вторник, 3 июля 2012 г.
четверг, 15 марта 2012 г.
Police: Bicycle bomb kills 5 in northwest Pakistan
A bomb rigged to a bicycle exploded in a northwest Pakistani city on Monday, killing at least five people and wounding 20 in the latest attack to rattle the volatile region.
The explosion occurred on a major road in Dera Ismail Khan, and most of the victims were either walking by the parked bicycle or traveling in nearby vehicles, area police chief Saeed Ullah said.
Taliban and al-Qaida militants are suspected in scores of attacks in Pakistan's northwest regions bordering Afghanistan. Dera Ismail Khan lies near the Waziristan tribal areas, which are insurgent strongholds and favorite targets for U.S. missile strikes.
But the rough and tumble city …
FDA: No Spinach Farm 'Off the Hook' Yet
SALINAS, Calif. - Local spinach farmers and processors expressed relief upon learning that the search for the source of a deadly E. coli outbreak has been linked to a nearby cattle ranch, but health officials cautioned that their investigation was far from over.
Inspectors confirmed Thursday that the same bacteria strain that killed three people and sickened nearly 200 nationwide was found at a Salinas Valley cattle ranch within a mile of spinach fields.
Officials still can't be sure if the E. coli found in cow manure contaminated the fields, but called the match an important finding.
"We do not have a smoking cow at this point," said Dr. Kevin Reilly, deputy …
среда, 14 марта 2012 г.
Families stream into New York ceremony
Families carrying photos of lost loved ones streamed into a plaza near "ground zero" in New York on Friday to observe the eighth anniversary of the World Trade Center attack, many standing tearfully through moments of silence in honor of those who died.
Thousands were expected at now-familiar ceremonies in New York, at the Pentagon and at the crash site of United Airlines Flight 93 in Shanksville, Pennsylvania.
In New York, a smaller-than-usual crowd of just hundreds gathered in rainy, windy weather to observe the anniversary of the worst attacks in the nation's history. Families used rain jackets and umbrellas to fend off the downpour as bells tolled …
'Small' rally nets big win for Clemente
A wild, riveting and bizarre game ended the only way imaginable.
Improbably.
Clemente scored three runs in its final at-bat without hitting the ball out of the infield and stunned Lane 11-10 Friday.
''Small ball wins championships,'' said senior Laboy Perez, who scored the game-winner without a play at the plate on a ground ball to short by Daniel Hernandez. ''This is our biggest rival, and next to a championship game if we got there, this is our biggest game of the year.'' The host Wildcats (5-7, 5-3 Jackie Robinson North) parlayed two walks, a perfectly executed bunt and an error to reverse Lane's 10-8 advantage.
Lane's Richard Green appeared to put the …
India: Online cotton trading
INSIDE ASIA
Futures trading in cotton started in December of 1998 after an interval of about 31 years (futures were banned in 1967 because of excessive speculation), but volumes have been eluding the East India Cotton Association (EICA), the main trade body which represents cotton interests and also manages the futures exchange.
The volume of trading so far has been nominal, to say the least. For example, there was no trading at all between June 10 and 13, 2002. There was some trading in June (spot) and September contracts but again, between June 17 and June 21, 2002, there was no trading at all. While leading members …
DNA tests exonerate 'Lizard Man' in van attack
DNA testing has shown an attack on a family van some blamed on the legendary Lizard Man appears to have been actually done by a domestic dog. Something chewed up the front fender of Bob and Dixie Rawson's van in February. Bite marks were left on the wheel wells and blood was found on the vehicle.
The Item of Sumter reported that a veterinary lab in California tested the blood and found it came from a dog.
But Bob Rawson isn't …
The way of the samurai Tinseltown revisits those legendarily stoic swordsmen who fought bloody battles -- honorably
The Last Samurai," which opens Friday, proves at least two things:Tom Cruise has come a long way from his tighty-whitey-floor-slidingdays, and Hollywood's ongoing fascination with the sword-wielding,honor-bound Japanese knights hasn't abated.
Cruise's character, American military man Capt. Nathan Algren, isa lost soul. Struggling to come to grips with an increasinglyindustrialized post-Civil War society, he feels worthless, out ofplace, not to mention deeply guilty for the battlefield atrocities heonce committed. Enter Japanese fighting man Katsumoto, ruler of anearly extinct breed: the samurai warrior. Eventually they meet, andAlgren becomes swept up in Katsumoto's …
Michael Gielen conducts CSO with fervor
Michael Gielen conducts CSO with fervor
Gone was the darkly rich splendid and luxurient textures of the Chicago Symphony Orchestra, in its place was abrillient ensemble, stunning in quality as Maestro Michael Giulen directed.
Mahler's "Adagio from Symphony No. 10" opened the evening program for Giulen's second week on the podium. Of course Mahler didn't finish his last symphony, but the part we heard was interesting for its interdominant harmonies.
Guilen's conducting featured a very brillient orchestra that glistened like the sparkling stars at midnight. His presentation of The Mahler was first rate and of a stunning quality, fervant and infectious.
Pianist …
Stony Brook defeats Coastal Carolina 28-24
Dayne Hoffman threw three touchdown passes, including a 61-yarder to Dwayne Eley with 13:40 remaining that held up as the game-winner in Stony Brook's 28-24 win against Coastal Carolina on Saturday night.
Hoffman completed 14 of 27 passes for 197 yards, and Conte Cuttino rushed for 136 yards and one touchdown on 23 carries for the Seawolves (3-5, 2-1 Big South Conference).
Zach MacDowall completed 22 of 33 passes for 306 yards with two touchdowns, and added 80 yards and one touchdown on 14 carries for the Chanticleers (4-5, 0-3).
Hoffman's game-winning touchdown to Eley came less than one …
Westminster is the way ahead ; Letters
THE cost of running the Welsh Assembly is very high and we haveto ask the question "to what advantage"? It was created with 25 percent voting no and 25 per cent plus a few hundred voting yes andmore than 49 per cent not voting. We then had a referendum thisspring to give the Assembly more law making power.
Why should we have to tolerate a Welsh Assembly that the majoritydid not vote for and do not want? If it was a success I would notmind, but it is an absolute disaster compared to other regions ofthe UK.
The standard of living of the Welsh people is lower than otherregions, edition, health service, road building and repair have alldeteriorated since we …
LA gang member gets life for killing teen actress
A Los Angeles gang member has been sentenced to life in prison without chance of parole for killing "Judging Amy" teen actress Tara Correa-McMullen and another victim.
Damien Watts, 23, was sentenced to consecutive life terms Friday.
Correa-McMullen appeared in the movie "Rebound" and had a recurring role on TV's "Judging Amy."
Prosecutors say the 16-year-old actress was killed in 2005 when Watts opened fire on a group of people outside an Inglewood apartment complex. Two men were wounded.
A day before that attack, Watts shot to death 31-year-old Thomas Sanders as he loaded laundry into a car.
Watts was convicted last month of murder with special circumstances, attempted murder and other charges. A co-defendant is awaiting trial.
Canadian Surgery Forum 2003/Forum canadien de chirurgie 2003; Canadian Association of Thoracic Surgeons/Association canadienne des chirurgiens thoraciques
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PREDICTING THYMOMA INVASIVENESS: THE ROLE OF CT SCAN. I. Goussev, J. Marschall. Department of Surgery, Royal University Hospital, University of Saskatchewan, Saskatoon, Sask.
Computer tomography (CT) remains the leading imaging modality to investigate mediastinal tumours including thymoma. However, the ability of CT to determine invasiveness of thymoma remains questionable.
Forty patients with a diagnosis of thymoma were identified using the Saskatchewan Cancer Centre database. Thirty-two patients had complete data available for analysis including CT, operative reports and pathology reports. The CT reports were compared to operative and pathology reports with pathology reports being considered the "gold standard" to determine invasiveness. CT correctly identified invasion in 9 out of 19 cases found to be invasive at operation. An additional 4 cases, totalling 23, revealed microinvasion into surrounding fat on pathologic examination. In 3 of the 9 cases demonstrating invasion, CT showed very advanced disease not amenable to surgical treatment. One of these 3 patients died soon after admission.
The sensitivity of CT in predicting invasiveness was 47.3% as compared to intraoperative diagnosis and 39.1% as compared to pathology evaluation. The accuracy of CT to predict invasion of thymoma into surrounding structures is relatively poor.
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IMMUNOHISTOCHEMICAL ANALYSIS OF N2 MEDIASTINAL LYMPH NODES. P. Nechala, R. Chibbar, R. Kennedy. Department of Surgery and Pathology, Royal University Hospital, University of Saskatchewan, Saskatoon, Sask.
The purpose of this study was to evaluate N2 mediastinal lymph nodes of non-small-cell lung cancer patients for presence of micrometastatic disease using immunohistochemistry.
Tissue blocks of N2 mediastinal lymph nodes obtained from patients with non-small-cell lung cancer were restained using ck-7, multi-ck and TTF-1 immunochemical stains. Presence or absence of micrometastases was correlated with survival data obtained from the Saskatoon Cancer Centre.
Thirty-eight patients with stage I and II non-small-cell lung carcinoma were identified and treated between January 1997 and December 2001. All patients had node-negative disease on routine histopathologic analysis and underwent resection of their primary tumour. Twenty-two of the 38 patients were identified as having micrometastases on multi-ck staining. Patients with micrometastases demonstrated a trend toward a poorer survival outcome (p = 0.13). Staining with ck-7 and TTF-1 showed no correlation with survival data.
Routine use of immunohistochemistry may help identify patients with poorer prognosis.
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IMPORTANCE OF NODAL STATUS AND IMPACT OF MEDIASTINOSCOPY IN PREOPERATIVE STAGING OF PATIENTS WITH MALIGNANT PLEURAL MESOTHELIOMA. M. de Perrot, Y. Shargall, T.K. Waddell, R.J. Ginsberg, G. Darling, A.F. Pierre, S. Keshavjee, M.R. Johnston. Division of Thoracic Surgery, Toronto General Hospital, University of Toronto, Toronto, Ont.
Introduction: The presence of metastatic lymph nodes (LN) is a factor of poor prognosis in patients with malignant pleural mesothelioma. However, the value of mediastinoscopy in the preoperative staging of malignant pleural mesothelioma has not been analyzed systematically. We have, therefore, evaluated the importance of metastatic LN and the impact of mediastinoscopy in the treatment of malignant pleural mesothelioma. Methods: Retrospective review of 33 consecutive patients (25 men and 8 women, median age 58 yr) with malignant pleural mesothelioma undergoing extrapleural pneumonectomy (EPP) between 1993 and 2002 in our institution. Results: Tumours were right- (n = 14), or left-sided (n = 19). Perioperative mortality was 6% (2 deaths) and morbidity 33%. Although all patients had small (< 1.5 cm in greatest diameter) and non-suspect mediastinal LN on preoperative computed tomography (CT), 15 patients presented with extrapleural metastatic LN (45%) and 3 with intrapleural metastatic LN (9%) on final pathologic examination after EPP. Recurrence rate was significantly higher in patients with metastatic LN than in patients with N0 LN status (2-yr disease-free survival of 14% versus 54%, respectively; p = 0.009). Mediastinoscopy was performed preoperatively in 18 patients and was positive for metastatic mediastinal LN in only 1 patient. Of the 17 patients with negative mediastinoscopy, 9 were found to have extrapleural metastatic LN on final pathology. Metastatic LN were located in the aortopulmonary window, along the phrenic nerve, and in the lower mediastinum in 4 of these patients and, thus, were not accessible by cervical mediastinoscopy. The remaining 5 patients had metastatic LN along the trachea or in the subcarinal space that were not detected by mediastinoscopy. Conclusions: Metastatic LN is an important predictor of outcome that may help to select patients for EPP. However, in our experience, the negative predictive value of mediastinoscopy to detect extrapleural nodes is low (47%) and not significantly different from CT (44%). The low yield of mediastinoscopy in detecting metastatic LN may be due to the distribution of metastasis outside of the regions easily accessible by cervical mediastinoscopy and to the difficulty to detect small clusters of mesothelial cells on samples obtained by mediastinoscopy.
91
15 YEARS' SINGLE-CENTRE EXPERIENCE WITH SURGICAL RESECTION OF THE SUPERIOR VENA CAVA FOR NON-SMALL-CELL LUNG CANCER. G. Darling, Y. Shargall, M. De Perrot, S. Keshavjee, M. Ginsberg, A. Pierre, T. Waddell. Toronto General Hospital, University of Toronto, Toronto, Ont.
Objectives: The role of surgical resection for locally advanced non-small-cell lung cancer (NSCLC) invading the superior vena cava (SVC) is controversial. We examined our results in this group of patients. Methods: Retrospective analysis of patients who underwent surgical resection for NSCLC with direct SVC involvement, between 1988 and 2003. Postoperative morbidity and long-term outcome were reviewed. Risk factors for overall and disease-free survival were examined using Kaplan-Meier methods and log-rank test. Results: Of 21 patients who underwent SVC resection for thoracic malignancies, 13 were operated upon for NSCLC (7 males, 6 females). Median age was 60 years (28-78). None had SVC syndrome preoperatively. All patients had direct SVC invasion by tumour. All underwent mediastinoscopy as part of their staging. Six patients with N2 disease (discovered during mediastinoscopy in 5, and based on CT scan in 1) received induction therapy. Nine underwent lobectomy, and 4 had pneumonectomy (2 carinal). The SVC was replaced by interposition graft in 8 patients, whereas 5 had partial resection and repair. There were 2 (15%) postoperative deaths secondary to respiratory failure, and 3 (23%) major morbidities (1 postop SVC syndrome, 1 recurrent laryngeal nerve palsy and 1 cardiac herniation). No SVC-related late morbidities were observed. Mean follow-up time was 22 months (1-132, median 9). Overall 1- and 3-year survivals were 74% and 40%, respectively. Disease-free survival was 67.5% and 30%, respectively. All late deaths were due to recurrence. Survival of those with N2 disease was not significantly worse than those with localized (N0/N1) disease. There was a trend towards delay in recurrence in patients who had induction therapy (median disease-free interval of 34 mo v. 10 mo in the untreated group) although there was no significant effect on overall survival. The extent of lung resection and type of SVC resection (repair v. replacement) were not found to influence long-term survival. Conclusions: Carefully selected patients with NSCLC and SVC involvement can be operated upon with acceptable postoperative morbidity and mortality. In this small group of patients, no significant prognostic factors could be identified. SVC resection with curative intent should be considered for patients with NSCLC involving the SVC.
92
MINI-INVASIVE TRANSAXILLARY UPPER LOBECTOMY FOR LUNG CANCER PATIENTS. H. Lara-Guerra, J. Clifton, K. Evans, R.J. Finley. Division of Thoracic Surgery, Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC
The purpose of this study is to report the experience of the Thoracic Surgery Service at the Vancouver General Hospital with lung cancer patients who underwent upper lobectomy by video-assisted procedure.
Retrospective chart review was carried out of patients with lung cancer who underwent upper lobectomy at Vancouver General Hospital between 1995 and 2001. They were divided into video-assisted, transaxillary lobectomy (VATSL) performed by surgeon 1 (group 1, n = 32), posterolateral thoracotomy (PLTL) by surgeon 1 (group 2, n = 24) and PLTL by surgeon 2 (group 3, n = 22). Demographic data, medical history, preoperative risk factors, surgical data and hospital stay information were recorded. Unpaired t-tests and [Symbol Not Transcribed] [chi][Symbol Not Transcribed] were performed using significance levels of p < 0.05.
Group 1 showed a shorter total operating time than group 2 (186.9 v. 203.7 min, p = 0.043). Group 1 reported lower pain levels throughout hospital stay (p < 0.05 at 1st, 5th, 6th and 7th days) and used epidural catheter less times (p < 00.1) and received less epidural drugs (38.5 v. 119.7 mL, p = 0.000).
Comparison of group 1 with group 3 showed that VATSL reported lower pain levels throughout hospital stay (p < 0.05 at 1st, 3rd, 6th and 7th days) and needed less Leritine and epidural analgesic drugs (176.6 v. 570.8 mg, p = 0.019; 38.6 v. 132.4 mL, p < 0.000).
Group 1 compared to groups 2 + 3 confirmed the following: group 1 reported lower pain levels at 1st, 3rd and 5th days (p < 0.05). Epidural catheter was indicated less times for group 1 (p < 0.000). Total mg of morphine IV were higher in VATSL (p = 0.03) but paracetamol and Leritine were lower (p = 0.053 and p = 0.02, respectively).
This study suggests that lung cancer patients who underwent upper lobectomy by VATS presented lower pain levels with less-invasive analgesic management. The results indicate the need to conduct a randomized controlled trial with sufficient power and sample size to answer these questions.
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A QUANTITATIVE APPROACH TO MAXIMIZING UTILIZATION OF SURGICAL RESOURCES FOR ELECTIVE OPERATIONS. A. Behzadi, R. Borgesa, H. Unruh, S. Bhatt. I.H. Asper School of Business, University of Manitoba, Section of Thoracic Surgery, Health Sciences Centre, Winnipeg, Man.
The objective of this project was to devise a linear program based on quantitative approach of management science, which can then be used as a tool by the hospital managers and surgeons to maximize utilization of surgical services and resources for elective operations.
This maximization approach to resource management was focused on 4 commonly performed elective pulmonary operations in a thoracic surgery section of a tertiary-care hospital. Using linear programming formulation, a maximization model was constructed. The model looks at 8 constraints: minimum number of operations of each type, maximum number of operating room hours, number of available hospital beds, number of operating room nurses, number of anesthetists, recovery room beds, intensive care unit beds, and number of nurses on the ward. All the constraints were then quantified into the number of hours per month. The program was formulated based on 2 core alternative pathways. First, the demand for the surgical services made by a surgeon exceeds the available resources, and second, the resources offered to the surgeon exceeds or is equal to the surgeon's demand.
The linear programming model was able to provide 2 sets of information. In situations where demand exceeded the available resources, the program was able to identify and quantify what constraints are the limiting elements. In other situations where resources matched or exceeded the demand, the program could identify and quantify the underused resources, and suggest which operations and in what quantities -- from the pool of operations already designed into the program -- can be added to the schedule.
Using our linear program as a blueprint, a more extensive model can be formulated that encompasses the activities of all the surgical services. This model will then allow for optimal utilization of the available resources to accommodate elective surgeries in a hospital.
94
CASPASE INHIBITION DECREASES APOPTOSIS AND LEADS TO IMPROVED LUNG FUNCTION IN A RAT MODEL OF LUNG TRANSPLANTATION. S.M. Quadri, L. Segall, A. Dutly, V. Edwards, B. Mullen, N. Jones, T.K. Waddell, M. Liu, S. Keshavjee. Thoracic Surgery, University Health Network -- Toronto General Hospital, Pathology, Mt. Sinai Hospital, Gastroenterology, Hospital for Sick Children, Toronto, Ont.
Previously, we have described significant apoptotic cell death in the lung following transplantation in humans and animals. Multiple pathways lead to programmed cell death; it is not known which are relevant in lung transplantation. Furthermore, the clinical significance of this cell death has not been studied.
In randomized blinded studies, syngeneic left single-lung transplantation (Lewis rats) was performed after 6 hours (n = 15) and 18 hours (n = 8) of cold ischemic storage (CIT). Animals and storage solutions were treated with caspase inhibitors or control. After transplantation and reperfusion, the PO[Symbol Not Transcribed] level of the transplanted lung at FiO[Symbol Not Transcribed] 1.0 was used to assess lung function. Caspase 3, 8 and 9 activities in lung tissue lysates were measured through fluorometric assays. Lung samples were subjected to electron microscopy; TUNEL was used to evaluate apoptosis in paraffin-embedded lung sections.
After 6 hours CIT, transplantation and 2 hours reperfusion, the PaO[Symbol Not Transcribed] levels, at FiO[Symbol Not Transcribed] 1.0, were not significantly different. However, after 18 hours CIT, transplantation and 2 hours reperfusion, the PaO[Symbol Not Transcribed] levels at FiO[Symbol Not Transcribed] 1.0 were significantly higher in the caspase inhibitor group as compared to control. Caspase 3, 8 and 9 activities rose dramatically from baseline to 6 hours CIT and then dropped back down by 18 hours CIT in control animals. Animals treated with caspase inhibitor did not exhibit any significant changes in caspase activities. Electron microscopy demonstrated apoptotic cell death in endothelial cells and lymphocytes in control animals. TUNEL studies show that apoptosis was significantly reduced in animals treated with caspase inhibitor.
Activation of caspases during cold ischemia contributes significantly to ischemia-reperfusion induced apoptosis of endothelial cells and lymphocytes in lung transplantation. A systemically administered pan-caspase inhibitor successfully inhibited caspase activity in the lung, led to decreased TUNEL positivity, and improved lung function after 18 hours CIT, transplantation and 2 hours reperfusion.
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LEVELS OF EVIDENCE AND GRADES OF RECOMMENDATIONS IN GENERAL THORACIC SURGERY. A.J. Graham, G. Gelfand, S.D. McFadden, S.C. Grondin. Division of Thoracic Surgery, University of Calgary, Calgary, Alta.
To determine the grades of recommendations and levels of evidence available if the formal practice of evidence-based medicine (EBM) is applied to general thoracic surgery.
Three general thoracic surgeons, by consensus developed a sample of 10 clinically important questions. The first 3 steps of evidence-based medicine (creation of answerable clinical questions, search for best external evidence, and. critical appraisal of literature) were performed. The best evidence found was categorized according to the Oxford Centre for Evidence-Based Medicine, grades of recommendations (A-D) and level of evidence (1-5).
Abstracts and appropriate articles were identified through MEDLINE January 1999-December 2001. A hierarchial series of search strategies was employed to identify the best level of evidence in order of systematic reviews then randomized controlled trials or other types of evidence.
The best evidence found for the 10 sample questions was categorized as grade A recommendations in 7 and grade B recommendations in 3. The levels of evidence found were 1a in 2 studies, 1b in 5, 2a in 1 and 2b in 2.
A formal evidence-based-medicine approach to general thoracic surgery found the grades of recommendation and levels of evidence for a sample of clinically important questions was high.
96
A PHASE II TRIAL OF INDUCTION CHEMOTHERAPY FOLLOWED BY EXTRAPLEURAL PNEUMONECTOMY AND HIGH-DOSE HEMITHORACIC RADIATION FOR MALIGNANT PLEURAL MESOTHELIOMA. M. de Perrot, R.J. Ginsberg, D. Payne, R. Feld, G. Darling, T.K. Waddell, S. Keshavjee, M.R. Johnston. Toronto General Hospital and Princess Margaret Hospital, University of Toronto, Toronto, Ont.
Introduction: We performed a single institution phase II trial with induction chemotherapy followed by extrapleural pneumonectomy (EPP) and high-dose hemithoracic radiation therapy for malignant pleural mesothelioma. Methods: Patients were eligible if they had a diagnosis of malignant pleural mesothelioma, a resectable tumour on computed tomography (CT) and adequate cardiopulmonary reserve to undergo EPP. Patients received 2-3 cycles of cisplatin/navelbine before EPP, and hemithoracic radiation (54 Gy) after EPP. Results: Between 06/01 and 12/02, 18 patients (13 men and 5 women, median age 59 yr) were eligible for the study. Nine patients (50%) completed the protocol. Two patients declined preoperative chemotherapy, 2 were found to have extensive disease at surgery and did not undergo EPP and 5 did not receive postoperative radiation therapy. Chemotherapy was performed in 16 patients and was well tolerated in all but 1 patient (fever and tachycardia). Chest CT was performed before and after chemotherapy to assess the response. Nine patients had no change in the bulk of disease, whereas 3 had minimal improvement and 1 had a partial response. Three patients had an increase in the size of the tumour during chemotherapy, and 2 of these were unresectable at surgery. Out of 16 patients undergoing EPP, 1 died postoperatively of arrhythmia and 7 developed complications (atrial fibrillation n = 2, recurrent nerve palsy n = 2, mild temporary kidney dysfunction n = 1, wound infection n = 1, and esophageal perforation n = 1). Eleven patients received postoperative hemithoracic radiation therapy to a total dose of 54 Gy. Fatigue (n = 8), skin erythema (n = 6), nauseas (n = 4) and esophagitis (n = 3) were often seen, but no major complications were observed. The 1-year disease-free survival for the 9 patients who completed the protocol was 74%, and tended to be better than for the remaining patients who underwent EPP but did not complete the protocol (1-year disease-free survival of 33%, p = 0.2). Conclusions: Induction chemotherapy followed by EPP and high-dose hemithoracic radiation is an aggressive but tolerable regimen for selected patients with malignant pleural mesothelioma. This approach may delay recurrence and improve survival. New chemotherapy regimens are needed to increase the response rate before surgery.
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A TWELVE-YEAR EXPERIENCE WITH ESOPHAGEAL RESECTION FOR MALIGNANT DISEASE OF THE ESOPHAGUS IN THE REGINA HEALTH DISTRICT. L.R.S. Dewar. Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Regina-Qu'Appelle Health Region, University of Saskatchewan, Regina, Sask.
The outcome of all surgical resections of the esophagus or gastroesophageal junction (GEJ) for malignant disease undertaken in all 3 hospitals of Regina from Jan. 1, 1989-Dec. 31, 2001 was retrospectively reviewed. A total of 129 patients were taken to the operating room; 119 underwent esophageal resection. Ten procedures were abandoned due to unresectable disease.
There were 16 postoperative deaths (13.4%). Perioperative morbidity was high, with 26 patients experiencing anastomotic leaks (21.8%); anastomotic strictures occurred in 32 patients (26.9%). Respiratory complications were frequent with 22 patients (18.5%) developing respiratory failure postoperatively requiring reintubation and ventilation (for a mean of 202.8 h). Atelectasis occurred in 102 patients (85.7%), pulmonary edema in 30 patients (25.2%), pneumonia in 21 patients (17.6%) and aspiration documented in 9 patients (7.6%).
Resource utilization was extensive with a mean hospital length of stay of 23.9 days (range 0-196 d). The mean ICU stay was 5.4 days (range 0.2-32 d).
Procedures were carried out by 14 members of the Divisions of General Surgery or Cardiovascular and Thoracic Surgery in the 3 Regina hospitals. Individual surgeon experience ranged from 1-46 cases over the 12-year interval. Perioperative mortality rates by individual surgeon ranged from 0%-50%.
The Regina-Qu'Appelle Health Region's Department of Surgery lacks a defined management pathways for malignant diseases of the esophagus or GEJ. Individual surgeon volumes are generally low and may contribute to high perioperative mortality and morbidity rates observed in the Regina Hospitals. Development of a specialized unit to maximize clinical experience of health care providers would appear to be a reasonable approach to improve patient outcome.
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CONTEMPORARY MANAGEMENT OF RUPTURE OF THE DESCENDING THORACIC AORTA. R. Karmy-Jones. Division of Cardiotheoracic Surgery, Harborview Medical Center, Seattle, Wash.
Objectives: To evaluate to the current role(s) of CT angiogram (CTA), nonoperative and endovascular approaches in managing traumatic thoracic aortic rupture (TAR). Methods: A retrospective review of patients admitted between 02/1998-3/2003 with injuries in the descending thoracic aorta. Patients were categorized as unstable if systolic pressure < 90 within 1 hour of admission. Repair was emergent if performed < 24 hours after admission, delayed if > 24 hours. Results: 46 (38 male, age 37.8 [Symbol Not Transcribed] [plus or minus] 18.4 yr, Injury Severity Score 43.5 [Symbol Not Transcribed] [plus or minus] 15.6) patients were admitted with overall mortality 12 (26%) due to: free rupture prior to control (3), closed head injury (2), cardiac causes (4), pulmonary embolism (1), late bleed (1), ARDS (1). Mortality by category was as follows: emergent (including 3 with free rupture) 10/32 (31%) versus delayed 2/8 (25%) versus nonoperative 0/6; stable 5/36 (14%) versus unstable 7/10 (70%); operative repair 9/30 (30%) versus endovascular stent graft 3/10 (30%). Multi-regression analysis identified that stable patients were 5.7 times more likely to survive than unstable (CI 2.0-15.6). The diagnosis was made by angiogram in 29 (63%) cases, including 6 at the time of embolization and by CTA in 17 (37%). Time to operating room in the urgent group was 2.9 [Symbol Not Transcribed] [plus or minus] 1.4 hours after CTA versus 4.4 [Symbol Not Transcribed] [plus or minus] 1.5 hours after angiogram (p = 0.02). The most common indication for not performing emergent intervention was acute lung injury (7), and no patient in the delayed and nonoperative groups (11/13 treated with beta blockade) suffered free rupture. Conclusions: Selective use of endovascular stent grafts and nonoperative therapy is appropriate. Mortality is primarily linked to patient stability. Angiograms should be used to make the diagnosis if embolization is required, but CTA [may] be quicker in other cases.
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VATS SYMPATHECTOMY AND SYMPATHICOTOMY IN PATIENTS WITH PRIMARY PALMAR HYPERHIDROSIS. S. Keshk. Department of Cardiothoracid Surgery, Alexandria University, Alexandria, Egypt
VATS sympathectomy is the most frequently used technique for surgical hyperhidrosis of the upper limbs. It has proven to be particularly effective. Objective: To evaluate the role of VATS in management of palmar hyperhidrosis. Patients and methods: 40 cases undergoing VATS for palmar hyperhidrosis, in 2 groups. Group I 20 patients (sympathectomy), group II 20 patients (sympathicotomy). Results: Mean operation time 23.47 [Symbol Not Transcribed] [plus or minus] 2.85 minutes in resection, and 18.87 [Symbol Not Transcribed] [plus or minus] 2.07 minutes in division. The mean duration of the operation was significantly longer in group I when compared with group II. Main outcome measures included incidence of dry hands, compensatory hyperhidrosis and recurrence. After both procedures 100% reported significant improvement of palmar hyperhidrosis. Post-surgery compensatory hyperhidrosis was experienced in 3.3% of cases, and 6.66% showed partial recurrence. VATS is a very useful, speedy and safer way than conventional thoracotomy in managing cases of palmar hyperhidrosis, with excellent cosmetic results while minimizing complications.
вторник, 13 марта 2012 г.
Padraig Harrington finds humor in disqualification
ABU DHABI, United Arab Emirates (AP) — Padraig Harrington has made light of his disqualification from the Abu Dhabi Golf Championship by showing a group of children at a golf clinic how to correctly mark your ball.
The Irishman, a three-time major winner, was disqualified Friday for signing an incorrect scorecard. He had failed to replace his ball after it had moved a fraction of an inch when he picked up his marker at the seventh green in Thursday's opening round.
Having reviewed video replays of the incident, Harrington accepted his disqualification after acknowledging his ball had moved slightly as he was picking up his coin.
He joked Saturday in a statement that the kids "seemed to think marking your ball is all very easy, but obviously it isn't."
Small Ultrasound Machines Help Patients
WAUWATOSA, Wis. - When doctors in a remote African town warned a 20-something pregnant woman she was well past her due date, the Liberian patient agreed to have labor induced.
But Dr. Simon Kotlyar wanted to confirm the diagnosis first. So the visiting doctor performed an ultrasound test using a new system - a machine miniaturized to the size of a laptop computer - and discovered the woman was only 32 weeks pregnant, not 40 weeks as anecdotal evidence had led doctors to believe.
"Having that system made a pretty big difference," said Kotlyar, chief resident in the department of emergency medicine at Yale-New Haven Hospital in Connecticut. "I told her to go home and come back in a few weeks."
As ultrasound machines become more compact and their image quality more precise, doctors have begun carrying the body-imaging technology to rural U.S. hospitals and developing countries. No longer is ultrasound available only to hospitals with reliable power supplies and room for bulky equipment.
The fledgling industry of portable ultrasound units has grown rapidly the past two years and it's expected to become an even bigger part of the ultrasound market. It is dominated by SonoSite Inc. of Bothell, Wash., and GE Healthcare, based in the Milwaukee suburb of Wauwatosa. Each commands about 40 percent of the worldwide market, according to industry expert Harvey Klein.
SonoSite pioneered the technology of hand-carried units in 1999. Industry leader GE Healthcare entered that market later - in 2002. Officials there said they had already planned their own line of portable units and SonoSite's entrance didn't alter their long-term strategy.
Cruder versions of portable ultrasound equipment have been around for almost 30 years but SonoSite was the first to produce images of usable quality, said Klein, president of Klein Biomedical Consultants in New York City.
The portable battery-operated machines aren't expected to replace standard console-sized units, just as laptop computers haven't rendered desktop models obsolete. But Klein said the compact machines are proving popular among doctors outside the traditional areas of radiology, cardiology and prenatal care.
"There are maybe 20 specialty areas - emergency medicine, anesthesiology - that represent new markets," he said. "There's plenty of interest here."
Ultrasound produces real-time imaging of a beating heart or developing fetus by interpreting sound waves bounced off solid internal objects.
Other common techniques for exploring inside the body without surgery include MRI - magnetic resonance imaging - systems that yield vivid results but whose scans require the patient to lie still for minutes. X-rays are still popular for producing images of bones, but the technology exposes a patient to potentially harmful radiation.
Ultrasound has its own drawbacks. Its effectiveness depends on operators knowing precisely how to position patients and where to place the imaging probes to reveal the best views.
To doctors, image quality is key. The newer compact units can now produce images comparable to those of the higher-end console units about 90 percent of the time, said Dr. Craig Sable of the Children's National Medical Center in Washington, D.C.
In 2003, Sable brought a portable unit to Uganda, where he used it to diagnose a life-threatening heart ailment in a 2-year-old girl. She later had successful surgery in the U.S.
"There are dozens of other patients just like that," the pediatric cardiologist said. "This technology still has a ways to go but it has tremendous potential."
GE Healthcare said the market for portable ultrasound is small but its business is growing rapidly, with sales of $174 million in 2006, a 74 percent increase over 2005.
That figure was about one-tenth of the company's $1.6 billion in sales of all ultrasound equipment, including the traditional machines so large that they are wheeled around on carts.
SonoSite makes only hand-carried units. Its systems have been used by the U.S. military in Afghanistan and Iraq as well as in Louisiana after Hurricane Katrina, company spokeswoman Ann Bugge said.
"Traditional ultrasound machines weigh hundreds of pounds. They're mounted on wheels but they're about as easy to move as your refrigerator," Bugge said. "Our systems all weigh between 3 and 7 pounds."
SonoSite had revenues of $171.1 million in 2006, a 16 percent increase over 2005 revenue. The cost of its hand-carried models has remained steady, from about $15,000 to around $50,000 depending on features.
GE Healthcare expects demand to remain strong both for full-sized units - which range from $30,000 to more than $200,000 - and the portable units - which cost $25,000 to $90,000.
"We see customers buying both," said Omar Ishrak, chief executive of the GE division's clinical-systems business unit. "In traditional markets where mobility isn't as important, they'll want the consoles with the higher-end technology."
Ultrasound makers hope that miniaturized equipment will make the technology more popular among doctors domestically and abroad.
Klein estimated the worldwide market for ultrasound machines at $4 billion last year, with about 10 percent coming from sales of portable units. The market will exceed $5 billion in 2011 of which more than 20 percent will come from portable-unit revenue, he predicted.
Kotlyar, the doctor who volunteered in Africa, said his Liberian patients were excited and grateful to have access to ultrasound images, especially since their country's health care system was ravaged in a civil war that ended in 2003.
"The women loved the notion of seeing the baby in their belly," he said. "I think it was incredibly uplifting for people who had not had a lot of positives in their health sector in a long time."
---
On the Net:
SonoSite: http://www.sonosite.com
GE Healthcare: http://www.gehealthcare.com
FTSE 100 falls 4.62 percent
Britain's benchmark stock index, the FTSE 100, was down 4.62 percent in the first 15 minutes of trading Monday, following a slide in Asian markets.
The FTSE fell 230.2 to 4,750.05. The worst declines were in the banking industry _ HBOS PLC's share price dropped 12.7 percent to 175 pence (US$3.08), while the Royal Bank of Scotland Group PLC fell 10.8 percent to 166 pence (US$2.92).
Census battle hinges on methods
Last month, Vice President Al Gore told thousands of members ofthe National Association for the Advancement of Colored People thatthe debate over the 2000 census was about race, not methodology. Itwas a simple and irresponsible statement, meant to raise old enmitiesand stereotypes rather than contribute to thoughtful discussion. Hadhe chosen the high road, Gore would have been forced to addresssomething totally new: the administration's plan for Census 2000.
Less than two years from now, the Clinton administrationproposes - for the first time ever - to blend estimates and actualcounts into a single population number for the decennial census.That mixed bag of counted and estimated people will determine theallocation of more than $182 billion in federal funds to the states.If the Census Bureau chooses to disregard current law and implementsits plan to produce this one-number census, the ability of states andlocalities to legally challenge the results will be severelycompromised.
As an example, in 1990 an entire ward was missed in one town inU.S. Rep. Tom Petri's district in Wisconsin. Community leadersfound and corrected this mistake during the post-census review. For2000, the bureau does not plan a review.
That concerns me, both as a former mayor of Cincinnati and asco-chairman of the Census Monitoring Board, a bipartisan federaloversight board reviewing Census 2000. In this extremely fast-movingprocess, I am concerned that decisions are being made, and actionstaken, without substantial input from some of the most importantplayers in the census process - specifically, state and localleaders, and Gore should be especially concerned with two things: The lack of plans for a post-census review. The master address file, the address list used to mail census formsacross the country, probably will be inaccurate in many poor andrural areas, as well as in high-growth areas, regardless of racialmakeup.
Last week, the board heard from local officials in Columbia,S.C., who reported several examples in the recent census dressrehearsal where the bureau was unresponsive.
Columbia's community development director said, "One of thethings that we ran into with the census . . . is that it's easy tosay one thing, but do another. For example, this idea of, `We'regoing to use multiple resources,' but, in fact, they used singularresources in the dress rehearsal."
South Carolina had a number of resources available - more thanmost states. For one, the state has one of the leading addressdatabase programs in the country. Jack Maguire, a state databaseexpert, testified that South Carolina officials found more than26,600 addresses missing from the Census Bureau's master addressfile.
If the bureau and Gore follow through with their plan to throwout the post-census review, states and localities would lose thatavenue to appeal. With limited local input on the front end, and noreview on the back end, state and local governments would beeffectively shut out of the process.
That must not happen. In the words of Maguire, "If it comes toaccurate data and precise data and data that make a difference, thefeds are the furthest away. And states are a little closer, but thelocal government is where it happens."
The U.S. House of Representatives recently passed anappropriations bill that provides for a review of this and othermajor changes planned for the 2000 census. The bill would buy timefor a review without shutting down all other federal agencies fundedby the same bill. President Clinton has threatened a veto.
He shouldn't.
We need to slow down the census process and take a look at itwithout shutting down government.
As a former mayor and undersecretary of HUD, I know and believein the power of local government. I also believe the U.S. House ofRepresentatives did state and local government a service, byproviding for our review of major changes planned for the 2000 census- changes that could have major repercussions in neighborhoods ofevery color. On the other hand, I believe Gore did us all adisservice by playing the race card.
J. Kenneth Blackwell is treasurer of the state of Ohio andco-chairman of the U.S. Census Monitoring Board, CongressionalMembers. He is a candidate for the office of secretary of state ofOhio. Distributed by Scripps Howard News Service
'Aida' was dream role for Roxbury girl
When Cynthia Miles Gray was 15, she found her heart's desire.
As a member of America's Youth in Concert, her participation underwritten by Roxbury's Freedom House, the young woman was touring six European countries.
"When we came to Italy," she describes, "we attended a performance of 'Aida.' The opera was completely staged with animals and fabulous costumes.
"It was my first introduction to opera. I was bowled over," she recalls.
From that day, Gray has longed to sing that opera, "hoping, wishing," she says. "It's been a deep down desire."
This Friday at Jordan Hall, you can hear Gray in the title role in Verdi's most popular opera. As Aida, the enslaved Ethiopian princess held captive by the conquering Egyptians, she finds love in the wrong place and at the wrong time. Tenor Marshall Hughes, who also directs the Opera UnMet production, sings the role of the commander of the Egyptian forces Radames. He falls madly in love with Aida much to the ire of his betrothed, the Egyptian princess Amneris, sung by Mauri Wheeler. The Feb. 4 concert at 8 p.m., which will be sung in Italian but narrated in English, also features Eric Sosman as the high priest and Andrea Bradford as the narrator.
The soprano Aida is a role with a strong black lineage in opera. First sung by white sopranos, Florence Cole Talbert was the first to break the color bar with her performance in 1927 in Italy. La Julia Rhea is another famed early black Aida.
It was Leontyne Price, however, who made the role hers', in the minds of opera lovers. "In 'Aida' my skin is my costume'" says Price about her favorite character. And because she had already sung other roles, Price didn't feel typecast but honored to take the part which she played with modern day implications. "She is where I am often as a woman," Price has said. "There's something about her that's provocative."
Leontyne Price wrote the opera up as a children's book which was illustrated by Leo and Diane Dillon. The beautifully depicted version was the inspiration for Tim Rice and Elton John's pop version of "Aida," which has been one of Broadway's top draws.
"We don't have the animals or the costumes," notes Gray about the Opera UnMet concert version of Verdi's "Aida," but we do have the music.
Gray, who grew up in Sharon, is the daughter of the late Edna and Benjamin Miles. Her parents supported her dreams. "When I sing the aria 'O Patria Mio,' (Oh, Fatherland Mine)," says Gray about that moment in the opera, "It's all I can do to say that. I think of my mother and father and the efforts they put forth on my behalf and how they were so very proud of me."
David Jackson
Musical stage singer David Jackson does his first straight role in "The Moonlight Room," a SpeakEasy Stage Company production currently at the Boston Center for the Arts. It's a new experience "not to have my attention split between the musical numbers and the play. I find I'm a little more focused," he says.
For the New England premiere of Tristine Skyler's drama that takes place in a waiting room of a hospital, Jackson plays the father of a teen who is in a coma from a drug overdose.
The part drains the emotions but Jackson comments that "it's rewarding to do a play.
"My voice is still good but it's a relief not to worry if I'm going to hit that F tonight," he said.
Article copyright The Bay State Banner.
Photograph (Cynthia Gray, Eric Sosman, Mauri Wheeler and Marshall Hughes)
Rethinking the IQ Test
2004 J. D. Power Initial Quality Survey consumers understand brands, not sales-weighting.
J.D. Power conducts a technically sound, quality/satisfaction research program that apparently generates interpretations that are often misunderstood by consumers and some of the general media. One misunderstanding was brought to mind at an automotiverelated luncheon when a long-time acquaintance, a detail-minded individual, asked how it was possible that Power rated the Japanese brands as having the best overall quality in the U.S. market when more of the Japanese brands were below Power's own average than were above?
Being unfairly tagged by my friend as a "numbers guy," he wanted an explanation. Not having a Power report in my back pocket, nor having seen the actual report, my comments, based on 60 years of mucking around in the numbers business, was that sales-weighting was probably involved and that if a fleet bought 100,000 vehicles in the exact proportion that they had been sold by the 37 brands listed by Power, the Japanese brands would win.
But, if 37 individuals bought one of each brand, the domestics would be best. These explanations were, despite my best and more detailed efforts, met by indifference, glazed eyes and near hostility by my table mates.
My friend, echoed by others, insisted that vehicles were bought by brand, not by sales weight. The question was raised, "what would the numbers look like based on the individual vehicle, not the sales weight?" The answer to that question is shown within the accompanying table. One version is statistics, one is real world as seen by the consumer.
However, it was apparent that with the exception of one person who actually looked at and had some interest in the Power data, the others remembered a headline or a few words from some article dealing with the Power report. The belief, nurtured over many years, that Japanese vehicles were all clear winners, while the actuality is, as a later checking of the Power listings verified, is that six Japanese brands were below and only five above Power's own sales-weighted averages.
That particular oddity of more Japanese brands below average than above apparently escaped most media people, as there is no mention of it in the articles that passed across my desk. However, top-10 comparisons and discussions are common, often noting that only three domestics (Cadillac, Buick and Mercury) appear in the top ten, but bottom-10 comparisons are rare or perhaps nonexistent. Therefore, a table showing that four Japanese brands (Suzuki, Nissan, Mazda and Scion) inhabit the bottom-10 is included for those who do not read articles and only glance at the tables.
The Power organization cheerfully provided a multi-page, multi-graph press package that was chock full of overviews and top-three segments lists, but was totally devoid of specific model data, and when asked, just as cheerfully advised that detailed model findings are for subscribing (very rich) clients. They will, however, provide a few bits and pieces, but not a complete listing of all models of all brands.
The model detail would be helpful when deciphering the importance of being HIGHEST RANKED within the 17 segments listed in the Power press release. The unanswered questions is, "what is the sampling error and is there any real difference between the highlighted highest and the small-print second, or third-place, for that matter?"
If one is inquisitive enough, digging around in the data and tying together bits and pieces from the press release can provide some clues. An example is that the plant that builds the two Lincoln car lines has a rating 27 points above average, yet the average total Lincoln brand is three points below average.
The conclusion would be that the Lincoln cars are really excellent and the SUVs are somewhere below average. Also, the plant that builds the Porsche cars is 47 points above average but the brand is 40 points below, forcing the conclusion that the Porsche Cayenne is far worse than the Hummer, the media poster-boy for ineptitude. The helpful Power public affairs people confirmed those concepts, but the consumer, and many in the media, would be clueless.
Power's total brand numbers are no doubt solid, but they are clouded by a considerable amount of consumer misunderstanding, a lack of real detail and shallow media reporting. Think of the fun a numbers guy could have if every bit of data by model and type of complaint were available. Hey, then this article could have been less shallow.
Roots radicals: punks celebrate album release with GPT show
Devon roots-punks, Crazy Arm, visits Bath's Green Park Tavern onSunday in support of their new album Union City Breath the follow upto 2009's dramatic debut, Born To Ruin.
The Guide spoke to Darren Johns, singer and guitarist of CrazyArm, to find out more: The Guide: Can you tell us how you got intomusic and what you hoped to achieve when you first started out onyour musical journey? Darren: I started listening to my dad's BuddyHolly, Elvis Presley and Eddie Cochran albums when I was eight.
I got completely hooked. Although '50s rock 'n' roll was a sexualsound, I think that I still understood the primitive urges!
I got my first acoustic guitar when I was 10, thanks again dad,heard the Sex Pistols, The Clash and Stiff Little Fingers when I was11 and the rest is history.
Can you tell us how Crazy Arm all came together? We were all goodfriends who were in other bands.
I was in The Once Over Twice, Jon (Dailey - guitar) and Simon(Marsh - drums) were in NoComply.
This was mid-2005.
We wanted to do something outside of the constraints of our'first' bands so started jamming.
Within a year both of our main bands had split up so Crazy Armbecame our priority.
Tim (Rowing-Parker - bass) joined us last August. He's anothergood friend from our home town.
Which vocalists and musicians do you admire and have theyinfluenced your style and approach to music? The Clash, Crass andthe Dead Kennedys pretty much tick all the right boxes for me: formusic, lyrics, vocals, politics, passion and attitude.
It might not be evident in our music but they've been a guidinglight for me since I was a kid.
A lot of American folk and protest music has also helped shapethe band - Crosby Stills & Nash, Woody Guthrie, Phil Ochs, PeggySeeger - although, once again, it might not seem that obvious.
These days, it's all about Nick Cave, Baroness, Austin Lucas,Black Tusk and Bruce Springsteen. You have to keep the blinkers off.
Can you tell us a little about your second album Union CityBreath. Does it differ from the debut Born To Ruin and was there apressure to follow its success? We're pretty proud of the new recordbut we never really saw the full picture until it was finished.
There was no gameplan.
There are things I'd do differently if we recorded it again butthat's always the case with most bands if you get too attached toyour music.
We recorded with Peter Miles again, in a converted Devonbarnhouse, which certainly imbued our country leanings with anauthentic glow! The songs in general talk about all kinds of thingsthat most neurotic middle-aged men like me think about. The onlydifference is, I still hold onto a semblance of anarchistphilosophy.
So it's an angry record but a self-analytical one too.
There was no external pressure as such - we just wanted to makesure that we, as a band, felt that it was a progression.
It's too soon for me to call yet, but it's definitely analtogether different beast to Born To Ruin.
I'd say the new record is more unrestrained, for sure. And moreovertly political, perhaps.
Again, not by design - it's just what came out.
How would you describe a Crazy Arm live show and are you lookingforward to playing Bath GPT? Puddles of sweat, dangerous volumes andendless movement.
That's pretty much the live ethos.
Things can get pretty intense on a good day.
Although I got ill two days into this tour and my voice is nowshot through.
Hopefully it won't disappear completely.
We haven't played Bath for a while so we're definitely lookingforward to it.
What's been the band's biggest highlight so far? Well, it'sprobably one of these: playing Reading and Leeds festivals lastyear, touring with Frank Turner and Chuck Ragan, touring withBangers, touring with Apologies I Have None, playing around Europe,putting out albums one and two, being picked up by Xtra Mile [UKlabel] and Gunner Records [Europe label], anticipating the tour withAgainst Me! next month, recording for Mike Davies Punk Show... Toomany good times!
What does the rest of 2011 have in store for Crazy Arm? As Isaid, we have the Against Me!
tour in November, taking in Europe and the UK, hopefully we'llrelease a new single in December and a mini-tour at the end of theyear with Great Cynics and Smokey Bastard.
We're planning on recording an acoustic EP after our recent, well-received acoustic tour, so fingers crossed we'll get in the studiosoon to do that.
We can't wait to play with Against Me! they're an awesome band.
We were supposed to tour with them this time last year but theyran into difficulties and cancelled the whole thing. We were gutted.
This couldn't have come at a better time. Crazy Arm releaseUnion City Breath on Monday.
Visit www.facebook.com/thecrazy arm for further information.
Denmark's 2012 draft budget sees $17.5B deficit
COPENHAGEN, Denmark (AP) — Denmark's new left-leaning government said Thursday it is planning an 11 billion kroner ($2 billion) economic stimulus package that will bring the country's total deficit for next year to 95 billion kroner ($17.5 billion).
The minority, three-party coalition says in its draft budget that it aims to speed up planned public works projects, which would create 9,000 more jobs in 2012, and raise taxes on cigarettes, soft drinks and sweets.
It also aims to spend 1 billion kroner ($185 million) more on education.
"We stand in a tough economic situation, but the Danish economy is not on the edge of a precipice," Social Democratic Finance Minister Bjarne Corydon said.
Prime Minister Helle Thorning-Schmidt — the country's first female leader — has warned that sacrifices would have to be made if the government's aims were to succeed in boosting growth.
There is a broad agreement to maintain the Scandinavian country's strong welfare system financed by high taxes, but parties also acknowledge that cuts must be made in the face of the uncertain global economy.
The new government has revoked a controversial plan to reinstate customs checks at Denmark's borders with Germany and Sweden, saying it wants more customs officers, but scattered across the country rather than at fixed border posts.
The unlikely government alliance, which includes former communists and pro-market liberals, took office after a center-right government lost the Sept. 15 elections. It relies on support from the Red-Green Alliance, a leftist party outside the coalition made up of Social Democrats, the center Social Liberals and the Socialist People's Party.
The 2012 budget proposals are subject to approval by lawmakers. A vote is expected in Parliament before the year-end.
понедельник, 12 марта 2012 г.
What earnings reports have revealed about ads
Here are highlights of recent quarterly earnings reports from selected Internet and media companies and what they say about the state of spending on advertising:
Jan. 19: Google Inc.'s fourth-quarter earnings report shows that the Internet search leader fetched less money per click on its ubiquitous online ads. That came as an unsettling surprise because investors had assumed a surge in online holiday shopping in the U.S. would enable Google Inc. to charge more for its ads. Instead, the average price decreased by 8 percent from the same time in 2010.
Microsoft Corp. reduces losses in its online services division, which includes the ad-supported Bing search engine. It lost $458 million in the latest quarter, down 18 percent from a loss of $559 million a year earlier. Revenue grew 10 percent to $784 million.
Tuesday: Yahoo Inc. says that after subtracting advertising commissions, revenue totaled $1.17 billion. That was $20 million below analyst projections. It's the 13th straight quarter that Yahoo's net revenue has declined from the prior year. Yahoo predicted its net revenue in the first quarter will range from $1.02 billion to $1.1 billion. The mid-point of that target works out to $1.06 billion, unchanged from last year's first quarter.
Meredith Corp., which owns women's magazines such as Better Homes and Gardens and local television stations, says quarterly net income and revenue fell in late 2011 because of weaker political advertising.
Thursday: Time Warner Cable Inc. says advertising revenue fell 10 percent to $242 million in the latest quarter, primarily because of decreases in political advertising.
Coming up:
Monday: Gannett Co.
Wednesday: IAC/InterActiveCorp, AOL Inc.
Thursday: Viacom Inc., The New York Times Co.
Feb. 7: Walt Disney Co., McClatchy Co.
Feb. 8: Time Warner Inc., News Corp.
Feb. 15: Comcast Corp., CBS Corp.
Feb. 24: The Washington Post Co., Interpublic Group of Cos.
March 1: WPP Group PLC
Unknown: Omnicom Group Inc.
Premium black watermelon auctioned in Japan at record 650,000 yen
A black jumbo watermelon auctioned in northern Japan fetched a record 650,000 yen (US$6,100) Friday, making it the most expensive watermelon ever sold in the country _ and possibly the world.
The 17-pound (8-kilogram) premium Densuke watermelon, one of only 65 from the first harvest of the season, was purchased by a marine products dealer who said he wanted to support local agriculture, according to Kyodo News agency. The fruit is grown only on the northern island of Hokkaido.
In a country where melons are a luxury item commonly given as gifts, the watermelon's hefty price tag follows another jaw-dropping auction last month, where a pair of Yubari cantaloupe melons sold for a record 2.5 million yen (US$23,500).
But for watermelon, Friday's winning bid drew a gasp even from veterans of the expensive-fruit market.
"This is the highest price on record for a Densuke watermelon, and that probably means it's the highest of any watermelon in Japanese history," said Kazuyoshi Ohira, a spokesman for the Tohma Agricultural Cooperative in Hokkaido.
Growers expect to produce about 9,000 Densuke watermelons this year, Ohira said.
For seasonal, high-end fruits like the Densuke watermelon and the Yubari cantaloupes, Japanese buyers are often willing to pay top prices at auction for the prestige of owning the very first ones of the year.
Unseasonably warm weather in April and May have helped boost sugar content and overall quality, and consequently prices, of the 2008 watermelons, Ohira said.
The biggest watermelon of the day departed for Tokyo immediately after the auction in Asahikawa city. By midafternoon Friday, the 24-pounder (11 kilograms) had traveled some 500 miles (804 kilometers) south to Isetan, an upscale department store in the capital, where it went on sale for 630,000 yen (US$5,945).
Other Densuke watermelons won't cost quite as much. Most will retail at department stores and supermarkets for a more modest 20,000 yen to 30,000 yen (US$188 to US$283), Ohira said.
And what makes a watermelon worth US$200, much less US$6,000?
Its unusual black skin, Ohira said. Inside, the watermelon is crisp and hard. And, he says, it has unparalleled taste.
"It's a watermelon, but it's not the same," he said. "It has a different level of sweetness."
Jun Otsuki, a spokesman for Guinness World Records' Tokyo office, said his organization does not keep records of any sort on watermelons.
Report: S. Williams says she has been 'depressed'
LOS ANGELES (AP) — Serena Williams is "at the end of (her) rope" after several physical setbacks that have kept her off the court since July.
"It's just been a tough year," the 29-year-old said at her Bel Air home in an interview published in Wednesday's edition of USA Today.
Shortly after her fourth Wimbledon title, Williams cut her foot on some broken glass at a restaurant — resulting in a pair of surgeries.
"I definitely have not been happy," she told the newspaper. "Especially when I had that second surgery (on my foot), I was definitely depressed. I cried all the time. I was miserable to be around."
Then last month, she suffered a pulmonary embolism and was hospitalized to remove a grapefruit-sized hemotoma from her stomach.
During her time away, Williams has fallen to No. 11 in the rankings.
"What's going to make me happy is going on the court and holding up trophies, singles and doubles," she said.
She has not set a timetable for her return to tennis but said it could come as early as this summer.
"I don't know what's realistic," Williams said. "I really don't know. I haven't put a date on it yet."
Rock ``gods'' far from almighty
Their attitude can be summed up by paraphrasing Chuck D. onElvis: Clapton was a god to many but he doesn't mean crap to me. Andit's hard to say that they're wrong.
As a third-generation rock critic who was 4 years old when Creamdisbanded, I've been grappling with Clapton's legacy for years, aswell as the broader issue of aging in rock 'n' roll. How does anartist grow old gracefully in an art form that's about never doinganything gracefully?Nostalgia is the biggest dilemma in rock today. Artists such asClapton, Paul McCartney, the Rolling Stones, the Eagles, FleetwoodMac, Page and Plant and others of their ``classic-rock'' ilk are fartoo happy to peddle discreetly sanitized, warm and fuzzy versions ofmusic that was once anything but. And fans are all too happy to buyit - as evidenced by the speed with which Clapton and the Stones soldout the United Center.This is not an issue of ageism. ``Never trust anyone over 30''is second only to ``Tune in, turn on, drop out'' as the stupidestcultural slogan of all time. There's nothing that says a rockercan't continue to be a vital and galvanizing force in his 40s and50s, and a small handful of them are, including Iggy Pop, Neil Young,Marianne Faithfull, Brian Eno and Bob Dylan.Others seem content to rest on their laurels and trade on pastglories. Which would be fine - no one is advocating euthanasia here- providing that the rock press, radio programmers, concert promotersand fans weren't pretending that these geezers' new music is anythingother than a rose-colored trip down memory lane.When the young and impressionable members of the Stones and theBeatles first saw '50s rock heroes such as Carl Perkins, Chuck Berryand Little Richard on package tours in the early '60s, those pioneerswere already considered oldies acts. They had stopped breaking newground, and everyone knew that rock had moved on to the next phase.The approach taken toward these Hall of Famers was similar tothat toward retired sports stars: We all know that nobody can playball forever, so we honor our heroes for their past accomplishments,and the playing field is cleared for new competitors.The idea that being a rock star is a lifelong honor like thedivine right of monarchs was introduced by the musicians who emergedin the '60s, prevailed through the '70s, limped into the '80s and arenow gasping and wheezing their way through the '90s.Even the most devout fans - the ones who are paying $300 for anight with the Stones and $75 for what the tickets bill as ``LexusPresents Eric Clapton'' - will readily admit that ``Bridges toBabylon'' is nowhere near as good as ``Some Girls,'' ``StickyFingers'' or ``Exile on Main Street,'' and that Clapton's latest,``Pilgrim,'' pales in comparison to ``Layla and Other Assorted LoveSongs'' or ``461 Ocean Boulevard.''Yes, artists grow and evolve, and fans have to acknowledge that.Some people contend that it's unfair to judge them by the music theymade in the past. But what better measure is there? It would beunfair to judge McCartney's ``Flaming Pie'' against Nirvana's``Nevermind,'' but why not compare ``Flaming Pie'' to ``Revolver,''holding him up to the standards that he himself set?The reason that nostalgia has no place in criticism is that itdistorts history and obfuscates those things that really are worthcelebrating and remembering.
Southern Miss holds off Tulane 66-57
Maurice Bolden and Gary Flowers had double-doubles as Southern Mississippi held off Tulane 66-57 on Tuesday night.
Bolden had 16 points and 12 rebounds and Flowers had 16 points and 11 boards for the Golden Eagles (17-12, 7-8 Conference USA).
Flowers grabbed his final offensive rebound and put it back to give Southern Miss an 11-point lead with 3 minutes remaining, but the Green Wave responded with a 19-12 run to cut the lead to five with 30 seconds left.
Southern Miss made all four of its free throw attempts on its last two possessions to put the game away.
The Golden Eagles completed the season sweep of Tulane (7-21, 2-13), winning 58-40 on Jan. 30.
Southern Miss shot only 35.3 percent (18-for-51) from the field, but made 28 of 36 foul shots (77.8 percent). The Golden Eagles also won the rebounding battle 44-25.
Jordan Callahan led Tulane with 16 points.
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