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Welcome to FindLaw's searchable database of United States Seventh Circuit decisions since January 1995. FindLaw offers a free RSS feed for this court. We also maintain an archive of Opinion Summaries from September 2000 to the Present. Cases are browsable by date and searchable by docket number, case title, and full text.
Federal Courts
State Courts
|Docket #
|BRUNO MANCARI v. NANCY BERRYHILL
|February 17, 2017
|No. 16-3122
|BRIAN ROAKE v. FOREST PRESERVE DISTRICT OF COOK COUNTY
|February 17, 2017
|No. 16-2976
|MARQUISE WRIGHT v. CALUMET CITY ILLINOIS
|February 17, 2017
|No. 16-2219
|EVERGREEN SQUARE OF CUDAHY v. WISCONSN HOUSING ECONOMIC DEVELOPMENT AUTHORITY CRAIG CLEMMENSEN
|February 17, 2017
|No. 16-1475
|INDIANAPOLIS AIRPORT AUTHORITY v. TRAVELERS PROPERTY CASUALTY CO OF AMERICA
|February 17, 2017
|No. 16-2675
|View more decisions »

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The 5 Numbers You Need to Know to Get a Handle on Your Money
Do you really know your money? You would be surprised how many people don't know anything about their all-important relationship with their finances. You may think you're pretty financially savvy, but if you can't answer these five questions you may need to get better acquainted with your money. 1. Monthly Income This may seem very basic, but more often than not people can't answer how much money comes into their home. That means knowing the gross and net income. Almost everyone knows what their salary is, roughly, but when it comes to pre- and post-tax income per month, many people have no clue.


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Listen to free music by Swan
Blip.fm is internet radio made social. It's easy to search for, play, and discover free music recommended by real people. Join today to create your own free station.
Dec 20, 2011 at 5:11 pm via YouTube | AMAZON | ITUNES
upholstery ..missing this
Feb 18, 2011 at 11:04 pm via YouTube | AMAZON | ITUNES
playita_djsurfer Swan – New York Born
playita_djsurfer Swan – New York Born
Seastonemusic TY!@Angelitos55: "New York Born:@Seastonemusic" (reblip)
Angelitos55 New York Born:@Seastonemusic
Aug 2, 2010 at 3:15 pm via YouTube | AMAZON | ITUNES
minostaurs I think it's an animal band month..
Angelitos55 New York born:
djsurfer Angel on My Shoulder
LikeAnAngel whoa. good luck with that. way to take the theme level up few.
SkyeRadio Swan - New York Born Added to the Skye Radio Playlist
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The box office data at this time of year usually doesn't tell us much, but last weekend was an exception. Reese Witherspoon is a star. "Barbershop" has legs. And "My Big Fat Greek Wedding" is still taking in $10 million a weekend!It's not news that "Greek Wedding" is a sleeper. But as it now drifts toward $150 million worldwide, it is clear it is also a major blockbuster. Perhaps the cheapest blockbuster ever, as well as the top-grossing indie hit. The runaway success of "Greek Wedding" tells us several things: It's a reminder that "people pictures" still resonate with the audience. With a cluster of pricey sequels and franchise movies about to rain down upon us, this is an important reminder. Its success also underscores the resilience of the independent market. People may pontificate about the problems of this sector, the difficulties with financing, the clutter in the marketplace, but these factors didn't inhibit "Greek Wedding." Sure, the movie may not represent "high art." It wouldn't win a festival award. It may not get an Oscar. But it nonetheless is a reminder of a lasting rule of showmanship. In a world of $50 million ad campaigns promoting $150 million movies, "word of mouth" is still the best marketing tool ever devised.
'Greek' technique: power to the people
2016-2017 Oscar Predictions
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Take advantage of local and seasonal foods with Blue Eggs and Yellow Tomatoes: Recipes from a Modern Kitchen Garden by Jeanne Kelley, including recipes like Clams with Chorizo and Saffron; Smoked Whitefish and Beet Relish Tartines; and Oven-Roasted Frites with Herbes de Provence.
Yield: 4 Tartines
Crusty organic wheat bread from a local bakery is really good in this recipe. Roasted beets are easy to make, but you can also buy cooked beets at several markets. I like smoked whitefish and trout—they are milder in flavor than smoked salmon and go excellently with the beets, watercress, and horseradish.
To make the relish: Preheat the oven to 400 degrees F
Trim the beets and arrange them in a medium-sized baking dish. Drizzle them with the vegetable oil, cover with aluminum foil, and roast until they are tender when pierced with a small sharp knife, about 45 minutes to 1 hour. Cool. (Can be made up to 5 days ahead of time. Cool and refrigerate in a plastic bag.)
Finely grate the beets into a medium-sized bowl. Mix in the green onions, olive oil, and lemon juice. Season with salt and pepper to taste.
To make the horseradish cream: Mix the crème fraîche and horseradish in a small bowl.
Season with salt and pepper to taste.
To assemble the tartines: Lightly toast the bread. Spread the beet relish on the toasts, dividing it evenly. Top the beet relish with smoked fish, dividing evenly. Decorate the tartines with the watercress. Drizzle about 1 generous tablespoonful of the horseradish cream over each tartine and serve.
Tip: I like to roast a bunch of beets all at once and keep them in the refrigerator to add to salads, sautés, and even sandwiches.
Buy Blue Eggs and Yellow Tomatoes: Recipes from a Modern Kitchen Garden
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Worldwide Locations
How is a second term for the Obama administration likely to affect relations with China, Myanmar, Pakistan, and Afghanistan — to name just some of the Asian nations that have featured most prominently in recent headlines? Click to read commentary from Asia Society experts.
"We do not condone violence," Foreign Minister Hina Rabbani Khar said Thursday at Asia Society in New York. "That is not what Islam teaches us."
During the Islamic month of Ramadan, Muslims break the fast with iftar, an evening meal taken after sunset. We take a look at some of the dishes typically served in different parts of Asia.
A man squats in the wreckage of his home in Baje-Baj, Iran after twin earthquakes hit the country's northwestern region on August 11, 2012. (Atta Kenare/Getty Images)
Inspired by a recent stay in India, Iranian-American artist Kimia Ferdowsi Kline unveils her Mughal garden paintings this week in Nashville, TN.
Asia Society experts reflect on the draft Pentagon report outlining key lessons from a decade of war in Afghanistan and Iraq.
Si-o-se Pol or the 33 Bridge in Isfahan, Iran on April 13, 2012. (froderamone/Flickr)
Christopher de Bellaigue discusses the American- and British-backed August 1953 coup in Iran and its far-reaching effects on the Iranian psyche.
Read the prologue from the new book about former Iranian prime minister Muhammad Mossadegh. Author Christopher de Bellaigue will appear at Asia Society New York on Tuesday, May 15.
Outside an art gallery in Tehran, Iran on March 30, 2012. (Ariel López /Flickr)
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Asia Society takes no institutional position on policy issues and has no affiliation with any government. All views expressed in its publications and on its website are the sole responsibility of the author or authors.


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More Light is Primal Scream's best effort in some time, not least due to producer David Holmes's skill in sculpting the likes of "River of Pain" and "Hit Void" into workable post-Bitches Brew jazz-fusion dubscapes.
Bobby Gillespie & Co are on their revolutionary mettle here, wondering, for example, "What happened to the voices of dissent? Gettin' rich, I guess" over the howling Krautrock of "2013". Things broaden out through the slinky electric piano groove of "Goodbye Johnny" and the blues moan of "Elimination Blues", but save for the throwaway "Turn Each Other Inside Out", there's very little filler here.
Download: 2013; River of Pain; Culturecide; It's Alright, It's OKReuse content


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Ed Hardy Kid
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Last updated on 12th Jul 2011
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Ed Hardy Kid
Ed Hardy Kid's Beautiful Ghost Short Sleeve Tee in Black, Cheap ED Hardy Boys Collection On Sale
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Call (888) 651-9785
the tour was good.. our tour guide Julliana was grt and she made it a point to explain every thing to us in english.(everyone speak portuguese thr).. she had grt co-ordination skills.. the pick up and drop off was grt..very fast...all my ratings are based on julliana's skills..she was awesome...
lazycat Italy
the trip takes 2h30'. Instead of a boat directly to Morro we had to take a ferry-boat (no places reserved, we had to stand 35' as it was crowded) then a bus for 1h30' and finally another boat for 30'. We remained in Morro 4 hours, and not in the best beaches..
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Tig Notaro Is Baaaack
Editor's note: Tig Notaro returns to Denver on January 13 for a gig at the hi-dive. Jef Otte had a chance to talk to her about her former life in Denver's music scene and her current life as a comic and Sarah Silverman sidekick. Read all about it: Tig Notaro on Denver, Sarah Silverman and hanging on to the mike for dear life."
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Frazer Classifieds
Viewing 1 - 4 of 4 results
Selected Filters:Make: Frazer
1947 Frazer Manhattan
Sandy, UT
1947 Frazer Manhattan -120 HP Straight 6 Engine -3 Speed Transmission with electric overdrive -Under 47,000 Miles on the odometer -Complete Restoration in the 1990s -New Exhaust, Battery, Plugs... More
1949 Frazer Manhattan 4 Door Convertible
West Frankfort, IL
The 1949 Frazer Manhattan 4 Door Convertible is very rare. it is an excellent example in pristine condition... More
Offered By: Glen Weeks Classic Cars
Advertiser since 1954
Advertiser since 1954
1951 Frazer F51 Four Door Sedan
Alsip, IL
The Final Year Of The Frazier Had A Much Anticipated face Lift. A New Body Design Had Crisp Highly Defined Body Lines, Windstream Curves... More
Offered By: Midwest Car Exchange
Frazer Windows
Diamond Springs, CA
AUTO glass for classic Frazers made from original factory patterns. 530-626-6923, CA; instant quote online: www.classicflatglass.com... More
Offered By: Private Seller
Advertiser since 2010
Advertiser since 2010
From February, 2017 print edition


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Running fast.
And then I was falling.
I sat straight up in bed, gasping as my eyes open wide. I must've jolted the bed, as Drocell yawned and sat up, holding me close against his chest, rubbing my back and shoulders and gently pushing my head down into the crease of his neck. I slowly relaxed and shifted back down into a laying position, Droc still holding me to him.
"I love you…" I whispered almost silently.
"I love you too." He whispered in my ear. He smiled at me, one of those crooked smiles that is enough to make your heart melt. I pressed my face back between his pillow and his neck and quickly fell back asleep.
Note from Fool!
I realize this is really super short. I've been working on the next one for a few hours, and it should be a hell of a lot longer. Thanks guys. <3
© Copyright 2017 FoolsJoke. All rights reserved.
Status: Finished
Genre: Gay and Lesbian
Hey I love the beginning - it's hooked me! Just asking, how do you say Drocell's name? Off to read the rest!
Paste the link to picture in the entry below:
Paste the link to Youtube video in the following entry:
Cannot annotate a non-flat selection. Make sure your selection starts and ends within the same node.
An annotation cannot contain another annotation.
There was an error uploading your file.


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Nonfiction » History » Holocaust
Archipiélago GULAG by Alexandr Solzhenitsyn
You set the price! Words: 677,880. Language: Spanish. Published: December 12, 2016 by Aurora Ebook. Categories: Nonfiction » History » Holocaust, Nonfiction » History » Russian
En este libro no hay personajes ni hechos imaginarios. Las gentes y los lugares aparecen con sus propios nombres. Cuando se emplean iniciales, ello obedece únicamente a razones de índole personal. Y cuando falta algún nombre, se debe a un fallo de la memoria humana, aunque todo ocurrió tal como se describe aquí.
Eyewitnesses From Belsen and Auschwitz by Robert Grey Reynolds, Jr
Price: $2.99 USD. Words: 2,660. Language: English. Published: December 1, 2016. Categories: Nonfiction » History » Holocaust, Nonfiction » History » Jewish
My ebook recounts testimony given by former prisoners who survived the horrors of Belsen and Auschwitz. Over a 9 week trial they graphically revealed their own experiences in a Lueneburg, Germany courtroom. A witness described a woman who was beaten to death after she tried to communicate with her mother through the walls that partitioned Auschwitz. Of 44 defendants only 30 of them were convicted.
After Auschwitz - The Unasked Question by Anthony Bellen
Price: $9.99 USD. Words: 33,070. Language: English. Published: August 30, 2016 by Chaim Mazo. Categories: Nonfiction » Psychology » Research, Nonfiction » History » Holocaust
In "After Auschwitz", Dr. Anthony D. Bellen dares to ask the "unasked question," and explore the possibility of perceived positive experiences within the horrific trauma of the Holocaust.
Genocide and Airpower - Holocaust, Interventions on Humanitarian Grounds, Somalia, Bosnia, Kosovo, Iraq, Darfur, Defining Genocide, Nuremberg, Convention, United Nations Action, ISR Support by Progressive Management
Price: $4.99 USD. Words: 23,260. Language: English. Published: June 4, 2016. Categories: Nonfiction » History » Military, Nonfiction » History » Holocaust
It is a moral imperative that states take action to prevent and punish genocide. History teaches that sometimes other states will not act unless America does its part. We must refine United States Government efforts—economic, diplomatic, and law-enforcement—so that they target those individuals responsible for genocide and not the innocent citizens they rule.
Spymistress: The True Story of the Greatest Female Secret Agent of World War II: Summary by Summary Station
Price: $2.99 USD. Words: 6,300. Language: English. Published: May 17, 2016. Categories: Nonfiction » Biography » Woman biographies, Nonfiction » History » Holocaust
"There is safety in conjecture," Atkins grew up learning to be a mass of conflictions. This served her well in later life by helping to confuse her enemies. Upon her relocation to Britain, Atkins followed another piece of her father's advice when he advised her not to sign any paperwork. She created her own identity and took her maternal grandfather's surname.
Together: A Journey for Survival by Ann Arnold
Price: $4.99 USD. Words: 52,390. Language: English. Published: May 3, 2016. Categories: Nonfiction » History » Holocaust, Nonfiction » History » Family history
In Together: A Journey for Survival, Ann S. Arnold shares her family's journey through Poland's countryside as a war of nations thunders around them. The story displays the magnificent strength of a mother's love and the incredible courage of good people during the worst of times.
Races at War: Nationalism and Genocide in Twentieth Century Europe - U.N., Hague Regulations, Ethnic Cleansing, Nazi Germany, Holocaust, Eugenics, Euthanasia, Killing Jews, Balkans, Bosnian Muslims by Progressive Management
Price: $5.99 USD. Words: 125,570. Language: English. Published: April 20, 2016. Categories: Nonfiction » History » Military, Nonfiction » History » Holocaust
Europe in the twentieth century witnessed the large-scale displacement and mass murder of civilian populations because of their ethnic or national identity.
Paramilitary Organizations in Germany from 1871-1945 - Stormtroopers, Freikorps, Treaty of Versailles, Landesjaegerkorps, Nazis, Third Riech, Hitler Youth, Waffen SS, Himmler, Holocaust by Progressive Management
Price: $8.99 USD. Words: 124,560. Language: English. Published: April 20, 2016. Categories: Nonfiction » History » Military, Nonfiction » History » Holocaust
This thesis analyzes the rise of paramilitary organizations in Germany from the end of the Franco-Prussian War in 1871, through World War I, into the Weimar Republic, and finally in the Third Reich.
Children's Letters to a Holocaust Survivor by Richard Rashke
Price: $5.49 USD. Words: 43,980. Language: English. Published: April 19, 2016 by Historic Heroines. Categories: Nonfiction » History » Holocaust, Plays » American / African American(5.00 from 1 review)
In 1943, Esther Terner and 300 other Jews escaped from Sobibor, a Nazi death camp. It was the biggest escape of WWII and the subject of Rashke's book, ESCAPE FROM SOBIBOR. The book, and movie based on it, brought Esther many invitations to speak in public schools. Her story generated hundreds of letters from children expressing their concern and outrage. Those letters inspired DEAR ESTHER.
Tragedie. Wyzwolenie. Lepsze Życie by Władysław Chmielewski
Price: Free! Words: 61,950. Language: Polish. Published: April 16, 2016. Categories: Nonfiction » History » Holocaust, Nonfiction » Relationships and Family » Emotions
Od 1941 r. mieszkańcy Skierbieszowa i okolicznych wsi zostali przez okupanta niemieckiego wysiedleni do obozu zagłady w Oświęcimiu lub wysłani na roboty do Niemiec. Niewielu przeżyło. Helena Dąbrowska przeżyła 30 miesięcy w niemieckich obozach. Jej relację (mp3 i tekst) nagrałem w 1999 r. Tu jest tekst tej relacji. Jest opis życia ludności od pokoleń i zmiany powojenne do normalności.
Черная сотня в Вологде by WP IP GEB
Price: $3.00 USD. Words: 72,980. Language: French. Published: March 29, 2016. Categories: Nonfiction » History » Holocaust
You are holding a unique book in its content, in which the famous Vologda journalist Alexander Tarunin, bringing together all the surviving information on the activities of the local department in Vologda UNION RUSSIAN PEOPLE, opened in front of us a new, exciting and something shocking stories page.
Souvenirs d'un survivant de la Shoah by Manny Steinberg
Price: $6.99 USD. Words: 58,820. Language: French. Published: September 24, 2015 by Liesbeth Heenk. Categories: Nonfiction » History » Holocaust, Nonfiction » Biography » Autobiographies & Memoirs
Souvenirs d'un survivant de la Shoah est le récit sincère d'un adolescent qui a survécu à quatre camps nazis : Dachau, Auschwitz, Vaihingen et Neckagerach. Manny Steinberg a miraculeusement survécu alors que des millions ont péri. En publiant ses souvenirs de l'Holocauste, il veut s'assurer que les générations futures n'oublieront jamais ce qui s'est passé durant la Deuxième Guerre mondiale.
The Auschwitz Bergen-Belsen Trials by Robert Grey Reynolds, Jr
Price: $3.99 USD. Words: 3,440. Language: English. Published: September 11, 2015. Categories: Nonfiction » History » Holocaust, Nonfiction » History » Jewish
Juana Bormann was one of three women who were tried after the European theater of World War II concluded in May 1945. The others, her colleagues, were much younger, in their 20s. Bormann worked at one of six Nazi extermination camps for Jews in Poland, i.e. Auschwitz, during 1943-1944. She was later transferred to Bergen-Belsen, which was classified as a work camp. She wreaked havoc and death.
Before the Iron Curtain: My WWII Childhood (Survive Little Buddy Iron Curtain Memoirs Book I) by Irene Kucholick
Price: $5.95 USD. Words: 42,180. Language: English. Published: June 27, 2015. Categories: Nonfiction » Biography » Woman biographies, Nonfiction » History » Holocaust
When Anne Frank was in Holland, Irene was growing up in Germany. Hitler was rising to power, and her friend, Esther, wore a yellow star and Nazi youth marched. From Kristallnacht and hidden Jewish neighbors to whistling bombs, and a prison cell, Irene takes us on a World War II journey through the eyes of a child who survived it all and is still living today.
La maison Anne Frank à Amsterdam by Marko Kassenaar
Series: Les Musées d'Amsterdam. Price: $2.99 USD. Words: 5,430. Language: French. Published: June 15, 2015 by Liesbeth Heenk. Categories: Nonfiction » Travel » Museums of the World, Nonfiction » History » Holocaust
La Maison Anne Frank, un des musées les plus populaires d'Amsterdam, accueille environ un million et demi de visiteurs par an. Anne Frank y a vécu dans la clandestinité pendant la seconde guerre mondiale, pour échapper aux déportations nazies. Découvrez l'annexe secrète dissimulée derrière la bibliothèque, où Anne, une jeune fille juive de treize ans, ainsi que sa famille vécurent pendant deux ans
Irma Grese Angel Of Death At Bergen-Belsen And Oswiecim Concentration Camps by Robert Grey Reynolds, Jr
Price: $3.99 USD. Words: 3,940. Language: English. Published: May 21, 2015. Categories: Nonfiction » History » Holocaust, Nonfiction » History » Military
Irma Grese was an abominable woman who looked like she might have been a fashion model. Born in 1923 she attended school until she found employment in agriculture for a time. Unable to succeed as a nurse, she was sent to Auschwitz and later to Bergen-Belsen and Oswiecim Concentration Camps. That a woman so young could be so diabolical is truly incredible! I have recounted her crimes in my e-book.
Ready Reference Treatise: Left to Tell by Raja Sharma
Series: Ready Reference Treatises · Study Gudes: English Literature. Price: $2.99 USD. Words: 7,520. Language: English. Published: May 21, 2015. Categories: Nonfiction » Reference » Study guides, Nonfiction » History » Holocaust
The Rwandan Genocide had taken place in 1994. The book was published 12 years after that tragedy. The genocide was so horrible that it claimed about one million lives in only one hundred days.
Auschwitz #34207 - The Joe Rubinstein Story by Nancy Geise
Price: $7.99 USD. Words: 79,520. Language: English. Published: April 19, 2015. Categories: Nonfiction » Biography » Autobiographies & Memoirs, Nonfiction » History » Holocaust
Seventy years ago Joe Rubinstein walked out of a Nazi concentration camp. Until now, his story has been hidden from the world. Shortly before dawn on a frigid morning in Radom, Poland, German soldiers forced twenty-one year-old Icek "Joe" Rubinsztejn onto a crowded, open-air truck. The next day, several around him were dead. From there, things got worse for young Joe—much worse.
NSA Secrets Declassified: Eavesdropping on Hell: Historical Guide to Western Communications Intelligence and the Holocaust 1939-1945 - Enigma, Codebreakers, World War II, Jewish Refugees, Nazi Gold by Progressive Management
Price: $8.99 USD. Words: 253,040. Language: English. Published: April 6, 2015. Categories: Nonfiction » History » Holocaust, Nonfiction » History » Military
Professionally converted for accurate flowing-text e-book format reproduction, this important NSA publication provides a historical guide to western communications intelligence and the Holocaust from 1939 to 1945.
Georgina: Holocaust Memoirs: True Holocaust Survivor Stories from the Darkest Days of the Holocaust by Gabriella Kovac
Price: $2.99 USD. Words: 35,250. Language: English. Published: March 31, 2015. Categories: Nonfiction » History » Holocaust, Nonfiction » Religion and Spirituality » Judaism / History
Holocaust Memoirs: Georgina: True Holocaust Survivor Stories from the Darkest Days of the Holocaust An Incredible True Story of Survival Audacity and Deception from the Darkest Days of the Holocaust. December 1944 whilst heavy snows fall over Budapest and soldiers battle for the streets, Georgina a young Jewish woman, is nearly starving to death with her new born son.


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Likely to sell out
Boston Dinner Cruise On The Odyssey
Duration: 3 hours
Dine aboard our unique boat, the Odyssey, which is designed to provide the ultimate viewing of Boston's sights. Dine on a gourmet three course meal…
BostonSee all 63 tickets & tours
Want to discover all there is to do in Boston Light? Click here for a full list.


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Clearview's Clairidge Cinema
486 Bloomfield Ave.
Montclair, NJ 07042
Montclair, NJ 07042
- n/a
Clairidge Cinema in Montclair sports four screens and specializes in foreign and independent films. All auditoriums are handicap accessible, with several New Jersey Transit bus stops nearby.
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The Town of Huntington approved a change of zone on Tuesday that allows 261 affordable senior homes to be built on a 13-acre parcel in Melville.
The zoning change comes along with a transfer of development rights that creates an 8-acre park at the old Meyer farm off Round Swamp Road and Old Country Road.
That property was owned by BAPS, an international socio-spiritual Hindu organization, which wanted to build a headquarters and temple there, but will instead build it on 5 acres next to the senior homes on Deshon Drive.
Also read
- Brookhaven pays $7.7 million to preserve housing site
- Q&A: John Halsey, Peconic Land Trust
- NY giving $4.6M to protect farmland
BAPS swapped the land it bought from Meyers and gave it to the town to use as a park. BAPS will also receive money from the town in the exchange.
Attorney Morton Weber of the Melville-based Weber Law Group, which represents the developer, Manhattan-based Lincoln Equities, said the zoning change only took nine weeks from date of application to approval.
"That's because there was great cooperation between the civics, the town and the developer," Weber said.
Weber said homeowners from the area and members of the Sweet Hollow Civic Association overwhelmingly supported the transfer of development rights and zoning change because it created a new park and preserves the open space that the farm once afforded them.
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text:
|Publication number
|Publication type
|Application number
|Publication date
|May 31, 2005
|Filing date
|Mar 4, 2002
|Priority date
|Oct 28, 1993
|Fee status
|Also published as
|Publication number
|Russell Morrison Evans, III, Arthur E. Uber, III
|Original Assignee
|Medrad, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (106), Non-Patent Citations (11), Referenced by (119), Classifications (19), Legal Events (5)
|External Links: USPTO, USPTO Assignment, Espacenet
This is a continuation of application Ser. No. 09/266,727, filed on Mar. 12, 1999, now U.S. Pat. No. 6,442,418, which is a continuation of application Ser. No. 08/919,742, filed on Aug. 28, 1997, now U.S. Pat. No. 5,885,216, which is a division of application Ser. No. 08/534,081, filed on Sep. 22, 1995, now U.S. Pat. No. 5,806,519, which is a continuation of application Ser. No. 08/144,462, filed on Oct. 28, 1993, now abandoned, the contents of which are incorporated herein in their entireties.
Contrast media are used in many medical diagnostic and therapeutic imaging procedures. Diagnostically these include X-ray procedures for instance, angiography, venography and urography, CT scanning, magnetic resonance imaging (MRI), and ultrasonic imaging. Contrast media is used during therapeutic procedures such as angioplastic and other interventional radiologic procedures. Because this contrast material is injected into the patient, it must be sterile and contain a minimum of pyrogens.
Presently, most contrast is provided in sterilized glass bottles, ranging in size from 20 ml to 200 ml. Plastic packages are also available. Non-ionic X-ray contrast media is expensive, on the order of $1/ml. Ionic contrast media costs about $0.10/ml. Non-ion contrast has fewer complications but because of the cost, it is not universally used. MRI contrast costs about $5/ml. All the containers are single use, which means that once a bottle is opened, it should be used for that patient or thrown away, although a multi-use 1,000 ml bottle has been recently approved by the FDA.
A hospital must purchase and stock many concentrations in multiple bottle sizes to provide the right amount of the right concentration for a specific procedure, while minimizing the wastage of contrast remaining in any opened bottles.
This multitude of sizes and concentrations increases costs throughout the contrast supplier chain. Manufacturers need to make many batches with various concentrations, and package each in many sized bottles. They must have inventories of each on hand to quickly meet the customer's request. Each concentration and size entails an added regulatory burden.
In the hospital, there are additional costs due to the work purchasing the various brands and sizes, storage space is required for stocking, cabinets are required in each procedure room; and time is required to make sure the right numbers of each bottle are kept in each room. Frustration, waste and/or less than optimal studies can occur if this complex logistics chain fails at any point.
To illustrate the problem, consider a manufacturer who makes 5 concentrations of contrast, packages them in bottles of 10, 25, 50, 75, 100, 150 and 200 ml. The manufacturer now has 35 different products to get approval for, schedule production for, maintain sufficient stock of, and finally, ship to his customers.
Presently, most hospitals utilize a standard protocol for a given set of indications. For instance, for a CT scan of the liver, the protocol may call for 130 ml of contrast injected at 3 ml/s. This protocol is used for a wide variety of patient weights and physical conditions. One goal of this standardization is to minimize errors. Another is to decrease the likelihood of having to repeat the procedure, with the problem of additional radiation and contrast dose to the patient.
However, there are costs associated with this method. Many patients may get more contrast than they need for an image to be diagnostic. Overdosing wastes contrast, but there is no way with the present contrast supply and delivery system to remedy this, without stocking many more sizes of bottles and working harder to fill syringes. Other patients may have studies that are less than optimum. They do not receive enough contrast. The contrast that isn't used doesn't cost anything, but there is a much greater chance of having to repeat the whole procedure, with a much greater cost than a few milliliters of contrast. Again, using many bottle sizes and a cumbersome filling procedure is the only solution presently available.
In angiography, there are no set protocols to the same extent as in CT, because patient size determines vessel size which in turn determines the volume and flow rate needed. This means that a fixed amount of contrast cannot be prepared ahead of time with any confidence that more won't be needed during the procedure or that a significant amount won't remain and be wasted at the end of the procedure. To avoid delays while working on the patient, the technician loads more than the average amount used, with the realization that some is likely to be wasted, and there still is a chance that a delay will occur when more has to be loaded.
Another problem this system addresses is the volume and cost of items which must be disposed of after each patient. To save contrast, several small glass bottles may be opened per patient. One or more plastic syringes, and various tubing arrangements are used. There is a cost to purchase and a cost to dispose of each of these items.
The problems arising from the use of a multiplicity of concentrations and container sizes was addressed in German DE 4121568A1. In this disclosure, there is provided a supply tank of contrast agent that could contain from about 0.1 to as much as 100 liters. The device also included a similar tank that contained a diluent so that the composition of the resulting mixture could be varied to form a variety of concentrations. The abstract in the German patent utilizes a bulk mechanical mixer with sequential flow and so it would not seem to provide for the production of continuously variable concentrations. Nor, and importantly, is there any description of means to prevent cross-contamination when the apparatus is used on a plurality of patients.
Machines for mixing IV solutions also do not connect directly to the patient. Generally, the controls require that the operator know which fluid is in which position and that he choose the mixing ratios. In U.S. Pat. No. 4,341,153, medication is diluted and delivered to a syringe. There are no means described for connection to a patient, there is no mixing means and only sequential flows are described.
U.S. Pat. No. 4,610,790 describes in great detail how to make sterile water for diluting medications. Making diluted fluids is mentioned in little detail. U.S. Pat. No. 4,783,273 describes the use of sterilizing filters to assure the sterility of bulk fluids. Concentration monitors are also described. A serious drawback is the use of chemical sterilants.
In none of the references mentioned above is a mechanism described which can be used to sequentially or simultaneously inject contrast into several patients while minimizing the chance of cross-contamination. Nor is there any mention of information integrity or information transfer so that the proper procedures are followed with the diluted medications.
It is a principal object of this invention to provide an improved apparatus for injecting a contrast medium sequentially into a plurality of patients while minimizing the chance of cross-contamination.
It is another object of this invention to provide a contrast medium apparatus in which the degree of concentration of the contrast medium can be continuously varied.
It is another object of this invention to provide an apparatus for producing contrast medium in which the medium can either be injected directly into the patient or can be loaded into containers and then injected by means of an injecting apparatus.
Other objects and advantages of this invention will be, in part, obvious and, in part, explained by reference to the accompanying specification and the drawings in which:
It is a goal of this invention to enable delivery of only the amount of contrast needed to a patient, with minimal contrast waste. A companion goal is to be able to deliver whatever volume of contrast is needed, when it is needed, without the arbitrary limitation of syringe or mixing chamber size. The bulk containers can hold more fluid than would be given to one patient, so its size is not a limit.
This is accomplished by changing the way contrast is packaged and delivered to the patient. Bulk contrast bottles would be manufactured and distributed to the hospital in only a few number of sizes. A given procedure room would only stock one size of bottle. The bulk contrast could only be available in a single high concentration, the highest used in current procedures, or it may be available in a limited number of different concentrations. Two bottle sizes times two concentrations is only four variations that a manufacturer would potentially have to deal with.
It is possible to eliminate the multiplicity of concentrations by providing bulk diluent and having a contrast delivery system able to dilute the most concentrated contrast to any concentration which the doctor desires. The diluent may be sterile water if the contrast is hyperosmolar, it may be saline if the contrast is iso-osmolar, or it may be a contrast specific diluent which preserves specific desirable properties of the contrast during dilution, such as pH. It may be most convenient if contrast and diluent are available as a pair from the manufacturer. Diluent is so inexpensive that its waste is not a problem. It is essential that sterility is preserved and that all materials be compatible with the contrast material in use. Pharmaceutical companies are experienced and have developed considerable expertise in materials selection.
In the present disclosure, all embodiments employ an electronic control system which provides the proper fluid flows according to the instructions of the operator. The operator can either input information on the concentrations in the various containers, or the control system can read a bar code or other code on the bulk container which informs it of the volume and concentration in that bulk container. Also, there can be sensors which inform the control system when a bulk container empties, or the control system can keep track of the volume removed and anticipate when it will run out. Anticipation is preferred because an operator can then be informed during programming of the need to add fluid, rather than start a procedure and then run out.
There is a benefit to having back-up monitors for these important parameters. If the system anticipates when fluid runs out, there can still be fluid assurance sensors, in case a technician installs a partially used bottle. Especially when the contrast is being delivered to a patient, there needs to be a fluid assurance sensor to prevent the problem of air embolism. While concentration is not as critical, an improper concentration can necessitate repeat procedure. A sensor measuring electro-conductivity could be used for both concentration monitoring and fluid assurance. There are commercially available ultrasonic sensors designed to detect the presence or absence of fluid in a line. For example, U.S. Pat. No. 4,981,467 discloses such a detector.
In the present instance, there are two classes of embodiments, the first being those that are directly connected to the patient and secondly, those which fill a dose container which is then moved to an injector for delivery to a patient. The first of these embodiments is shown in
Upon leaving the metering pumps 12 and 13, the fluids meet as they are joined and flow through a static mixer 20 that contains helical vanes. The company ConProTec makes many sizes and lengths, some with polypropylene vanes and a case. These static mixers are designed for mixing fluids with very different viscosities and varying dilution ratios. The exact length and diameter to be used will depend to some degree upon the viscosity of the contrast, dilution ranges, and flow rates. The flow is next through a concentration monitor 23. With metering pumps, this is optional but serves a useful verification function signaling if an incorrect mix occurs. Or, the metering pumps could be replaced by valves and the concentration monitor could continuously monitor and be part of the feed back control of the valves. The monitor measures a property which changes with concentration, such as electrical conducting, optical refraction index, rotation of polarized light, attenuation of sound, speed of sound, density, viscosity, or pressure drop through a fixed section. The mixture next flows through a back-flow prevention valve 21 which can be either a spring-loaded ball valve or a duck bill valve. This is an important feature of the overall device since it helps prevent cross-contamination when the device is used on another patient. By including valve 21 in the system, it is possible for fluid to flow only in one direction and there is no chance that contaminated fluid can be drawn back into the bulk fluid reservoirs from the patient's body.
Next, the fluid flows through a fluid assurance detector 22 which may be an ultrasonic detector so that the presence or absence of air in the fluid can be determined. Since these types of devices cannot detect small air bubbles, by being located before the pressurization pump 25, bubbles will be as large as possible. The fluid assurance detector helps minimize the chance that a broken line or human error can inject air into the patient.
Up until this point, the flow of the liquid has been at relatively low pressures. To inject the fluid through the connector tube 27 and catheter into the patient, relatively high pressures are needed: 300 psi for CT, up to 1200 psi fpr angiography, and 300 psi for MRI. Ultrasound contrast is presently not stable at high pressures, but its viscosity is similar to that of water so high pressures are not necessary. Presently this procedure is done by a powerful syringe pump, but these have the draw back that they can only inject one syringe full at a time. In the present embodiment, the pressurizing pump 25 is a gear pump, with the housing and gears made from TPX. The parts could optionally be polycarbonate or Teflon coated polycarbonate. This gives the clarity needed to check for bubbles, and the drug compatibility of Teflon. The shaft of the gear pump 25 is connected to an electric motor with a spline or other coupling mechanism so that the pump head can be removed and disposed of when required Depending upon the fluid path which leads to the gear pump 25 and the turbulence within the pump 25, enough mixing could take place that the static vane mixer could be eliminated. Fassbender in U.S. Pat. No. 3,349,713 teaches how a gear pump can be modified to accomplish the mixing of fluids of different viscosities. Because of the wildely varying flow rate, this is not possible for all applications, but some would benefit by the elimination of the mixing element and the incorporation of its function into the pump 25.
The pressurized fluid flows through a 0.2 micron "sterilizing" filter 26. These filters are becoming a standard way to assure sterility of the solution. Its purpose here is to prevent migration of any bacteria from the patient into the pump. In cooperation with the backflow valve, cross-contamination in minimized. The sterile filter prevents bacteria from swimming up stream and the back flow preventer stops passive pathogens from being carried backward through the sterile filter. The fluid coming out of the pump is sterile. The area of the sterile filter will need to be adjusted to accommodate the flow rates of the various procedures while maintaining a reasonable pressure drop. A flexible connector tube 27, which is preferably sterile, carries the fluid to the patient. These are commercially available, usually made out of PVC. This component is disposed of after each patient so that it does not need to have long term compatibility with contrast medium.
At the patient, there is a three-way stopcock 30 and a hand syringe 31. This part can be used for several things. It can be used to aspirate blood and thus, verify good IV catheter placement in CT. It can be used to inject other medications. It can also be used to fill a hand syringe which can be removed and used for test injections during angiography. With one position of the stopcock, the fluid flows straight into the patient.
The present apparatus includes an electronic control system (ECS) 35 to assure that the needs of the patient are met safely. ECS 35 gets information on the contents of the bulk reservoirs 10 and 11. The preferred method is to read bar codes indicated by numerals 10′ and 11′ respectively. Another way is to quiz the operator to enter the data each time a bulk reservoir is changed, and then store that information. The operator would read the label on or packaged with the bulk reservoir, and enter the appropriate data. This need only be done when a bulk reservoir is changed.
With each injection, the operator needs to tell the system what to do. The data most similar to present practice is: 1) the concentration desired, 2) the flow rate, and 3) the total volume to be delivered. Present practice also includes multiple phases with various constant flow rates during each phase. This system would allow various contrast concentrations during each phase as well.
However, given the capabilities of this system, a preferred set of information is: 1) the procedure being done, and 2) the patient weight. This way the contrast dose could be optimized for the patient. The algorithm would have been previously provided information on milligrams of iodine per kilogram of patient for each procedure when the system was first installed in the hospital. It could display concentration, flow rate and volume for operator verification, if the operator desired. An electronic interface 36 is shown which can connect to the hospital information system HIS 100 to get information on the patient, such as weight. Then the operator would only have to input the patient number. The electronic interface 36 could also be connected to the imaging unit IU 90 and the pressurizing unit 25. It could send or receive information so that, for instance, the operator only needs to program the CT scanner with the number of slices and the body section, and this would be transmitted to the contrast delivery system to be used in determining flow rates and delays. The electronic interface 36 would also be used to let the scanner trigger the contrast delivery system or vice versa, after the appropriate delays. A hard copy printer may be optionally part of the user interface, receiving data from the ECS 35. This can print a record of the actual injection for insertion into the patient records. The output may be alphanumeric or be a graphical representation of the injection.
The operation of delivering fluid to the patient can be started by the operator with a start switch on the contrast delivery system, or from the console of the scanner. There would need to be an arming procedure similar to that of present injectors to help assure patient safety.
In CT, usually only one injection is given, sometimes with pauses and changes in flow rates. As the end of the injection is reached, contrast can be conserved if the contrast flow is stopped and the diluent flow continued so the "bolus" of diluted contrast is flushed out of the tubing and into the patient. In angiography, several injections may be used. It is necessary to flush only after the last injection, although no harm, except injecting a little extra fluid, occurs if the flush follows each injection.
Another form of waste is using contrast to prime the fluid path which is disposed of with each patient, especially if the concentration has not yet been decided upon. The flush or diluent fluid is much cheaper than the contrast and of lower viscosity, so it can be used to prime the line and make sure that all air has been removed from the path to the patient.
The present invention envisions that the "per patient" disposable portion of the apparatus starts just above the sterile filter 26 and ends at the patient This "per patient" connection 26′ may be made farther upstream, with the result that more of the fluid path is disposed of. This connection must be broken after one patient and made before the next. After the connection to one patient is removed, the connection for the next patient is quickly installed and sterilized, as by means of ultraviolet illumination. The present practice of making aseptic connections as discussed in U.S. Pat. No. 5,207,642 involves inserting a spike through a resilient member. This is common practice and is acceptable when used on one patient although it does not provide the level of sterility provided by ultraviolet illumination. The remainder of the connector tube and the patient connection end can remain in the sterile bag, ready for the patient who may come in the next hour or in the next few days. To further enhance sterility, the remainder of the fluid path connecting containers 10, 11; heaters 14, 15; metering pumps 12 and 13, etc., is disposable, in which case the "per patient" connection 26′ would be moved farther upstream, as described above, to the desired position, bearing in mind that the disposable portion is defined as everything below the connection 26′, inclusive of elements downstream of the connection 26′. For example, if the connection 26′ is positioned along the fluid path that connects the containers, heaters or metering pumps, everything downstream of the connection 26′, e.g., pump 25, detector 22 and/or valve 21, would be included with the disposable portion. However, it is only recommended that the disposable portion be replaced when the bulk contrast container is replaced. Thus, this system needs no active sterilization mechanism nor any toxic sterilants.
It is possible for the bulk fluid containers to feed more than one imaging suite, and thus, more than one patient at the same time. With large enough containers, this would be desireable. Each imaging suite would have all the components shown in
It is possible to operate the device without the addition of any diluent. In this case, the static mixer could be removed since there will be no change in the concentration of the contrast medium. This system provides several simplifications but does require a departure from the normal practice that has existed in hospital practices until this time. In operating by this method, the operator would put in patient weight and the procedure, the electronic control system would calculate total volume and flow rate and the patient weight and procedure would determine the milligrams of Iodine per second that were needed. The contrast delivery system would then deliver at the flow rate needed to provide the proper mgI/s. With the removal of the limitations of syringe and bottle size, concentration is a redundant parameter when flow rate can be freely determined.
In the apparatus shown in
The dose container need not be physically moved from one machine to another. It may stay in place, but the connection to the static mixer is opened and the connection to the patient is made. Interlocks would assure that a syringe could not be refilled after being connected to a patient. This prevents contamination by pathogens from the patient.
The embodiment presented above is the one preferred by the inventors, but it is possible for someone skilled in the art to rearrange the order of the components in the fluid path and still accomplish the goals of this device. In particular, the first component could be pressurizing pumps which create high enough pressures to drive the fluid through the remainder of the system and into the patient. Or, the bulk containers could be pressurized, and the metering pumps could then be metering valves. Mixing could be after the sterile filters, right before injection into the patient. These are only a few of the reasonable permutations. It is also a reasonable extension of this idea that more than two bulk containers may be used. These can sequentially or simultaneously dispense their fluid as medically necessary. They may contain various medicines to be diluted or not. An example is heparinized saline to prevent clotting in the catheter.
Although the present invention has been described in terms of preferred embodiments, the present description is given by way of example and is not intended to be limiting to the scope of the invention described and claimed.
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|Transluminal infusion of magnesium during coronary angioplasty
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|Oct 24, 1991
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|Schering Aktiengesellschaft
|Process for making doses formulation of contrast media from concentrate
|May 11, 1993
|Dec 5, 1995
|The Regents Of The University Of California
|Device for automatic injection of radionuclide
|Jul 30, 1993
|May 14, 1996
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|Angelini, P., Use of Mechanical Injectors During Percutaneous Transluminal Coronary Angioplasty (PTCA), Catheterrization and Cardiovascular Diagnosis 16: 193-194 (1989).
|Dardik, H., et al., "Remote Hydraulic Syringe Actuator," Arch Surg., vol. 115 (Jan. 1980).
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|Hack, D. P., "Coronary Injections: Flow-Controlled vs. power Controlled," Letters to the Editor (Apr. 1990).
|Ireland, M. A., et al., "Safety and Convenience of a Mechanical Injector Pump for Coronary Angiography," Catheterrization and Cardiovascular Diagnosis 16: 199-201 (1989).
|Kreiger, R. A., "CO2 Power-Assisted Hand-Held Syringe: Better Visualization During Diagnostic and Interventional Angiography," Catheterrization and Cardiovascular Diagnosis 19: 123-128 (1990).
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|Aug 8, 2014
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|Pressure sleeve assembly
|Aug 8, 2003
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|Sep 24, 2003
|Jul 8, 2004
|Doug Duchon
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|Duchon Douglas J
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|Dec 29, 2006
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|Jun 11, 2008
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|Jun 11, 2008
|Dec 17, 2009
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|Bracco Diagnostics, Inc.
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|Jul 2, 2009
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|Fluid injector system
|Oct 7, 2009
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|Apparatus and methods for support of a membrane filter in a medical infusion system
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|Feb 4, 2010
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|Jun 3, 2010
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|Aug 2, 2010
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|U.S. Classification
|International Classification
|Cooperative Classification
|European Classification
|Mar 4, 2002
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VELUX Modular Skylights mark a shift in the evolution of commercial daylighting. For the first time the market is offered a fully prefabricated skylight concept. Made from a composite material that ensures excellent energy performance, thermal stability and high strength, the product was elegantly designed in collaboration with Foster + Partners.
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Growing Indy IT Firm, RPM Technologies, Moves Downtown
RPM Technologies, an Indianapolis-based IT consulting firm has been growing since 2006. With its most recent growth RPM has decided to move into a new downtown location at 627 E. Market Street, to accommodate a growing list of clients and staff.
It was this growth that prompted the move to downtown, to a larger building that will house a central open work-space where RPM employees can monitor all of their clients' systems. According to Mark Fricker, Vice President of RPM, "the space is going to be command central. We will have the ability to monitor all of our clients' systems twenty-four hours a day, 365 days a year. The goal is to give them peace of mind knowing their systems are constantly being looked after."
But the new space will be more than just a work environment. Although renovating the building, RPM has plans to keep some of the original architecture in place. They want to open this space up to local businesses for technology meetings, social gatherings and small business IT help seminars. "Indianapolis has been a great place for Mark and me," says Chris Prader, President of RPM. "We both raised families as well as built our business here. We want to give back to the community. The goal is not just to relocate, but to become a part of the downtown business culture."
Both Prader and Fricker agree that the future still looks promising for RPM Technologies. They expect to land a couple of new clients in 2013 and, if so, hire some new IT consultants to their staff. But for now, the focus is on the big move to downtown later this year.
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text: Graph Your Expenses to See Where You Can Cut BackKristin Wong4/14/14 7:00amFiled to: MoneyPersonal FinanceBudgetSavings357EditPromoteShare to KinjaToggle Conversation toolsGo to permalink So you're trying to tighten your budget, and you want to know which expenses to cut first. Money blog Moolanomy suggests graphing your expenses to figure out how to prioritize them. Advertisement Moolanomy writer Pinyo Bhulipongsanon calls it a "scattergram"—a graph that shows two characteristics. In this case, the characteristics are: frequency and necessity."When you physically plot your expenses on a scattergram (or simply visualizing it), the process help you understand each of them better and give you a place to start formulating your plan."After graphing your expenses this way, you can better understand how to cut out the luxuries, go after recurring expenses and reduce frequency. For more detail on this "geeky" frugal strategy, check out his full post. Advertisement Lower Your Cost of Living the Geeky Way | MoolanomyPhoto by Moolanomy.Two Cents is a new blog from Lifehacker all about personal finance.Follow us on Twitter here.Gear from Kinja DealsBestsellers: Lodge 10-inch Cast Iron SkilletBestsellers: Anker PowerLine Lightning Cable, 3ftAutomate An Outlet For $25Reply35 repliesLeave a reply


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Female mannequin En Vogue "Madeleine", left arm on the hip
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Hillerman is a prolific writer, not just of fiction, but also
non-fiction (usually on Indian Country issues), and has also edited four
Navajo mystery series order: The Blessing Way, in 1970, Dance Hall of the Dead (1973), Listening Woman (1978), People of Darkness (1980), The Dark Wind (1982), The Ghostway (1984). Skinwalkers (1986), A Thief of Time (1988), Talking God (1989), Coyote Waits (1990), Sacred Clowns (1993), The Fallen Man (1996), The First Eagle (1998), Hunting Badger (1999), The Wailing Wind (2002), The Sinister Pig (2003), Skeleton Man (2004)
Coming Soon The Shape Shifter (to be published June 2006).
You'll find excerpts from, and reviews of, four of his more recent books at BookBrowse.
Useful Links:
- About the Hopis ...


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Taking part in the Noosa Triathlon and fundraising has become a hugely popular way to raise money for charity and make your Noosa exerience even more rewarding. Raising money for charity can give purpose to taking part in the Noosa Triathlon and serve as a goal to work towards. Remember, when you race for charity you're helping real people, fantastic causes and changing lives. Why not race for a cause that's close to your heart? Maybe there's a charity that's helped you, or a loved one, through difficult times?
There are two ways that you can race and fundraise:
Platinum Entries are very limited special entries in the Noosa Triathlon allocated to a small number of carefully selected charities. If you sign up for one of these places for the 2016 event you'll need to raise a pre-agreed amount of money for the charity that you join up with. This will be set by the individual charities, but will be around $1500. These entries come with a host of benefits including:
To find out more about how you can enter the 2016 Noosa Triathlon with a charity and which charities you can race for, view the listings below.
These are all fantastic causes, and by racing for them you'll be making a real difference to the lives of those who truly need it with your Noosa Triathlon journey. Browse through our charity listings to find your chosen charity and get in touch.
Looking for a charity place? Please click the 'I Need a Charity Place' button below to find charities who have limited spaces available.
If you have secured a place in the 2016 Noosa Triathlon by purchasing your own entry and you're interested in entering the race to raise money for charity, this section is for you.
You don't need to raise massive amounts for your charity to feel the benefit, and and you're guaranteed to meet loads of great new people along the way.
Looking to support a charity using your own entry? Please click the 'I Have My Own Place' button below to find out about good causes who would appreciate your support.
If the charity you'd like to support isn't listed don't worry. Just complete your registration then head over to our Everydayhero page to select a charity close to your heart.


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