections.
Largely I think the redesign is attractive, but the blue and red just doesn't work, visually. It draws the eye to the person who posted the thread, not the thread title. Sage green instead of red there, perhaps?
The title field wraps text on the forum level, but not in the "Today's Posts" list. Makes it oddly difficult to spot things you're looking for because suddenly key words are missing.
ETA: I see now it is because the forum the post is in is now below the title instead of at the right margin.... Still want my wrap back :confused:
I'm annoyed there is an "appreciate post" button. This is not Facebook. I would like people to learn how to use their words...
Ditch the red.
Makes my eyes hurt. I can tell the diff between subject and poster just fine in the same color.
I miss the forum jump at the bottom of the page already....
Is there a way to change the font and/or colour? The red makes my eyes bleed. Between that and the pop-up ad at the bottom every 3 seconds, it's really difficult to actually read any content because of how 'busy' the screen is.
Pop Up Ad has now completely destroyed the Back buttn 100% rrather than intermittently :eek:
I haven't had any problem yet with Google Doubleclick filling my back button, but I'm disappointed to hear this upgrade did not eliminate it. I'm sure it will catch up to me later today.
"Similar Threads" table is completely useless and a waste of space.
Pop-up and new-window ads are ten times worse with the new software.
Rest assured, we are monitoring this thread and investigating issues you guys find as you test out the new format. There will be ongoing tweaks and adjustments.
If you're having a technical issue such as a page not found or an error message, please include what browser you're using, as that's sometimes helpful in troubleshooting.
Thanks! Mod 3
The red really is nasty. Too agressive.
Font size is far too small. I also appreciated having thread titles slightly larger than date/time/op. ETA: Oh, it IS slightly larger. It's just the red making it "pop".
I am also having problems with the post reply button. Gave up & used quick reply for this post.
Overall, I like many of the changes and am confident the kinks will be worked out.
The font on the main forum listing is way too small.


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Tegernsee taking off runway 18 as Lufthansa 1022 to BRU at 19:47 hrs.
Beautiful vortex under the right engine!
Photo taken from the ground. Flight VIR24 LAX-LHR . FL370 . EOS 600D + 2400mm
-1600 pix-
Seoul Sister is arriving on route VS 652 from Los Angeles [1400 px]
1400px "Virgin 7 Heavy" low over Sepulveda Blvd inbound from London Heathrow. [Canon 7D]


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StumbleUpon | Surprise Yourself. Escape the ordinary. StumbleUpon takes the boring ol' Internet and makes it way more awesome by only showing you stuff you like. Tap or click on the Stumble button and explore an epic wonderland of videos, photos, and web pages personalized just for you. Download the free StumbleUpon app to transform your PC into a fun time-killing machine! Bonus: PC World called it one of the "10 Windows 8 apps you should download first" "My favorite app. If you don't have it, you're missing out." "This app provides endless entertainment!" "Super addictive! This app is strongly recommended for all of humanity."More
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1-10 of 3,137 reviews
Addictive, Entertaining, Enlightening
Watch out. Taking an organized tour of the internet and visiting places you say you like is seriously addictive. But it is a great source of entertainment mixed with a little education along the way. In a way it, is the opposite of Google that only takes you to places you already know. This takes you to places you don't know but are in areas of relevant interest. And if you just want to see what others like, you can do that too!More
- Yes (27)
- No (0)
fast and fun
variety is the spice of life this app rocksMore
- Yes (1)
- No (1)
Great App
Tried the Astronomy part, and it is really excellent. The collection of the best things on internet in a single app. Great work.More
- Yes (14)
- No (1)
Fun, useful app!
My 13 year old daughter and I love this app! Our favorites are the crafts and the bizarre/oddities sites, but enjoy many more. It's a great way to find new ideas and sites that we wouldn't have otherwise even thought of searching for.More
- Yes (13)
- No (0)
Honestly I love it. I can't think of a single feature it could use (except maybe an advanced text to speech option lol), or a single thing I could do without.More
- Yes (18)
- No (2)
Very poor UI
The UI isn't intuitive in trying to navigate. There's no obvious way to end the app other than going to the Task Manager. Interest tiles are not labeled and hovering over them gives no clue to what interest area they represent. Don't waste your time on this.More
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what happened
App will no longer open. I keep getting error messages. quite bummed out about it.More
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its awsome
stumble upon gives a lot of infoMore
- Yes (1)
- No (0)
UI sucks
Plain and simple, usability of this app sucks. The second you open to view something, the controls disappear (on desktop), and you have to constantly click the menu up top to bring them back to interact with the app in any way. Plus I have a browser with a search engine that does exactly what this app does.More
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Need my right click
I wish that I was still able to right click on items. Makes saving pictures difficultMore
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1-10 of 3,137 reviews
- Discover awesome new photos, videos and web pages.
- Use the Share charm to share amazing stuff with friends.
- Explore over 500 Interests.
- Enter a phrase in search to Stumble specific Interests.
- Dive into an immersive, full-screen Stumbling experience.
- See recommended Stumbles directly in the StumbleUpon Live Tile.
App details
- Publisher
StumbleUpon, Inc.More
- Category
- Approximate size
5.75 MBMore
- Age rating
For ages 16 and upMore
- Supported processors
- Supported languages
English (United States)
- Learn more
- Additional terms
StumbleUpon license termsStumbleUpon Terms and Services: http://www.stumbleupon.com/terms
- Capabilities
Access your Internet connection
Version notes
Hotkeys - Stumble at your leisure using your keyboard's forward and back page navigation keys. Minor bug fixes - Reduced crashes.