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37 year old man | Northfield, IL, USA | Seeking women 21-38 within 25 miles of Glencoe, IL
Looking for love in all the wrong places...
Since everyone is looking for the short-and-sweet version of who we are in these things, here are my Cliff Notes: 1. I am an intelligent, caring, successful individual looking for someone who can make me laugh, smile, and inspire me without really trying. 2. I value honesty and integrity, as well as compassion. 3. I typically don't see the world as black or white, but lots of shades of gray, blue, and some green mixed in for good measure. 4. I don't believe in regret as long as we can learn and grow from the experience. 5. I try to say yes to opportunities as they present themselves, and ask that you are as open to new experiences and adventure as well. 6. I love being challenged physically, mentally, and spiritually, and promise to return the favor. 7. I'm looking for someone to be my best friend one moment, my lover the next, and a companion in all points in between. Nothing more, nothing less. 8. Apparently my entire being can be summed up in exactly 8 bullet points, and that saddens me just a bit. Let's chat and see if you can help me come up with more bullets. OK - seriously I'm sure I can come up with more than 8 bullet points, but then where's the mystery in that? What would we talk about on our first date if everything was completely outlined in our profiles? Interested it knowing more? Drop me a note!
Coffee and conversation , Business networking , Dining out , Movies/Videos , Museums and art , Music and concerts , Nightclubs/Dancing , Performing arts , Travel/Sightseeing , Video games , Watching sports , Wine tasting
Auto racing / Motorcross, Basketball, Football, Hockey, Weights / Machines
I exercise 1-2 times per week.
I like Dogs
I prefer bigger pets/animals than smaller ones. I think its because I like the sense of presence a larger animal has than a smaller one. I'd love to own a German Shepherd or other big dog once I have a nice big yard.
Middle of the Road
Favorite place to have a great meal: Thai or Japanese restaurant. Favorite vacation spot to go party: Las Vegas Favorite place to go with loved one: An island getaway Place I've always wanted to go: Iceland, Japan, Ireland
DePaul University, Chicago, IL
Huge fan of all things Las Vegas. I'm a sci-fi and comedy fan, but I have a sweet spot for most Pixar cartoons too. Favorite guilty pleasure: Watching the Joy of Painting. Bob Ross' voice instantly relaxes me and puts me to sleep.
Depending on my mood, I can feel right at home in the middle of a club, watching a movie or concert, or just sitting back at the local bookstore drinking something warm and reading a good book or magazine.
I'm a self-described magazine addict - European cars, business news, personal finance, technology, and home improvement/decorating.
Z{{Cta}} {{#if HasMoreInfo}} ?{{CtaSecondary}} {{/if}}
|What he is looking for
|5'11" (180cms)
|5'4" (162cms) to 6'0" (182cms)
|Body type:
|A few extra pounds
|Slender, About average, Athletic and toned
|Black, Blue, Brown, Grey, Green, Hazel
|Auburn / Red, Black, Light brown, Dark brown, Blonde, Dark blonde, Platinum
|No Way
|No Way, Occasionally, Cigar aficionado
|Social Drinker
|Never, Social Drinker, Moderately
|Self-Employed / Entrepreneur
|Administrative / Secretarial, Artistic / Creative / Performance, Executive / Management, Financial / Accounting / Real Estate, Labor / Construction, Legal, Medical / Dental / Veterinary / Fitness, Political / Govt / Civil Service / Military, Retail / Food services, Retired, Sales / Marketing, Self-Employed / Entrepreneur, Student, Education / Teacher / Professor, Technical / Science / Computers / Engineering, Travel / Hospitality / Transportation, Other profession, Nonprofit / Volunteer / Activist, Law enforcement / Security / Military, Fashion / Model / Beauty, Architecture / Interior design
After spending years as a consultant and executive manager for another company, I recently founded my own Digital Marketing consulting firm. I believe if you're passionate and dedicated to something, success comes naturally.
|$35,001 to $50,000, $50,001 to $75,000, $75,001 to $100,000, $100,001 to $150,000, $150,001+
|Never Married
|Never Married
|Have kids:
|Wants kids:
|Definitely, Someday, Not sure
|Asian, Pacific Islander
|East Indian, Latino / Hispanic, Middle Eastern, Native American, Pacific Islander, White / Caucasian, Other
Both my parents are from the Philippines, but I was born and raised in the US. I've started to appreciate my filipino heritage more as I get older. There's no denying it has helped to shape me into the man I am today.
|Christian / Catholic
|Agnostic, Buddhist / Taoist, Christian / Catholic, Christian / LDS, Christian / Protestant, Jewish, Spiritual but not religious, Christian / Other
Born and raised a Catholic, and even did the whole Catholic education thing. I realized during college that all organized religions have their faults, so I'm content with believing in a higher power, no matter how we try to quantify/qualify it.
|English, Tagalog
|Bachelors degree
|Some college, Associates degree, Bachelors degree, Graduate degree, PhD / Post Doctoral
After high school, I shipped off to Syracuse University for awhile to study Vocal Performance and to get away from the Midwest. I came back and finished up @ DePaul University with a degree in Finance and Comp. Science.


text:
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January 31st, 2006 #1Registered User
- Join Date
- Mar 2003
- Location
- Denver
- Posts
- 3
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Student thesis - need concept art
Would anyone be interested in creating some concept art for a 3 minute portfolio short? I am near my graduation date and feel I have a pretty interesting storyline, but I need some visual concepts. My main area of expertise is in lighting/rendering, so I assure you, if the artwork fits the short, then it will be realized as best as I can. Any interest please email me at: firstname.lastname@example.com
setting: Small village in the german countryside in the early 1900's.
detail: The village is surrounded by a large wall that seperates the people from the war happening on the otherside. The adults fight in the battles, but attempt to keep the children unaware, but they know.
synopsis: 7 year old boy is shown sitting near the wall, playing with war planes and other primitive toys. As we see the boy playing with the toys, we come to find out that he is actually puppeteering the planes in the war on the other side of the wall.
Anyone interested, I would be excited to hear from you.
- Similar Threads
- Concept art thesis
Hide this ad by registering as a memberJanuary 31st, 2006 #2
Scott, post this over in the non-paying job listings section.
Tristan Elwell
**Finished Work Thread **Process Thread **Edges Tutorial
Crash Course for Artists, Illustrators, and Cartoonists, NYC, the 2013 Edition!
"Work is more fun than fun."
-John Cale
"Art is supposed to punch you in the brain, and it's supposed to stay punched."
-Marc Maron

subset: commoncrawl


text:
Wuulfräd's Journey (Part 10)
By Hero_Swe 1 Comments
Danni wrote the entirety of this one. So the props goes all the way to her
Middas, 5th of Sun's Dusk, 4E201
My companion and I, followed by Tolfdir, rushed into the Hall of Elements to confront Ancano. The elf babbled something about having the power to destroy the world, and that we could not stop him. Tolfdir threw a fireball at him, but the spell seemed to have no effect - with a manic laughter, Ancano welcomed the power from the Eye as it cracked open, filling the room with a blinding flash, as well as creating what I found were called Magical Anomalies. The professor screamed to me, telling me to use the Staff of Magnus, before being paralyzed alongside my companion. I had almost forgotten that I wielded the Staff, and my grip around it grew tighter in a teeth-gritting anger.
The Staff's power forced the Eye closed once again, and Ancano was made vulnerable: his attempts to force the powerful artifact open left him defenseless, and I swung my axe down on his neck, killing him instantly with a sickening crack. Tolfdir and the Khajiit worked to destroy the Anomalies as I caught my breath and allowed my brain to understand what was going on.
The college and everybody in it celebrated, and I was named the Arch-Mage, though I feel the title was wasted on me.
But as I lay in bed, the festivities dying down as the sun comes up; I realize I have done something terribly, terribly wrong.
I love you.


text:
How Can I Add a Handling Fee to Orders?
To add a handling fee go to System -> Configuration in the admin panel. Select Shipping Methods from the left navigation.
Here you will be able to add a handling fee to the real-time rates provided by UPS, USPS, FedEx and DHL, and even the predetermined rates that you can set up for Flat Rate and Table Rates shipping. Simply enter the value of the handling fee in the handling fee field for the carrier you want to update.
Select the Save Config button and the handling fee will be added to all the rates received from that carrier.


text:
Kevin Love says chance that he won't play again this season has 'crossed his mind'
Mar 16, 2013, 3:30 PM EDT
The Timberwolves have been as decimated by injuries as any team in the league this season, and that's included their best player, Kevin Love, appearing in just 18 games.
Love broke his hand in the preseason, then re-injured it to the point where it required surgery. As the team's medical staff tells him he's still another few weeks away from being able to play, the thought that Love might not make it back at all this season has begun to cross his mind.
From Jerry Zgoda of the Star Tribune:
Timberwolves forward Kevin Love knows the season is ticking away on him and he said before Friday's game at Houston there's a chance he won't play again this season.
"I'd say that has crossed my mind, but as far as making a decision, I haven't made that decision yet," he said.
Love said he still hopes —and intends — to play the season's final eight to 12 games.
"We'll see what a guy like Glen says and see what D.K. and Coach says and we'll probably all make a decision," Love said, referring to team owner Glen Taylor, president of basketball operations David Kahn and coach Rick Adelman. "At the end of the day, the decision is still mine and I'd still like to go out there and join the team."
It isn't as important to return to the court following a hand injury for a player to regain confidence as it would be with say, a knee injury.
But there would be no reason to hold Love out if he is indeed cleared to go, so while it's certainly a possibility he might not return this season, if the doctors say he can play, we'll likely see him for at least a handful of games.
- eugenesaxe - Mar 16, 2013 at 5:35 PM
Why bother, so they may end up with a slightly better record/worse lottery position?
- bougin89 - Mar 17, 2013 at 1:40 AM
BREAKING NEWS: LAKERLUVER says Kevin Love will be gifted to the Lakers in the offseason. Internal source denies rumor based on a man having a screen name of LAKERLUVER.
- bougin89 - Mar 17, 2013 at 1:42 AM
Nobody cares but I'm officially done on my lakerluver rant.
- fanofevilempire - Mar 17, 2013 at 7:30 AM
when a team doesn't know what to do with a great player they call the Lakers.
Lew Alcindor
K-love will look good in the purple N gold lined up next to D-12.
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Friday, September 13, 2013
© Copyright 2015 Clayton News Daily
JONESBORO — Clayton County firefighter Antonio Merkerson picked up a book about a pig who also happens to be a firefighter and pointed to the illustrations.
"Which is the most important part of this picture?" he asked about 30 preschool and kindergartners Friday morning.
"The hat?" asked one.
"No, the truck," offered another.
Merkerson looked at them seriously and told them they were wrong. They looked puzzled. Surely, a hat and truck are important to a firefighter?
"The most important part of this picture is the sandwich," he said, confirming the adage that firefighters run on food.
Merkerson and three others helped kick off a fall series of "story time at the library" featuring Clayton County firefighters.
The children were well-entertained as Merkerson provided sound effects and asked questions as he read several fire-related storybooks at Jonesboro Branch Library.
"Who would climb this ladder?" he asked, pointing to an extension ladder reaching into the sky.
Nearly all the children raised their hands, eager to prove their bravery.
"Who's afraid of the dark?" he asked.
"Not me," several children yelled out.
When Merkerson told them that he is afraid of the dark, he was reassured.
"There's nothing in the dark that isn't in the light," said a child.
Librarian Jennifer Pelt said she was satisfied with the turnout for the first event.
"This has been great and the response from the kids is just wonderful," she said. "It's great to see the kids so excited."
Pelt said the series emphasizes community involvement and children love firefighters and fire trucks so it was a perfect partnership.
"They've all been great with the kids," she said. "They're very entertaining."
After story time and a song, the kids went outside to inspect a fire truck — with an extension ladder — and fire gear.
The next story time is Sept. 27 at 10:30 a.m. at Morrow Branch Library, followed by Oct. 18 at 10 a.m. at Riverdale, Oct. 23 at 10:30 a.m. at Lovejoy, Nov. 6 at 10:30 a.m. at headquarters on Battle Creek Road in Jonesboro and Nov. 14 at 10:30 a.m. at Forest Park.
The events are for kids age 3-10. Groups are welcome but must register in advance because of space limitations. To register, patrons should contact the library they want to visit.
More like this story
- Youth celebrate literacy, Dr. Seuss ( March 4, 2014 )
- 'Dependable' Morrow firefighter receives five-year pin ( September 12, 2014 )
- Clayton libraries celebrate Black History Month ( February 3, 2015 )
- Clayton County libraries to kick-off summer reading ( May 15, 2014 )
- A drug-free life starts with rebirth ( November 19, 2013 )


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A-Cat Hull Used for Trimaran
Chris Ostlind is currently building a new small trimaran that sports a main center hull taken from a beach cat. It looks great. Below is an actually picture of the boat now, as it's being built and also a "mock-up" photo of what Chris envisions it will look like on the beach when it's finally finished (and repainted).
Be sure to click on the images to enlarge them for better viewing. Oh, by the way, I'd love to see what guys are building now; contact me about your building projects for posting here so we can see what's happening out there in small tri land :-) (more…)


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HARRISBURG, Pa.—The winning numbers in Saturday afternoon's drawing of the Pennsylvania Lottery's "Midday Quinto" game were:
(six, seven, four, nine, one)
Cat rescued from engine of pickup truck after 28-mile ride
HACKETTSTOWN, N.J. (AP) — A cat has been rescued from the engine of a pickup truck after a 28-mile ride from Pennsylvania to New Jersey. Full Story
(Rick Bowmer/AP)
APNewsBreak: New details on alleged Emile Hirsch assault
PARK CITY, Utah (AP) — A studio executive who authorities say was assaulted by actor Emile Hirsch during the Sundance Film Festival earlier this year described the incident as being "insanely painful and absolutely terrifying," according to public records obtained by The Associated Press. Full Story
(Photo by Darren Carroll/Getty Images)
Did Tiger Woods cheat with Amanda Dufner?
Lindsey Vonn reportedly caught golfer with his competitor's ex-wife, which is likely why they aren't dating anymore.


text:
Tossed Mixed Greens
27 Feb 2010
|Torn iceberg lettuce
|3 Cup (48 tbs)
|Torn fresh spinach
|2 Cup (32 tbs)
|Watercress leaves
|1 Cup (16 tbs)
|1 Medium, cut into wedges
|Chopped celery
|1⁄4 Cup (4 tbs)
|Snipped chives
|1 Tablespoon
|1⁄4 Cup (4 tbs)
|White wine vinegar
|1⁄4 Cup (4 tbs)
|Chopped onion
|1 Tablespoon
|Dry mustard
|1⁄2 Teaspoon
|Worcestershire sauce
|1⁄4 Teaspoon
|Bottled hot pepper sauce
|6 Drop
|Salad oil
|1⁄3 Cup (5.33 tbs)
In salad bowl combine lettuce, spinach, watercress, tomato wedges, celery, and chives.
To make dressing, in small mixer bowl combine sugar and white wine vinegar; blend in onion, dry mustard, Worcestershire sauce, bottled hot pepper sauce, and 1/4 teaspoon salt.
Gradually add salad oil, beating with electric mixer about 2 minutes or till thick.
Cover and chill.
Pour dressing over salad.
Toss to coat vegetables.
Rate It
0 Comments
Tossed Mixed Greens Recipe


text:
realmagick.com The shrine of knowledge.
Paroxetine Chemistry
A selection of articles related to paroxetine chemistry.
Original articles from our library related to the Paroxetine Chemistry. See Table of Contents for further available material (downloadable resources) on Paroxetine Chemistry.
- Everyday Earth
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The Elements >> Earth
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- The day of the month on which the you were born - regardless of which month or year it is - is a key numerological indicator, providing an excellent "thumbnail sketch" of standout traits. It strongly influences your Life Path and is helpful in...
Symbology >> Numerology
- The PK Man Seen From an African Perspective
- I have been fortunate over the past ten years to have had the opportunity to study the shamanism used in the rain forest of southwestern Nigeria. This is the traditional home of the Yoruba Nation which is one of the largest cultural groups in Western Africa...
>> Psychic Abilities
- Survivalists' Guide for the New Millennium: Chapter 1
- FACING OUR REALITY Lets face it, the pace and direction of worldly changes have run far ahead of the current human capacity to change with them. Modern society has become a force with its own momentum; a great machine of mass production and...
Philosophy >> Survivalists Guide for the New Millennium
- Survivalists' Guide for the New Millennium: Chapter 6
- AS THE WORM TURNS Health and well being are part of the natural birthright of the human being. With all of its organs intact, the right diet, exercise and mental focus, a human body can overcome any disease. Even so, the effects of living in this...
Philosophy >> Survivalists Guide for the New Millennium
- Egyptian Temples, part VI: The House of Life
- Library - Archive 'The House of Life' could well be called a library. It was that part of the temple where all records and texts were kept and stored. These papyrii encompassed many different fields of learning as well as the accountings on the daily and...
Religions >> Egyptian
Paroxetine Chemistry is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Paroxetine Chemistry books and related discussion.
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- Green Enzymatic Synthetic Organic Chemistry
- Green Chemistry is not just good chemistry; it is the Green Chemistry should be a priority driver, not a by-product of achieved .
- www.epa.gov
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- Deuterium offers a subtle, but sometimes powerful, medicinal chemistry tool that has .
- www.concertpharma.com
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- Apr 1, 2005 Chemistry and Life Sciences, Research Triangle Institute, 3040 have been investigated through the preparation of rigid paroxetine analogs.
- www.ncbi.nlm.nih.gov
- Synthesis of the major metabolites of paroxetine.
- www.ncbi.nlm.nih.gov
- Paroxetine - Wikipedia, the free encyclopedia
- In adults, the efficacy of paroxetine for depression is comparable to that of older tricyclic antidepressants, with fewer side ... "The Chemistry of Happiness".
- en.wikipedia.org
- Paroxetine | 61869-08-7
- www.chemicalbook.com
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text:
STK 2008 1967 Pontiac GTO Only a few cars in automotive history have garnered so much popularity during their first generation as the Pontiac GTO.... More
STK 2006 1965 Chevrolet Pickup If you were looking for a great pickup in 1965, the Chevy ½ ton was the truck of choice. Standard... More
STK 2004 2005 Chevrolet Corvette Z-51 The Corvette C6 was the result of lessons learned from C5-R's successes on the track combined with fresh... More
STK 2005 1992 Alfa Romeo Spider Veloce Convertible. See Salesperson for more information. ALL VEHICLES SOLD "AS-IS"... More
STK 2011 2010 Chevrolet Camaro ZL-1 See Salesperson for more information. ALL VEHICLES SOLD "AS-IS"... More
STK 2003 1992 Chevrolet Caprice Wagon This stunning Caprice wagon is truly a one of a kind creation; sporting a two-tone paint job of... More
STK 1975 1954 Bentley Call 800-650-1055 or visit our website at www.autobarnclassiccars.com for more information. ALL VEHICLES SOLD "AS IS"... More
STK 2002 1961 Ford Thunderbird Many of us remember seeing photos of these unique roadsters, but few of us are very familiar with them. The... More
STK 2001 1986 Ford Mustang This 1986 Ford Mustang hatchback has undergone a nice restoration. The snow-white exterior was given a professional re-spray in 2013... More
STK 1997 2011 Audi A5 Cabriolet Designed by Walter De Silva and assembled in Ingolstadt, Germany, the basic A5 first appeared on our shores in... More
STK 1994 2015 BMW Z-4 It's not very often that we receive many late model automobiles for sale, but in this particular BMW's case… we... More
STK 1996 1939 Pontiac Coupe Restored six years ago to an exceptionally nice level, this 1939 Pontiac Coupe is a real sweetheart. Its straight and... More
STK 1995 1974 Triumph TR6 Originally produced in November of 1974 with chassis number CF29225U, actually makes this a 1974 ½ model. The only visible... More
2004 Chevy Colorado Z-71 These trucks are few and far between and one in this condition is rare indeed. This all original Z-71 Colorado appears... More
STK 1989 1955 Pontiac Star Chief Back in 1955, the Catalina Star Chief was the top-of-the-line Pontiac. This particular 2-door hardtop is a rust-free California... More


text:
Originally posted by Logos23
Well, i felt like such an idiot that the post content just disappeared despite showing me a preview....but i feel i redeemed myself at least by starting off a discussion even if it was by default!
My problem now, is that i feel almost sure that the actual content I intended to be posted will probably not spark the same amount of interest! haha :-D And if i edited the original post by filling it with what i had intended it will take away from the discussion that as followed it!
The thing is.....I know what was contained in my disappearing post and I have to say with that knowledge the irony of what then followed in the discussion isn't missed on me!
If anyone is interested I saved my original intended post, I just didn't have the time to re-post earlier as i was on my way off.I will start a new thread.....not sure what to call this one though!
But thank you all for making me smile and laugh instead of feeling like a fool
Originally posted by chagahunter
ATS members are magical....they can make something out of
Originally posted by Logos23
Originally posted by Xaphan
Was your experience missing time?
Originally posted by chagahunter
I m new too. Haven t introduced myself yet. Still working on replies.
I know how you feel. I n my replies I keep hitting something and the reply gets posted without me finishing it.
At least it doesn t disappear
Originally posted by Char-Lee
Originally posted by Logos23
new thread
Originally posted by ZetaExplorer15
I'm having trouble making sense of this thread....?


text:
1990 Geo Metro Q&A
1990 Geo Metro Question: Air Conditioner Low pressure point
I just bought my Geo Metro 2 days ago. I would like to add Freon to the Air Conditioning system. The instructions suggest inserting it at the low pressure end on the system. I see 2 insertion points. One is near the pasenger cab the other is near the air condtioning fan. Any one know which one is the low pressure point ? - frankmas
Answer 1
first of all, why are you doing this?? it is dangerous stuff that can hurt you if you do something wrong. the system needs an exact amount to perform correctly. you cannot tell how much is in it or how much it need. take it to a shop to make sre of your concern. by the way, the fitting will only fit on one port. they are different sizes. Roy - mastertech6371
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2. stevieray1
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text:
Bigger Isn't Better:Worst gift was a pair of jeans from my mother in law. The jeans weren't so bad, it was that she got me a size 10 and I wear size 4. Made me feel like "Really?!? I look that big?" I just thanked her and moved on. I'll exchange them for my size soon.
--Chrissy, Kearney, Mo.
Reflection Rejection: I received a 10X magnifying mirror with lights. I don't really want to know what my face looks like at that magnification. Tooooo scary.
--Susan, Norcross, Ga.
Sparkling Trucker Cap With Matching Tank: My family draws names every year for gifts, kind of like secret santa … to aid in the gift purchasing we make lists. I was relatively specific. One of my items was "fun party clothes, sparkly, fun colors etc."
Last year my mom drew my name. Christmas started with my mother snatching a gift from my hands as I was midway threw unwrapping because she suddenly realized she labled it wrong and it wasnt mine. Next, I opened an XL mens Canada hoodie that my brother-in-law opened the previous night and claimed was too small for him. Thanks mom. She replied that I'd gained some weight and she thought I needed some bigger comfortable lounge wear.
Lastly, was my "sparkly fun clothing item." As I opened the package I was blinded by glitter. It wasn't technically clothes but was a large trucker-like cap covered in purple and silver glitter. I'd never seen anything like it. To match was a bright purple tank top decorated in silver glitter. I still have no idea where she purchased a baseball cap like this. It looked like a prop for a high school show choir, and maybe it was appropriate for someone but I just turned 30.
--C. Mondragon, Memphis, Tenn.
Who Is 'Our'?: I received this gift from an older, married, female co-worker. She gave me a Spode Christmas ornament, shaped like a bell, with the inscription "Our First Christmas 2009." The problem with this gift is that not only am I not newly-married, I'm not married at all! I don't even have a boyfriend with which to share this warm sentiment.
I pondered and pondered, wondering if she was referring to some milestone at our company, or some other work-related anniversary I was unaware of, but to no avail. It was a curious choice of a gift for me, indeed! In addition to that, by the time I received the gift, it was too late to re-gift it to any couples I knew who had wed in 2009. Hopefully, someone at the Salvation Army store will find it appealing.
--Amy Cooper, Houston, Texas


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7.30 be round at andy's house to get a lift to school
8.25 stop whatever work i've been doing in the school computer room and dash hurriedly to regsitration.
8.50 onwards
deal with belligerent, short, angry, excited, hormonal, illogical people who are full of
sugar all day.
3.00 stay behind for an extra hour and a half of work most days.
4.30 wait ages for bus to show up.
5.30 get home, make dinner.
6.00 climb into bed because it's cold. eat dinner and watch simpsons.
6.20 fall asleep before end of simpsons.
8.45 wake up cursing own tiredness. try to finish work.
11.00 andy turns up. chat, read, have tea.
11.30 bully andy into playing chess with me.
11.45 andy takes my queen at chess and i fly into a fifteen-minute rage then
demand a rematch.
1.30 andy falls asleep like a reasonable person. livid at his blatant attempts
to make me lose the game and sated by my earlier nap, i lie awake, unable to drift off,
smoking furiously and plotting his downfall. i will fall asleep around 3am and in all
likelihood sleep late in the morning.
brakes - beatific visionsbroken family band - ballsisobel campbell and mark lanegan - ballad of the broken seasneko case - fox confessor brings the floodjohnny cash - american 5: a hundred highwayschatham county line - speed of the whippoorwillflaming lips - at war with the mysticsfujiya and miyagi - transparent thingsthe handsome family - last days of wondera hawk and a hacksaw - the way the wind blowsthe hot puppies - under the crooked moonlanghorne slim - when the sun's gone downthe legendary shack-shakers - pandeliriumjenny lewis and the watson twins - rabbit fur coatpeter bjorn and john - writer's blockshooting at unarmed men - yes! tinnitus!sparklehorse - dreamt for lightyears in the belly of a mountaintv on the radio - return to cookie mountainthe victorian english gentleman's club - s/tyeah yeah yeahs - show your bones
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a) amusing - one of the customers thought we were impressed when he told us he once played football with UB40b) horrifying - a large, wet-looking rat appeared out of nowhere and ran the length of the shop and out the front door.c) boring - no jamie, only half a day of ami and too much work to do.d) ok, but not as nice as yesterday when andy turned up unexpectedly, swept me out of the shop and took me out to lunch at kensington's.
a) doing the same old work-sleep-moan crap.b) having a great time - all day drinking-chatting-and-curry on bank holiday monday with all the boys; free gigs; cinema trips and nice thingsc) worrying about things and stuff and pressing matters til my whole skull hurts from the teethgrindingd) falling asleep in inappropriate places and shouting at people who spell things wrong.
a) getting home tonight and eating pizza and cake and drinking wine and having spliffs and watching dvds and making andy rub my stupid shoulders for me cause they hurt.b) just getting through the next three weeks if i stick to my budget, get my observation days sorted and manage to see everyone i promised to see.c) october, because i need a holiday and that's the earliest we can really take one.d) dying, so i can have some peace.
a) abolsutely lovely and i think you're great.b) an asshole who doesn't deserve nice things.c) slightly bewildered by the crap i'm talkingd) a fool for reading this.


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This property can be rented with 'WIFI ', which so that you can connect from your PC, tablet or phone
This property can be rented with 'WIFI ', which so that you can connect from your PC, tablet or phone
Cottage Ocean view one consists of 70 square meters located between the fishing villages of Punta Mujeres and Arrieta, in the municipality of Haria, North of the island of Lanzarote, in a complex of cottages, located just 10 metres from the sea shore. The complex is retired from the tourist areas of the island and all the residents of the complex are residents, making it a very quiet place at all hours... Bungalow rentals in Punta Mujeres #10402 >
Exclusive, far away from mass tourism, rest, nature, 260m in elevation, high level facilities. Land size ca 7, 600 sqm. Internet.
Internet Wi-Fi, heated swimming pool 8m x 8m, Jacuzzi with 38 ° C permanently heated water, pool bar with Warsteiner beer tap and additional outside kitchen. The Finca is located perfectly, in the middle of a natural mountain landscape, beyond a ravine, with just a few neighbors, very private, cannot be viewed. Gîte - Self Catering rentals in San Juan, House #7264 >
Tranquility, peace and comfort, that's for all our customers that enjoy with us their holidays.
It is a small complex of 5 apartments and 1 Studio. With fully equipped kitchen. In the bathroom: hairdryer, shower, washbasin, toilet and pool or beach towels. DVB-t television and satellite, free Wifi for customers in apartments and swimming pool area. Ideal for sharing a group of friends or family, since they can be together but independent at the same time. Customers who visit Playa Blanca in summer... Bungalow rentals in Playa Blanca #53644 >
The cottage is located in a privileged environment that breathes tranquility everywhere. It´s ideal place to relax, reading, sunbathing or swimming.
Traditional Canarian cottage, placed in the south of Tenerife in a picturesque, tranquil and heritage area, surrounding by mountains and with stunning views to the sea, sunrise, another island and a volcano. It is only 350 m height over sea. There is a mild weather all the year with an average of 20º C. It is a fantastic place for relaxing, reading, sunbathing, hiking and all of these outdoor activities... Gîte - Self Catering rentals in Igueste de Candelaria, House #51994 >


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Live updates
Government bid to tackle reoffending in women
The new plan to try and tackle female offending is being set out to work alongside Transforming Rehabilitation reforms in which every offender receives 12 months of tailored support as they leave prison.
With the aim of trying to cut reoffending and trigger further falls in the female prison population, a new open unit at HMP Styal is to focus on helping women into jobs on release.
Several reports to be published later today, including The Government's response to the Justice Select Committee report on Women Offenders: After the Corston Report and the NOMS Women's Custodial Estate Review, are set to help feed in to the new approach towards tackling female offending.
Female prisoners to serve sentences closer to home
Female inmates will serve their sentences closer to home and will be offered skills to help find work upon their release under new reforms revealed.
Under the proposals, low risk offenders will be encouraged to undertake practical training so they can seek employment following their jail term.
The reforms, unveiled by Justice minister Lord McNally, who is also the minister for female offenders, call for all women's prisons to become resettlement prisons so that women are close to home and are re-integrated into society.
Juliet Lyon, director of the Prison Reform Trust, said: "Trying to improve women's imprisonment would be a waste when the best way to reduce women's offending is to invest in treatment for addictions, mental healthcare, training for work and safe housing away from domestic violence and abuse."
MoJ 'took immediate steps to recover data' leaked
A Ministry of Justice spokesman said: "We treat the security of information very seriously and took immediate steps to recover the data as soon as the loss was reported to ensure that it went no further.
"These types of incidents are extremely rare but this does not mean that we are complacent.
"A thorough investigation was held by the prison who immediately altered their procedures, and further changes were implemented across the prison estate."
Ministry of Justice fined over 'serious data breach'
The potential damage and distress that could have been caused by this serious data breach is obvious.
Disclosing this information not only had the potential to put the prisoners at risk, but also risked the welfare of their families through the release of their home addresses.
Fortunately it appears that the fall-out from this breach was contained, but we cannot ignore the fact that this breach was caused by a clear lack of management oversight of a relatively new member of staff.
Furthermore the prison service failed to have procedures in place to spot the original mistakes.
It is only due to the honesty of a member of the public that the disclosures were uncovered as early as they were and that it was still possible to contain the breach.
Ministry of Justice fined over prisoner data gaffe
The Ministry of Justice is to be fined £140,000 by the data watchdog after the personal details of all 1,182 prisoners at a jail were mistakenly emailed to inmates' families.
A spreadsheet containing sensitive information including names, ethnicity, addresses, sentence length, release dates and details of the offences by all inmates at HMP Cardiff was sent to three families, the Information Commissioner's Office (ICO) said.
The breach was only discovered when one of the recipients contacted the prison on August 2, 2011 to report they had received an email from the prison clerk about an upcoming visit, which included the file.
The ICO found there was a clear lack of management oversight at the prison, with the clerk working unsupervised despite only having worked at the prison for two months and having limited experience and training.
Connelly faces strict controls and restrictions on release
The Ministry of Justice said Baby P's mother Tracey Connelly will be subject to strict controls and restrictions following her release from prison for as long as is required.
A Ministry of Justice spokeswoman said:
The release of life and other indeterminate sentence prisoners is directed by the independent Parole Board once they are satisfied they can be safely managed in the community.
The IPP [imprisonment for public protection] licence lasts for a minimum of 10 years, and an offender on an IPP licence may be recalled to prison at any time for breaching their licence conditions.
Bidding for probation service contracts opened up
A bidding competition for £450 million-worth of probation service contracts across England and Wales was opened to the private and voluntary sectors by the Ministry of Justice.
No 'titan' prisons but 'campus' jails says Grayling
Justice Secretary Chris Grayling has said the announcement of four prison closures and two new "super" prisons was part of a "process of new for old in the prison system" aimed at creating more places.
He said a new prison in Wrexham would be Britain's "biggest prison" and would meet the need for capacity in north wales, and a shortage of places in the north west.
Mr Grayling said there was no plan for so-called "titan" prisons, with one single big building holding thousands of prisoners, and added that the new jails would be a spread out over a "campus" of individual blocks holding a few hundred prisoners, with shared facilities.
Closing local prison 'will not reduce crime'
Juliet Lyon, director of the Prison Reform Trust, has said closing small local prisons and replacing them with super-sized prisons "will not reduce crime or make communities safer".
She added: "The millions secured for new-build prisons could be more effectively spent on robust community service, treatment for addicts and care for people who are mentally ill."
She added: "Smaller prisons tend to be safer and more effective than larger establishments, holding people closer to home and with a higher ratio of prison staff to prisoners.
"Prison ought to be an important place of last resort in our justice system, not a giant economic regeneration or job creation scheme."
Wrexham 'super' jail will 'create 1,000 new jobs'
Secretary of State for Wales, David Jones, has welcomed plans to build a 'super' jail in Wrexham, north Wales.
He said: "The construction of this much needed facility will bring with it considerable economic benefits for local businesses, and create up to 1,000 employment opportunities across the region.
"It will facilitate the rehabilitation of offenders by making them more accessible to their families, legal advisers and the probation service, enabling a smoother transition back into the community."


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Joy Global Surface Mining suppliers play a vital role.
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Location: Caribbean > St. Kitts and Nevis > St. Kitts > Basseterre
Ranked #2 of 7 B&Bs / Inns in Basseterre
Price Range (Based on Average Rates): $
Number of rooms: 10
- Reservation Options:
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Now showing throughout Sydney Australia's bus shelters are posters of animals up for adoption. These aren't your typical pictures of homeless pets. These adorably cute animals have been shot by 21 of Australia's top photographers for a project called Limited Edition. Put on by Sydney Dogs and Cats Home, the creative project had each of the 21 photographers shoot three cats or dogs resulting in 63 one-off prints."The photographers were asked to bring out the personality of each animal. And just like the animals at the Home, each print is unique. All prints are signed 1 of 1 by the artist."
Full gallery here
Agency: M&C Saatchi
See the results here.


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Youghal Enthusiast
- +
- Size, adjustability and the colour :)
- −
- Straps are a bit hard
Published on: 30 June 2015
Womens Elbrus ND65:75 Rucksack
The Elbrus ND65:75 Rucksack is a high-spec entry-level pack designed for the female trekker seeking a comfortable solution to multi-day treks and weekend camps without straining their budget. Lots of features, including a large storage volume, and the excellent Axiom adjustable back system makes this incredible value.
Storage is divided into two compartments with a buckled lid allowing access at the top and a lower zip giving access from the bottom. The divider can be removed to create a single larger compartment if you require. There is a bellows pocket on each side of the bag, as well as a flat pocket on the front of the bag and two on the hipbelt to store the small things you need to get to quickly. If you run out of space inside the pack you can strap equipment to the outside using the strong lash points and the supplied accessory straps.
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Twin bomb blasts in the northern Nigerian city of Kaduna have claimed dozens of lives. The attacks bear the hallmarks of the militant Islamist group Boko Haram.
Two separate bomb blasts killed dozens of people in the city of Kaduna in northern Nigeria on Wednesday in attacks blamed on the Islamist extremist group Boko Haram.
The number of casualties remains unclear, but dozens of people were reported to have been killed.
Police said the first blast targeted the convoy of a prominent Islamic cleric who has publicly criticized Boko Haram, which has been waging a deadly insurgency for the past five years.
The cleric, Sheikh Dahiru Bauchi, was unharmed in the attack, but the bomber and some 25 people who had gathered at the roadside to cheer him were killed, police said.
A second bomb two hours later struck the busy Kawo area on the outskirts of Kaduna, with emergency workers saying at least 17 people were killed.
That blast was targeting the convoy of the senior Nigerian opposition leader and former president Muhammadu Buhari, according to the Reuters news agency. Buhari's son Musa told Reuters his father was not hurt in the attack.
No group immediately took responsibility for either blast, but Boko Haram has already launched several attacks outside of its heartland in northeasten Borno state, and has claimed the killings of several moderate clerics across the north.
Deadly rebellion
The group, which claims it wants to establish an Islamic state in Nigeria, killed more than 2,000 civilians in the first half of this year, according to an estimate by Human Rights Watch a week ago.
In recent attacks, Boko Haram raided the northeastern town of Damboa and surrounding villages over the weekend, killing at least 50 people.
The group has come into the international spotlight since it kidnapped more than 200 girls from a school in the village of Chibok, also in the northeast, on April 14th.
President Goodluck Jonathan met parents of the abducted girls and some students who had escaped for the first time on Tuesday, amid criticism of his government's handling of the hunt for the girls and their kidnappers.
tj/mkg (Reuters, AFP, AP)


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3 bed, 2 full bath. A corner lot located at 16th & Ada. Hard to find 23' X 47' tandem four car garage. A good sized norMore info
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You making this so black and white is unrealistic. Although I may not have traded Wood for bullpen help necessarily, I wouldn't say that you never do this now because one crappy former starter has turned into a good reliever for two months.
You making this so black and white is unrealistic. Although I may not have traded Wood for bullpen help necessarily, I wouldn't say that you never do this now because one crappy former starter has turned into a good reliever for two months.
Madsen, Broxton, and Marshall represent a lot of flushed money. Bad luck? Yeah, to some extent. I'd like to see those outlays go to bats in the future, which are safer bets (and better bets, given the changed landscape ofbaseball). Relievers were available at the deadline; hitters weren't.
I am jealous about the farm system and seemingly endless supply of major league hitters and pitchers the Cards seem to have.
May the Lord bless
Revering4Blue (08-04-2013),vaticanplum (08-04-2013)
I still like the Marshall trade and signing. Broxton is another matter. I was surprised by how well he did after lambasting the trade last year - for which I got pretty soundly spanked. Broxton's signing after the season was a huge miscalculation. I believe it was entirely due to expectation that Chapman would be in the rotation. Now it's wasted dollars, and for a guy who has been hurt more than he hasn't for quite awhile now.
This post is BABIP-lucky.
Maybe the issue isn't where Wood would slot into the rotation as much as what else they could have gotten for him. I didn't hate the deal at the time, but thought it was a little much for a reliever.
"All I can tell them is pick a good one and sock it." --BABE RUTH
Having better players makes "the right time" or "the big hit" happen a lot more often. PLUS PLUS
If not to Broxton, where would those dollars have gone? It's doubtful the Reds would have mustered enough cash to buy a LF in addition to Ludwick.
"I prefer books and movies where the conflict isn't of the extreme cannibal apocalypse variety I guess." Redsfaithful
I think many are overvalueing Travis Wood and his 4.48 xFIP (lifetime 4.45).
I don't know how long he can be expected to have a BABIP in the low .240's, but for the record, he's done it since the start of the 2012 season, more than 1.5 years.
His only fault was getting injured this season.
"Man, the pitch looks fast, even in slow motion." Thom Brennaman on Chapman's fastball.
m21eagle45 (08-04-2013)
So what impact bat would you have gotten for Wood after 2011 when Wood had a 4.84 ERA?
"Since I've been with the Reds in 1989, we've never had a farm system this loaded," Bowden said. "If we were the New York Yankees and had unlimited dollars, we could have traded for Colon, (Jeff) Weaver, Rolen, (Cliff) Floyd, (Kenny) Rogers and Finley and gotten them all -- and still held onto our top five prospects. That's an amazing statement."
reds1869 (08-04-2013)
The Reds might not have won the division last season without Marshall. That alone makes the trade a smart move.
"Man, the pitch looks fast, even in slow motion." Thom Brennaman on Chapman's fastball.
I really don't care what the Reds traded away to get Marshall. That's not been an issue. To me it's using a slenderer and slenderer amount of payroll space on relievers.
What's done is done, however; just start tilting those "win now" contracts and trades toward the offense side and less on middle relievers.
Last edited by Falls City Beer; 08-04-2013 at 12:12 PM.
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Patients with ulcerative colitis (UC) are treated with prednisolone (PSL), which causes adverse side effects. Extracorporeal granulocyte/monocyte adsorption (GMA) with an Adacolumn depletes elevated/activated myeloid lineage leucocytes as sources of inflammatory cytokines. We were interested to evaluate the efficacy, safety and the treatment cost for PSL and GMA.
Forty-one patients with active UC had achieved remission with GMA, at 1 or 2 sessions/week, up to 10 sessions (n=24) or with orally administered PSL (1mg/kg bodyweight, n=17). Clinical activity index (CAI) ≤4 was considered clinical remission. Following remission, patients received 5-aminosalicylic acid (2250-3000mg/day) or sulphasalazine (4000-6000mg/day) as maintenance therapy and were followed for 600 days. The total treatment cost was assessed based on 1€=150JPY.
PSL was tapered after two weeks, and discontinued when a patient achieved remission. The average time to the disappearance of at least one major UC symptom (haematochezia, diarrhoea, or abdominal discomfort) was 15.3 days in the GMA group and 12.7 days in the PSL group, while time to remission was 27.9 days in the GMA group and 27.6 days in the PSL group, CAI 0.8 and 2.0, respectively. The Kaplan-Meier plots showed similar remission maintenance rates over the 600 days follow-up period. The average medical cost was 12739.4€/patient in the GMA group and 8751.3€ in the PSL group (P<0.05). In the GMA group, 5 transient adverse events were observed vs 10 steroid related adverse events in the PSL group (P<0.001).
In appropriately selected patients, GMA has significant efficacy with no safety concern. The higher cost of GMA vs PSL should be compromised by good safety profile of this non-pharmacological treatment intervention.
Keywords:Ulcerative colitis; Adsorptive granulocyte and monocyte apheresis; Prednisolone; Medical cost; Treatment safety
Ulcerative colitis (UC) is one of the two major phenotypes of the chronic inflammatory bowel disease (IBD); the other major phenotype of IBD is Crohn's disease [1,2]. UC afflicts millions of individuals throughout the world, causing symptoms like fever, weight loss, diarrhoea, rectal bleeding and abdominal discomfort, which impair individual's activities and quality of life. Currently, there is no permanent cure for UC, the treatments focus on controlling the disease activity with pharmacologics, often at high doses over long periods of time [1,3,4]. Corticosteroids like prednisolone (PSL) have had a major role in the treatment of UC since the pioneering trials by Truelove, and colleagues several decades ago [5,6]. However, when used in chronic, remitting-relapsing conditions like UC, corticosteroids cause adverse side effects, steroid dependency and refractoriness [1,3]. It is known that long-term administration of corticosteroids potentially increases the development of osteoporosis, and cataracts as adverse side effects, which are more likely at higher corticosteroid doses [7-9]. Accordingly, in one major study, the incidence of severe adverse events was higher in the high dose PSL group as compared with the low dose group [9].
There is evolving evidence for myeloid lineage leucocytes (granulocytes and monocytes) as major factors in the immunopathogenesis of UC. Thus, patients with UC may harbour elevated peripheral neutrophils [10] in the presence of compromised lymphocytes [11-13]. Further, in UC, neutrophils show activation behavior [14] and prolonged survival [15]. Factors known to promote neutrophil survival include inflammatory cytokines [16], and paradoxically corticosteroids [17]. Indeed, neutrophil activation and prolonged survival is a feature of persistent intestinal inflammation and histological examinations of the mucosal tissue in biopsy specimens from patients with active UC reveals a spectrum of pathologic manifestations among which presence of neutrophils accounts not only for the morphologic lesions of UC, but also for the prevailing patterns of mucosal inflammation [1,14,15,18]. When activated, granulocytes together with monocytes/macrophages produce an array of pleiotropic cytokines like tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-12, IL-23 which are strongly inflammatory [19-23]. These have given rise to the inference that elevated and activated granulocytes and monocytes should be targets of therapy in UC. Based on theses observations, the Adacolumn has been developed for selective depletion of granulocytes and monocytes by adsorption (GMA).
In the early 2000, following a major multicentre clinical trial [24,25], GMA was introduced into the Japan national health reimbursement scheme as remission induction therapy for patients with UC. Subsequently, investigators reported high remission rates and good safety profile for GMA [26-30], but disappointing trial outcomes have been reported as well [31]. In this study, we aimed to assess the efficacy, safety and treatment cost in two cohorts of patients with active UC treated with GMA or with PSL as remission induction therapy.
The subjects were 41 patients with UC in the active stage who had been successfully treated by GMA as remission induction therapy in the period from April 2000 to March 2009 at our hospital (GMA group, n=24) or with the corticosteroid, prednisolone (PSL group, n=17). The demographic features of the included patients are presented in Table 1. These 41 patients were retrospectively reviewed. The patients were from two bigger cohorts, 43 and 24, respectively who had responded to these interventions. The remaining patients (19 and 7) either had not achieved remission or were not eligible for this follow-up study (receiving additional medications was one exclusion criterion). Following remission induction, patients were given 5-aminosalicylic acid (5-ASA, 2250-3000mg/day) or sulphasalazine (4000-6000mg/day) as maintenance therapy. If a patient had been on azathioprine (AZA) for >8 weeks prior to the start of the present therapy (GMA or PSL), the patient could be included and AZA was to be continued at the same dosage if required (Table 1). PSL dose was to be tapered within two weeks following the start of administration and subsequently discontinued when patient achieved remission.
Table 1. Entry demography of the 41 patients of this study
Adsorptive depletion of myeloid lineage leucocytes
Adsorptive depletion of myeloid lineage leucocytes (GMA) was done with the Adacolumn as previously described [10,12,13,28]. The Adacolumn is filled with cellulose acetate beads of 2mm in diameter as the column adsorptive leucocytapheresis carriers [32,33]. The carriers adsorb from the blood in the column most of the granulocytes and monocytes together with a significant fraction of platelets (FcγR and complement receptor bearing cells); lymphocytes are spared. In fact lymphocytes increase after GMA [12,13,32,33], including the CD4+CD25high+ phenotype, which is known as a key regulator of immune function [33,34]. Each patient received 1 or 2 GMA sessions/week, up to 10 sessions. One session was 60–90 min at 30mL/min [28].
Treatment of patients in the PSL group
In the PSL group, patients received PSL orally, at 1mg/kg (bodyweight)/day orally as the starting dose. The PSL dose was to be tapered at 5 to 10 mg per week within 2 weeks following initiation of therapy. Following remission, PSL could be discontinued and replaced with maintenance therapy, 5-ASA or sulphasalazine (indicated above).
Assessment of disease activity and treatment efficacy
UC clinical activity index (CAI) was determined at entry and at appropriate time points during active treatment and the 24 months follow-up period according to Rachmilewitz [35]. Factors considered in the present study for assessing efficacy were blood in the stool, diarrhoea and abdominal pain as major complication of UC that most seriously impact activities and quality of life [1,2]. The time to the cessation of at least one major UC symptom as well as the time to remission (CAI ≤4) was used to assess the immediate efficacy of the treatments, while the long-term effect on UC activity was assessed by the Kaplan-Meier survival graphs. The cumulative dose of PSL, average treatment cost per patient were also determined.
Ethical considerations
In Japan, GMA with the Adacolumn is an officially approved therapeutic option for patients with active IBD. Additionally, informed consent was obtained from all patients after explaining the study aim and the nature of the procedures involved. Adherence was made to the Principle of Good Clinical Practice and the Declaration of Helsinki at all times.
Statistical analysis
Where appropriate, data are presented as the mean ± SD values. The differences between sets of parametric data were analyzed by using the t-statistic. The relapse rate was estimated by the Kaplan-Meier survival graphs and the log-rank test. P<0.05 was considered significant.
Time to the disappearance of at least one major UC symptom and clinical remission
Figure 1 shows time to the disappearance of at least one major UC complication like diarrhoea, haematochezia or abdominal discomfort as well as time to remission (CAI ≤4) in the two groups following start of interventions (GMA and PSL). As shown, no statistically significant difference between the patients who received PSL and those who received the non-pharmacologic, GMA was found. The average time to the cessation of at least one major UC complication was 15.6 ± 15.2 days in the GMA group and 12.7 ± 12.9 days in the PSL group. Likewise, the average time to clinical remission was 27.9 ± 19.6 days in the GMA group and 27.6 ± 29.0 days in the PSL group.
Figure 1. This figure shows time to the disappearance of at least one major ulcerative colitis (UC) symptoms (diarrhoea, rectal bleeding, and abdominal discomfort) as well as time to remission (clinical activity index, CAI≤4) following the start of interventions. As shown, no statistically significant (ns) difference between the patients who received the corticosteroid, PSL and those who received the non-pharmacologic, GMA was found.
Efficacy outcomes based on CAI
The outcomes of the efficacy assessment based on CAI is presented in Figure 2, essentially echoing the outcomes seen in Figure 1. The average CAI value when at least one of the major complications of UC disappeared was 4.3 ± 2.9 in the GMA group and 6.7 ± 3.4 in the PSL group indicating that at this time point, clinical remission was not achieved by all patients. Instead, the CAI value was significantly reduced in both groups relative to active disease, but without any significant difference between the two groups. Similarly, the average CAI value when the patients achieved remission was 0.8 ± 1.3 in the GMA group and 2.0 ± 2.2 in the PSL group, without significant difference between the GAM and the PSL groups.
Figure 2. Overall improvements in the clinical activity indices (CAI) in two groups of patients with active UC receiving GMA or PSL. This figure shows average CAI values at baseline, at the time point when major UC symptoms were reduced and when patients achieved remission. No significant (ns) difference between the patients who received PSL and those who received the non-pharmacologic intervention, GMA was found.
The Kaplan-Meier graphs of remission maintenance
Figure 3 shows the Kaplan-Meier survival graphs of remission maintenance during a 600 day follow-up observation at the end of active treatment. As shown, the rate of relapse was not significantly different between the GMA and the PSL groups.
Figure 3. The Kaplan-Meier plots showing maintenance of remission in two groups of patients receiving GMA or PSL. Patients who achieved remission (CAI≤4) at the end of the active treatment period (arrow head) were followed to monitor maintenance of remission. As shown, no significant (ns) difference between the two groups was found with respect to maintenance of clinical remission at the end of the follow-up time (600 days).
The cumulative dose of corticosteroid in the GMA and the PSL groups
From patients' case records, we could calculate the total amount of corticosteroid patients had received for the duration of UC in either group. Corticosteroid was PSL in all patients at our hospital. The cumulative amount of PSL before the start of the present investigation was 2556.8mg in the GMA group and 3030.4mg in the PSL group, not significantly different (Table 2). The cumulative amount of PSL during the present study was 0mg in the GMA group and 1122.4mg in the PSL group (P<0.001). All patients in the GMA group were steroid naïve for that flare up.
Table 2. Outcomes of the cost analyses for two groups of patients receiving adsorptive granulocyte and monocyte apheresis (GMA) or prednisolone (PSL) at the end of the study (average values are presented)
Adverse events and treatment cost
Figure 4 shows the outcomes of the adverse event assessment, and medical costs (1€ = 150JPY) in the two groups of patients with UC who received GMA or PSL as a treatment intervention. Five adverse events in 3 of 24 patients (12.5%) were reported in the GMA group. These were transient fever, dizziness and light headedness developed towards the end of a GMA session. These events remitted within 3 h without any medication. In the PSL group, 6 of 17 patients (35.3%) developed corticosteroid related adverse events, total 10 events including steroid acne in 2 patients, mild liver disorder in 2 patients, moon face in 2 patients; osteoporosis in 1 patient and Candida oesophagitis in 1 patient Additionally two patients (11.8%) in the PSL group developed nausea just after the administration of PSL. The latter two events resolved within a few hours similar to the events in the GMA group. Regarding the treatment cost in the present investigation, our calculation showed an average cost of 12739.4€ per patient for GMA and 8751.3€ per patient for PSL (P<0.05).
Figure 4. Assessment of adverse events, medical costs (1€ = 150JPY) and the cumulative dose of prednisolone (PSL) in two groups of patients with active ulcerative colitis (UC) who received GMA or PSL as a treatment intervention. This figure shows GMA has favourable safety over PSL, while the treatment cost is in favour of PSL.
The major focus of this study was on the safety, efficacy, and the medication cost analyses in patients with active UC being treated by GMA as a non-pharmacologic intervention (GMA group) or with the corticosteroid, PSL (PSL group). All included patients had already achieved remission following these interventions and were reviewed retrospectively. This was possible for the fact that all patients were registered at our hospital and had been treated by the physicians who are the authors of this article. Further, for the analyses we undertook in this study, patients who had achieved remission were included to allow us to see the sustainability of remission achieved with these two interventions. The outcomes might be summarised as follows. As the first treatment end point, we considered UC symptoms, which patients consider as the most serious cause of impaired activities and quality of life. These included diarrhoea, rectal bleeding, and abdominal discomfort. The average time to the cessation of at least one of these symptoms was not significantly different between the patients who received PSL and those who received GMA. The second treatment end point we considered was clinical remission. Similar to the first end point, the average time to remission was not significantly different between the two groups. Further, the efficacy outcomes in terms of CAI reflected the outcomes we monitored as time to the cessation of major UC symptoms and UC remission. The sustainability of remission was another significant consideration in this study. To see this, we applied the Kaplan-Meier survival analysis of remission maintenance during a 600 day follow-up. The rate of relapse was not significantly different between the two groups.
Regarding the cumulative amount of PSL, in the GMA group, patients had relapsed while not being on a corticosteroid (were steroid naïve for that relapse). These patients received GMA as the only medication for that flare up except that AZA could be continued if a patient had started well in advance of receiving GMA. Nonetheless, we calculated the total amount of PSL patients in the two groups had received for the duration of UC disease. Our calculations did not show any significant difference in the amount of corticosteroid patients had received before the start of the medications factored into this investigation (GMA and PSL). This was because, like the patients in the GMA group, patients in the PSL group had relapsed while not being on a corticosteroid. Further, for this investigation, we ensured that all patients in the GMA group remain corticosteroid free during the follow-up time as well and in the PSL group, the dose of PSL was tapered when patients improve and discontinued when patients achieved remission. Accordingly, the cumulative amount of PSL during the present study was 0mg in the GMA group and 1122.4 mg per patient in the PSL group, clearly showing that GMA spares patients from corticosteroids. Similarly, our safety evaluation showed the data to be very much in favour of GMA with just a few transient and non-serious adverse side effects, which is in line with earlier reports on the safety of GMA in patients with UC [10,12,25-33]. In contrast, over 40% of patients in the PSL group developed adverse events. However our figures from the calculations of the medication cost was in favour of PSL as this is a relatively inexpensive medication as compared with the single use Adacolumns required for GMA. Our impression is that this cost difference is more than offset by the safety of GMA [36].
Following the publication of the first clinical trial of GMA in patients with UC [24], several investigators from Japan, Europe, and the USA [12,27-30,37-43], have reported varying efficacy outcomes ranging from an impressive 85% [12] to a statistically insignificant level [31] Except [31,37,38,41], most other studies did not include a control arm, relying on patients' disease activity at baseline to serve as a control parameter to judge treatment efficacy [12,27-30]. Among controlled studies, Maiden et al., used GMA to suppress clinical relapse in one arm, while the control arm received no treatment [14]. At the end of a 6-month follow-up, both the relapse rate and time to clinical relapse were significantly better in the GMA arm [14]. Further, intensive GMA involving two sessions per week was found to be more effective than the routinely applied weekly GMA sessions [44]. Likewise, there are reports saying that patients with deep colonic lesions and extensive loss of the mucosal tissue at the lesion sites show very poor response to GMA [12,29,43], while first episode and steroid naïve cases respond well and avoid corticosteroids [12,29,39].
The results of this study showed that GMA as a non-pharmacologic treatment intervention in patients with UC produced efficacy equivalent to the corticosteroid, PSL and was without safety concern. In view of serious adverse side effects associated with long-term administration of drugs, GMA is very much favoured by patients for its safety profile. In particular, young and elderly patients should benefit most from GMA as a replacement for corticosteroids and other potentially unsafe medications including biologics. However, the results of this study require further support by a prospective controlled study in large cohorts of patients.
5-ASA: 5-aminosalicylic acid; CAI: Clinical activity index; GMA: Granulocytes and monocytes apheresis; IBD: Inflammatory bowel disease; PSL: Prednisolone; UC: Ulcerative colitis.
Competing interest
The authors declare that they have no competing interests.
Authors' contribution
1) KT, KK, and HH: Made substantial contribution to the conception, study design and preparation of the manuscript draft; 2) KT, MN, MH: Patient management, generation, collection, assembly, analysis and interpretation of data; 3) KT, MN, MH, KK, and HH: Revision and approval of the final version of the manuscript.
No external fund was used to carry out this investigation. Further, the authors hereby declare having no conflict of interest in connection with the publication of this manuscript.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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Originally written on From the Marbles | Last updated 10/10/11
This is some fun video: Darrell Waltrip, who's allegedly a three-time NASCAR champion but you couldn't prove it here, riding at Bathurst as part of the Bathurst 1000 in Australia. He was on board as a commentator, and oh my heavens, the commentating that was going on here! If you're not a DW fan, this will annoy you but also delight you. Just watch it. [Hat tip to Rick Tallman and highflyjet for sending along this one.]
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