text:
$1,125—$1,595 1—3 bed 30000 Rancho California Rd., Temecula CA, 92591
: from $1,125 1—3 bed
30000 Rancho California Rd., Temecula, 92591
Commute to Downtown Temecula
The rent at Portofino Apartments ranges from $1,125 for a one bedroom to a $1,595 three bedroom. Apartments in this building are about 8% less expensive than the Temecula average.
This apartment is in Temecula. Nearby parks include Margarita Community Park, Temecula Duck Pond Park and Sam Hicks Monument Park.
Portofino Apartments has a Walk Score of 48 out of 100. This location is a Car-Dependent neighborhood so most errands require a car.
Luxury living in the heart of Temecula's wine country! Portofino Apartment Homes elegant relaxed lifestyle is the perfect retreat from a busy world. A wealth of amenities including a state of the art fitness center, 2 pools, 2 spas, 2 tennis courts, video library, plus, we are minutes from fine dining, shopping at the new Promenade Mall and entertainment. Portofino offers you the finest in luxury living. Come and experience the difference.
Charlotte Curley
Oct 28, 2014
I lived at this property for a couple years in 2009 and the apartments were spacious and perfectly spread out. I loved the gas cooking stove because all other apartments in the area had electric. Maintenance guys always came and fixed any issues in a timely manner. Management and staff were not friendly but it wasn't a huge issue of mine considering I didn't have to bring up any ongoing problems to them. Property was always clean and well maintained.
Alaura Fonseca
Feb 25, 2014
I have lived at Portofino for the last 7 years. In that time they have had the same manager and the same maintenance man. Yes I too have had ants as did my house before I moved here, only difference is I had to pay a monthly pest control $75 a month to treat my house and yard. Portofino offers free weekly pest control as well as having a bee hive removed by my bedroom window. Portofino is over 13 yrs old, yes the appliances do break down but they are fixed. In fact every time I call to let them know my disposal is clogged, my smoke detector is beeping, toilet clogged or not flushing the repairs are made within a day for no charge unlike owning a home where you have to pay a plumber, electrician or a a/c man! I too have noticed the manager does drive her car to work every day... I can only assume because she dresses in a professional manner and wears heels every day...That driving to work saves her feet...or she has to pick up her children.. But is that anyone's business? So that leads me to wonder if the previous petty comments regarding the management driving a new car to work have anything to do with the management of our home or does come from a place of insecurity because you don't have a new car and can't wear heels? I'm only posting all this because I have referred friends to Portofino and they have come across a few negative reviews. As a supervisor in the retail management field, I remind them of that saying "the unhappy customer shouts it to the world but the majority of the happy/satisfied customers generally keep it to themselves"
Linsey Bidwell
Aug 14, 2013
Seriously ridiculous. It does look decent for the price (I'm from orange county and I'm sure the same place would have cost me $400+ more) definitely not luxury at all though. Quite a few problems with the appliances. The apartment complex next to us is extremely low rent (aka low class/ghetto) and therefore you have those types lurking around all the time. We walked up to someone breaking into my husbands car in broad daylight, my husband made him give everything back and the guy said he had a warrant and ran off. Classy. Talked to some of our neighbors and 5 in just our little court had their cars broken into as well in the past couple months. Definitely not as safe as you might think. Can't wait to get out of here. One more month until the lease is up!!
Cass J
Dec 26, 2012
I have been a resident for close to a year and I honestly have to say that this was the worst experience to date. There is absolutely nothing luxurious about these apartments. They keep the units closest to the rental office nice to attract prospective tenants but after that, it's terrible. I have never seen appliances this old in my life. If something breaks down, they replace it with another ancient appliance. It's embarassing for me to have friends or family visit me. The kitchen cabinets are old and chipped and they just keep putting putty on them so they look weird and spotted and it always smells moldy. Moving as soon as my lease is up. You can complain until you are blue in the face - they don't care. Don't come here!
A Google User
Jan 02, 2012
TERRIBLE!! The sprinklers constantly flood the walkways and make the grass all muddy, smelly waterway goes through the middle of the complex. Apartments are poorly painted (paint drops everywhere!) If you move stuff around you will find nasty dirt clobs all over! There is an awful ant problem also.. They will spray for them, but won't give you any traps or anything. They come right back.. The lighting is terrible in the apartment . In the living room their is no light. Just reminds you of the bummy apartment complex that you are in.. Poorly managed, the manager is rude, and she is only worried about showcasing her new white mustang outside. She takes a parking spot right in the front every day! YOU LIVE THEIR, PARK IN YOUR OWN SPOT.. Her apartment is less than a one block walk to the front.. But she still likes to park her mustang right up front. The Tennis courts are in bad shape, not all of the lights work on it either. The hot tub is constantly broken.. Never gets fixed properly! To top it all off.. WHEN YOU MOVE OUT THEY WILL CHARGE YOU TONS OF FEE'S (carpet cleaning, walls repainting, steam cleaning.. etc) I had over 400 dollars in fee's when i moved out in December because they said they had to repaint the walls.. I ONLY LIVED THEIR FOR 2 MONTHS.. I was never home but somehow they needed to repaint the entire apartment for "SCUFFS".. TAKE A DAMN RAG TO IT. or just tell me and i will get them out. Don't charge me $170 to repaint an apartment that was in AWFUL condition when i moved in.. I LEFT IT HOW I FOUND IT! TERRIBLE!!! TERRIBLE!! TERRIBLE!! don't move in here.. way better places within 1 mile.. PLUS SAVE YOUR KIDS FROM SEEING DRUNK PEOPLE WALKING AROUND LATE AT NIGHT. NOT TO FORGET THE CONSTANT SHADY (DRUG DEAL) LOOKING ACTIVITY..
Temecula, California, 92591
Most errands require a car.
Score Details
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Portofino Apartments is in the city of Temecula, CA. Temecula has an average Walk Score of 28 and has 100,097 residents.Learn More About Temecula


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|Industry Recognition
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After serving as a United States Army Officer from 1972 to 1976, I entered law school at Mizzou, graduating in 1979. Since then, I've been practicing civil... moreView all photos and/or videos
I endorse Mr. Rich McLeod. Rich is very well respected amongst lawyers and judges in the legal community. Even the most experienced lawyers in the... more

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Hiv And Colds
Here's a taste of what TheBody.com has to offer on this topic:
Ask the Experts
Dr Bob's Divine Sentence - "We could stop HIV cold in its tracks!"Dear Dr Bob, I just write to express my heartfelt "thank you" for your definitive (and kind) answer to my question, "What exactly is mycoplasma?" dated Feb 3, 2010. Your answer addressed my irrational fears, and also I hope, of other like minded...
Response from Robert J. Frascino, M.D.
The Robert James Frascino AIDS Foundation...healer, and friend" dated Jan 11, 2010. Dr Bob, on Day 30, I tested -ve on the OraQuick rapid test. I know from reading the archives that it is encouraging but not definitive unless taken at the 3 month mark. However, on Day 38, I tested +ve for... Read more »
mixing hiv meds with cold medsCan a pregnant woman with hiv take cold or cough medicine while currently taking hiv medication Read more »
HIV and coldsAre colds and sore throats together symptoms of HIV infection?? Read more »
Wall Street Journal Examines Experimental Procedure Modifying Cold Virus to Deliver HIV/AIDS Vaccine...School and the Dutch biotechnology company Crucell that might deliver experimental HIV/AIDS vaccines using a modified common cold virus. NIH and Merck have developed two experimental AIDS vaccines, currently in trials, that attempt to use... Read more »
Herpes Simplex (Cold Sores and Genital Herpes)...with no warning. Herpes can be active without symptoms or visible signs. Herpes simplex virus 1 (HSV1) is the common cause of cold sores (oral herpes) around the mouth. HSV2 normally causes genital herpes. However, through sexual activity, HSV1... Read more »
What Are the Symptoms of HIV and AIDS?...perfectly well-rested. It can make you break out into rashes, elevate your heart rate or cause you to wake up at night drenched in a cold sweat. In short, your mind can convince you that you have HIV when you don't. This can happen for any... Read more »
Women, Anemia and HIV/AIDS...breathing Rapid heart rate Pale skin Decreased pinkness of the lips, gums, lining of the eyelids, nail beds, and palms Feeling cold Confusion or loss of concentration Dizziness or fainting Sadness or depression Anemia and HIV Anemia... Read more »
Connect With Others
Cold sores /hiv infection
Posted by bug, 2 Replies...had sex with a prostitute and was so drunk(and stupid) i couldn't think of any possible dangers. The prostitute had several cold sores on her body. We had unprotected oral sex (lasted less than a minute) and 2 times protected vaginal sex. Next... Read more »
Sore Throat And Colds Have Nothing To Do With HIV!
Posted by Anonymous, 1 Reply...http://www.hopkins-aids.edu/forum/view_question.html?section_id=61&id=48209&category_id=0 The doctor says that neither the frequency of, nor susceptibility to common colds (including sore throat symptoms) is different in HIV+ people. Apart from... Read more »
Common Cold?
Posted by Anonym, 2 Replies...Is a constant cold (sneezing, runny nose, etc) a sign that you are close or even at at the point of full blown aids or a substantial decrease in Read more »
cold sores
Posted by Anonymous, 1 Reply...about 4 months ago(while under alot of stress) on my upper lip i noticed lots of little white bumps(tiny)I thought maybe it was cold sores but 3 months later they have not burst or anything, Iam wondering are they cold sores or something else,... Read more »
Resource Centers
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Christine U. Lashlee, 79, of Benton, passed away Tuesday, Sept. 25. She was born March 22, 1933 in Malvern.Â
Mrs. Lashlee was a member of Oak Grove Missionary Baptist Church. She was preceded in death by her parents, Benjamin Neill Carr and Ella Mae Carr and her husband, Jim Lashlee.
Juanita Bingham of Mabelvale passed away Friday, Sept. 21.
She was born to the late Lonnie and Ethel Brazil. She was a member of Pleasant Hill Baptist Church in Sardis. Her greatest joy was spending time with her family and children, whom she loved dearly. She was known for always putting others before herself.


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Are there any over the counter products that are comparable to nasacort aq?
- Posted:
- 16 Mar 2010 by kgibbas
- Topics:
- nasacort, nasacort aq
|Question is Closed
|Report Mark as Favorite
Answers (1)
28 Mar 2010
There are many steroid nasal sprays similar to Nasacort aq available over the counter.
See: http://www.drugs.com/drug-class/nasal-steroids.html - click on the drug name for more detailed information.
Talk to your pharmacist for advice.
Further Information
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Canon 50D, 100mm f2.8 macro
October Spring morning,
RAW, CS5 post-ed, tweaked with Nik's Silver Effex Pro, reverted back to colour
Beautiful Ell, you could just take out the ,with in the title and you've named a new rose. :)
True true, Maree! This lovely already has a name – forgotten it though, hehe ;-)
but I DO like your alternate title suggestion :-))) Many thanks for the fave! :-D x
– Ell-on-Wheels
OOO oooo oooo, fabulous !!!
Many many thanks, Di :-)))
– Ell-on-Wheels
so beautiful :)
Thank you Karin, very pleased to have your comment – your work is exquisite! :-)))
– Ell-on-Wheels
Simply wonderful.
Jane, thank you :-))
A bit of a 'floral distraction' (for a 'street' photographer!) at the moment, given my backyard is quite good with Spring blooms this year – I'm more normally found capturing people just being themselves in their day-to-day doings ;-)
– Ell-on-Wheels
Very nicely done :-)
I'm very pleased you like it, Trish, thanks so much :-)))
– Ell-on-Wheels
Just love this !
Tis a stunner Ell!
Sensuous, so sensuous. Even more enveloping enlarged!
Thank you very much, Cindy :-D
– Ell-on-Wheels


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Launcher Update
Get the Desktop App for Battle.net Now
- All your games in 1 place
- Log in once
- Automatic game updates
Posts: 682View profile
How long does it take to update?
You either came from WoW, where there's a TON of information available on profiles, or you're just upset about the game in general and you don't want to admit that Blizzard's on the right track with profiles. Either way, you're wrong, the profiles are well done and are a pretty nice start.
Community Manager
Posts: 1,405
But is there any way to make them private? I don't like people seeing my gear, lol. :p
We're glad you're enjoying the new character profiles! Like the World of Warcraft armory, all character profiles are intended to be visible within the Diablo III character profiles. It's a great way to share your progress into the depths of Sanctuary with your friends. :) Remember, if there's something else you'd like to see appear in a character profile, please make sure to let us know.
As a point of clarification: the character profile pages are spearheaded by our Web and Mobile team, as opposed to utilizing the resources of the Diablo III development team.
Quinthalus #6661
Posts: 21View profile
looks cool..
that's it.
or just fix the god damn game
Obviously Blizzard's going to make more money if players are happy, so it's not like they're avoiding updates just to be jerks. Give it time man, not all games are the final product on release, but with a few patches they can be better than you ever expected.
Don't get me wrong, I understand where the !@#$%ing is coming from, but just relax, the updates are coming. If you're not happy, take a break from the game and come back later.
Edited by demaxxus#1684 on 8/6/2012 4:34 PM PDT
Posts: 174View profile
I really like it! Not that my profile is very flattering in any way, shape or form, but it's just great to poke around and look at things about your characters in a laid-back, offline manner.
As a number of people have already said, it's also nifty as a reference for if you're asking the community for advice.
Thumbs up. Again, I really like it!
Posts: 21,413View profile
So you think people are just going to randomly brute-force passwords to hack someone's account over gear? You know Blizzard can see everything and will restore hacked accounts if you're honest. Be more defensive, don't click unknown links and don't buy illegal gold or even go to their websites. Virus check your comp often, don't log in from public/friend's computer. Use your authenticator, follow security precautions as advised by Bliizzard and you won't lose everything. That's common sense.
ps. your btag's been on forum avatars since forever. Protect your password.
pps. your email is your login name - make a separate email just for battle.net and never use it anywhere else.
Edited by vixie#1798 on 8/7/2012 2:17 PM PDT
Posts: 4,098View profile
I agree!
P.S. I wonder if Nebu is still around...
Posts: 1,092View profile
Well done on profiles feature, Blizzard. Hopefully it dramatically reduces the amount of pure whining on the forums.
For the haters, RMAH ruining the game, inferno is a gear check (so different from D2, yea right..) crowd : The profile feature is just a cunning money grab forcing you to buy a different Blizzard game so you can maintain your anonymity for whining purposes.
Tin foil hats ON!
More visibility = more risk. Period.
Posts: 270View profile
Well, I guess it is time for me to log off the forums for good. I do not like my profile being public at all, bugs me as well in game that people can peep at my gear and stats as it is. This is the end of the line for me on the forums.
I enjoyed them when I was not playing, and will continue to browse them logged out, but this will be my last post as that requires logging in.
Thanks for "nerfing" the forums for me, not. What a bad idea to not have a private feature, it is no ones business but my own how much I play and what I have. I am just disgusted by this.
Posts: 102View profile
One small point. The characters should be shown on site wearing their bad@$$ gear much like the main menu screen. Then have a tab to show the gear in inventory menu form with its actual stats and such.
Posts: 33View profile
Nice profile pages.... thumbs up.
Keep up the good work, btw, please release 1.0.4 asap.
Well, I guess it is time for me to log off the forums for good. I do not like my profile being public at all, bugs me as well in game that people can peep at my gear and stats as it is. This is the end of the line for me on the forums.
Although I agree with you on some levels, it's not like it actually lists how many hours you've played, just the percentage that you've played each class. Though if it listed the actual hours, yeah, I wouldn't be happy either.
Posts: 1,424View profile
Just waiting until threads are full of people posting on non-Diablo forum accounts...it'll be like the equivalent of posting on a level 1 alt, on the WoW boards back in the day.
Posts: 329View profile
Agreed. The character profile pages are sweet! Good job Web team!
Any thoughts on sharing your stash & inventory as well? Just a thought?
Threats of violence. We take these seriously and will alert the proper authorities.
Posts containing personal information about other players. This includes physical addresses, e-mail addresses, phone numbers, and inappropriate photos and/or videos.
Harassing or discriminatory language. This will not be tolerated.


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to insulate or not to insulate
I have a question, which will require a guesstimate from someone who knows the impact of insulating, specifically in the roof, above the ceiling.
We live in Markham, just north of Toronto, and are considering blowing insulation into the roof area of our 1700 square foot brick bungalow. We have done all the other walls in the house, and are considering doing this, when the kitchen is being renovated. However, it's going to cost us and additional $1,700 for this job, and we're not really sure if it will be economically feasible. This is an old house (double bricked) built in the late 60's when heating costs were not a majour concern. The contractor says that it is currently about R10, and that inslulating it would increase it to R50. Is there anyone out there who can give me some sort of guesstimate as to how much we might save on our heating bill (%wise), assuming cold winters. We will likely be in the house for the next 20 years, assuming we live that long.
Thanks for your help. I know this is a tricky question, but I'm really not sure if we should spend the money or not.
...... john
heat loss from unisulated attics is about 30%
if you air seal between living space and attic before
adding insulation you will see a savings, and an
improvement in comfort both summer and winter.
best of luck
Energy_rater means that you have to make sure all the holes are closed. Examples of holes are "can lights", holes drilled for cables and poorly sealed HVAC boots (if you have them in the ceiling).
Hi Ionized,
I'm sorry. I haven't the slightest idea what "can lights" or "HVAC boots", or even "holes drilled for cables" are.
Thanks David,
If I do do it, I will probably get the contractor to do it. I'm not a home improvement kind of guy.
However, 30%, 25%, even 15%, would probably be enough of a saving to justify doing it.
.... john
can lights are recessed lights
if Insulation Contact IC they have holes
in the housing. you will be able to see light
thru the holes when in the attic.
retrofit by boxing in with ice chest with 4" clearance
on top and sides, cutting ice chest to fit tightly to
attic floor and caulking in place.
or buy air tight inserts to retrofit from inside the
hvac boots are the supply box that attaches to attic floor
and supply grill on inside of house. I use mastic tape
remove the supply grill from inside the house and
seal sheetrock to inside of supply box (hvac boot)
at the same time mastic seal plenums (supply and return)
to equipment, and mastic seal ducts where they take off
from supply plenum. I use hardcast brand mastic tape
and paint on mastic that is applied with a brush.
electrical & plumbing penetrations are also sealed
prior to insulation install.
if you insulate without doing any of this you will
still see a savings, but to do these things before
insulating you will improve the indoor air quality
of the house (esp if using cellulose)
the average house has 30% duct/return leakage.
in our hot humid climate these leakage areas
introduct humidity laden air into the house.
hvac has to work harder to remove humidity.
while I understand the frustration of adding to
the list when wanting to simply blow insulation
and be done with it..these areas make a huge difference
in how the house performs.
insulation is essentially useless when air moves
through it. to complete the air barrier, and
minimize duct/return leakage is the right thing to do.
also be aware that cellulose creates a fine 'dust'
(actually borate treated newspaper) that enters
through small cracks in attic floor into house.
we can help advise your diy if you'd like.
best of luck.
Thanks again,
My contractor didn't mention anything like the things you speak of. I think he just intends to blow insulation into the space between the ceiling and roof. You, of course, would not recommend this. I would imagine that doing it 'the right way' will add significantly to the cost, probably rendering not cost effective (from my point of view). So, the question is, what would be the heat savings if he just blows the insulation in, without any of the steps you recommend? Any thoughts? Would you recommend this over doing nothing.
..... john
The frustrating thing is that a basic air sealing should be a few hundred dollars and perhaps increase savings from 25% to 35%. Caulk is pretty cheap. Even with the labor we aren't talking much.
In the end $1700 is not a terrible price for the insulation so you might ask him about air sealing - it won't be that bad.
With an old house, you might not have that many penetrations. Recessed cans were not that popular and I would presume you don't have forced air heat with ducts in the attic. Those are the 2 biggest leak points. Next is probably bathroom fans. After that, overhead lights and smoke detectors. All of these things are less common and less numerous on older houses. In a newer house, these things add up to tremendous leakage if not properly addressed.
Hi again,
Our contractor said that to put an air seal in our house he would have do majour renovations on the space about the ceiling, and that he intends only to blow insulation into that space. I reiterated my concern wrt whether the job is worth doing ...... $wise. After speaking with his insulation contractor, he told me that I can expect to save between $300 and $500/per year on my heating bill, and feels this is a conservative estimate. This would be between 17% and 28%, and seems to agree with what's being said here.
....... john
If you turn every light on in the house and go in the attic armed with a caulking gun and flashlight and seal anything that you see light coming through or where any wire or pipe you can find that goes from the attic down into the living space even just a few adds up. After you find some you will get 'snoopy' and want to find more. Each recessed light in my house was leaking 5cfm (cubic feet per minute) and I have 14. This is not including where other pipes and wires enter and exit.
If you seal only 20 cubic feet per minute of air leaks which doesn't seem like much but in a day thats 28,000 cubic feet in a DAY. A living space 50x50x8 has 20,000 cubic feet of air. If you THEN add insulation on top of that and do some other sealing here and there and some duct sealing the difference in comfort and money savings really will become noticeable.
If someone is going to seal its a WHOLE lot easier now than after a load of insulation is on top of everything.
The old 'cellulose' will pack in and seal the cracks and gaps is garbage. It will help somewhat but nothing like sealing the leaks shut and air going through cellulose or fiberglass as you open and close doors will pull dust and other stuff out of your attic in.


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Silicon Valley Astronomy Lectures
The Silicon Valley Astronomy Lectures, featuring noted scientists giving nontechnical illustrated lectures on recent...
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The Silicon Valley Astronomy Lectures, featuring noted scientists giving nontechnical illustrated lectures on recent developments in astronomy, are now available on their own YouTube Channel, at: http://www.youtube.com/SVAstronomyLectures/ The talks include: * Frank Drake discussing his modern view of the Drake Equation, * Michael Brown explaining how his discovery of Eris led to the demotion of Pluto, * Alex Filippenko talking about the latest ideas and observations of black holes, * Natalie Batalha sharing the latest planet discoveries from the Kepler mission, * Anthony Aguirre discussing how it is possible to have multiple universes, and * Chris McKay updating the Cassini discoveries about Saturn's moon Titan. The lectures are taped at Foothill College near San Francisco, and co-sponsored by NASA's Ames Research Center, the SETI Institute, and the Astronomical Society of the Pacific. Note that the top page of the channel shows the lectures in the order they happened to be uploaded to YouTube. If you want to see them in chronological order, select the Playlist option. Both new and older talks in the series will be added to the channel as time goes by. Many pioneering astronomers have given talks in this series since its founding in 1999; recent lectures are being recorded so that people around the world can "tune in.״
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Andrew Fraknoi
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VIEWS: 158 PAGES: 2 CATEGORY: Biology POSTED ON: 11/16/2012
A lab covering the basics of making a bacterial slide to view under the microscope. Covers the use of methylene blue stain and heat fixing.
Name: __________________________ Class: _____________________ Date: _____________________ Finding Bacteria from a Culture Looking at a petri dish, you might be able to see lots of circular colonies of bacteria growing. Each colony may contain millions of individual bacteria cells. The best way to learn more about what is growing in the culture is to isolate some of the cells and view them under a microscope. Sampling the Bacteria 1. Get a clean glass slide. Place a small drop of distilled water on the surface. 2. Take a metal inoculating loop and put the tip over a flame until it glows. 3. Allow the metal loop to cool long enough to stop glowing. Place it in an empty part of the agar (you should hear it sizzle as it cools.) 4. Scrape off part of one of the colonies and touch it to the droplet of water on the glass slide. The water should appear slightly cloudy. - Warning: If you add too much bacteria, they will clump together, and you won't be able to see them individually! 5. Burn the rest of the bacteria off the metal loop. Allow it to cool again. 6. Spread the water/bacteria mixture around the center part of the slide, making a thin film. 7. Allow the slide to air dry. (This will take a few minutes) 8. Pass the slide over a Bunsen burner 3 or 4 times to heat-fix the bacteria. This will hold them in place for staining. - Warning: Adding too much heat will distort the bacteria. The slide should be warm, not hot! Staining the Bacteria 9. Add enough Methylene Blue stain to cover the bacteria on the slide. Allow the dye to remain for 1-2 minutes. 10. Wash the excess stain off the slide with a little distilled water. 11. Take a small piece of paper towel and blot off the excess stain (do not rub!). 12. Place the slide under the microscope. Viewing the Bacteria 13. Place the microscope under the lowest power magnification. 14. Using the course adjustment (large) knob, focus the slide until it is clear. 15. Change to medium power magnification. 16. Use both the course and fine (small) adjustment knobs to focus the slide. 17. Change to high power magnification. 18. Use only the fine (small) adjustment knob to focus the slide. 19. Record your observations on the following pages. Biology Teaching Resources http://www.aurumscience.com Page 1 Data Take a prepared bacteria slide and place it under the microscope. Focus the microscope under high power. Scan through the slide and locate the three different shapes of bacteria. Draw a sample of bacteria from each shape below. Rod-shaped bacteria are named bacillus, sphere-shaped coccus, and spiral shaped spirilla. Label each of your drawings above with the correct term to indicate shape. Bacteria arranged in clusters are called "staphylo" while bacteria arranged in chains or pairs are called "strepto". Label each of your bacteria that show either of these patterns. Source: ______________ Source: ______________ Source: ______________ Source: ______________ Source: ______________ Source: ______________ Source: ______________ Source: ______________ Source: ______________ Page 2
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The Spirit of Troy
By Ralph Ford
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The Spirit of Troy composed by Ralph Ford. Concert Band. Concert Band; SmartMusic. Belwin Concert Band. Form: Overture. Grade 3. Conductor Score & Parts. 254 pages. Published by Belwin Music (AP.32522).
Spirited indeed, this Ralph Ford original overture provides ample opportunity to showcase every member of your ensemble. Opening with a broad and building fanfare, the work bursts with energy featuring a charismatic rhythmic foundation that sets the stage for several soloist statements. The work builds to a frenzy and develops quietly and reflectively to a dramatic, grandiose conclusion. Diverse and endearing, this is an outstanding choice for concert and contest alike! This title is available in SmartMusic.
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text: http://androidforums.com – My phone was deleted a few days ago, and I want to recover some specific conversations from Whatsapp. The issue is that the latest .db.crypt file I got is from July, and I do not know if the new version of the app has changed anything, but there is absolutely no way the phone recognizes an existing backup when I reinstall Whatsapp. I have tried several times but no luck at all. Any help appreciated. (General)


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Tag: young justice
Showing results 89-98 of 98
Art Baltazar and Franco Reform "Young Justice"
The writing team spoke with CBR News about their brand-new ongoing series from DC that brings the heroes of the new animated television show off the screen and onto the printed page.
SPINOFF: "Young Justice" Is In DC Continuity
More details have emerged about Cartoon Network's "Young Justice" animated series including the fact that the show takes place on Earth 16, placing it firmly in DC Comics' continuity. SPINOFF has the details.
X-Men: First Class, Green Lantern, Wolverine: Aug 17th Comic Reel
Jackman readies himself for "Wolverine" sequel. Tomar-Re of the "Green Lantern" Corps is ready for his close-up. "Hellboy" director talks a possible third film. Also, "The Avengers" in 3D and more.
Green Lantern, Spider-Man, Nemesis: Aug 9th Comic Reel
"Green Lantern" wraps principle photography! A "Basterd" for "Spider-Man" mystery villain? Tony Scott for Mark Millar's "Nemesis"! Also, "Batman 3" may shoot in New Orleans and more.
CCI: Producers Talk "Young Justice" Cartoon
Following their brief appearance at the "Batman: The Brave & the Bold" panel, animation producers Brandon Vietti and Greg Weisman spoke with CBR News about their new series, "Young Justice."
CCI: The DC Kids Panel
The shake-up of DC Comics' kids line was a major topic at their CCI panel, but along with reassuring young fans, DiDio, Art Baltazar, Franco and Mike Norton said, "Aw yeah, man!" to a new "Young Justice" series.
The Avengers, Dan Dare, Cowboys & Aliens: July 26th Comic Reel
"The Avengers" assemble at Comic-Con! Sam Worthington to be "Dan Dare!" First photo from "Cowboys & Aliens" arrives online! Also, will "Thor" see the Infinity Gauntlet and much more.
CCI: First Look At Animated "Young Justice"
Warner Bros. Animation has released a first look at the upcoming Cartoon Network series "Young Justice" featuring the YJ roster plus looks at Superman, Batman, Wonder Woman and other DCU heroes.
DC Confirms "Young Justice" Cartoon
Superboy, Robin, Kid Flash and more will join forces on the Cartoon Network this year for an all-new DC Entertainment animated series on the heels of a confirmed Adult Swim-style MAD Magazine show.
Iron Man 2, Justice League, Heroes: Feb 3rd Comic Reel
Don Cheadle says "no" to War Machine spin-off. A "Justice League" clip reveals the state of Earth-3. Season finale "Heroes" photos. Also, "Tron Legacy," "Young Justice" heads for TV & more.
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ARM Talks Up Wayland For Mali
Published on 23 August 2014 08:06 AM EDT
Written by
Michael Larabel
46 Comments
Earlier this month at SIGGRAPH, ARM and Collabora was talking up the benefits and possibilities for Wayland over X11.
ARM and Collabora have been working together to show off Wayland and in preparation for the SIGGRAPH conference earlier this month in Vancouver they got Wayland up and running on a Samsung Chromebook 2 with the latest ARM Mali graphics drivers.
ARM shared, "Replacing something such as X is not to be taken lightly; we view Wayland as the culmination of the last decade of the work by the entire open-source graphics community. Wayland reached 1.0 maturity in 2012, and since then has shipped in millions of smart TVs, set-top boxes, IVI systems, and more. This week at SIGGRAPH together with ARM, we have been showcasing some of our recent development on Wayland, as well as on the entire graphics stack, to provide best-in-class media playback with GStreamer."
Wayland was marketed for every frame being perfect, power and resource efficient, delivers a first-class media experience, and is easier to deploy and support. There was a blog post last week on the ARM web-site about their Wayland SIGGRAPH work, which had been on my TODO list to cover but with LinuxCon Chicago and Linux 3.17 articles it fell behind. For those that haven't already read the article, you can read the post at the
ARM Connected Community
. Embedded below is also a video by Collabora's Daniel Stone on the Wayland work they've done for ARM.
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A Raincoat For Your Stomach
With the monsoon finally gracing us with its pompous presence, coffee mugs and frying pans are bound to be put to greater use. However, as
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cloudchowk's will save healthcare from complex information management.Sajat Jain
Chicken Eaters have had a rather unpleasant weekend. The Centre for Science and Environment (CSE) sent shock waves across the non vegetarian community with its
India's best cloud driven medical lab information management software. Improve operational efficiency and easily share information with doctors and patients.Ravi Sharma
Despite more than 24 Million people worldwide suffering its effects, Schizophrenia is unfortunately largely misunderstood, and very often, misdiagnosed. Besides being brushed aside as being
Popular Belief, much like Common Sense, doesn't always scream factual correctness or consistency- what with the world having been discovered to be round after all-
Loaded with features for better clinic and hospital management.Sajat Jain
The Indian Monsoon sees everything from minor dust storms to violent thunderstorms. It always comes suddenly; one week we're staring at the skies, shying away


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February 2014, TruckingInfo.com - WebXclusive
By Denise Rondini
The trucking industry is extremely competitive, and shippers have lots of choices when it comes to getting their products to market. If you are going to capture business, you need to stand out from the crowd.
Tags: Competition, Business, HDAW 2014
We offer e-newsletters that deliver targeted news and information for the entire fleet industry.
The expert, Mark Betner from CITGO, will answer your questions
The expert, Rence Oliphant from Hendrickson, will answer your questions
Drones And the Future of Package Delivery
How Will 3D Printing Affect Trucking?
Ultimate Test Drive Video: Brain and Brawn
Ultimate Test Drive Video: Small Block, Big Load
Dynasys SL Auxiliary Power Unit
Webasto Releases Advanced Heater Controls
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Cloud-Based In-Cab Video System Launched


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fond terrorisme© alain wacquier - See portfolio
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["attack","awe","background","ban","bomb","buttons","cloud","danger","dead","demolition","extremist","eyesore","fear","hatred","no","refusal","stop","tags","targeting","team","terrorism","terrorist","word"]attack awe background ban bomb buttons cloud danger dead demolition extremist eyesore fear hatred no refusal stop tags targeting team terrorism terrorist word
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Top-Hat Games
Top-Hat Entertainment
Im jewish and i enjoy games and movies. although the are not my life i still watch alot of movies and play many many games. i also enjoy making people angry,
Top-Hat Games
Top-Hat Entertainment
great work jebus
Like real life? DUHHHHHHHHHHHHHH
aww man, well that sucks and its a shame but while you were working you did a bunch of great work, sucks to c u go
Very cool mod, ill definitly play this upon release
This is a great idea, Good luck
Jst asking if anyone using this is still alive, what happens when one person dies?
looking very nice, keep it up
you and me both but it still loosk great
swedish people rule... keep on ruling my swedish brother
if u need another voice in the mod ill take any part and i got a couple of great voices that u might like.
im having some trouble watching the video on this page iss their another link to it? also wats twith the psp game gateway?
Is this mod dead? oh yea i already killed it... OVER KILL
Is this mod dead?
has anyone been able to get it to work yet>? or does the site have a new domain name?
looks very nice XD good luck with development
it really sucks that this died someonw should definitly make a bleach mod
this update looks really cool XD great great work
gerat vid XDD im gunna try out first strike XD nice
great pic
AND another one bites the dust , dead mod ( liked the name though XD )
dead mod?
dead mod?
dead mod?
dead mod?
is this a dead mod?
yea dead
is this dead?
kik *** pic XD wat game?
wow great video XD! why didnt u tell me u were working on one lol!
no use cars dont take shortcuts like that or the mod will be ****
I like the menu choice but the backround i personally like more would be the desk only cause it makes u feel like ur going to start his story idk im just weird but still XD nice cjhoice this backround was gunan be my second choice anywaysXD
cul stry braaaaaaaaaaaaaa
XD alright btw please fix your spelling in your comments their very newby.
also try not to get so offended, their just comments.
The trollz vid is done ill give it to you to upload on ur acc XD
its cause he deletes all the comments he finds offensive which is ok its his mod he can do what he wants
hot dog costume looks funny btw nice job on that, but to be serious for a second here. how many maps are you gonna make for this mod dec?
Memebrs are being invited if you wish to joine please apply.
TROLLZ UNITED, blastoff at the speed of light
To denounce the evils of truth and love
To protect the world from devestation
OMG dec is cheating on meh wif u!??? HOW DARE THAT FKN FGOT!!!!!
Is this profile page dead?
you will? see soon?
this mod is loooking good lol keep up the nice work
make sure the tv sais wanted for 5 murders not convicted. but it sounds cool
dont reduce the spec lights too much it looks good but maybe get rid of the repeating textures like at 00:27 on the wall
I as the AoD of ModdB can forsee the future and to this mod i will wish luck lots and lots of luck
hey this is looking very sweet u guys had a great idea and id say some real talent keep it up
eww unreal? man that sucks well keep up the good work
the video for the mod right now is reallly cool looking im definitly guna try this mod upon release
maps look really professional id say this mod will look very nice when its all done. keep up the great work
hey hey this is looking pretty D's so far lol im licking it i hope it all worx out for u all
dude the map is amazing GREAT JOB no wonder its taken u this long for the map it looks absolutly amazing and professional
well im jus happy it wasnt something seriuse
the technology was made to counter the apposeing forces tecnology.. dont worry you will find out everything you will need to know apon game realease
and another one bites the dust, dead mod
wow looks great, i didnt even know people still cared about 1.6 .. i stoped playin it cause everyone is a douche bag but this mod looks liek real fun
I declare this mod dead
Dead mod
Is This mod is dead ?
hey dude i dont know what i said.. cause it was a long time ago but im sry if i offended any1
very meh right now hope this is like pre-alpha or something the idea has been done but i have no problem playing it if u add some melee wepons like what dead rising had
nice screen shots XD when can we expect a gameplay vid XD
=========every one below this comment needs to calm done cause no one was ment to be offended ========== ========== =========== ========== =====
ALSO this mod looks very cool good luck with the dev XD u got me watching
i hope this mod pwn XD wait its online right?
I agree with dec1234 good luck XD i hope u surpas the others
AND another one bites the dust , dead mod
AND another one bites the dust , dead mod
dead mod
LOl bFg XD
this looks so good im thankfull u guys pushd back the release date XD ill make sure this mod never dies


text:
Tim is dead on Great first or just fun to fly jet Mine was only reinforced glue joints with carpenters glue and stuffed a dowel in the tube My last flight i did a blender with it and the...
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Type: Posts; User: TCHIEF
Tim is dead on Great first or just fun to fly jet Mine was only reinforced glue joints with carpenters glue and stuffed a dowel in the tube My last flight i did a blender with it and the...
DAMN why cant deals like this show up in my area
T-38 Talon
We had the same problem with Team Geritol at our club wanting to ban turbines It went to the point the point of ready to file a law suit because it was a public field and as far as the City of...
Tim and I also didnt mention that we fly them both off of a 370 ft runway the one in the background
Mine is the second generation kit that is flat bottomed for a single ramtec or turbine
It has full controls aile and flaps I dont trust using elevons loose one surface and you loose the jet...
I have the old Avonds and my friend Tim has the Yellow Aircraft The Avonds was built out to 23 lbs dry the yellow was at 29 lbs dry both of us are using a fte 750 the avonds i did not duct the...
If using UPS build it out of 1/4 " steel plate and wrap it in plastic and incase it with concrete and i would still insure it
Looks like house of balsa or the Pauls flying stuff f86
UPS Ultimate Package Smashers sometimes i wonder if they use the package as a parking brake
8411 ultra torque mg 188 oz on 6 volts used them on my elevators on my jets with no problems
JR 8411 on 6 volts and stock build with the fiber glass horns
I was the one Andy (Barracuda Hockey)was talking about It was a new build with a dle 55 and pipe built to specs by the book It took off and I climbed out about 45degrees and pulled back on the...
resin has my vote
After seeing the guys brand new f15 in ashes in his shop I pull mine out
I have had a battery go up in smoke 45 minutes after i strained it through some trees so i dont trust them
I use a stanley fat max 22 it holds a 5 gallon fuel can in the bottom my air compressor and propane in the top and tools in between and it rolls plus you can stack a small bit on top between...
the guy probably saw a couple of hot starts and got a good idea
mine does also it howls like mad while throttled up and my friends yellow f15 sounds about the same
knights of the air i still have one
cutest little cigarette lighter ive ever seen
Ive done that many times with my planes amazingly with the same results tumbling after the impact
then you might have a problem with a tail pipe collapse aka the pilots sphincter
what they really need to use if it were to fly is the turbo encabulator off of a B-17
what happend to the f-16
it looks more like UPS shipping damage
that looks like some skunkworks for an early model jetjoe


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Looking for Teak Patio Furniture or other wood on-line
Hi all,
We are looking for better teak or other wood (is teak the best?) for our new Florida pool patio. My SO wants wood, I am thinking cast aluminum because of maintenance issues associated with wood.
Can anyone suggest an on-line dealer or any insight on wood vs. metal?
Teak wood is a kind of wood that has been well known as the strongest kind of woods. There are no other kinds of woods that could be as strong as the teak wood. The eminence of the teak wood is that this wood could handle such extreme weather changes. There wouldn�t be any problems at all for the teak furniture if we out it outside for such long times. Definitely, the teak wood is the perfect material for the outdoor furniture.
Do you have to stain teak regularly to maintain it due to outdoor exposure? I'm so tired of having to retain our wood deck and other outdoor furniture regularly; we get quite a bit of rain thorough out the year. I told myself that our next set of outdoor furniture will be something that does not require so much maintenance to maintain its good looks.


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Davis at the Legislature: Rain, brand fees, state aid to schools
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Click Here for theHOTTEST SHEETS!
The North Platte Public Library book sale began at noon Thursday for members of the "Friends of the Library," with more than 10,000 books on sale.
The sale Thursday is only for dues paying "Friends," but the general public is invited at 9 a.m. Friday and Saturday, continuing until 5 p.m. each day.
The RSVP volunteers have baked goodies for sale, and book gift baskets are also for sale, library director Cecilia Lawrence said.
Flatrock Publishing, Inc.
1300 E 4th St., Suite F
North Platte, NE 69101


text:
A tube for implantation into the eye for replacement conduction of aqueous humor from the chambers of the eyeball to the subconjunctival tissue and ultimately to the venous system is comprised of an elongated fluid conducting conduit having distal and proximate ends, a sidewall and an interior passageway and at least one longitudinally extending opening in the sidewall that exposes the interior passageway and at least one nidi-forming structure carried by the conduit and extending laterally therefrom to implement the formation of at least one aqueous filtration bleb in the tissue of the eyeball. In one embodiment, the tube also contains at least one releasable ligature circumscribing the conduit. In another embodiment, the tube also contains an anchor appended to the conduit to prevent it from migrating from its placement site.
1. A tube for implantation into the eye for replacement conduction of aqueous humor from the chambers of the eyeball to the subconjunctival tissue and ultimately the venous system, comprising:
an elongated fluid conducting conduit having distal and proximate ends, a sidewall and an interior passageway and at least one longitudinally extending opening in the sidewall that exposes the interior passageway; and
at least one nidi-forming means carried by the conduit and extending laterally therefrom to implement the formation of at least one aqueous filtration bleb in the tissue of the eyeball.
2. The tube of
3. The tube implant of
4. The tube of
5. The tube of
6. The tube of
7. The tube of
The invention described herein may be manufactured and used by or for the Government of the United States for all governmental purposes without the payment of any royalty.
The present invention relates generally to tubular shunts for the control of intraocular pressure in glaucomatous eyes, and more specifically to a tubular shunt with a C-shaped radial cross section along portions of the tube and a method of controlling intraocular pressure.
Glaucoma is a disease characterized by high pressure inside the eye, leading to the loss of retinal nerve fibers with a corresponding loss of vision. Glaucoma therefore is a disease affecting the optic nerve, the nerve bundle which carries visual information to the brain.
The eyeball is basically a rigid sphere filled with fluid. Positive pressure inside the eye is needed to keep the retina attached to the back of the eye. Pressure is maintained by fluid production from a bilayer of cells on top of the ciliary body, which is located adjacent to the iris root in the eye. This clear fluid called aqueous humor carries nutrients to the lens and cornea of the eye, both of which have no blood supply. The shape of the front part of the eye is maintained by aqueous humor production. The ciliary body is located behind the colored part of the eye (iris). Fibrous strands called zonule fibers attached to the ciliary body support the lens. Tension from the rigid structure of the eye, transferred to these zonules, deforms the lens and focuses the image onto the retina. Radial muscles behind the ciliary body, contract and release tension on the zonules allowing the lens to round up and focus near images onto the retina. Aqueous humor flows into the front of the eye through the pupil and drains out of the eye through the trabecular meshwork. The trabecular meshwork is a spongy mass of tiny channels located in the drainage angle, between the clear covering of the eye (cornea) and the colored part (iris) at the location where the iris meets the white outer covering of the eye (sclera). The fluid drains from the meshwork into a small canal, called Schlemm's canal, which is connected to the bloodstream at the venous return from the eye. Aqueous humor is produced by the ciliary body and removed from the eye at a constant rate (about 1.0 tsp or 5.0 ml per day) to maintain a constant pressure in the front (anterior) chamber of the eye. While pressure in the eye varies throughout the day, the average pressure within the eye is 10 mm Hg to 21 mm Hg. If the resistance to fluid flow increases or the amount of fluid generated exceeds the capacity of the meshwork to vent it, pressure inside the eye increases, similar to over-inflating a tire. The higher the pressure inside the eye, the greater the chance of damage to the optic nerve. Glaucoma is the leading cause of blindness in third world countries, and the leading cause of preventable blindness in industrial countries. It affects approximately 2% of the entire population; blacks and native Americans are disproportionately represented, with elevated occurrence of the disease. Early signs of the disease are often observed as enlargement and cupping of the physiological blind spot which is the point where the optic nerve leaves the eyeball and projects to the brain. Blind spots in the superior and inferior visual fields (called arcuate scotomas) correspond to the loss of nerve cells. In later stages more visual field losses eventually end in total blindness. If the drainage angle becomes blocked, fluid pressure transferred throughout the eye increases, damaging the optic nerve�the part of the eye responsible for transforming images into impulses the brain can translate. This damage results in partial or complete blindness.
In acute angle-closure glaucoma, eye pressure builds up rapidly. This type of glaucoma commonly occurs in individuals who have narrow anterior chamber angles. In these cases, aqueous fluid behind the iris cannot pass through the pupil and pushes the iris forward, preventing aqueous drainage through the angle. It is as though a sheet of paper floating near a drain suddenly drops over the opening and blocks the flow out of the sink. In cases of acute angle closure glaucoma, one may experience blurred vision, halos around lights, pain, nausea, and vomiting. If pressure within the eye is not immediately relieved, blindness may result in a matter of days. Migration of pigmented epithelial cells in the eye either congenital or following blunt trauma can occlude angle structures quickly elevating pressure in the eye. Primary open-angle glaucoma has a longer time course and many components that exacerbate the condition. The end effect is the same. Secondary glaucoma can occur from inflammation, degeneration, trauma, or tumor growth within the eye. Certain medications are also reported to cause secondary glaucoma. In summary, the disease glaucoma is a plethora of conditions that elevate intraocular pressure. Left uncontrolled, high intraocular pressure leads to blindness.
In the detection of glaucoma, measuring the pressure in the eye by itself does not give a diagnosis of glaucoma. Of more importance is the direct observation of damage to the optic nerve itself and sometimes the nerve fiber layer of the retina. Quantifying a loss of vision in part of the visual field consistent with observed nerve fiber loss is the true definitive diagnosis for glaucoma. Loss of nerve fibers caused by glaucoma cannot be reversed. Therefore, the goal in the management of glaucoma is to reduce the intraocular pressure to the point whereby the remaining healthy nerve fibers are able to maintain function.
Glaucoma is usually controlled with eye drops taken several times a day, sometimes in combination with pills. These medications are used to prevent damage to the optic nerve by decreasing eye pressure, either by slowing the production of aqueous fluid within the eye or by improving the flow leaving the drainage angle structures. If topical and/or oral therapy does not control intraocular pressure, laser surgery may be an effective alternative treatment or adjunct. A laser can be used in one of two ways. In open-angle glaucoma, the laser is used to puncture a hole and enlarge the drain (laser trabeculectomy) or a low power beam can be used to form scar tissue that contracts and pulls on the meshwork (trabeculoplasty) to improve outflow of aqueous humor and lower pressure in the eye. In angle-closure glaucoma, a laser can create a hole in the iris (iridotomy) to improve the flow of aqueous fluid to the drain. Another surgical procedure using a knife controls pressure by creating a new drainage channel, trabeculectomy, through the angle structures to the extracellular space beneath the conjunctiva. If the hole through the meshwork is too large, the outflow rate will exceed production, reducing the intraocular pressure so low (a condition called pthisis bulbi) that the retina is in danger of detachment. Once the anterior chamber is breached, a capsule often forms around a fluid filled cavity called a bleb, a medical term for a blister, and vents aqueous humor from the eye, thereby lowering the intraocular pressure. The capsule prevents decompression of the anterior chamber by providing resistance to flow. The capsule filters aqueous humor to the extracellular space under the conjunctiva.
Scarring of the opening after surgery is the most common problem with trabeculectomy. Likewise, the capsule can scar with fibrous tissue and cease filtration. The risk of excessive scarring is sometimes decreased when corticosteroids are used after surgery. An antifibrotic, 5-fluorouracil, may be used to prevent scarring, which is the most common cause of bleb failure. If bleb failure continues to be a problem, a drainage device called a seton may be placed in the eye to help keep the channel open and draining fluid.
Earlier work by the inventor, described in Michael J. Wilcox, Ph.D., and Donald S. Minckler, M.D., �Hypothesis for Improving Accessory Filtration by Using Geometry,� Journal of Glaucoma 3:244�247 (1994), proposes an improved tube shunt which should allow control of intraocular pressure in glaucomatous eyes that do not respond to other approaches. That hypothesis was recently tested and the performance of the device reported in Journal of Glaucoma 9:74�82 (2000). The overwhelming cause of compromise in accessory filtration devices is excessive fibrosis, i.e., buildup of scar tissue, on the filtering capsule over time. In conventional implants, inserting a tube provides a conduit for aqueous humor to bypass angle structures and enter the large blister-like cavity called a bleb, which is formed around a plate to provide a two dimensional nidus of a given surface area. The fibrous capsule formed around the cavity provides most of the resistance to outflow of aqueous that filters into the adjacent extracellular space. Continuous buildup of fibrous tissue in the capsule leads to decreased outflow with consequent re-elevation of intraocular pressure and failure of the device. The Journal of Glaucoma (1994) article described two recent studies that may improve understanding the mechanisms of filtration and fibrosis and could supply a countermeasure to this stimulus to fibrose. First, studies of primate eyes with experimental glaucoma had demonstrated that aqueous outflow through a Molteno implant functions by passive filtration, with little contribution from vascular routes. Second, recent experimental evidence suggested that mechanical deformation of cultured fibroblasts stimulates them to lay down more extracellular matrix. Based on these two premises, a design was conceived for countering this stimulus by using the geometry of the implant to reduce tension on the capsule surrounding the implant. An additional advantage of that new implant design is that it provided an easily customized total surface area that will minimize the volume of functioning blebs and, at the same time, maintain or even increase the total filtering surface of the capsule. Decreasing the size of the lumen of a bleb alone will reduce surface tension on the capsule wall, thereby reducing the fibrosing stimulus and extending the useful life of accessory filtration devices. Moreover, decreased volume will reduce extraocular muscle complications. Consistent with a passive filtration mechanism, total outflow through conventional implants is proportional to the surface area of the capsule. Each glaucomatous eye differs in the extent of damage to the normal aqueous outflow routes. Therefore, easily customized surface area allows tailoring each implant to the accessory filtration needed. In the case of the present device, the surface area is proportional to the length of the implant. Cutting appropriate lengths of tubing will give the desired filtration surface area.
Capsule fibrosis remains the major source of compromise for accessory filtration devices. It has been suggested that aqueous humor has a stimulatory effect on fibroblasts, causing them to lay down more extracellular matrix and effectively doom these filtering procedures. However, improved filtration in mature, functioning blebs suggests that perfusion with aqueous humor paradoxically contributes to improved permeability. This notion is consistent with the idea that capsules do become better filters with time, provided intraocular pressure remains controlled. In time, the quality of the capsule changes and the bleb acquires a more diffuse boundary. From his original studies, Molteno noted poor long-term control of intraocular pressure if excessive postoperative inflammation remained, resulting in immediate re-elevation of intraocular pressure. Alternatively, if intraocular pressure were well controlled after tube opening and inflammation were minimal, long periods with controlled intraocular pressure followed. Molteno has justified his initial use of systemic antifibrosis therapy on the basis of suppressing inflammatory response, to minimize postoperative capsular fibrosis. Indeed, his series of long-term successes with histological study (some exceeding 15 years) show minimal capsule fibrosis and virtually nonexistent inflammatory infiltrate.
Retrospective examination of these observations suggested that increased tension on the capsule due to high pressure stimulated fibrosis. Hypervascularity of a bleb is associated with poor function, presumably due to fibrosis. In other tissues, inflammatory infiltrates bring enzymes that initially degrade collagen, but this episode is followed by remodeling and augmented rebuilding of the collagen matrix. Research into vascular mechanisms of fibrosis offered insight into the reason for this extracellular buildup. Mechanical tension induces connective tissue synthesis by stimulating cells to produce more extracellular matrix. Mechanically stretching cultured mesangial cells increases their production of collagen and other extracellular matrix components, without affecting cell division. Once matrix deformation ends, cells return to a more quiescent state, suggesting that vascular leakage continues to stretch the matrix and stimulates fibroblasts to reinforce it.
Collagen deposition in a fibrosing matrix is an extra-cellular process. In aqueous humor there are usually no inflammatory infiltrates to stimulate fibroblasts. Therefore, if inflammation of the bleb can be kept to a minimum, fibrosis will be minimized. However, aqueous outflow can function to wash out molecular collagen before it incorporates into the extracellular matrix. Hence, two processes must be interacting in functional blebs and regulating both is required to minimize fibrosis. First, tension stimulates fibroblasts to excrete more pro-collagen, which becomes incorporated into the extracellular matrix. Second, aqueous perfusion washes out pro-collagen before it becomes part of the matrix. Therefore, two approaches may limit the incessant collagen deposition: decreased pro-collagen production by reducing surface tension and/or increased outflow to wash out molecular collagen before incorporation into the extracellular matrix.
In the case of long-term failures in accessory filtration, fibroblasts apparently proliferate or migrate into a stretched capsule and lay down matrix in an attempt to strengthen the relatively thin walled structure. A fibrous extracellular matrix compromises filtration, leading to decreased outflow and re-elevation of intraocular pressure. The role of surface tension in capsule structure and function has both a mechanical and a geometrical component to it. In Laplace's well-known soap bubble experiment, he showed that a large pressurized cavity exerts greater tension on its wall than a small cavity does at the same internal pressure. Laplace's law states that along a single dimension, tension on the wall is proportional to the pressure and also to the radius of the cavity. The same concept has been used to explain the difference in thickness between large vessels and capillaries. Even though the pressure gradient across a capillary is much higher than the gradient across the vena cava, the thin walls of capillaries do not rupture because the tension on their walls is actually less than tension on the wall of the vena cava. This is due simply to the smaller diameter of the lumen of the capillary.
Conventional implant devices for reduction of intraocular pressure are exemplified in the patents to Molteno (U.S. Pat. No. 4,750,901), Schocket (U.S. Pat. No. 4,826,478), Mateen (U.S. Pat. No. 5,785,674), and Baerveldt (U.S. Pat. No. 6,050,970). These conventional implant devices all have a tube extending from the anterior chamber to some sort of plate-or loop of predetermined size and shape, around which forms a filtration capsule. The filtration capacity of a capsule formed in this manner is therefore predetermined by the total surface area of the plates or loops around which the capsule forms as well as the permeability of the capsule as determined by its thickness. This includes an anterior chamber tubule shunt to an encircling band and an anterior chamber shunt to a surgical membrane. These are installed far behind far behind the extraoccular muscles around the equator of the eyeball, in order to avoid muscle complications. Still these other devices have problems with excess fibrosis. My present invention is the only one that uses the approach of minimizing the dimension of the lumen in order to minimize fibrosis. I have achieved this in animal studies and my present research suggests that the amount of fibrosis can be controlled with the present invention thereby producing a functional implant with a lifetime equal to that of the person receiving the implant.
Reducing tension on the formed capsule wall by decreasing the size of the lumen was a logical design modification. A cylinder is an ideal geometry for minimizing volume, while maximizing surface area. The small diameter of the cylindrical bleb decreases tension on the formed capsule wall and, thus, decreases fibrosing stimuli. The prior art implant shown in
As with most surgical intervention, in the early postoperative days, there is a seton effect, where aqueous leakage occurs along the path where the implant enters the anterior chamber. It is during this period that the eye is at risk due to hypotony, i.e. low pressure. Therefore, like the Molteno implant, the newly installed tube is ligated initially, until a proper capsule can grow around the implant. The weakest tissue adhesion point in implants is between the fibrous capsule and the latex tubing. The portion removed along the side of the implant to form a C-shaped cross section as shown in
A cylinder provides an ideal geometry for both these qualities. The additional benefit of customized surface area and minimal volume had other desirable effects that avoid complications seen with the use of other implant designs. This concept was tested in animals and recently reported in Journal of Glaucoma 9; 74�82 (2000). An improved outflow from this accessory filtration device was attained by reducing surface tension on the capsule and increasing the effective surface area filtering aqueous, attaining an eight-fold increased hydraulic conductivity of the capsule with a concomitant reduction in capsule thickness compared to Baerveldt and Molteno implants. Reduced tension on the bleb counters the stimulus for capsular fibrosis and should extend the useful lives of these accessory filtration devices.
Further improvements, however, may still be made to the earlier improved tube shunt apparatus and procedure.
It is, therefore, a principal object of the present invention to provide a post-surgical ability to customize the implant by increasing its surface area, without the need of further surgery or an additional implant, by simply removing a ligature or series of ligatures after post-surgical intraocular pressure has been determined. This results in increased flow of aqueous humor and reduced intraocular pressure.
Another object of the present invention is to provide an anchor for the implant, which is attachable to the sclera at the limbus. This has the advantage of preventing migration of the implant into the anterior chamber.
Another object of the present invention is to provide a further three-fold reduction in bleb diameter resulting in a capsule only one cell layer thick, with the advantage that the resultant structure approaches the dimensions of the trabecular meshwork in a human eye.
Another object of the present invention is to provide a post-surgical ability to customize the total surface area of the implant by increasing filtration surface area without the need of further surgery or an additional implant by simply removing, after post-surgical intraocular pressure has been determined, a ligature or series of ligatures located at intact portions along the length of the insert situated between C-shaped, open, cross-sectional portions.
Another object of the present invention is to provide an implant with a resultant reduced surface tension on the wall of the implant with the advantage that fibrosis is minimized, thereby allowing continuous and on-going hydraulic conductivity of aqueous with a concomitant reduction in intraocular pressure to a safe and stabilized level.
Another object of the present invention is to provide an implant nidus with a scalloped cross-section whereby separation of the fibrous tissue of the bleb from the implant nidus is facilitated and the cross-sectional dimension of the nidus may be reduced as compared to a smooth, round surface.
Another object of the present invention is to provide a method for reducing intraocular pressure by creating a cylindrical bleb for producing improved accessory filtration by implanting a cylindrical tube having a proximal end and distal end, the distal portion of the cylindrical tube side wall being removed, into an eye to serve as a nidus for a conduit of aqueous humor to bypass angle structures.
These and other objects, features and advantages of the present invention will be apparent in the description of representative embodiments.
The present invention comprises an implant for the reduction of intraocular pressure. The novelty of the present invention is a post-surgical ability to customize the total surface area of the implant, increasing fluid filtration by increasing surface area without the need of further surgery or an additional implant. After post-surgical intraocular pressure has been determined, a ligature or series of ligatures located at intact portions along the length of the implant situated between C-shaped, open, cross-sectional portions can simply be removed. The present invention also comprises an implant anchor attachable to the sclera at the limbus and having the advantage of preventing migration of the implant into the anterior chamber. The invention provides a further three-fold reduction in bleb diameter as compared to the prior art resulting in a thinner capsule with hydraulic conductivity higher than capsules around implants of any prior art. Such a capsule, in the best case only one cell layer thick, has the further advantage that the resultant structure approaches the dimensions of the normal trabecular meshwork in a human eye. The small diameter of the present invention provides an implant with a resultant low surface tension on the wall of the capsule with the advantage that fibrosis is minimized, thereby allowing a constant filtration rate of aqueous and reduction in intraocular pressure to a safe and stabilized level.
The implant consists of a cylindrical tube with a diameter of approximately three hundred micrometers and with proximal end and a distal end for implantation into an eye to serve as a conduit for aqueous humor to bypass angle structures. Where a lateral portion of the tube is removed, the interior of the tube is exposed creating an open side walled portion of the tube. A cross section of the open side walled portion normal to the length of the tube is in the shape of an arch. The tube may further comprise a series of lateral portions where the sidewall of the tube is removed. Removed lateral portions are located serially along the length of the tube and separated by whole cylindrical portions. Lateral portions are situated in a non-overlapping configuration. A ligature is tied to each of the whole cylindrical portions whereby flow through the whole cylindrical portions is prevented until the ligature is released. A second form of anchor comprises a split end of the tube wherein the end of the tube is split multiple times.
The invention may also incorporate a portion, scalloped (or asterisk-shaped) in cross section, extending outwardly from at least one side of the exposed interior of the tube to further serve as a nidus for cell growth and capsule formation. The scalloped portion has a radius of 50 microns from the center to the tip of the scallop, a tip width of 5 microns, and preferably extends between 10 millimeters and 20 millimeters in a normal direction from the tube. If the capsule or bleb is deposited onto a smooth, solid surface, pressure from the anterior chamber may not always be sufficient to separate the capsule from the smooth, solid surface and inflate a volume in the subconjunctival space. If a bleb does not form or if the capsule remains attached to the implant material, it will not vent fluid and will not become functional.
The method of the present invention for reducing intraocular pressure by creating a cylindrical bleb for producing improved accessory filtration comprises the steps of implanting a cylindrical tube having a proximal end and distal end. The proximal end of the tube is intact and serves as a conduit for aqueous humor to bypass the angle structures. The distal portion of the cylindrical tube has the side wall removed to allow fibrous tissue to form on its surface. Once this fibrous capsule has formed, a ligature around the intact portion of the tube is removed. Pressurized aqueous humor from the anterior chamber elevates the capsule into a functional bleb that filters aqueous humor into the extracellular space underneath the conjunctiva. This fluid is eventually removed from the eye and reenters the vascular circulation. Installation consists of the steps of incising the conjunctiva, elevating the conjunctiva from the sclera, implanting the distal portion of the cylindrical tube under the conjunctiva, anchoring the proximal end of the cylindrical tube to the sclera at the limbus, inserting the proximal, intact end of the tube into the anterior chamber through a needle track, ligating the proximal end to prevent hypotony, allowing approximately one week for cell growth around the tube, releasing a ligature around the proximal end after approximately one week to inflate the bleb, measuring the intraocular pressure to determine if additional drainage is required, if additional drainage is required, releasing additional ligatures whereby additional blebs are inflated.
The present invention will be more clearly understood from a reading of the following detailed description in conjunction with the accompanying drawings wherein:
Referring now to
The inserted tube may be made of latex or any other suitable, flexible material. Flexible material is chosen to prevent erosion of eye tissues in contact with the implant. The proximal end 34 comprises a whole cylindrical portion 46 which is ligated, i.e., tied off with ligature 44 as shown in
The tube of the present embodiment is bifurcated at distal end 36,
Referring to
The advantage of the scalloped geometry is that, if the capsule or bleb is deposited onto a smooth, solid surface, pressure from the anterior chamber may not always be sufficient to separate the capsule from the smooth, solid surface and inflate a volume in the subconjunctival space. If a bleb does not form or if the capsule remains attached to the implant material, it will not vent fluid and will not become functional. The number of scallops is a matter of choice, however 3, 4, 5, or 6 scallops is a reasonable number. Likewise, other forms providing a wave-like perimeter, such that the length of the perimeter is greater than the diameter of the form multiplied by pi, are within the scope of the present invention.
The method of the present invention for reducing intraocular pressure by creating a cylindrical bleb for producing improved accessory filtration comprises the steps of implanting a cylindrical tube having a proximal end and distal end, the distal portion of the cylindrical tube side wall being removed, into an eye to serve as a nidus for a conduit of aqueous humor to bypass angle structures consists of the steps of implanting the distal portion of the cylindrical tube under the conjunctiva, anchoring the proximal end of the cylindrical tube to the limbus, inserting the proximal, intact end of the tube into the anterior chamber through a needle track, ligating the distal end to prevent hypotony, allowing approximately one week for a bleb to grow around the tube, releasing a ligature around the proximal end after approximately one week to inflate the bleb, measuring the intraocular pressure to determine if additional drainage is required, if additional drainage is required, releasing additional ligatures whereby additional blebs are inflated.
Those with skill in the art of surgical treatment of glaucoma will readily see the invention's simplicity and flexibility. Thus the reader will see that the implant and method of reducing intraocular pressure of the present invention provides a more effective and customizable, yet economical solution for reduction of intraocular pressure.
While the above description contains many specificities, these should not be construed as limitations of the scope of the invention, but rather as an exemplification of preferred embodiments thereof. Many other variations are possible. For example, the material of the insert may be made of many types of elastomers other than latex; the size of the needle may be other than 23 gauge; the size, number, shape and dimensions of nidi and slip knot ligatures may vary and is not limited to four or to a �C� shape; the open diameter of the implant could vary; and the shape of the implant could be other than circular in cross section. The term �slip knot� as used here and in the claims includes any releasable knot. Accordingly, the scope of the invention should be determined not by the embodiments illustrated, but by the appended claims and their legal equivalents.
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Mr. Brian J. Cormier
Internal Medicine
- 2222 E Orangeburg Ave Ste A2
Modesto, CA 95355
- 3 Locations
- (209) 622-0877
Mr. Cormier works in Modesto, CA and 2 other locations and specializes in Internal Medicine. Mr. Cormier is affiliated with Doctors Medical Center Modesto and Memorial Medical Center. Mr. Cormier speaks English and Spanish.
Gender: Not Available
Languages Spoken: English, Spanish
Internal Medicine
Medical School: Not Available
*This physician has multiple office locations. See Office Information for details.


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Section 5A volleyball: Silverstreaks season ends
The match may not have started well, but the Osakis volleyball team pulled it all together to earn a 3-1 win over Kimball and advanced to the second round of the Section 5A-Southwest tournament last Friday.
The win gave the Silverstreaks the dubious honor of facing Class A's No. 9 ranked Belgrade-Brooten-Elrosa, and Osakis proved up to the test, battling the Jaguars to five sets before falling.
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