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A gear change mechanism coupling a pair of shafts employs a planetary gear set comprising a sun gear fast with a first of the shafts, planet gears in a planet carrier, and an annulus or ring gear, the latter being fixed. A selector hub slidable on the other of the shafts has sets of radially spaced dogs to engage with corresponding dogs on the planet carrier and sun gear respectively, so as to couple the shafts at two different ratios depending on the axial position of the selector hub. This results in a more axially compact package than conventional dog clutch gear changers. In an alternative embodiment a reversing mechanism is provided by fixing the planet carrier and engaging the selector hub with the sun gear or annulus depending on its axial position.

A system for introducing an elongated spinal rod comprising a bone fastener having a head, the head including a top end, a bottom end, and a pair of side walls connected at the bottom end defining an elongated U-shaped channel having a first longitudinal axis and a top opening located at the top end. The top opening and the channel further define a passageway configured for receiving the spinal rod and each side wall further defining a first end face and a second end face, the second end face opposite the first end face. A bone engaging element extends from the bottom end of the head for anchoring the bone fastener to the bone. The system further comprises a tool for introducing the rod into the U-shaped channel. The tool includes a first member having a distal end and a proximal end. The distal end is configured for guiding the rod through the passageway to introduce the rod into the U-shaped channel through the top opening. A second member defines a second longitudinal axis substantially perpendicular to the first longitudinal axis. The second member has first and second ends, the second end having a pair of jaws for securing the tool to one of the side walls of the head of the bone fastener such that second member is disposed outside of the passageway of the spinal rod, and preferably so as not to interfere with or block access to the top opening. The first member is operably associated with the second member such that the first member is pivotable with respect to the second member and linearly translatable in a direction parallel to the second longitudinal axis between the first and second ends of the second member along the second longitudinal axis for introducing the spinal rod through the top opening into the passageway.

A graft fixation device combination. The device is useful for affixing a tissue graft to a bone or other body surface. The fixation device has two implantation members connected by a graft retention member. The retention member optionally has at least one lateral wing member extending therefrom. The implantation members have longitudinal passageways therethrough. The graft fixation device also has an insertion member extending from the distal end of each implantation member, the insertion member having a longitudinal passage having a distal blind wall. The passages of the implantation members and the insertion members are in communication with each other, and may be mounted onto insertion members.

A vertebral retrieval device includes a retrieval rod which is gripped firmly in a receiving slot of a fixation seat between two grooves of a pressing element and a C-shaped ring. The C-shaped ring rests on a spherical head fastening screw, a spherical head of which is received in the fixation seat and a shank of which is protruding from a through hole provided in a bottom of the fixation seat. The pressing element is pressed against the retrieval rod by a pressing screw, which is threaded into a threaded hole formed in a fixation element mounted in the receiving slot of the fixation seat.

This invention relates to providing a system for improved methods of promoting, forming and managing Internet-based communities on the Internet through and within standard web pages without requiring the installation of additional software on a user's computer or on web sites where the system is implemented by using the latest software tools, presentation techniques and Internet communication methods. Additionally, this invention provides real time monitoring of user counts to all visitors and web page owners when a page with the embedded URL is accessed. In particular, this invention permits web page visitors to initiate and participate in anonymous ad hoc chat sessions initiated from a selected web page. Additionally, this invention provides a web-based location which permits Internet users to join and participate in Internet-based communities and the related activities such as messaging other members, participating in member chat sessions and web resource sharing without the need to install software.

Visualization apparatus and methods for transseptal access are described herein where intravascular access across a septal wall is facilitated via devices which provide for direct visual viewing of tissue area. Such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to the tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid can be pumped into the imaging hood until the fluid displaces any blood leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. Any number of therapeutic tools or a guidewire can be passed through the catheter and into the imaging hood for crossing the septal wall and passing the guidewire or instruments therethrough.

The present invention relates generally to multifunctional catheters for performing ablation procedures, and more particularly to ablation catheters utilized in the treatment of atrial fibrillation and other cardiac disorders. The present invention eliminates many of the problems associated with previous ablation catheters by providing an ablation treatment not dependent upon continuous lesions.

A method and apparatus for use in gaming activities such as slot machines. A display grid having a multiple display segments is presented, where one or more of the display segments is presented having multiple display subsegments. Each of the display subsegments presents a subsegment symbol independently of the other display subsegments in its respective display segment. Paylines are created from a plurality of the display segments, where each of the subsegment symbols of each of the display subsegments is independently used in formulating payout results for each of the paylines in which the display segment is affiliated. Paylines may be dynamically created at any location as a result of corresponding symbols occurring in a predetermined number of adjacent display segments and/or subsegments.

A spinal implant includes an elongated body dimensioned and configured to function as a spacer, for placement in a target interspinous process space, between two adjacent spinous processes, a distal anchor associated with a distal end of the body, and a proximal anchor mounted for longitudinal movement along the body between a first position spaced apart from the head and a second position approximated with the head, adapted to compress the two adjacent spinous processes, in conjunction with the distal anchor.

Embodiments of the present invention provide devices and methods for treating various target sites, such as vascular abnormalities. For example, a medical device according to one embodiment includes at least one layer of a fabric of braided strands having proximal and distal ends and a central axis extending therebetween. The medical device has an expanded configuration a generally frustroconical shaped portion at each end. The medical device is configured to be constrained to a reduced configuration for delivery through a diagnostic catheter and to at least partially return, when unconstrained, towards the expanded configuration.

An electrosurgical forceps includes a shaft having a pair of jaw members at a distal end thereof that are movable about a pivot from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for grasping tissue. A movable handle is included that actuates the shaft to move the jaw members relative to one another. One or both of the jaw members are adapted to connect to a source of electrical energy such that the jaw members are capable of conducting energy to tissue held therebetween. An insulating boot is disposed on at least a portion of an exterior surface of one or both jaw members, about the pivot and at a distal end of the shaft. The insulating boot includes an inner flexible portion and an outer shell that is operably engaged with one or both of the pair of jaw members.

Methods and systems for delivery of digital data in connection with medical treatment and patient care include detecting a current medical condition of a patient receiving medical treatment and delivering electronic informational data to the patient over a network. The informational data can be selected for delivery based on the current medical condition of the patient. The informational data can includes a plurality of informational data content options, and the patient can choose one or more of the informational data content options for delivery to the patient over the network. The chosen content can be displayed to the patient on a digital data display device, such as a touch screen monitor.

Apparatus and methods for delivering prosthetic segments to a body lumen, utilize a device having an elongated flexible member including proximal and distal ends, a plurality of prosthetic segments releasably arranged axially along the elongated flexible member near the distal end and an outer sheath slidably disposed over at least a portion of the prosthetic segments. The apparatus further includes a separator disposed on the outer sheath and adapted to engage the prosthetic segments. The separator is also adapted to be retracted proximally over the prosthetic segments and advanced distally to separate a proximal group of the prosthetic segments from a distal group of the prosthetic segments which are to be deployed in the body lumen.

A computer network and method for electronically trading combinations of derivatives. One preferred method of trading includes providing quotes information to a central server, and determining indicative quotes for combination trades, and providing the non-binding, indicative quotes to market participants (which typically includes subscribers, but may also include market makers). A participant may then submit an e-RFQ, which is a request for a binding quote for the combination of derivatives. Market Makers may then elect to submit a binding quote for the corresponding derivative combination. Market participants may then elect to enter a binding order.

A novel headphone system includes a first speaker assembly, a second speaker assembly, and an interactive visual display system. The interactive visual display system includes a display operative to output visual contents according to interaction with a user. In a more particular embodiment, the headphone system includes an external device interface that enables a user to interact with the contents displayed from the screen via an external device or via the Internet. In another embodiment, the interactive visual display system is removable from the rest of the headphone system and can optionally be installed in another compatible non-headphone device.

Disclosed is an introducer apparatus comprising an sleeve fixation mechanism or introducer member, such as a catheter, introducer, or ring-like structure, which is attached to a protective sleeve comprising a thin flexible material such a polymeric film. The sleeve is inverted into the passageway of a second member, such as a catheter, feeding tube, introducer, etc., that is advanced through the passageway of the introducer member and is introduced into a bodily passage of a patient, such as the bile duct, nasal passages, colon, etc. The sleeve everts from the passageway of the second member during its advancement to lay down a friction-reducing surface. The sleeve prevents frictional contact between the second member and delicate or sensitive tissues.

Apparatus and methods are provided to prevent an operator from inadvertently dropping a string into a wellbore during assembling and disassembling of tubulars. Additionally, the apparatus and methods can be used to for running in casing, running in wellbore components or for a drill string.

The invention relates to measures for controlling or reducing drag torque occurring in a multi-plate clutch device (202) due to temperature-related increased viscosity of an operating fluid which is supplied to the plates in operation. The aim of the invention is to enable a motor vehicle to be started or operated even at low temperatures. According to one aspect of the invention, a motor vehicle comprising a drive train is especially provided. Said drive train comprises a drive unit (238), gearbox (330) having a first gearbox input shaft and a second gearbox input shaft, and a clutch (202) having a first clutch device which is associated with the first gearbox input shaft, and a second clutch device which is associated with the second gearbox input shaft, for transferring torque between the drive unit and the gearbox. Said clutch devices are embodied in the form of plate clutches to which an operating fluid can be supplied, especially a cooling oil in order to operate the same. Said gearbox (330) is associated with an actuator device and a control device (316) for controlling the actuator device, the arrangement of which enables the gears associated with the first and second gearbox input shafts to be engaged and disengaged. According to the invention, the control device (316) is designed in such a way that at least one gear is automatically engaged by means of the actuator device (236), as a result of the clutch release of the vehicle.

An extensible business method for performing research over the internet is presented. A first community web site is provided for a first targeted industry. User profile and feedback information is gathered from the users of the first community web site. The gathered user profile and feedback information from the first community web site is provided to at least one subscribing client of another web site. This method may be duplicated by repeating the above steps to a second targeted industry. In one example, a method for performing on-line consumer research over the internet is implemented comprising the following steps. User reaction of at least one user to at least one advertisement displayed on a first web site is gathered. Then research information is provided to a subscribing client on a second web site, based on the gathered user reaction on the first web site.