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About This Booklet
This National Cancer Institute (NCI) booklet (NIH Publication No. 06-1561) is about ovarian epithelial cancer. It is the most common type of ovarian cancer. It begins in the tissue that covers the ovaries.
You will read about possible causes, symptoms, diagnosis, and treatment. You will also find lists of questions to ask your doctor. It may help to take this booklet with you to your next appointment.
This booklet is not about ovarian germ cell tumors or other types of ovarian cancer. To find out about these types of ovarian cancer, please visit our Web site at http://www.cancer.gov/cancertopics/types/ovarian. Or, contact our Cancer Information Service. We can answer your questions about cancer. We can send you NCI booklets, fact sheets, and other materials. You can call 1-800-4-CANCER or instant message us at LiveHelp.
The Ovaries
The ovaries are part of a woman's reproductive system. They are in the pelvis. Each ovary is about the size of an almond.
The ovaries make the female hormones — estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus).
When a woman goes through her "change of life" (menopause), her ovaries stop releasing eggs and make far lower levels of hormones.
Understanding Cancer
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
- Benign tumors are not cancer:
- Benign tumors are rarely life-threatening.
- Generally, benign tumors can be removed. They usually do not grow back.
- Benign tumors do not invade the tissues around them.
- Cells from benign tumors do not spread to other parts of the body.
- Malignant tumors are cancer:
- Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
- Malignant tumors often can be removed. But sometimes they grow back.
- Malignant tumors can invade and damage nearby tissues and organs.
- Cells from malignant tumors can spread to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the lymphatic system or bloodstream. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.
Benign and Malignant Cysts
An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer).
Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer.
Ovarian Cancer
Ovarian cancer can invade, shed, or spread to other organs:
- Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus.
- Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants.
- Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.
Risk Factors
Doctors cannot always explain why one woman develops ovarian cancer and another does not. However, we do know that women with certain risk factors may be more likely than others to develop ovarian cancer. A risk factor is something that may increase the chance of developing a disease.
Studies have found the following risk factors for ovarian cancer:
- Family history of cancer: Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer.
If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history. If you have a strong family history of ovarian or breast cancer, you may wish to talk to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer.
- Personal history of cancer: Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.
- Age over 55: Most women are over age 55 when diagnosed with ovarian cancer.
- Never pregnant: Older women who have never been pregnant have an increased risk of ovarian cancer.
- Menopausal hormone therapy: Some studies have suggested that women who take estrogen by itself (estrogen without progesterone) for 10 or more years may have an increased risk of ovarian cancer.
Having a risk factor does not mean that a woman will get ovarian cancer. Most women who have risk factors do not get ovarian cancer. On the other hand, women who do get the disease often have no known risk factors, except for growing older. Women who think they may be at risk of ovarian cancer should talk with their doctor.
Early ovarian cancer may not cause obvious symptoms. But, as the cancer grows, symptoms may include:
- Pressure or pain in the abdomen, pelvis, back, or legs
- A swollen or bloated abdomen
- Nausea, indigestion, gas, constipation, or diarrhea
- Feeling very tired all the time
- Shortness of breath
- Feeling the need to urinate often
- Unusual vaginal bleeding (heavy periods, or bleeding after menopause)
Most often these symptoms are not due to cancer, but only a doctor can tell for sure. Any woman with these symptoms should tell her doctor.
If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history.
You may have one or more of the following tests. Your doctor can explain more about each test:
- Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
- Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.
- Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman's response to ovarian cancer treatment and for detecting its return after treatment.
- Ultrasound: The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
- Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen. Surgery is usually needed to diagnose ovarian cancer. To learn more about surgery, see the "Treatment" section.
Although most women have a laparotomy for diagnosis, some women have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.
A pathologist uses a microscope to look for cancer cells in the tissue or fluid. If ovarian cancer cells are found, the pathologist describes the grade of the cells. Grades 1, 2, and 3 describe how abnormal the cancer cells look. Grade 1 cancer cells are not as likely as to grow and spread as Grade 3 cells.
To plan the best treatment, your doctor needs to know the grade of the tumor (see Diagnosis) and the extent (stage) of the disease. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body.
Usually, surgery is needed before staging can be complete. The surgeon takes many samples of tissue from the pelvis and abdomen to look for cancer.
Your doctor may order tests to find out whether the cancer has spread:
- CT scan: Doctors often use CT scans to make pictures of organs and tissues in the pelvis or abdomen. An x-ray machine linked to a computer takes several pictures. You may receive contrast material by mouth and by injection into your arm or hand. The contrast material helps the organs or tissues show up more clearly. Abdominal fluid or a tumor may show up on the CT scan.
- Chest x-ray: X-rays of the chest can show tumors or fluid.
- Barium enema x-ray: Your doctor may order a series of x-rays of the lower intestine. You are given an enema with a barium solution. The barium outlines the intestine on the x-rays. Areas blocked by cancer may show up on the x-rays.
- Colonoscopy: Your doctor inserts a long, lighted tube into the rectum and colon. This exam can help tell if cancer has spread to the colon or rectum.
These are the stages of ovarian cancer:
- Stage I: Cancer cells are found in one or both ovaries. Cancer cells may be found on the surface of the ovaries or in fluid collected from the abdomen.
- Stage II: Cancer cells have spread from one or both ovaries to other tissues in the pelvis. Cancer cells are found on the fallopian tubes, the uterus, or other tissues in the pelvis. Cancer cells may be found in fluid collected from the abdomen.
- Stage III: Cancer cells have spread to tissues outside the pelvis or to the regional lymph nodes. Cancer cells may be found on the outside of the liver.
- Stage IV: Cancer cells have spread to tissues outside the abdomen and pelvis. Cancer cells may be found inside the liver, in the lungs, or in other organs.
Many women with ovarian cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all you can about your disease and treatment choices. Knowing more about ovarian cancer helps many women cope.
Shock and stress after the diagnosis can make it hard to think of everything you want to ask your doctor. It often helps to make a list of questions before an appointment. To help remember what your doctor says, you may take notes or ask whether you may use a tape recorder. You may also want to have a family member or friend with you when you talk to your doctor-to take part in the discussion, to take notes, or just to listen.
You do not need to ask all your questions at once. You will have other chances to ask your doctor or nurse to explain things that are not clear and to ask for more details.
Your doctor may refer you to a gynecologic oncologist, a surgeon who specializes in treating ovarian cancer. Or you may ask for a referral. Other types of doctors who help treat women with ovarian cancer include gynecologists, medical oncologists, and radiation oncologists. You may have a team of doctors and nurses.
Getting a Second OpinionBefore starting treatment, you might want a second opinion about your diagnosis and treatment plan. Many insurance companies cover a second opinion if you or your doctor requests it.
It may take some time and effort to gather medical records and arrange to see another doctor. In most cases, a brief delay in starting treatment will not make treatment less effective. To make sure, you should discuss this delay with your doctor. Sometimes women with ovarian cancer need treatment right away.
There are a number of ways to find a doctor for a second opinion:
- Your doctor may refer you to one or more specialists. At cancer centers, several specialists often work together as a team.
- NCI's Cancer Information Service, at 1-800-4-CANCER, can tell you about nearby treatment centers. Information Specialists also can assist you online at LiveHelp.
- A local or state medical society, a nearby hospital, or a medical school can usually provide the names of specialists.
- NCI provides a helpful fact sheet called "How To Find a Doctor or Treatment Facility If You Have Cancer."
Treatment MethodsYour doctor can describe your treatment choices and the expected results. Most women have surgery and chemotherapy. Rarely, radiation therapy is used.
Cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body:
- Local therapy: Surgery and radiation therapy are local therapies. They remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
- Intraperitoneal chemotherapy: Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.
- Systemic chemotherapy: When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.
You may want to know how treatment may change your normal activities. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.
Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each woman, and they may change from one treatment session to the next. Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.
You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods. Clinical trials are an important option for women with all stages of ovarian cancer. The section on "The Promise of Cancer Research" has more information about clinical trials.
You may want to ask your doctor these questions before your treatment begins:
- What is the stage of my disease? Has the cancer spread from the ovaries? If so, to where?
- What are my treatment choices? Do you recommend intraperitoneal chemotherapy for me? Why?
- Would a clinical trial be appropriate for me?
- Will I need more than one kind of treatment?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment? What can we do to control side effects? Will they go away after treatment ends?
- What can I do to prepare for treatment?
- Will I need to stay in the hospital? If so, for how long?
- What is the treatment likely to cost? Will my insurance cover the cost?
- How will treatment affect my normal activities?
- Will treatment cause me to go through an early menopause?
- Will I be able to get pregnant and have children after treatment?
- How often should I have checkups after treatment?
The surgeon makes a long cut in the wall of the abdomen. This type of surgery is called a laparotomy. If ovarian cancer is found, the surgeon removes:
- both ovaries and fallopian tubes (salpingo-oophorectomy)
- the uterus (hysterectomy)
- the omentum (the thin, fatty pad of tissue that covers the intestines)
- nearby lymph nodes
- samples of tissue from the pelvis and abdomen
If you have early Stage I ovarian cancer, the extent of surgery may depend on whether you want to get pregnant and have children. Some women with very early ovarian cancer may decide with their doctor to have only one ovary, one fallopian tube, and the omentum removed.
You may be uncomfortable for the first few days after surgery. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain relief.
The time it takes to heal after surgery is different for each woman. You will spend several days in the hospital. It may be several weeks before you return to normal activities.
If you haven't gone through menopause yet, surgery may cause hot flashes, vaginal dryness, and night sweats. These symptoms are caused by the sudden loss of female hormones. Talk with your doctor or nurse about your symptoms so that you can develop a treatment plan together. There are drugs and lifestyle changes that can help, and most symptoms go away or lessen with time.
You may want to ask your doctor these questions about surgery:
- What kind of surgery do you recommend for me? Will lymph nodes and other tissues be removed? Why?
- How soon will I know the results from the pathology report? Who will explain them to me?
- How will I feel after surgery?
- If I have pain, how will it be controlled?
- How long will I be in the hospital?
- Will I have any long-term effects because of this surgery?
- Will the surgery affect my sex life?
Chemotherapy uses anticancer drugs to kill cancer cells. Most women have chemotherapy for ovarian cancer after surgery. Some women have chemotherapy before surgery.
Usually, more than one drug is given. Drugs for ovarian cancer can be given in different ways:
- By vein (IV): The drugs can be given through a thin tube inserted into a vein.
- By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.
- By mouth: Some drugs for ovarian cancer can be given by mouth.
Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used.
You may have your treatment in a clinic, at the doctor's office, or at home. Some women may need to stay in the hospital during treatment.
The side effects of chemotherapy depend mainly on which drugs are given and how much. The drugs can harm normal cells that divide rapidly:
- Blood cells: These cells fight infection, help blood to clot, and carry oxygen to all parts of your body. When drugs affect your blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team checks you for low levels of blood cells. If blood tests show low levels, your health care team can suggest medicines that can help your body make new blood cells.
- Cells in hair roots: Some drugs can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.
- Cells that line the digestive tract: Some drugs can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Ask your health care team about medicines that help with these problems.
Some drugs used to treat ovarian cancer can cause hearing loss, kidney damage, joint pain, and tingling or numbness in the hands or feet. Most of these side effects usually go away after treatment ends.
You may find it helpful to read NCI's booklet Chemotherapy and You.
You may want to ask your doctor these questions about chemotherapy:
- When will treatment start? When will it end? How often will I have treatment?
- Which drug or drugs will I have?
- How do the drugs work?
- Do you recommend both IV and IP (intraperitoneal) chemotherapy for me? Why?
- What are the expected benefits of the treatment?
- What are the risks of the treatment? What side effects might I have?
- Can I prevent or treat any of these side effects? How?
- How much will it cost? Will my health insurance pay for all of the treatment?
Radiation TherapyRadiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. A large machine directs radiation at the body.
Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.
Side effects depend mainly on the amount of radiation given and the part of your body that is treated. Radiation therapy to your abdomen and pelvis may cause nausea, vomiting, diarrhea, or bloody stools. Also, your skin in the treated area may become red, dry, and tender. Although the side effects can be distressing, your doctor can usually treat or control them. Also, they gradually go away after treatment ends.
NCI provides a booklet called Radiation Therapy and You.
Supportive Care
Ovarian cancer and its treatment can lead to other health problems. You may receive supportive care to prevent or control these problems and to improve your comfort and quality of life.
Your health care team can help you with the following problems:
- Pain: Your doctor or a specialist in pain control can suggest ways to relieve or reduce pain. You may want to read the NCI booklet Pain Control.
- Swollen abdomen (from abnormal fluid buildup called ascites): The swelling can be uncomfortable. Your health care team can remove the fluid whenever it builds up.
- Blocked intestine: Cancer can block the intestine. Your doctor may be able to open the blockage with surgery.
- Swollen legs (from lymphedema): Swollen legs can be uncomfortable and hard to bend. You may find exercises, massages, or compression bandages helpful. Physical therapists trained to manage lymphedema can also help.
- Shortness of breath: Advanced cancer can cause fluid to collect around the lungs. The fluid can make it hard to breathe. Your health care team can remove the fluid whenever it builds up.
- Sadness: It is normal to feel sad after a diagnosis of a serious illness. Some people find it helpful to talk about their feelings. See the "Sources of Support" section for more information.
You can get information about supportive care on NCI's Web site at http://www.cancer.gov/cancertopics/coping and from NCI's Cancer Information Service at 1-800-4-CANCER or LiveHelp.
Nutrition and Physical Activity
It's important for women with ovarian cancer to take care of themselves. Taking care of yourself includes eating well and staying as active as you can.
You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy.
Sometimes, especially during or soon after treatment, you may not feel like eating. You may be uncomfortable or tired. You may find that foods do not taste as good as they used to. In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth sores) can make it hard to eat well. Your doctor, a registered dietitian, or another health care provider can suggest ways to deal with these problems. Also, the NCI booklet Eating Hints has many useful ideas and recipes.
Many women find they feel better when they stay active. Walking, yoga, swimming, and other activities can keep you strong and increase your energy. Whatever physical activity you choose, be sure to talk to your doctor before you start. Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know about it.
Follow-up Care
You will need regular checkups after treatment for ovarian cancer. Even when there are no longer any signs of cancer, the disease sometimes returns because undetected cancer cells remained somewhere in your body after treatment.
Checkups help ensure that any changes in your health are noted and treated if needed. Checkups may include a pelvic exam, a CA-125 test, other blood tests, and imaging exams.
If you have any health problems between checkups, you should contact your doctor.
You may wish to read the NCI booklet Facing Forward: Life After Cancer Treatment. It answers questions about follow-up care and other concerns. It also suggests ways to talk with your doctor about making a plan of action for recovery and future health.
Complementary Medicine
It's natural to want to help yourself feel better. Some people with cancer say that complementary medicine helps them feel better. An approach is called complementary medicine when it is used along with standard cancer treatment. Acupuncture, massage therapy, herbal products, vitamins or special diets, and meditation are examples of such approaches.
Talk with your doctor if you are thinking about trying anything new. Things that seem safe, such as certain herbal teas, may change the way your cancer treatment works. These changes could be harmful. And certain complementary approaches could be harmful even if used alone.
You may find it helpful to read the NCI booklet Thinking About Complementary & Alternative Medicine: A Guide for People with Cancer.
You also may request materials from the National Center for Complementary and Alternative Medicine, which is part of the National Institutes of Health. You can reach their clearinghouse at 1-888-644-6226 (voice) and 1-866-464-3615 (TTY). Also, you can visit their Web site at http://www.nccam.nih.gov.
You may want to ask your doctor these questions before you decide to use complementary medicine:
- What benefits can I expect from this approach?
- What are its risks?
- Do the expected benefits outweigh the risks?
- What side effects should I watch for?
- Will the approach change the way my cancer treatment works? Could this be harmful?
- Is this approach under study in a clinical trial?
- How much will it cost? Will my health insurance pay for this approach?
- Can you refer me to a complementary medicine practitioner?
Sources of Support
Learning you have ovarian cancer can change your life and the lives of those close to you. These changes can be hard to handle. It is normal for you, your family, and your friends to have many different and sometimes confusing feelings.
You may worry about caring for your family, keeping your job, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of your health care team can answer questions about treatment, working, and other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful if you want to talk about your feelings or concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.
Support groups also can help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, over the telephone, or on the Internet. You may want to talk with a member of your health care team about finding a support group.
It is natural for you to be worried about the effects of ovarian cancer and its treatment on your sexuality. You may want to talk with your doctor about possible sexual side effects and whether these effects will be permanent. Whatever happens, it may be helpful for you and your partner to talk about your feelings and help one another find ways to share intimacy during and after treatment.
For tips on coping, you may want to read the NCI booklet Taking Time: Support for People With Cancer. NCI's Information Specialists at 1-800-4-CANCER and at LiveHelp can help you locate programs, services, and publications. They can send you a list of organizations that offer services to women with cancer.
The Promise of Cancer Research
Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). They are studying new and better ways to prevent, detect, and treat ovarian cancer.
Clinical trials are designed to answer important questions and to find out whether new approaches are safe and effective. Research already has led to advances, and researchers continue to search for more effective methods.
Women who join clinical trials may be among the first to benefit if a new approach is effective. And even if the women in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about ovarian cancer and how to control it. Although clinical trials may pose some risks, researchers do all they can to protect their patients.
Researchers are conducting studies with women across the country:
- Prevention studies: For women who have a family history of ovarian cancer, the risk of developing the disease may be reduced by removing the ovaries before cancer is detected. This surgery is called prophylactic oophorectomy. Women who are at high risk of ovarian cancer are taking part in trials to study the benefits and harms of this surgery. Other doctors are studying whether certain drugs can help prevent ovarian cancer in women at high risk.
- Screening studies: Researchers are studying ways to find ovarian cancer in women who do not have symptoms.
- Treatment studies: Doctors are testing novel drugs and new combinations. They are studying biological therapies, such as monoclonal antibodies. Monoclonal antibodies can bind to cancer cells. They interfere with cancer cell growth and the spread of cancer.
If you are interested in being part of a clinical trial, talk with your doctor. You may want to read the NCI booklet Taking Part in Cancer Treatment Research Studies. It explains how clinical trials are carried out and explains their possible benefits and risks.
NCI's Web site includes a section on clinical trials at http://www.cancer.gov/clinicaltrials. It has general information about clinical trials as well as detailed information about specific ongoing studies of ovarian cancer. NCI's Information Specialists at 1-800-4-CANCER and at LiveHelp can answer questions and provide information about clinical trials.


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Ocean of Acronyms
Age Range: 3-5
Craft Time: Under 30 mins
Messy Rating:
1 3 4 5
Uses Recycled Items: No
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Craft Notes
Adult supervision is required at all times.


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Costing tools
Costing tools are normally provided for each technology appraisal, quality standard, medical technology, diagnostic technology, clinical guideline and public health guidance. Costing tools are not provided for interventional procedures.
Types of costing tool
NICE provides five types of costing tool:
- national cost reports summarise the national estimate cost and discuss the assumptions made when estimating the financial impact of implementing the guidance. For technology appraisals, the report is incorporated into the costing template.
- costing templates support estimating the local cost of implementing guidance. and public health guidelines. These templates allow individual NHS organisations and local health economies to quickly assess the impact guidance will have on local budgets. A video tutorial explaining how to use the costing templates is available in Windows Media Player and Quick Time format.
- business case. It presents the financial costs and benefits of implementing guidance.
- cost impact and commissioning assessment for NICE quality standards
- costing statements are used when cost impact is considered to be minimal to explain why the cost impact is not considered to be significant.
- NICE support for commissioners and others using the quality standard
All guidance published since January 2005 has costing tools. Costing tools currently available are listed below.
Further information on the methodology for developing costing tools.
This page was last updated: 31 August 2011


text: Consumer Protection – Fair Debt Practices Act – Initial Compliance By: Michigan Lawyers Weekly Staff in Opinion Digests, U.S. District Court Western District of Michigan March 3, 1997 Fair Debt Practices Act - Initial Compliance Subscribe Login Email Address: Password: Already a paid subscriber but not registered for online access yet? For instructions on how to get premium web access, click here.Forgot your password? Share this:EmailPrintFacebookLinkedInTwitterGoogle +1 1:00 am Mon, March 3, 1997 Michigan Lawyers Weekly Michigan Lawyers Weekly Staff


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Drift off with our podcasts and learn the secrets of arriving ready.
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The day Osama bin Laden died
Published On: Sep 01 2011 11:23:57 AM PDT Updated On: Sep 10 2013 11:25:14 AM PDT
Take a look back at the day Osama bin Laden, the mastermind behind 9/11, was killed as it unfolded.
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Parent Directory | Revision Log
|Links to HEAD:
|(view) (annotate)
|Links to mcvs-0-23:
|(view) (annotate)
|Sticky Tag:
Retargetting CVS with new system call bindings that are not GNU/Linux specific.
New scripts for building LaTeX document. These do the right thing to minimize the number of times latex is run. Make proved useless. * docs/generate.sh: New file. * docs/cleanup.sh: New file.
File rename.
New files.
Adding documentation, rearranging directory structure.
* purge.lisp (mcvs-purge): Factor out code for computing deleted files. * mapping.lisp (mapping-removed-files): New function, contains code factored from mcvs-purge. * restore.lisp: New file. (mcvs-restore, mcvs-restore-wrapper): New functions.
Adding purge command. * mcvs-main.lisp (*purge-options*): New constant. (*mcvs-command-table*): New entry. (*usage*): Update. * purge.lisp: New file. (mcvs-purge, mcvs-purge-wrapper): New functions.
Adding some cool code: a multi-hash datatype which implements multi-dimensional sparse arrays using a tree of hash tables, and a function memoizer which uses multi hash to index on function arguments. * multi-hash.lisp (multi-hash): New class. (initialize-instance): New method on multi-hash. (multi-hash-common-code): New macro. (get-multi-hash, set-multi-hash): New functions. * memoize.lisp (define-memoized-function, memoized-labels): New macros. (remove-key-aux-rest strip-lambda-list, extract-tests, remove-tests, memoize-expander): New functions. * seqfuncs.lisp (lcs-list): Function is now correctly memoized using define-memoized-function.
New feature: grab command. Takes snapshot of code and imports it to a branch, trying to determine which of the added and removed files are actually moves. * grab.lisp: New file. (read-word-hash, word-hash-file, correlate, added-removed, move-candidates, mcvs-grab, mcvs-grab-wrapper): New functions. * mcvs-main.lisp (*grab-options*): New constant. (*mcvs-command-table*): New entry. (*usage*): New text. * checkout.lisp (mcvs-checkout): Write out MAP-LOCAL even if :no-generate t is specified.
The ``import'' command is renamed to ``create''. * mcvs.main (*create-options*): Renamed to *import-options*. (*mcvs-command-table*): Updated. (*usage*): Updated. * import.lisp: File renamed to create.lisp. (mcvs-import): Renamed to mcvs-create; some arguments renamed. (mcvs-import-wrapper): Renamed to mcvs-create-wrapper. * README: Updated.
Adding mcvs remap command. * dirwalk.lisp (dirwalk-fi, dirwalk, for-each-file-info): Default behavior is now preorder (visit directory before its entries). A keyword is provided to select the old postorder behavior. A catch is provided in dirwalk-fi that allows the caller to skip processing the currently traversed directory. The for-each-* macros provide a local function called (skip) to do this. (delete-recursive): This function depends on postorder behavior in for-each-file-info, so it explicitly selects it now. * mcvs.lisp (*remap-options*): New constant. (*mcvs-command-table*): Add entry for new function. (*usage*): Describes new function. * remap.lisp: New file. (mcvs-remap, mcvs-remap-wrapper): New functions.
Porting to CMUCL. * system.lisp: Conditionally load new module cmucl-unix. * mapping.lisp (mapping-dupe-check, mapping-write, mapping-difference): Fixes related to sort function; we were relying on CLISP's preservation of the cons cell order. * cmucl-unix.lisp: New file.
First cut at implementing more automated branching and merging. * mcvs-main.lisp (*branch-options*, *merge-options*): New constants. (*mcvs-command-table*): New entries for branch and merge commands. (*usage*): New help text. * branch.lisp: New file. (*branch-char*): New constant. (tags-from-cvs-log, what-branch-are-we-on, branch-tag-check, mcvs-branch, mcvs-branch-wrapper, cvs-make-or-advance-tag, mcvs-merge, mcvs-merge-wrapper): New functions.
* rcsparse.lisp: File renamed to rcs-utils.lisp. (rcs-delta): New slot, delta-hash. (rcs-make-delta-hash): New function. (rcs-parse): Calls rcs-make-delta-hash to set up new slot. * convert.lisp: require changed to match file rename.
Some new macros for slot access. * slot-refs.lisp: New file. (with-slot-refs): New macro. (with-multi-slot-refs): New macro. * rcsparse.lisp (rcs-parse-newphrases, rcs-parse-admin, rcs-parse-delta): Replace uses of symbol-macrolet by with-slot-refs and with-multi-slot-refs.
* posix.lisp (parse-posix-namestring): New function. Converts POSIX path to CL Path object. * rcsparse.lisp: New file (rcs-admin, rcs-file, rcs-token, rcs-token-stream): New structs. (rcs-peek-token, rcs-read-token): New generic functions. (rcs-extract-id-sym-or-num, rcs-extract-string, rcs-match-optional, rcs-match-token, rcs-parse, rcs-parse-admin, rcs-special-p): New functions. * convert.lisp (classify-tags): Work with association list rather than raw strings. (mcvs-convert): Use rcs-parse to extract tags. Fix call to mapping-generate name. Use parse-posix-namestring when opening version file. Generate informative chatter.
* find-bind.lisp: New file. (find-bind-extract-vals): New function. (find-bind): New macro. * error.lisp (restart-destructure): Macro removed. (mcvs-error-handler): Uses generic find-bind instead of restart-destructure.
Commit is handled through mcvs-generic, so it can take filename arguments, and honor --nometa. * commit.lisp: File removed. (mcvs-commit): Function removed. (mcvs-commit-wrapper): Moved to generic.lisp. * generic.lisp (mcvs-commit-wrapper): Moved from commit.lisp, changed to invoke mcvs-generic. (mcvs-generic): Only add TYPES file to list if it actually exists.
* print.lisp: New file. (print-assoc-list): New function. * types.lisp: Use print-assoc-list to nicely print the types. * import.lisp (mcvs-import): Don't bother getting user to edit the types if the type list is empty. In fact, don't even create the file. * add.lisp (mcvs-add): Use new form of mapping-generate-name.
Support for filetypes in import. * posix.lisp (suffix): Separator character parameter is optional; multiple occurences of character lead to one big suffix like ".tar.gz" instead of ".gz". A leading dot means it's not a suffix but a hidden file like ".exrc". (edit-file): New function, brings up text editor for specified file. * clisp-linux.lisp (env-lookup): New function for environment variable lookup. * types.lisp: New source file. (*mcvs-types-name*, *mcvs-types*): New constants for TYPES filename. (types-read, types-write, types-sanity-check, types-to-import-wrapper-args): New functions. * import.lisp (*types-comments*): New constant. (mcvs-import): Restructured to build up list of file suffixes, allow the user to edit the file which determines how they are treated, filter out ignored files and pass -W options to cvs import to handle the rest. Failed cvs import is turned into restartable condition. * mapping.lisp (mapping-generate-name): Takes a suffix parameter. The F-files now carry a suffix obtained from the original file, because I have concluded that this was the only reasonable way to integrate with CVS.
Added a much improved error handling routine in anticipation of better use of restarts. * error.lisp: New file (restart-destructure): New macro. (*mcvs-error-treatment*): Special variable, moved here from mcvs-main. (mcvs-error-handler): New function. * mcvs-main.lisp (mcvs-top-error-handler): Function removed. (mcvs-execute): Bind error to new mcvs-error-handler instad of mcvs-top-error-handler.
* convert.lisp: New file. Contains conversion utility to make an Meta-CVS repository from an ordinary CVS repository, while preserving all history, tags and branches. (remove-attic-component, classify-tags, read-tags, mcvs-convert): New functions. * posix.lisp (suffix): New function. Computes suffix of file. (execute-program-xargs): New optional parameter, for specifying fixed part added at the end of each generated command line. * mapping.lisp (*mcvs-map-name*, *mcvs-local-map-name*): New constants. (*mcvs-map*, *mcvs-map-local*): Redefined in terms of new constants. (mapping-generate-name): New key parameter no-dir for not adding the directory prefix.
Map sorting order is changing.
Added tag command. * diff.lisp: File renamed to generic.lisp. (mcvs-diff): Function renamed to mcvs-generic. * generic.lisp (mcvs-generic): Function no longer dedicated to diffing only; takes CVS command to execute as an argument, also takes arguments and files as separate lists. (mcvs-diff-wrapper): Modified to invoke mcvs-generic properly. (mcvs-tag-wrapper): New function, uses mcvs-generic to implement tag command. * mcvs-main.lisp (*tag-options*): New constant. (*mcvs-command-table*): New entry for tag command.
MCVS is being renamed to Meta-CVS.
Bugfix for mcvs add -R.
Adding release notes file.
Added mcvs filt command to decode F- names in text streams.
Adding TODO list.
Forgot to add this.
Adding README file with instructions.
Lots of wording changes and clarifications.
Installation instructions.
Adding README file which contains a ``paper'' about MCVS.
Adding GNU License.
Adding simple installer.
Renaming mcvs.lisp to mcvs-main.lisp.
Moving closer toward delivery.
A bit of refactoring. Added mcvs-move.
Adding mcvs-remove operation.
Adding mcvs-diff.
Adding all existing source files.
Initial revision
This form allows you to request diffs between any two revisions of this file. For each of the two "sides" of the diff, select a symbolic revision name using the selection box, or choose 'Use Text Field' and enter a numeric revision.
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text: Information contained on this page is provided by NewsUSA, an independent third-party content provider. WorldNow and this Station make no warranties or representations in connection therewith.(NewsUSA) - At one time, Latin America was deemed the "development of underdevelopment," by economist Andre Gunder Frank. As of late, however, the region is enjoying a kind of renaissance, and some investors are estimating that this resource-rich market could be poised for a turnaround.


text:
Big Checkers Floor Mat
As temperatures outside cool down, bring the fun indoors and create lasting memories with projects the whole family can enjoy such as this fun checkers floor mat.
Designed by the Michaels Design Studio.
Material List
- Creatology™ Basic Felt, 36"x36" – Black
- Creatology™ Basic Felt, 9"x12" – Red
- Lara's Crafts® Wood Circle, 3"
- Martha Stewart Crafts™ Acrylic Paint – Beetle Black and Tartan Red
- Aleene's® Peel 'n Stick Fabric Fuse
- Creatology™ Foam Stickers
- Scissors
Project Instructions
Step 1
Paint the front and back of the wood circles. Let dry.
Step 2
Cut the large piece of black felt to a 26"x26" square.
Step 3
Cut 32 3" squares.
Step 4
Lay black felt flat and lay out the red squares in a checkerboard pattern (see photo).
Step 5
Adhere red felt squares to black felt with Peel 'n Stick Fabric Fuse.
Step 6
Add Creatology™ foam stickers to the wood circle game pieces.


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When you take the entire cavern complex as a whole, instead of examining the individual encounters, you really get the sense that this is the lair of an evil overlord. It feels large and impressive and populated and guarded and like a real place.
--Bryce Lynch, tenfootpole.org
Book 4 of the Bone-Hilt Sword campaign. An intrepid band of adventurers ply dangerous waters inhabited by intelligent sea-dwelling creatures, to reach the even more dangerous island of the Isle of Valen'cya; a dead lanscape inhabited by an undead red dragon and her innumerable minions.
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Designed for OSRIC and first edition fantasy-based role-playing game systems.
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Should Louis van Gaal take over at Old Trafford, there seems little guarantee...
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ome have said that it doesn't matter how Chelsea played as long as they won, but...
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Saturday, 26 April 2014, 17:30
Sunday, 20 April 2014, 12:00
Gary Hooper feels he is starting to show what he is capable of in a Norwich City shirt.
hy don't you call in Becks as well...and we will all have a lovely tea party!
ourinho is just a good-looking version of Allardyce (Fit Sam?). Clearly 19th century football isn't such a big deal after all?
tay put, Pep. Timothy Sherwood has this under control.
Real Madrid boss Carlo Ancelotti hailed the 'sacrifices' made by Cristiano Ronaldo in the 1-0 win over Bayern Munich.
Hugo Lloris admits it will be difficult for Spurs to be any worse next season following a torrid league campaign.
Bayern Munich boss Pep Guardiola was proud of his side's performance, despite their 1-0 first-leg defeat to Real Madrid.
Some have said that it doesn't matter how Chelsea played as long as they won, but is that true? Plus, we've found the one chap who enjoyed Tuesday's game...
There is plenty of 'that's 90 minutes I'll never get back' sentiment about Chelsea's 'performance' in Madrid, but at least one person thinks they did what was required...


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IWTS-28SUB Dual 8-Inch Passive In-Wall Subwoofer
Atlantic Technology 224SB-BLK 10 inch Powered Subwoofer, 180-Watt
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Atlantic Technology SB-900DF-BLK 8 inch Down-Firing Powered Subwoofer, 125-Watt
Small, unobtrusive and deceptively simple-looking, the Atlantic Technology SB-900DF powered subwoofer has a rugged 8" driver with an oversized surround for exceptionally long excursion and low distortion, even at very high output levels. Its high-current, equalized 125-watt amplifier and massive finned heat sink allow the SB-900DF to achieve a low-end extension of 32 Hz (-3 dB) - the...
Blaupunkt Blue Magic XLb 250 A - 500 Watt 10-Inch Active Subwoofer System
10-Inch 500 watts active subwoofer system with Class - D Amplifier, spun paper cone, 2X high level and 2X RCA/Cinch inputs, automatic on/off, cable remote control, power on 2-color ED's. General: Frequency Response: 25-200Hz Low Pass Filter: Variable 50-200Hz Gain Control/Phase: 0.2-5V/0-180° Bass Boost: 0-12dB Sensitivity: 91dB Dimensions: 455mm x 338mm x 226mm Housing Volume: 22...


text: What kind of help do you need? (Example:"Panda AdminSecure", "2093 error") Tweet Error 2093 installing Panda Cloud Office Protection Information applies to: Products Panda Cloud Office ProtectionPanda Cloud Office Protection AdvancedSymptomsError 2093 occurs installing Panda Cloud Office Protection.CauseThere is another antivirus installed or there are traces from a previous antivirus.Elements to checkGo to Start -> Programs and make sure there is no other antivirus installed that can be automatically uninstalled. Check the Which programs are uninstalled automatically by Panda Cloud Office Protection? help.SolutionIn case the antivirus protection you have installed is/is not on the above list, please contact your Panda Support office indicating the installation package and full version of your antivirus software so that we can study the reason why the program is not uninstalled or add the program to the list.While your case is studied, and using the Administrator account, you can apply the following steps:Uninstall the antivirus software using the Add or Remove Programs option and restart your computer.Retry Panda Cloud Office Protection installation.If error 2093 persists, and ensuring you are using the Administrator account, type the following in the Command line console:If Windows XP:WMIC /NAMESPACE:\\root\SecurityCenter PATH AntiVirusProduct DELETEIf Windows Vista, Windows 7 or Windows 8, go to C:\Windows\system32\, right click cmd.exe file, select Run as... and select the Administrator account. Then, type the following in the Command Line console:WMIC /NAMESPACE:\\root\SecurityCenter2 PATH AntiVirusProduct DELETERetry Panda Cloud Office Protection installation and confirm error 2093 is not reproduced.Data needed to report the incidentIf the issue is not solved, it is necessary to collect a series of data from the computer. This information is collected automatically by the PSInfo tool that you need to download and run following these instructions:From a computer with Internet connection, download the PSInfo2_V2.exe file into your computer and save it in your Windows Desktop.Double click the PSInfo2_V2.exe file, so that the information about hardware and software from your computer is gathered.Fill in all the requested fields.If PCOP is installed in the computer, the PCOPDIAGS application will be launched.Follow the PCOPDIAGS wizard.When the data collection finishes, a file called XXXX.psz is generated in your hard drive. Send to Panda Security this file which is located in the TEMP folder of your hard drive, by default.In the event that for whatever reason PsInfo cannot be run, or the PCOPDIAGS application has not been released, it is necessary to send the files below to the Panda Security Support address for analysis:WalUpg log file (once the error occurs):To get it, follow the steps below: Find the WalUpg.ini file in %Programfiles%\Panda Security\WaAgent\WalUpg\WalUpg Edit the file by adding the following lines:[LOG]LevelLog=2000Restart the Panda Endpoint Administration Agent service.To reproduce the error, double-click the protection installer named PandaCloudEndpointProtectionxXX.msi, in %ProgramFiles%\Panda Security\WAC\WARepository\InstallerThe log file generated, WALUPG.log, is saved in the folder %Programfiles%\Panda Security\WaAgent\WalUpg.WalUpg.ini configuration file. This file is found in %ProgramFiles%\Panda Security\WaAgent\WalUpgFile retval.ini generated by the installer. This file is found in %Programfiles%\Panda Security\WaAgent\Common\DATAWAC_Installer.log file. This log file is generated in %Programfiles%\Panda Security\WaAgent\WalUpg when an error occurs.Once this is complete, collect all necessary data and send them to the Panda Security tech support contact address.Help nº- 20131125 502093 EN Help us improve our service by letting us know your opinion. Your suggestions will help to resolve your questions more quickly and effectively. Have you resolved your query with this article? YES NO Thanks for your answer How would you improve this article? Do you want to contact TechSupport?


text:
Explore Undiscovered Food, Fashion & Fun.
You know when you pull your hair back to wash your face and somehow it looks so good you wish you were going out? Okay, so maybe that's happened only once. But it's the same accidental elegance Kérastase's Odile Gilbert channeled for Suno last Friday night. In this video, she discusses the hairstyle and her inspiration.
Want to keep watching? Check out our backstage videos at Rachel Antonoff, Tracy Reese, and Creatures of the Wind.


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On the outside looking in, Frank Gilbreth seems a little nutty.
Caesar Rodney High School's drama club will welcome patrons in the leader of Siam's palace through its musical production of "The King and I," opening Thursday.
Hot videoLast night on "Late Night With Seth Meyers," Andy Samberg showed off a photo of the hilarious gift David Copperfield gave a soon-to-be-wed Samberg last year.
Joyce Casanova was a bit shell shocked when she married into the family of her husband, John. He was the youngest of 11 children and she wasn't used to a large family, but over the years she found a friend in her sister-in-law Olive Nickotopulous.
A project that has been four years in the making was finally complete on Monday when legislators, city officials and TransCore employees cut the ribbon on the new E-ZPass office and DMV call center at 22 and 24 W. Loockerman St.
Middle school students from across Delaware are invited to compete in the 20th annual Delaware Junior Solar Spring competition May 14 at Dover International Speedway.
Brian Schad and his K9 Sparks are a crime-fighting duo that have been investigating fires together for nearly six years..
- Events Calendar


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Parent Directory | Revision Log
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Oops. Register A0 was not properly initialized for the undefined foreign symbol error trap.
fpu_restore was missing a blr instruction. (Noted by Cyrus Harmon.) How could this have worked at all?
Merge ppc_gencgc_branch to HEAD.
Missing a nop in breakpoint guts.
Remove unused code.
Make ppc port look a little more like sparc by making fdefn-raw-addr-slot actually hold a tagged pointer instead of the raw address. Not sure if this is good or not, but making it like sparc makes ppc a little easier. Might need a cross-compile; the 2005-12-1-ppc cross-compile script works fine. assembly/ppc/arith.lisp: o Static functions are now tagged, so need to adjust address before branching to them. compiler/generic/new-genesis.lisp: o Fill fdefn-raw-addr-slot with the tagged address instead of converting to untagged. compiler/ppc/call.lisp: o fdefn-raw-addr-slot is tagged, so need to adjust it before branching to function. compiler/ppc/cell.lisp: o No need to adjust function address before storing it in the fdefn-raw-addr-slot. compiler/ppc/static-fn.lisp: o Static functions are tagged, so need to adjust address before branching to them. lisp/gc.c: o Don't need scav_fdefn, because the fdefn is a tagged object now. lisp/ppc-assem.S: o Make undefined_tramp and closure_tramp be tagged instead of untagged. lisp/purify.c o RAW_ADDR_OFFSET is 0 now, like sparc.
The boxed register reg_FDEFN is r10, but r10 is one of the registers used in the C calling convention, so it's a bad idea to have reg_FDEFN be r10. So, make r10 be the new unboxed register reg_NL7 and replace reg_L2 with reg_FDEFN. (I was too lazy to renumber all registers, and I don't think it matters where reg_FDEFN is.) A simple cross-compile is needed. Use boot-2005-12-1-ppc.lisp for the cross-compile script. compiler/ppc/vm.lisp: o Make old FDEFN be the new unboxed register NL7. o Rename L2 to be FDEFN, removing L2 complete. lisp/ppc-assem.S: o reg_L2 no longer exists, so don't use it. lisp/ppc-lispregs.h: o Make the corresponding changes here that were made in vm.lisp. bootfiles/19c/boot-2005-12-1-ppc.lisp: o Simple cross-compile script for this change.
The stack pointer is supposed to be on a 16-byte boundary, so make sure FULL_FRAME_SIZE is a multiple of 16. (From a patch to sbcl from Cyrus Harmon.)
Change ## to the traditional /**/ so that we can compile CMUCL on Tiger (10.4) with gcc (4.x) or Jaguar (10.2) gcc (3.x). Not the best solution, but I think gcc 4 doesn't handle ## the same as gcc 3. But this allows using the default gcc on both platforms to compile CMUCL.
New pseudo-atomic scheme that looks more like sparc where we use the LSB of alloc-tn to denote pseudo-atomic interrupted. We still need the flag-gn (hardwired to NL3) as a temporary though because we need somewhere to store the LSB of alloc-tn so we can trap if it's not zero. ppc/macros.lisp: o New pseudo-atomic macro implementing the change. lisp/ppc-arch.c: o Update arch_set_pseudo_atomic_interrupted to set the LSB of alloc-tn. o Catch the TWNEI reg_NL3, 0 instruction that denotes a deferred interrupt. lisp/ppc-assem.S: o Update assembly to code to set and test pseudo-atomic stuff like the pseudo-atomic macro does.
The ppc port no longer uses the ppc-fun-hack where the function-pointer and instance-pointer tags were swapped compared to all other ports. Remove code for ppc-fun-hack.
Port Helmut's trace/known-return to ppc. Fix some bugs along the way as well. lisp/breakpoint.c: o Enable function-end stuff in compute_offset for DARWIN too. o Lots of printf's so we can see what's happening on ppc since gdb is majorly broken there. lisp/ppc-assem.S: o Actually implement the function-end breakpoint template. Basically copied the sparc version, with appropriate mods. lisp/ppc-arch.c: o Add TWLLEI_R0 macro to create the appropriate trap instructions that we need, and use as appropriate. o arch_install_breakpoint was actually broken and installed a twllgei instruction instead of twllei. o arch_do_displaced_inst was also broken. It didn't install the after-break-point trap after the breakpoint trap. And it also didn't continue running the code and returned instead. That's wrong. o The trap_AfterBreakpoint case in sigill_handler was inserting the wrong instruction back. (Probably too much copying of the sparc port.)
o Fix typo. o When PPC_FUN_HACK is not defined, the raw_addr slot of an fdefn object should be on a word boundary, so change undefined_tramp and closure_tramp to be on such a boundary. Previously, these had a lowtag of 1. With this change, can we get rid of the other parts of a function definition that we don't use?
Save FP register args before calling lazy_resolve_linkage. (Might not be necessary, but this is safe.)
Initial support for linkage-tables on PPC/Darwin. This is a relatively straightforward port of the sparc version of linkage-tables. Some refinements are probably still needed, as well as some testing. Use boot-2005-02-ppc-linkage.lisp to bootstrap this change from the 2005-02 snapshot. * code/ppc-vm.lisp o Add appropriate FOREIGN-SYMBOL-ADDRESS-AUX and FIND-FOREIGN-SYMBOL functions for linkage-table. * compiler/generic/new-genesis.lisp o Basically do the same as the sparc port for linkage-tables. o need to extern-alien-name on the cold linkages since they C names depend on the backend conventions. * compiler/ppc/alloc.lisp o Load "undefined_tramp" appropriately for linkage-tables. * compiler/ppc/c-call.lisp o Define new vops (FOREIGN-SYMBOL-CODE-ADDRESS, FOREIGN-SYMBOL-DATA-ADDRESS) for linkage-tables so we can access correctly. * compiler/ppc/cell.lisp o Load "closure_tramp" appropriately for linkage-tables o Load "undefined_tramp" appropriately for linkage-tables * compiler/ppc/parms.lisp o Put the foreign linkage space start at the end of the static space to make it easier to bootstrap. (We need already mapped memory.) We can move this later. o Correct TARGET-FOREIGN-LINKAGE-ENTRY-SIZE. o Add new static-symbol *linkage-table-data* o While were at it, add SPARE-9 and SPARE-0 static symbols so we have 10 spares. * lisp/Config.ppc_darwin o Add -DLINKAGE_TABLE to CFLAGS/ASFLAGS if we have linkage-table support. * lisp/Darwin-os.c o Add os_dlsym to support linkage-tables. (This nees a little refactoring because we just copied the #defines for dlopen modes.) * lisp/os-common.c o The checking of the linkage tables that is done for sparc almost works for ppc, but not quite. Implement one for ppc. * lisp/ppc-arch.c o Add PPC version of arch_make_jump_entry, arch_make_linkage_entry, arch_linkage_entry. * lisp/ppc-assem.S o Add lazy_resolve_linkage to support linkage-tables. This needs some more work. o Add undefined_foreign_symbol_trap. This probably needs work, and definitely needs testing. * lisp/ppc-validate.h o Define the start of the linkage space and size.
lispregs.h, sparc-lispregs.h: o Move the SC_OFFSET_{HI,LO} macros from sparc-lispregs to lispregs.h, so they can be used elsewhere. ppc-lispregs.h: o Define the register numbers so they can be used in the SC_OFFSET macros. ppc-assem.S: o Document what the byte 18<<2, 0, 0, 24 is supposed to do. o Use the SC_OFFSET macros in undefined_tramp instead of hard-wiring the register number.
Fix typo introduced in previous fix.
(defun foo () (zot)) when compiled and run gave a silly message about #C(0d0 0d0) failing a typecase. Then doing a backtrace gave another error about some negative number not being a positive fixnum. The former error is caused by a bad definition of undefined_tramp. The latter error is caused by the debugger not being able to compute the offset correctly. (Fixes ported from sbcl.)
First merge of the C side of the OS X/Darwin port. Besides adding Darwin versions of all the required things, this commit separates the interrupt handler proper (now interrupt_handle_now_handler) from the actual work-horse (interrupt_handle_now), which is now only ever called from the two interrupt handlers, interrupt_handle_now_handler and maybe_now_maybe_later. This follows similar changes in SBCL, and is in fact needed in order to properly use sigreturn in signal handlers, as required to work around a problem with the G5.
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Time's 'Person of the Year' 2001-2013
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Catch full episodes of this hit CW show online.
Best perceived beers among consumers.
Here's a look at 10 things to watch.
Check out stars who are related to royalty.
See the best critter photos of the week.
Watch this hilarious FOX comedy online.
Popular types of toys collected as investments.
Players who failed when it counted the most.
See your favorite ex-child stars all grown up.
Artist's fantasy photos fulfill kids' dreams.


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Watch an eclipse of the moon tonight!
"If the clouds stay away, it will be fascinating to watch the Moon's graceful movement through the shadow of the Earth," said Robin Scagell, from the Society for Popular Astronomy.
The eclipse began at 2018 GMT, with the Moon totally immersed in the shadow of the Earth between 2244 and 2358 GMT.
The eclipse is visible from the whole of Europe, Africa, South America, and eastern parts of the US and Canada.
Latest news
So 25 Editions set for October release
To celebrate the 25th anniversary of 'So' Peter will be releasing a newly re-mastered version of his 1986 album. As well as the re-mastered So album , the So anniversary editions also include a Special Edition 3 CD and Deluxe box set...15th Aug 2012, 1:31pm
Peter discusses 30 years of WOMAD
The Guardian caught up with Peter to discuss the 30th year of WOMAD . Topics of discussion also included the festivals troubled beginnings, bonding with Kofi Annan over congas and how music mixes with politics.1st Aug 2012, 2:39pm
Peter talks to Tom Robinson on BBC 6 Music
BBC Radio 6 Music's Tom Robinson invited Peter into the studio to chat about his career to date and the 30th anniversary of WOMAD festival . The interview was broadcasted on Saturday evening, but is available to listen to...23rd Jul 2012, 10:37am
Happy 20th Birthday WITNESS!
For 20 years, WITNESS has been empowering activists to expose human rights abuse through video. To kick-start their birthday celebration their goal is to raise $20,000 from supporters like you. These funds will help them give more activists...22nd Jun 2012, 4:44pm
Secret World Live remastered (old VS. new comparison)
Discover more about the restoration process of 'Secret World Live', Peter's Grammy Award winning film from 1994. The newly restored film is to be released on DVD & Bluray on the July 16th (24th US).19th Jun 2012, 5:14pm
Additional dates added to the 'Back To Front' tour
Three additional dates in October have been added to the 'Back To Front' tour of North America / Canada. Fan Club Pre-sale / VIP tickets go on sale on the 19 June at 10am (EST), with the General public sale being the 22 June at 10am (EST)....18th Jun 2012, 11:35am
The Interspecies Internet
The Interspecies Internet (I2I) is a non-profit organisation founded by Peter which was created to explore, encourage and facilitate communication between cognitive species. Some of you may have already seen the footage of Peter playing with...14th Jun 2012, 5:39pm
WITNESS launches Human Rights channel on YouTube
WITNESS have launched the Human Rights channel [BETA] on YouTube in conjunction with Storyful . The channel will be curating the most powerful human rights content - breaking news, cutting edge activism video, under-covered stories,...12th Jun 2012, 12:16pm
Back To Front: VIP Packages
VIP packages for the 'Back To Front' shows will be on sale from May 23. Choose from Front Row Package, Hot Sound Package and Hot Ticket Package. See below for more information: FRONT ROW PACKAGE o Approx 16 shows - limited to 20 packages...22nd May 2012, 12:40pm
Peter Announces North American Tour 'Back To Front' To Celebrate 25th Anniversary of 'So'
Following a critically acclaimed New Blood tour in 2011 that reignited Peter Gabriel fans across the world by reimagining his best known songs through stunning orchestral arrangements, Gabriel announced today his return to U.S. stages to...22nd May 2012, 10:09am
What kind of world do we want for our great-great-grandchildren? People, profit and the environment - can we balance them, or do we have to make a choice? Can global summits achieve anything? And how do we create change - starting now? The...18th May 2012, 12:05pm
An exclusive interview with Peter...
Peter caught up with broadcaster Mark Coles for his "The Shed" radio show earlier this month to chat about Real World Gold - a major re-release programme for his label Real World Records . Peter talks world music past and present, his love...14th May 2012, 11:06am
"Toast To Freedom"
"Toast To Freedom" is dedicated to human rights activism around the world. Nearly 50 artists contributed to celebrate Amnesty International's 50th Anniversary. Toast To Freedom was written by music veterans Carl Carlton and Larry Campbell.4th May 2012, 10:38am
Newly-restored Secret World Live to be released July 16th (24th US)
"Secret World Live", the outstanding Grammy Award winning film from 1994 is now to be re-released. The new version allows the original film to be seen and heard in the best possible quality on DVD / Blu-ray. Filmed in Modena, Italy across two...30th Apr 2012, 5:48pm
Re-releases in Italy
Friday 16 March marked the first date in a series of re-releases in Italy from Peter's back catalogue, in conjunction with the magazine TV Sorrisi e Canzoni and the newspaper Corriere della Sera" The collection includes the remastered studio...21st Mar 2012, 9:47am
Watch 'Classic Albums: So' on BBC 4 (UK only)
Catch an hour long program this Friday on UK television regarding the release of Peter's fifth studio album, 'So'. By returning to the original multi-tracks, along with musical demonstrations and rare archive footage, the BBC discover how...19th Mar 2012, 2:35pm
Full Moon update March 2012
Better late than never - here is March's Full Moon video... Peter talks about 12 new grooves he's been working on this year and a fascinating diversion into life as an eHealth ambassador at the behest of Archbishop Desmond Tutu which...13th Mar 2012, 2:40pm
Live Blood
Following last year's New Blood Live in London DVD, Blu-Ray and 3D disc comes Live Blood - a live 2-CD set recorded at the London Hammersmith Apollo on March 23rd 2011. The album is released on 23 April (Europe)/ 24 April (USA). Live Blood...12th Mar 2012, 3:16pm
5 - 4 - 3...Peter's Full Moon Update
Peter's Full Moon Update is out there somewhere but we haven't quite managed to get a transporter lock on all it's parts - either the cold atmospheric conditions of this, the last full moon of winter or the massive amount of solar particles...8th Mar 2012, 5:55pm
Peter's response to 'Sledgehammer' on the Rush Limbaugh show
Peter Gabriel has asked that this response be published when he found out that his track 'Sledgehammer' has been used on the Rush Limbaugh show: 'Peter was appalled to learn that his music was linked to Rush Limbaugh's extraordinary attack on...5th Mar 2012, 5:58pm
SPARKies Tech Awards 2012
Peter & Real World are delighted to be sponsoring a category in The SPARKies - Bath's first ever tech awards aiming to shout about the great people, companies and products that exist in the city. Nominations are now open - click here to enter -...2nd Feb 2012, 5:40pm
Peter Live on Letterman
Peter was on Live on Letterman on Wednesday night, for an online concert exclusive. Catch up with the whole performance which was broadcasted from the Ed Sullivan Theatre in New York.10th Nov 2011, 2:34pm
Peter Live Interview on BBC 6 Music
You can hear Peter discussing his album New Blood and chatting about life and work at Real World this afternoon on the Radcliffe & Maconie show on BBC 6 Music. Expect some lively and intelligent conversation and a selection of music. The show...3rd Oct 2011, 1:05pm
Pre-Sale for New Blood Live in 3D on the big screen (UK) & South American Tour dates
For two nights only you can experience New Blood Live in 3D on the big screen in selected cinemas across the UK. Pre-Order tickets for the screenings. Over two nights in March 2011, Peter Gabriel took to the stage at the HMV Hammersmith...12th Aug 2011, 6:19pm
South America / Mexico Tour 2011
Peter is bringing his 'New Blood' orchestra to South America / Mexico this November, please see dates below. More details to be announced imminently... Date Location 13th November Sao Paulo, Brazil 16th November Santiago, Chile...1st Aug 2011, 6:27pm
Real World artists come to WOMAD Charlton Park, 29 - 31 July
"With hundreds of artists from everywhere in the world, everyone's WOMAD will be different," The Evening Standard This year at Charlton Park, Real World Records will be represented by a range of exciting and diverse artists: Aurelio...25th Jul 2011, 9:46pm
Peter's July update15th Jul 2011, 6:08pm
For more than three decades, Chevron has chosen profit over people.
While drilling for oil in Ecuador's Amazon rainforest region, Texaco - which merged with Chevron in 2001 - operated without concern for the environment or local residents. The company deliberately dumped billions of gallons of toxic wastewater...1st Jul 2011, 3:46pm
June's Full Moon update
We're trying not to make a habit of it, but this month's update is going to be slightly delayed. Peter is filming his piece at the Verizon Theatre in Dallas Texas today - Peter and the New Blood Orchestra are on stage there this evening, so...15th Jun 2011, 6:36pm
Tutu's 'battle to end child marriage'
Archbishop Desmond Tutu of The Elders appeared on BBC Radio 4's news program Yesterday announcing a key initiative of The Elders. (You can listen to the piece again below) The Nobel Prize winner Archbishop Desmond Tutu spoke of his intentions...8th Jun 2011, 1:54pm
Eagle draws New Blood from key players
Peter, arranger John Metcalfe and conductor Ben Foster spent yesterday talking New Blood in front of 3D cameras from Eagle Rock with comedian David Baddiel on hand to tickle out some of the details. The interviews will be seeing the light of day...7th Jun 2011, 10:48am
Competition Winners: New Blood Live in North America
Congratulations to the winners of our Hot Sound Package competition (see winners below) . We will be in touch with further details via email. Venue Winners Greek Theatre Berkeley, CA Shauna Berquist de Marquez & Reef Roberts...7th Jun 2011, 9:29am
New Blood is on it's way
We packed the truck and waved the equipment off at the start of it's transatlantic journey today - New Blood is on its way to North America.2nd Jun 2011, 7:05pm
On the eve of Peter's North American tour, we chew the fat with the New Blood Orchestra
John Metcalfe loves to tour. And, as the orchestral arranger of both the Scratch My Back and New Blood projects, he's got a rather enviable itinerary ahead of him - a 12-date, 12-city tour of the United States in the company of Peter Gabriel and...1st Jun 2011, 3:15pm
May's Full Moon Update
Slightly delayed through various location based tribulations Peter's May update is now available to watch.19th May 2011, 7:14pm
Right Now, All Donations to WITNESS Doubled
If a picture's worth a thousand words, what's a video worth? Video has the power to change the world. Please help WITNESS put a stop to human rights abuse. Our goal is to raise $70K by June 3rd. Join Project: FOCUS with a donation and share...10th May 2011, 9:33am
Happy Birthday So
Today marks the 25th Anniversary of the release date of So. Watch out for a celebratory release before the end of the 25th year.6th May 2011, 5:51pm
Competition to win Hot Sound VIP Packages for Peter Gabriel live in North America
This is an extraordinary opportunity to see Peter perform classic songs from his repertoire with a 46-piece orchestra - guaranteed to be an intimate and captivating experience. As reported by Nige Tassel from last months' performance in London...27th Apr 2011, 3:47pm
Don't Give Up on the Full Moon
Peter's escaped from the studios this month and unfortunately the internet connection at his location is proving to be an unreliable conduit for his update. We're not giving up hope that his words emerge from the ether in the near future, but in...18th Apr 2011, 7:58pm
Peter Performs 'Biko' for Desmond Tutu
On Thursday 31st March, Archbishop Desmond Tutu was awarded a "Skoll Foundation Global Treasure". He came out of retirement from public speaking to deliver a keynote address at the New Theatre in Oxford. As part of the evening's celebration...7th Apr 2011, 12:09pm


text:
With the introduction of a number of new engine variants, Volvo Penta can now offer the mining industry a complete range of engines approved for underground mining applications. The selection of nine Tier 2 engines and nine Tier 4i engines – which provide outstanding ventilation rates – enable manufacturers and users of mining equipment to make the perfect Volvo Penta engine choice.
Today, operators of industrial machines and equipment strive to increase engine uptime. Every stop, even planned ones, means extra costs and a loss of income. However, with a quick oil analysis, performed regularly, operators can now extend the periods between the service occasions. This service from Volvo Penta takes the operators one step closer to the dream of their life – the one of the perpetual motion machine.
Volvo Penta´s marine drive system IPS has been awarded Best Innovation 2012 by the International Powerboat Association (UIM).
Sandvik Mining has selected Volvo Penta engines for its underground vehicles for the global mining industry. Engines meet Tier 4i/Stage IIIB emission standards and reduce fuel and ventilation costs.
Volvo Penta is providing the engines, drives and Dynamic Positioning Systems for a new class of support vessels for America's Cup.
This summer the MTS Duandra was launched in Benelux as the world's first semi-hybrid inland waterway tanker built by Shipyard Trico B.V. This ship uses Volvo Penta diesel engines for both propulsion and generator set that helps to reduce emissions significantly.
When the Italian leading boat magazine Vela e Motore appointed the prize Barca dell'anno (Boat of the Year) for 2012 – 11th edition, it was Volvo Penta power in four of five categories.
Volvo Penta's recently launched new V8-380 sterndrive engine has been awarded a prestigious IBEX Innovation Award.
Plus léger, plus propre, plus rapide et plus puissant, avec un rapport poids/puissance hors pair. Cette saison voit le lancement par Volvo Penta d'un moteur marin V8 essence dernier cri alliant technologie de pointe et performances, un moteur conforme (et de loin) aux exigences de la nouvelle norme EPA Tier 3.
Ron Huibers has been appointed new president of Volvo Penta Americas. He succeeds Clint Moore who earlier announced he has decided to retire.