Abstract: Progressive multifocal leukoencephalopathy (PML) has been identified in patients taking natalizumab (NMAB) for the treatment of multiple sclerosis (MS). This patent application provides a novel method of patient screening and monitoring intended to decrease the risk of PML and other opportunistic central nervous system (CNS) diseases in patients undergoing MS therapy with NMAB, and proposes a novel method of screening and monitoring intended to decrease the risk of opportunistic disease processes of the CNS during the treatment of other medical disorders with NMAB.

Abstract: Recessed head fasteners are provided with a configuration by which the force applied by the blades of the driver to the recessed wings is applied at the radially outer regions of the wings. The wings of the fastener recess may be provided with torque pads at the outer regions of the wings adapted to engage the outer portions of the driver blades. The torque pads may be defined by relieved regions on the drive walls of the recess wings. The relieved regions are formed to avoid contact with the driver blades. Stabilizing ribs also may be defined at the radially inward regions of the drive walls. A recess engageable driver may include a plurality of radially extending ribs configured to promote engagement of the ribs with the most radially outward regions of the recess drive walls. The driver and the recess are compatible with each other as well as with otherwise corresponding conventional recesses and drivers that do not incorporate the invention.

Abstract: A yo-yo incorporates a construction that enables the gap between the yo-yo halves to be adjusted simply and quickly. The halves of the yo-yo are threadably mounted on the ends of the yo-yo axle. The yo-yo halves are biased apart axially to maintain firm frictional contact between the yo-yo halves and the axial. The gap may be adjusted simply by rotating the yo-yo halves with respect to each other. The inwardly facing surfaces of the yo-yo halves also incorporate angular relationships to facilitate yo-yo play.

Abstract: A metal yo-yo embodies a construction in which each of the halves of the yo-yo body is formed from a disc and a hub that are made separately and secured to each other in an integral structure. The discs can be die cut from sheet material and may be deformed about the peripheral margin to define a dished configuration. The hub is inserted into the center hole of the disc and the two are assembled together in a swaging operation that constricts the metal of the disc about a portion of the hub. A pair of such yo-yo halves are connected together by an axle assembly that includes a bearing to facilitate extended spin time for the yo-yo. The yo-yo construction and method of fabrication provides substantial economies in the manufacture of metal yo-yos.

Abstract: A medical suction and irrigation apparatus includes a suction/irrigation tip removably connected to a conventional suction/irrigation handpiece. Suction is provided through a suction tube which has a bypass conduit in the tip. The bypass conduit is directly connectable to a suction source so that aspirated debris passes through the tip to the suction source. The suction tube thus prevents aspirated debris from entering the conventional suction tube in the handpiece and contaminating the handpiece. The suction tube is also designed to have a maximum size to prevent the tip from clogging. The tip also has an irrigation tube for directing irrigation liquid to the irrigation site, and a connector which connects the irrigation tube to the handpiece so that the handpiece pumps fluid through the tip in a conventional manner. A flexible splash shield, slidably mounted to the irrigation tube, confines irrigation fluid to the local site.

Abstract: An apparatus for irrigating a local irrigation site includes a suction/irrigation tip that is removably connected to a suction/irrigation handpiece. The tip has an irrigation tube for directing irrigation liquid to the irrigation site, and a suction tube coaxially aligned within the irrigation tube. The handpiece pumps irrigation liquid from an external reservoir, through the annular space between the irrigation tubes and the suction tube to the irrigation site. Suction is applied to the site through the central suction lumen which has a large unobstructed opening to reduce clogging. A flexible splash shield, slidably mounted to the tip, is conically shaped and extends distally from a collar to a rim. The rim is sized to fit around and about the local site.

Abstract: A graft assembly for securely positioning a graft at a predetermined location across an abdominal aortic aneurysm. The assembly includes a resilient self-expanding anchor that is secured to the graft. The anchor is characterized as being at least as long as the graft, and further as being adapted to be removed or repositioned at any time prior to complete deployment in the patient.

Abstract: A self contained pulsatile surgical irrigation device includes a housing, a trigger moveably connected to the housing, a motor within the housing, a pump within the housing, and a mechanical drive train for coupling the motor to the pump. The trigger is mechanically connected to the drive train to enable the stroke of the pump to be varied, thereby varying the output flow from the device.

Abstract: A graft assembly for securely position a graft at a predetermined location across an abdominal aortic aneurysm. The assembly includes a resilient self expanding anchor that is secured to the distal end of a mesh graft. The anchor is formed from a single wire having a series of zigzag bends, such that when the ends of the wire are attached a tubular anchor is produced. The anchor is further characterized by curved segments between the bends which a create an anchor having a reverse barrel shape.

Abstract: An uncured or partially cured, collagen-based material is delivered to a selected site in a blood vessel and is crosslinked in the blood vessel by laser energy or other suitable energy to form an endovascular stent. The collagen-based material can be delivered to the blood vessel as a coating on an inflatable balloon mounted on the distal end of a catheter. The collagen-based material can also be delivered to the blood vessel in liquid form. The liquid collagen-based material is forced through a porous balloon to form either an imperforate tubular configuration or a tubular mesh configuration. The collagen-based material is preferably crosslinked by laser radiation carried through an optical fiber to a diffusing tip located within the balloon.

Abstract: An endoprosthesis assembly adapted to be securely positioned within a body lumen is provided with one or more hooks adapted to engage tissue that defines the body lumen. The endoprosthesis includes a resilient self-expanding anchor attached to the tubular graft. The anchor and hooks carried by the anchor are constructed to enable the endoprosthesis to be recaptured in a delivery device to enable repositioning or removal of the endoprosthesis and any time prior to complete deployment of the endoprosthesis in the patient.

Abstract: A spiral drive system for threaded fasteners includes driver-engageable surfaces on the head end of the fastener in which at least some of the driver-engageable surfaces are defined by a spiral segment configured to maximize torque transmission while spreading the driving load over a broad driver-fastener interface to reduce the risk of development of high stress regions. Drivers and related tooling also are disclosed.

Abstract: The stent appears as a prismatic cage (3) of which the flat faces consist in a corresponding number of modular elements (2) linked one to the next in sequence, each comprising a pair of first mutually parallel tubular elements (4), fashioned in a biocompatible material, and a pair of filiform spacer elements (5), likewise biocompatible, which are inserted into the first tubular elements (4) in such a way that the assembled modular element (2) assumes a closed quadrangular configuration; each of the spacer elements (5) is deformable along its own longitudinal axis (X) so that the distance (D) separating the pair of first tubular elements (4) can be varied between a non-operative position of minimum clearance, in which the spacer elements (5) are collapsed and folded, and a stable operating position in which the first tubular elements (4) are spread fully apart with the spacer elements (5) at right angles to them.

Abstract: A graft assembly for securely positioning a graft at a predetermined location across an abdominal aortic aneurysm. The assembly includes a resilient self-expanding anchor that is secured to the graft. The anchor is characterized as being at least as long as the graft, and further as being adapted to be removed or repositioned at any time prior to complete deployment in the patient.

Abstract: A handle is provided for attachment to a medical endoscope for advancing instrumentalities through the instrument channel of the endoscope. The handle is adapted for use with instrumentalities requiring multiple longitudinal strokes to be performed in a predetermined sequence. A detent mechanism is provided to assure that a first stroke is completed before the next succeeding stroke begins. The invention as disclosed is used to operate an endoscopic sewing machine.

Abstract: An endoprosthesis assembly adapted to be positioned within a body lumen includes a resilient, self-expanding anchor attached to a tubular graft. The endoprosthesis can be recaptured in a delivery device to enable repositioning or removal of the endoprosthesis at any time prior to complete deployment of the endoprosthesis in the patient. The delivery device includes an outer tubular member that carries the endoprosthesis in a radially contracted configuration and an elongate inner tubular member that extends through the prosthesis and beyond the distal end of the outer tubular member. A retainer is carried by the inner member that engages and retains the proximal end of the endoprosthesis relative to the inner member until the endoprosthesis is released.

Abstract: A graft assembly for securely positioning a graft at a predetermined location across an abdominal aortic aneurysm. The assembly includes a resilient self-expanding anchor that is secured to the graft. The anchor is characterized as being at least as long as the graft, and further as being adapted to be removed or repositioned at any time prior to complete deployment in the patient.

Abstract: An autotransfusion system for collecting blood from a patient and reinfusing the blood back into the patient is disclosed. The system includes a collection unit, a manually operable portable suction evacuator removably connected to the collection unit, and a blood reinfusion bag removably connected to the collection unit. The collection unit includes a collection chamber that is oversized relative to the volume of blood that the unit is intended to contain, and an airflow port located and oriented in the collection chamber to prevent blood from leaking into the port when the collection unit is oriented upright or on its side. When connected to the patient, the collection unit and portable suction evacuator are maintained free of blood by enclosing them within a substantially transparent, flexible envelope. The envelope enables the unit and evacuator to be connected and set-up for proper operation while preventing blood from contacting the outer surfaces of the unit and evacuator.

Abstract: An endoprosthetic implant is formed from a plurality of separate individual components that are inserted sequentially and transluminally into a bifurcated vascular region with each component being deployed in sequence by a sequence of catheter-like deployment devices. The separate components are placed relative to each other to define a bifurcated endoprosthesis. In one embodiment the deployment device includes a tubular sheath for maintaining the radially expandable tubular implant in a contracted configuration and a gripping device including a cup and a gripping member that cooperate to define an annular space by which the trailing end of the implant can be securely held by the deployment device during positioning of the device.

Abstract: A self-sealing hemostatic valve for use in a catheter apparatus is disclosed, comprising a proximal valve element having a sealing hole, a distal valve element having a flap and biasing means to enhance the force with which the flap bears against the distal side of the proximal valve element to normally seal the hole. The sealing hole seals about an instrument passed through the valve and the flap seals the valve when no instrument is present. The proximal face of the proximal valve element is provided with discontinuities that increase the flexibility of the proximal valve element in a distal direction.