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Brigadier General George Miller Sternberg (June 8, 1838 – November 3, 1915) was a U.S. Army physician who is considered to have been the first bacteriologist in the United States. He was the 18th U.S. Army Surgeon General from 1893 to 1902. Pioneering German bacteriologist Robert Koch honored him with the sobriquet, "Father of American Bacteriology".
George Sternberg was born at Hartwick Seminary, Otsego County, New York, where he spent most of his childhood. His father, Levi Sternberg, a Lutheran clergyman who later became principal of Hartwick Seminary, was descended from a German family from the Palatinate, which had settled in the Schoharie Valley in the early years of the 18th century. His mother, Margaret Levering (Miller) Sternberg, was the daughter of George B. Miller, also a Lutheran clergyman and professor of theology at the seminary, which was a Lutheran school. He was the eldest child of a large family and he was given adult responsibilities from an early age. He interrupted his studies at the seminary with a year of work in a bookstore in Cooperstown and three years of teaching in nearby rural schools. During his last year at Hartwick he was an instructor in mathematics, chemistry, and natural philosophy. He was at the same time pursuing the study of medicine with Horace Lathrop of Cooperstown. For his formal medical training he went first to Buffalo, and later to the College of Physicians and Surgeons of New York (M.D. degree, 1860). After graduation he settled in Elizabeth, New Jersey to practice, remaining there until the outbreak of the Civil War.
The years following the war followed the pattern of frequent moves typical of junior medical officers of the day. He married Louisa Russell, daughter of Robert Russell of Cooperstown, on October 19, 1865 and took his bride to Jefferson Barracks, Missouri, from where he was soon transferred to Fort Harker, near Ellsworth in Kansas. Louisa did not accompany him to the latter post, but joined him in 1867 just prior to an outbreak of cholera. She was one of the first civilians to develop the disease which killed her within a few hours on July 15 and soon claimed a toll of about 75 people at the fort.
Sternberg also collected vertebrate fossils, including shark teeth, fish remains and mosasaur bones, from the Smoky Hill Chalk and Pierre Shale formations in western Kansas, and sent the specimens back to Washington, D.C., where they were eventually curated in the United States National Museum (Smithsonian Institution). There they were studied and later described in publications by Joseph Leidy. The type specimen of the giant Late Cretaceous fish, Xiphactinus audax, was collected by Dr. Sternberg. His work was also credited by Edward D. Cope and Samuel W. Williston. Sternberg was also responsible for getting his younger brother, Charles H. Sternberg, started in paleontology. Charles would later credit his older brother for getting many other paleontologists of the day interested in the fossil resources of Kansas.
Sternberg served at Fort Riley until July 1870, when be was ordered to Governors Island, New York. In the meantime, he had remarried on September 1, 1869, at Indianapolis, Indiana, to Martha L. Pattison, a daughter of Thomas T. N. Pattison of that city.
On December 1, 1875, Sternberg was promoted major and in April 1879 be was ordered to Washington, D. C., and detailed with the Havana Yellow Fever Commission His medical colleagues on the Commission were Doctors Stanfard Chaille of New Orleans and Juan Guiteras of Havana. Sternberg was assigned to work on the problems relating to the nature and natural history of the disease and especially to its etiology. This involved the microscopical examination of blood and tissues in which he was one of the first to employ the newly discovered process of photomicrography. He developed high efficiency in its use. In the course of this work, he spent three months in Havana closely associated with Dr. Carlos Finlay, the main proponent of the theory of mosquito transmission of yellow fever.
During the Hamburg cholera epidemic of 1892 he was detailed for duty with the New York quarantine station as a consultant on disinfection as applied to ships, their personnel, and cargo. Although some cases of the disease reached United States shores, none developed within the country.
Sternberg's nine year tenure (1893-1902) as Surgeon General coincided with immense professional progress in the field of bacteriology as well as the occurrence of the Spanish-American War. He was responsible for the 1893 establishment of the Army Medical School (precursor of today's Walter Reed Army Institute of Research), the organization of a contract dental service, the creation of the tuberculosis hospital at Fort Bayard, New Mexico, and of a special surgical hospital at Washington Barracks. The equipment of the medical school included laboratories of chemistry and bacteriology, and a liberal-minded policy was adopted in the supply of laboratory supplies to the larger military hospitals. With the Spanish-American War and its epidemic of typhoid fever, the problem of field hospitalization was confronted with fair success. (He was subjected to much criticism for conditions at these hospitals, but made little reply.) Sternberg created the Typhoid Fever Board (1898), consisting of Majors Walter Reed, Victor C. Vaughan, and Edward O. Shakespeare, which established the facts of contact infection and fly carriage of the disease. In 1900 he organized the Yellow Fever Commission, headed by Reed, which ultimately fixed the transmission of yellow fever upon a particular species of mosquito. (These became celebrated as the "Walter Reed Boards"). On his recommendation the first tropical disease board was also established in Manila (January 1900) where it continued for about the next two years. In 1901, Sternberg oversaw the establishment of the U.S. Army Nurse Corps.
Sternberg was retired on account of age on June 8, 1902, and devoted the later years of his life to social welfare activities in Washington, particularly to the sanitary improvement of dwellings and to the care of tuberculous patients. Sternberg died at his home in Washington, on November 3, 1915.
Pioneer American Bacteriologist, distinguished by his studies of the causation and prevention of infectious diseases, by his discovery of the microorganism causing pneumonia, and scientific investigations of yellow fever, which paved the way for the experimental demonstration of the mode of transmission of this pestilence. Veteran of three wars, breveted for bravery in action in the Civil War and the Nez Perce Wars. Served as Surgeon General of United States Army for period of nine years including the Spanish War. Founder of the Army Medical School. Scientist, author and philanthropist. M. D., LL. D.
Along with Pasteur and Koch, Sternberg is credited with first bringing the fundamental principles and techniques of the new science of bacteriology within the reach of the average physician.


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Produced using traditional Persian methods, this caviar made its debut at the grand opening of the Prunier Restaurant in Saint James's Street in London in 1932.

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27 year old man | Costa Mesa, CA, USA | Seeking women 21-28 within 50 miles
A little bit about myself... I grew up in the bay area and just recently moved to Orange County. I absolutely love it here. I work at a publishing/marketing company but my true passion is a website business that I started. I have a great sense of humor and I love sarcasm. I'm a very spontaneous person and I love to do anything outdoors. That being said I do enjoy my downtime and there is nothing more enjoyable to me than getting a bag of popcorn and cuddling up with someone close to me. Health and fitness is a big part of my life and I consider it To be natures natural anti depressant. I do crossfit 4-5 times a week and live a very healthy lifestyle. One thing that I constantly remind myself of is that life is too short to worry about the small things. I always try to keep a positive and optimistic outlook on everything and tend to shy away from negative people. Anyways, I'm boring myself just thinking about reading my profile, lol. Please just email me for a more enthusiastic dialogue.
Coffee and conversation , Business networking , Gardening/Landscaping , Hobbies and crafts , Movies/Videos , Music and concerts , Exploring new areas , Playing cards , Playing sports , Shopping/Antiques , Travel/Sightseeing , Volunteering , Watching sports
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I absolutely love Spain. I had the privilege of going there a couple of years ago and it was amazing. There is so much history and their culture is fascinating.
San Jose State University, San Jose, CA
One of my favorite things to do is to relax with someone I care about while watching a hilarious movie.
I enjoy playing sports, watching a good movie or TV show, coffee and conversation, going on walks, going to concerts, going out to eat, playing cards, doing puzzles, watching TV, exercising, reading, and anything new and exciting.
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Assistant Operations Manager at a publishing/marketing company
|$50,001 to $75,000
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|Never Married
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|Some college
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Buzz Bissinger on the shame of the sport that fed his addiction.
This play also calls attention to your own personal struggles with addiction.
Your addiction years must help with your portrayal of Nurse Jackie, who is addicted to painkillers.
c.1600, "tendency," of habits, pursuits, etc.; 1640s as "state of being self-addicted," from Latin addictionem (nominative addictio) "an awarding, a devoting," noun of action from past participle stem of addicere (see addict). Earliest sense was less severe: "inclination, penchant," but this has become obsolete. In main modern sense it is first attested 1906, in reference to opium (there is an isolated instance from 1779, with reference to tobacco).
addiction ad·dic·tion (ə-dĭk'shən)
Habitual psychological and physiological dependence on a substance or practice beyond one's voluntary control.


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Emily Blunt & Matt Damon looked stunning on Monday during the premiere of their film The Adjustment Bureau at New York's Ziegfeld Theatre.


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Crysis, developed by German studio Crytek and released in late 2007, was one of the most highly praised PC-exclusive games last year. It won GameSpot's Best of 2007 Editors' Choice award for Best PC Game and a host of other gongs.
However, it seems that all is not rosy at Crytek HQ in Germany. The studio's director and founder, Cevat Yerli, recently spoke out about the problems currently besetting his firm, PC gaming in general, and how Crytek plans to address the issues it faces.
In an interview with Croatian magazine PC Play, Yerli said, "We are suffering currently from the huge piracy that is encompassing Crysis. We seem to lead the charts in piracy by a large margin... PC gamers that pirate games, inherently destroy the platform.
"Similar games on consoles sell factors of 4-5 more. It was a big lesson for us, and I believe we won't have PC exclusives as we did with Crysis in future. We are going to support PC, but not exclusive anymore."
When asked if this meant that the rumours of Crysis coming to consoles were correct, Yerli simply stated that the port would be "impossible," saying that the game would have to be "largely changed to bring it to Xbox 360 or PlayStation 3," and that Crytek's "internal focus is not linked to bring Crysis to consoles."


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Look Inside | Enlarge Cover
Modern Library | Jan 14, 2003
| 272 Pages
| 5-3/16 x 8
Modern Library
| Jan 14, 2003
| 272 Pages
| 5-3/16 x 8
In The Lost World, the first in a series of books to feature the bold Professor Challenger—a character many critics consider one of the most finely drawn in science fiction—Challenger and his party embark on an expedition to a remote Amazonian plateau where, as the good professor puts it, "the ordinary laws of Nature are suspended" and numerous prehistoric creatures and ape-men have survived. "Just as Sherlock Holmes set the standard—and in some sense established the formula—for the detective story . . . , so too has The Lost World set the standard and the formula for fantasy-adventure stories . . . ," Michael Crichton writes in his Introduction. "The tone and techniques that Conan Doyle first refined in The Lost World have become standard narrative procedures in popular entertainment of the present day."
"The Lost World . . . provide[s] evidence that Doyle had it in him to be one of the greatest science fiction writers of all time."—Sam Moskowitz
Arthur Conan Doyle was born in Edinburgh, Scotland, in 1859. A Study in Scarlet, his first novel and Sherlock Holmes story, was published in Beeton's Christmas Annual in 1887. He was the author of more than fifty novels, ranging in… More about Sir Arthur Conan Doyle
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Fiesta 11-pc. Ceramic Nonstick Aluminum Cookware Set
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Transform your kitchen collection with this vibrant Fiesta cookware set.
Limit 5 per household.
Product Features:
- Heavy-gauge aluminum evenly distributes heat.
- Nonstick ceramic interiors make cleanup a breeze.
- Glass lids help lock in moisture and nutrients.
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What's Included:
- 3-qt. covered stockpot
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- 1-qt. covered saucepan
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Product Care:
- Oven safe to 850°F
- Hand wash
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- Turquoise: CW0005634
- Promotional offers available online at Kohls.com may vary from those offered in Kohl's stores.
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The Historic Town of Steilacoom, Washington - Incorporated 1854
Established as a National Historic District in 1974
The Town of Steilacoom is a residential community of approximately
6,050 located in the central portion of Puget Sound
Friends of Steilacoom Library
Click Here
Steilacoom Garden Club
Click Here
Local Business Directory
Click Here
Residential Recycling Collection Schedule
Click Here
Please support your local, Steilacoom Food Pantry ~ 581-1076
Financial contributions can be sent to:
We Love Steilacoom; 2301 Worthington Street; Steilacoom, WA 98388
Kiwanis Club of Steilacoom
Click Here
Local Farmers Markets
Click Here
Mailing List
Steilacoom Trading Post
Click Here!
Ferry Study Public Meeting Thursday 11 June 2015
7:00-8:30 p.m., Anderson Island Elementary School
Make your voice count! Ferry Study Public Meeting
Pierce County Public Works and Utilities is conducting a study to plan for the long-term future of the ferry system. The second and final public meeting will be held to solicit public input on preliminary consultant draft recommendations: Thursday, June 11. The meeting will be from 7-8:30 p.m. and will be held at Anderson Island Elementary School, 13005 Camus Rd.
If you cannot attend a meeting, all meeting materials will be posted online at:
Click Here
following the meeting.
For more information, contact: Valerie Thorsen, Aviation and Ferry Planner: email@example.com
Steilacoom Library Upcoming Events:
FOSL's Board of Directors will have its last meeting prior to a summer break on Tuesday, June 16, 6:30 PM at the Steilacoom Library. We'll be honoring two outgoing Board members, Beth Whitney-Teeple and Carolyn Adams. Last month, Grace Melony, retired from the Board. We'll miss them, but we have three new Board members ready to serve. They are Ellen Balls, Dr. Bob Edington, and Jean Manza.
Continuing are Bev Isenson, as president; Yoshie Wong, vice president; Voraya Srisamang, treasurer and membership chair; Teri Litt, Steilacoom High School librarian; and Patti Cox, librarian.
The Board meets on the third Tuesday of the month from September through November, and January through June. The annual meeting is usually held in March.
Library supporters interested in attending a Board meeting should check at the Library desk to any late changes in the meeting schedule.
Lakewold Gardens Open For Spring/Summer Season
- 1 April - 27 September 2015
Located in Lakewood, Washington, Lakewold offers landscape architecture by Thomas Church surrounded by rare and native plants, State Champion trees, over 900 rhododendrons, 30 Japanese maples and stunning statuary. A Washington State historic landmark, Lakewold's Georgian-style mansion and historic architecture complete the 10 acres where visitors can step back in time to an elegant past or enjoy a relaxing moment to contemplate the future.
General Admission is $9 per person. Senior/Student/Military admission is $6 per person. Members of Lakewold and children 12 and under receive free admission. 10:00 a.m. to 4:00 p.m.
2317 Gravelly Lake Dr SW, Lakewood - (253) 584-4106
Click Here For Details
4th of July Fireworks - Paid For Entirely By Donations!
The Steilacoom Chamber of Commerce once again opens Lafayette Street to the public for the day-long July 4th Celebration. Come join in the fun!
The Steilacoom Fireworks Committee is once more soliciting donations to pay for the annual gala finale to the 4th of July in the Town on the Sound. For more than a decade, local citizens and businesses have contributed to this fantastic fireworks display. Please consider making a donation toward the this year's display.
Please mail your donation to:
Steilacoom Citizens' Fireworks Committee
P.O. Box 88207
Steilacoom, WA 98388
Or make a donation via PayPal.
A PayPal account is not necessary for
a Credit Card contribution.
The Steilacoom Citizens' Fireworks Committee would like to recognize the generous contributions of this year's Fireworks Sponsors:
Key Bank
Sound Tax & Bookkeeping, Inc.
Umpqua Bank
Harriet E. Heyda - Financial Advisor
Thank you sponsors!
Freedom Fair on the Ruston Way Waterfront
- Saturday 4 July 2015
On July 4th, finally, the big event all along the Ruston Way waterfront!! Join us all day on the 4th of July for Freedom Fair, featuring all the usual 4th of July activities, airshows, great food, vendors, exhibits, rides, and events - along with a lot of very exciting new ones! It's the South Sound's biggest annual event, and a party that you don't want to miss, which ends with the Northwest's biggest firework show over Puget Sound!
Click Here For Details
Northwest Trek Slug Fest
- Saturday & Sunday, 27 & 28 June 2015
Slug Fest reigns supreme as one of the zaniest weekends of the year at Northwest Trek. Celebrate all that is slimy and silly about the Pacific Northwest�s most valuable and misunderstood mollusk: the yellow-greenish banana slug. Join us for slug-themed games, crafts, and presentations!
Activities are FREE with admission and include:
Slug Tattoos
Human Slug Races
Slime Art
Tentacle Headbands
Bubbles & Slime activity
Photo Booth with props
And More!
Click Here For Details
Freedom Fair on the Ruston Way Waterfront
- Saturday 4 July 2015
On July 4th, finally, the big event all along the Ruston Way waterfront!! Join us all day on the 4th of July for Freedom Fair, featuring all the usual 4th of July activities, airshows, great food, vendors, exhibits, rides, and events - along with a lot of very exciting new ones! It's the South Sound's biggest annual event, and a party that you don't want to miss, which ends with the Northwest's biggest firework show over Puget Sound!
Click Here For Details
Lakewood SummerFEST
- Saturday 11 July 2015
One Day Festival - Saturday, July 11th - 11:00am - 11:30pm
Fort Steilacoom Park; 8714 87th Avenue SW; Lakewood, WA 98498
Activities include:
Musical entertainment on two different stages.
KIDZ Zone Play Area
Car Show
Historical Tours and Activities
Sports Tournament
Safety Fair
Demonstrations and Displays
Army Strong Fitness Expo
Vendor Booths
Outdoor Movie at Dusk
And much, much more!
Box Tops for Education & Campbell's Soup Labels
Help Steilacoom's schools by saving and turning in the Box Tops for Education and/or Campbell's Soup labels at any school.
Click Here for a List of Box Top Brands
We Love Steilacoom Association Food Pantry
The Association operates a food bank for low-income individuals and families. Additionally, the Association provides need-based assistance for utility payments and, to the extent funds are available, scholarships for Steilacoom High School students with preference given to those attending a 2-year college or vocational school.
Food distributions are on the 2nd and 4th Saturday of each month from 10:00 a.m. to 11:30 a.m. at Oberlin Congregational Church. Food donations may be dropped off at the Community Center or at the Food Bank during operating hours.
Financial contributions for any of the programs, including the scholarship program, may be dropped off at the Community Center. A separate check, made payable to the Association, may also be sent in with your utility bill.
For more information, contact Paul Loveless at 581-1912 or Sharon Cornett, Food Pantry Coordinator, at 581-1076.
You will meet great new friends and have fun!
For activities at the Community Center, contact Pauline Monk at 983-2599.
The Steilacoom Food Bank always welcomes volunteers. Contact Paul Loveless at 983-2074
We have a very active volunteer Parks Group. Contact Nancy Henderson at 584-7284
The Citizens Fireworks Committee is preparing for this year's 4th of July. Contact Danny Lopez at 582-4995.
Steilacoom Museum Association Annual Events
Ice Cream Social
located on the Museum patio on Rainier Street.
During the Town-Wide 4th of July Celebration, Noon - 4 p.m.
Salmon Bake
on the shores of Puget Sound at Sunnyside Beach.
Last Sunday in July, Noon - 4 p.m.
Apple Squeeze
Festival of the apple with 20 presses for cider squeezing; apple products for sale.
1st Sunday in October, 10 a.m. - 4 p.m.
Christmas At the Orr Home
253 584-4133 for more information
Click Here for SHMA Event Details
Steilacoom's Main Street, a route through Puget Sound History - By Nancy Covert
Come Memorial Day 2014, national and state flags will ripple from the lamp posts lining Main Street that are accented with colorful, flowering baskets that remain in place until after Labor Day.
That's the way Steilacoomites celebrate the spring/summer seasons in its waterfront town, a place that once had sincere aspirations to become: state capitol, terminus for the Northern Pacific Railroad, summer resort destination, and a few other things... after it was founded in the 19th century. Tacoma, i.e., "the City of Destiny" and, later, other cities, eventually took over those roles.
Instead Steilacoom, a 2.1 square mile town, became a Bedroom Community. But that's OK with its residents, who take pride in the 160-year history that it marks this year. This summer, while visiting the Town on the Sound, take time to enjoy its popular Farmers Market and Concerts in the Park: two of the town's most enjoyable summer activities.
Although Main St. is technically the second major arterial in the Town of Pink Flowers-Steilacoom's Main Street also is one rich in history about the first town in the state-founded 160 years ago this spring. Since this year also marks Washington State's 125th Anniversary, it's a dual opportunity to learn more about the city's role in early state history.
For those who haven't already visited Steilacoom Historical Museum on Main Street or the Steilacoom Tribal Cultural Center and Museum on Lafayette Street, consider stopping by these local repositories of community history. Both sites offer overviews about why this area was settled first in the state-160 years ago.
The steep route-3/10th of a mile, from the top of Main to the waterfront below, bypasses a community center, public safety department, Immaculate Conception Mission Church, as well as Steilacoom Historical Museum, Orr's wagon Shop, Town Hall, and terminates at the Bandstand in Pioneer Orchard Park, with a marker for the site of the town's first school, plus a spectacular view of the snow-capped Olympic Mountains.
Just around the corner from the intersection of Lafayette and Main streets, is Chambers Bay Road: the route to the 2015 USGA tournament at Chambers Bay. Enjoy your summer-whether it's shopping at the Market or enjoying the music in the Park-very few places compare with Steilacoom.
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Provide your email address below and join our mailing list.
Mailing List
We have a very simple privacy policy:
Your email address will be shared with absolutely no one!
Magic Mops Cleaning
Family owned and locally operated business serving Olympia, Lacey, Dupont, Steilacoom, Lakewood, Tacoma, Washington. We pride ourselves on the quality of work we do and the professional demeanor in which we do it.
Click Here For Web Site
Call Now For Your
Free In-Home Estimate
Phone: 360.350.4805
Lakewood Nails Salon
Manicures, pedicures, facials, waxing... professional salon services! Your hands, feet, and body deserve the same attention you give your hair. Indulge yourself in relaxing and beautifying services that complete your finished look.
Click Here For Web Site
10511 Gravelly Lake Drive S.W.
Lakewood, Washington 98499
Pederson & Sons Contractors
Full service, licensed, bonded, insured general contractor. Home improvement, repair, remodeling company specializing in residential and commercial projects. Will beat any written estimate and help you design your project to work within your budget.
Click Here For Web Site
916 1st Street
Steilacoom, WA 98388
Town of Steilacoom Annual Events
Garden Club Plant Sale - Second Saturday in May
Steilacoom Farmers Market
- June, July, August - Every Wednesday
Concerts In The Park - June, July, August - Every Wednesday at 6:30 p.m.
Old Fashioned, Hometown,
Independence Day Parade
, Street Fair, Fireworks
Salmon Bake
- Last Sunday in July, Noon - 4:00 p.m.
Garage Sale Saturday
- Second Saturday in August, 9:00 a.m. - 4:00 p.m.
Apple Squeeze
- First Sunday in October, 10:00 a.m. - 4:00 p.m.
Christmas At Town Hall - First Friday in December
Rowdy Woods
Custom, rustic woodworking. Corbels, beams,
columns, mantles, arches, doors, gates, purlins,
signs, cat houses, doghouses, bird houses,
log shelters, animal sculptures, tikis, and
ornamental crosses.
Click Here For Web Site
Pierce County Alert
Get alerts about emergencies and other important community news by signing up for our Pierce County Alert Program. This emergency notification service enables Pierce County to provide you with critical information quickly in a variety of situations, such as severe weather, unexpected road closures, missing persons, and evacuation of buildings or neighborhoods.
You will receive time-sensitive messages wherever you specify, such as your home, cell, or business phone, email, text messages, hearing impaired receiving devices, and more. You pick where, you pick how.
Click Here to Sign Up
Search Washington Government Web Sites
Click Here!
Click Here


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Staff Assistant applications are now CLOSED.
The Big Event is made possible by countless hours of behind the scenes work from our executive team, committee, and staff assistants. If you enjoyed participating last year, you would be a great fit for staff. Here are some reasons you should apply for staff assistant:
- Join the Family of Big Event by meeting nearly 300 new people who love community service, and who desire to make an impact the world
- Develop relationships with 20 residents and determine how best to serve them on the day of.
- Determine the job description, tool count, and participant number for every job site you check.
- Play an active role on day of in distrubuting food, tools, check-in process, problem management, tool bringback, media relations, and various other jobs.
- Have the chance to make an impact at Texas A&M University through impacting the community.
Email us if you have any questions at email@example.com and we look forward to seeing you on March 28, 2015!
What are we looking for?
The Big Event is looking for individuals who posses the following qualities:
1. Passion/Zeal to Serve-Those with a selfless motivation to serve people. We are looking for people that serve others regardless of their position or social standing.
2. Humility- We look for individuals who have a mindset and perspective that is greater than themselves and who can impact and affect the lives of those around them
3. Hard-Working- Individuals that give themselves to a worthy cause and will accomplish the dreams they set their minds to.
4. Self-Starter- We look for people that can deliver well not out of obligation but, because of the passion for service they posses, they naturally start, create and build new ideas.
5. Creative/Innovative- We look for people that relentlessly seek improvement and always posses the question: How can this be done better?
6. Synergetic- It is vital to have members that work well in a team environment and have experience in leadership positions. The family of The Big Event is built upon people that encourage one another.
7. Communicative- Finally we seek people with strong oral and written communication skills. As a member on The Big Event you will be contacting and meeting with companies and will need to be able to express your thoughts and ideas in a manner that represents The Big Event of Texas A&M.
How do we choose among applicants?
Applicants are chosen based on the needs of The Big Event Team for the year. The combination of the application and interview will be determined through a weighted scoring system. The Big Event considers the whole individual and the personal hard work, dedication to the service of others, and leadership skills exemplified through the application process. "The Student Government shall not discriminate against, nor give preferential treatment to, any person on the basis of race, color, national or ethnic origin, religion, sex, gender, disability, age, sexual orientation, or veteran status. Prohibiting discrimination based on these factors in any and all forms. Big Event's admissions process can be found in Chapter 104, Article 2, and Section 2 of the SGA Code. You have the right to appeal any committee decision to The Judicial Court."
Application Specifics
Please respond to the 3 questions on the Main Application on no more than 2 pieces of single-spaced, one sided paper, using Times New Roman 14pt font. Turn in three stapled copies of your responses with your UIN only at the top of each page, and paper clip the Main Application as a cover sheet to your responses.
What does a Staff Assistant do?
A Staff Assistant on Big Event is the hands and feet of the organization. Staff Assistants meet with residents of the Bryan/College Station community through job checks. On these job checks Staff get to know the story of the residents and will be in charge of organizing the details for about 18 jobs they will be assigned. Staff Assistants also have the incredible opportunity to recruit about 22,000 student particpants for the Day of Big Event and recruit about 2,500 jobs in the community. Staff Assistants will also be running the operations of the Big Event on March 28, 2015. Most importantly our Staff Assistants will be incorporated into the Big Event family. This family has deep traditions, and the character/selfless attitude of each individual makes this organization unmatched on campus.
Time commitment
We have many student leaders from across campus particpate as Staff Assistants and the time commitment is very managable for these leaders. Please review the mandatory dates and hours on the application for more details concerning time commitments.
Contact our Development Executives David Jordan and Katie Edwards at email@example.com if you have any questions about the application.


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Genetic Testing for Tamoxifen Treatment
Revision Date(s) 07/14/14; 08/12/13; 06/12/12
Genotyping to determine cytochrome p450 2D6 (CYP2D6) genetic polymorphisms is considered investigational for the purpose of managing treatment with tamoxifen for women at high risk for or with breast cancer.
The specific CPT code for this test is:
Tamoxifen is prescribed as a component of adjuvant endocrine therapy to prevent endocrine receptor-positive breast cancer recurrence, as treatment for metastatic breast cancer, and to prevent disease in high-risk populations and in women with ductal carcinoma in situ (DCIS). The cytochrome p450 (CYP450) metabolic enzyme, CYP2D6, has a major role in tamoxifen metabolism. The CYP2D6 gene is polymorphic; variant DNA gene sequences resulting in proteins with reduced or absent enzyme function may be associated with lower plasma levels of active tamoxifen metabolites, which have been hypothesized to have a negative impact on tamoxifen treatment efficacy.
Because a small, but significant, proportion of most ethnic populations have markedly reduced CYP2D6 metabolic capacity, there is concern that similar proportions of patients treated with tamoxifen may have poorer outcomes than patients with relatively normal CYP2D6 activity. Some have recommended that patients who are to be prescribed tamoxifen be genotyped for CYP2D6, and patients who are poor metabolizers (PMs) be treated with alternative therapy, if possible.
Tamoxifen Metabolism
Tamoxifen undergoes extensive primary and secondary metabolism, and plasma concentrations of tamoxifen and its metabolites vary widely. 4-hydroxytamoxifen (4-OH tamoxifen) has demonstrated 100-fold greater affinity for the estrogen receptor and 30- to 100-fold greater potency in suppressing estrogen-dependent cell proliferation in vitro compared with the parent drug (summarized in (1)). Another metabolite, 4-hydroxy-N-desmethyl tamoxifen (endoxifen), has identical properties and potency compared with 4-OH tamoxifen. (2-5) Because 4-OH tamoxifen represents less than 20% of the product of tamoxifen primary metabolism, and because steady-state plasma endoxifen concentrations are on average 5- to 10-fold higher than 4-OH tamoxifen plasma levels, it has been assumed that endoxifen is the major active metabolite of tamoxifen.
The metabolism of tamoxifen to 4-OH tamoxifen is catalyzed by multiple enzymes. However, endoxifen is formed predominantly by CYP2D6. Plasma concentrations of endoxifen exhibit high interindividual variability, as described in breast cancer patients. (5) Because CYP2D6 enzyme activity is known to vary across individuals, CYP2D6 is of great interest for understanding tamoxifen metabolism variability and variation in levels of circulating active metabolites. Moreover, known variability in endoxifen levels has been hypothesized to result in variable response to tamoxifen treatment.
Alternatively and more recently, it has been estimated that at doses used for adjuvant treatment, which are intended to saturate the estrogen receptor, more than 99% of estrogen receptors are bound by low-affinity tamoxifen and both low- and high-affinity metabolites. (6) Lash et al (2009) modeled the effect of CYP2D6 variant alleles on estrogen receptor binding by tamoxifen and metabolites and found negligible effect. (7) As the authors note, however, modeling cannot account for many metabolic complexities, and mechanistic data would be needed to show how a decrease in high-affinity metabolites associated with CYP2D6 variants reduces the protection against recurrence conferred by tamoxifen therapy.
Metabolic Enzyme Genotypes
The CYP2D6 gene exhibits a high degree of polymorphism, with more than 75 allelic variants identified. Although the most prevalent CYP2D6 *1 and *2 alleles (both termed "wild-type" for this Policy) produce an enzyme with normal activity, there are several variant (V) alleles that result in enzymes with no activity or reduced activity. Because individuals have 2 CYP2D6 alleles, various combinations of the possible alleles result in a spectrum of CYP2D6 function; these have been categorized as extensive metabolizers (EM or "normal"), intermediate metabolizers (IM), and PMs. An additional, rare category of ultra-rapid metabolizers (UM) is defined by possession of three or more functional alleles due to gene duplication.
The prevalence of CYP2D6 PMs is approximately 7% to 10% in whites of Northern European descent, 1.9% to 7.3% in blacks, and 1% or less in most Asian populations studied. The PM phenotype in whites is largely accounted for by CYP2D6*3 and *4 nonfunctional variants, and in black and Asian populations, by the *5 non-functional variant. Some PMs may have 1 nonfunctional allele and 1 reduced function allele. Among reduced function variants, *17, *10, and *8 are the most important in blacks, Asians, and whites, respectively. Few studies have investigated the frequency of CYP2D6 variant alleles or of PMs in the Hispanic population. (8)
Other enzymes metabolize tamoxifen to the active metabolite, 4-OH tamoxifen. Polymorphisms in the genes for these enzymes could have an effect on overall tamoxifen efficacy. Research regarding the effect of variant alleles for these enzymes is in earlier stages of discovery.
Endocrine Therapy Regimens
Tamoxifen has several labelled indications (9):
In women with breast cancer, endocrine receptor-positive disease predicts likely benefit from tamoxifen treatment.
Tamoxifen is the only adjuvant treatment approved for preventing breast cancer in women with DCIS (approximately 20% of all new breast cancers) (10) and for preventing disease in pre- or perimenopausal women at high risk. Thus, pharmacogenomic evaluation would not change treatment in these women.
Tamoxifen is currently the most commonly prescribed adjuvant treatment to prevent recurrence of endocrine receptor-positive breast cancer in pre- or perimenopausal women. Pharmacogenomic evaluation could direct consideration of ovarian ablation or suppression in those found to be CYP2D6 PMs. In pre- or perimenopausal women with hormone receptor -positive tumors, ovarian ablation is an effective treatment compared with no adjuvant therapy but may be accompanied by acute and chronic adverse effects, e.g., hot flushes, sweats, and sleep disturbance. Ovarian ablation does not appear to add benefit to adjuvant chemotherapy. Similarly, functional ovarian suppression with gonadotropin-releasing factor analogs in pre- or perimenopausal women with hormone receptor-positive tumors confers benefits comparable with chemotherapy. National Comprehensive Cancer Network (NCCN) guidelines indicate ovarian ablation/suppression is an option in combination with endocrine therapy for premenopausal women who have invasive or recurrent disease and is recommended for premenopausal women with systemic disease. (11)
For post-menopausal women with osteoporosis or at high-risk for invasive breast cancer, raloxifene is an alternative treatment for invasive cancer risk reduction; efficacy equals that of tamoxifen, and risk of endometrial hyperplasia is markedly reduced. Currently, raloxifene is not indicated for treatment of invasive breast cancer; reduction of breast cancer recurrence risk; or noninvasive breast cancer risk reduction. (12)
Pharmacogenomics of tamoxifen have been most often studied in post-menopausal women who have endocrine receptor-positive tumors and require endocrine therapy to prevent recurrence. For this population, breast cancer guidelines from the National Comprehensive Cancer Network (NCCN) make no preferential treatment recommendations among the following choices (11):
In clinical practice, aromatase inhibitors (AIs) may eventually replace tamoxifen because of fewer adverse effects and equal or better efficacy. However, there is no evidence as yet to support AI use in premenopausal women. Tamoxifen also is important for treatment of metastatic cancer, where either tamoxifen or AI resistance may develop. Therefore, the use of pharmacogenomics to increase the likelihood of tamoxifen benefit is of current interest.
Pharmacologic Inhibitors of Metabolic Enzymes
CYP2D6 activity may be affected not only by genotype but also by coadministered drugs that block CYP2D6 function. Studies of selective serotonin reuptake inhibitors (SSRIs) in particular have shown that fluoxetine and paroxetine, but not sertraline, fluvoxamine, or venlafaxine, are potent CYP2D6 inhibitors. (14-16) Some individuals treated with fluoxetine or paroxetine changed from EM phenotype to PM. (12) The degree of inhibition may depend upon SSRI dose. Thus, CYP2D6 inhibitor use must be considered in assigning CYP2D6 functional status, and potent CYP2D6 inhibitors may need to be avoided when tamoxifen is administered.
Regulatory Status
The Roche AmpliChip CYP450 Test (Model 04381866190) is cleared by the U.S. Food and Drug Administration (FDA) and can be used to identify a patient's CYP2D6 genotype.
CYP2D6 genotyping assays are also available as non-FDA-cleared laboratory-developed services; laboratories offering such tests as a clinical service must meet the general regulatory standards of the Clinical Laboratory Improvement Act (CLIA) and must be licensed by CLIA for high-complexity testing.
Although the FDA has considered updating the label for tamoxifen (brand and generics) with information or recommendations regarding CYP2D6 genotyping and impact on tamoxifen efficacy, and has held an Advisory Committee meeting to answer specific questions regarding the evidence and recommendations, no label update has yet been issued.
Medical policies are systematically developed guidelines that serve as a resource for Company staff when determining coverage for specific medical procedures, drugs or devices. Coverage for medical services is subject to the limits and conditions of the member benefit plan. Members and their providers should consult the member benefit booklet or contact a customer service representative to determine whether there are any benefit limitations applicable to this service or supply. This medical policy does not apply to Medicare Advantage.
Literature Review
This policy was created in 2008 and has been updated regularly, with the most recent literature review through March 26, 2014.
This policy is based on a 2011 TEC Assessment, (17) which was updated in 2013. (18) Additional details about the studies described in this section are available in the Assessments.
Potential indications for CYP2D6 pharmacogenomic testing include tamoxifen treatment of breast cancer in the adjuvant setting to prevent recurrence (alone or preceding aromatase inhibitor [AI] therapy) or for metastatic disease; prevention of breast cancer in high-risk women or women with ductal carcinoma in situ (DCIS); and absence of contraindications to AIs (for treatment) or raloxifene (for disease prevention). If evidence indicated poorer outcomes with tamoxifen treatment in CYP2D6-poor metabolizers (PMs), postmenopausal patients determined to be CYP2D6 PMs could avoid tamoxifen therapy and receive AIs alone. Premenopausal patients might consider ovarian ablation. For any indication, co-administration of drugs that inhibit CYP2D6 activity should be taken into account.
Analytic Validity (technical performance of the assay)
The Roche AmpliChip CYP450 Test for detecting variants in CYP2D6 and CYP2C19 has been fully validated for analytic validity; a summary of results submitted for clearance by the U.S. Food and Drug Administration (FDA) is provided in FDA's decision summary. (19)
Although comparable information on the analytic validity of laboratory-developed tests usually is not available, in an experienced laboratory and with validation of in-house results compared with either sequencing or AmpliChip, accurate and reliable performance should be achievable as demonstrated by Heller et al. (20)
Clinical Validity (association of genetic marker with intermediate or clinical outcomes)
Four studies evaluated CYP2D6 genotype as a prognostic marker in patients not treated with tamoxifen to ensure that a prognostic association would not confound the effect of genotype on tamoxifen outcomes. (21-24) Although there were limitations in study quality or reporting, none of the studies found that outcome varied by CYP2D6 genotype in untreated patients.
Indirect Association of Genotype with Clinical Outcomes
Fifteen prospective cohort studies of adjuvant tamoxifen treatment provided consistent evidence that CYP2D6 nonfunctional variant alleles are associated with significantly reduced plasma endoxifen levels. (5, 24-37) However, endoxifen levels overlap across all genotypes, suggesting that CYP2D6 genetic variability does not explain all variation in endoxifen levels; in a 2013 study of 224 Asian women, 10% of the variance in endoxifen levels was explained by CYP2D6 genotype. (37) Seven of 8 studies reported significant associations of low CYP2D6 function with reduced plasma 4-hydroxytamoxifen (4-OH tamoxifen) levels. (24, 25, 27, 28, 31-33, 35) Coadministration of potent CYP2D6 inhibitors to CYP2D6 homozygous wild-type patients (extensive metabolizers, EMs) was associated with endoxifen levels near those of patients who are PMs; thus, use of CYP2D6 inhibitors should be taken into account in assigning metabolizer status in clinical studies.
Two studies reported on the relationship between CYP2D6 genotype and active tamoxifen metabolites and between genotype and clinical outcomes in the same patient population. (24, 28) Both studies enrolled breast cancer patients from Asian populations, focusing almost exclusively on the reduced (but not absent) function CYP2D6*10 variant. Both studies reported reduced endoxifen and/or 4-OH tamoxifen concentrations in conjunction with one or two variant alleles and also reported decreasing disease- or recurrence-free survival. Both studies were small and had study design flaws likely resulting in selection bias. In 2011, Madlensky et al reported on the association of tamoxifen metabolite levels with breast cancer outcomes in 1,370 samples from the Women's Healthy Eating and Living (WHEL) Study. (32) WHEL enrolled 3088 women with early-stage breast cancer who were diagnosed from 1991 to early 2000 and received tamoxifen. (38) endoxifen and 4-OH tamoxifen levels were strongly associated with CYP2D6 phenotype but were not linearly associated with breast cancer outcome. A threshold effect was identified with endoxifen, such that patients with endoxifen levels greater than 6 ng/mL had a 30% lower risk of additional breast cancer events (hazard ratio [HR]=0.70, 95% confidence interval [CI], 0.52 to 0.94). Notably, 24% of PM patients had endoxifen levels above this threshold.
Three prospective studies in 2011 and 2012 increased tamoxifen dose for patients who were already taking tamoxifen and were genotyped as intermediate metabolizers (IMs) or PMs (and not administered CYP2D6 inhibitors). (29-31) tamoxifen metabolite levels were measured at baseline and after 2 to 4 months and compared with those of EM patients who had no dose change. In general, tamoxifen metabolite concentrations increased with increasing dose; IM patient levels reached those of EM patients, and PM patient levels remained somewhat lower. However, these results were not related to breast cancer outcomes. Moreover, metabolite levels were highly variable across individuals, and in one study, low plasma endoxifen concentrations were found in all CYP2D6 genotypes. (30) Thus, it is likely that CYP2D6 accounts for only part of the variability in endoxifen levels. (39) The influence of other gene variants on tamoxifen treatment outcomes has been reported. (40, 41)
Direct Association of Genotype with Clinical Outcomes
An ideal study would compare tamoxifen-treated women versus those not receiving tamoxifen, with stratification by CYP2D6 genotype to see if PMs derive less benefit from tamoxifen than EMs. One group conducted such a study retrospectively, on archived samples from a randomized controlled trial (RCT) of tamoxifen treatment. (23) Paradoxically, they found that EMs treated with tamoxifen received no statistically significant clinical benefit compared with EMs not treated with tamoxifen and that carriers of a CYP2D6*4 nonfunctional variant allele obtained significant benefit from tamoxifen treatment. There were several limitations to this study.
Twenty-four other studies evaluated the association between CYP2D6 genotype and clinical outcomes in women treated with tamoxifen.
Nine small studies (range of N=21-282) in Asian populations focused on the CYP2D6*10 reduced function allele (24, 27, 28, 41-46), and 6 reported significant results for the association of CYP2D6 genotype with outcomes of tamoxifen treatment. (24, 27, 28, 45, 46) However, some of these studies may be affected in unpredictable ways by different types of bias, for example, by selecting among survivors at a time distant from diagnosis and surgery to draw whole blood for CYP2D6 genotyping (survivor selection bias). Two studies that reported no association may have had less potential for bias. (42, 43) One larger study (n=716) of Korean patients with breast cancer who received tamoxifen adjuvant therapy (most with adjuvant chemotherapy) found no CYP2D6 genotype-associated significant difference in recurrence-free survival (RFS) regardless of treatment or prognostic subgroup. (33)
Thirteen studies evaluated samples from primarily white patients administered tamoxifen for adjuvant treatment of invasive breast cancer or, in one study, for metastatic breast cancer. (21, 22, 47-58) Of the 5 largest studies, 4 reported no significant association for time to recurrence. (47, 49-51) Two of the negative studies were retrospective analyses of clinical trial samples, (49, 50) and a third was a case-control study nested in a population-based cancer registry. (47) All three were designed to minimize potential for bias; their size (range, N=588-991) allowed comparison of homozygous nonfunctional CYP2D6 genotypes with fully functional wild-type genotypes, i.e., the most extreme comparison and most likely to reveal a true association. The largest of the 5 studies (N=1,345) reported significant results; however, this study combined samples from different sources, some of which had already been analyzed for this hypothesis. (48) In addition, it is unclear from the report whether nearly half of the samples were obtained from patients who had survived and were available at a time distant from their diagnosis and surgery, a type of selection bias that can unpredictably affect results. The remaining 8 small studies reported a variety of significant and non-significant results; no pattern of bias, genotyping or group scheme, or accounting for CYP2D6 inhibitor use (among possibilities) explained the differences in results. The heterogeneity of results across all studies and clear results of no genotype-tamoxifen treatment outcome in 3 large studies with the least apparent potential for bias strongly suggests lack of support for clinical validity in post-menopausal patients treated with adjuvant tamoxifen for breast cancer.
Two nested matched case-control studies examined patients who were originally enrolled in chemoprevention trials using tamoxifen. (59, 60) In neither the larger (591 cases, 1,126 controls) nor the smaller study (47 cases, 135 controls) was CYP2D6 genotype associated with the risk of developing breast cancer. A 2013 matched case-control study from the Women's Environment Cancer and Radiation Epidemiology (WECARE) study sample reported no association of CYP2D6 variants and risk for contralateral breast cancer in tamoxifen-treated women (139 cases, 338 controls). (61) WECARE participants (998 cases [women with contralateral breast cancer] and 2112 controls [women without contralateral breast cancer]) comprised women from 4 U.S. cancer registries and 1 Danish registry who were diagnosed with localized invasive breast cancer before age 55.
Published literature on the association of CYP2D6 genotype with tamoxifen therapy effectiveness for treatment of non-metastatic breast cancer has yielded inconsistent results. A 2012 review tried to identify factors that may have led to discrepant findings. (62) The authors selected 6 factors to compare across 11 negative and 6 positive studies and identified 3 factors that may account for contradictory results: tamoxifen combination therapy (defined as any additional therapy, including radiation); genotyping comprehensiveness (how many and which alleles were tested); and CYP2D6 inhibitor coadministration. studies that enrolled patients on tamoxifen monotherapy, genotyped the CYP2D6 gene more comprehensively, and accounted for CYP2D6 inhibitor coadministration were more likely to have positive findings.
Subsequent studies in white patients have reported discrepant results. Two large studies from Scandinavia (total N=1365) reported no association between CYP2D6 genotype and disease recurrence in tamoxifen-treated women with early breast cancer. (63, 64) In contrast, a 2013 German study of 94 women with advanced breast cancer reported significantly shorter progression-free survival (PFS) and overall survival (OS) in patients without any fully functional CYP2D6 allele (IM/IM [intermediate metabolizers], IM/PM, PM/PM) compared with those who had at least 1 functional allele (EM/EM, EM/IM, EM/PM) (HR for PFS, 2.19 [95% CI: 1.15 to 4.18], p=0.017; HR for OS, 2.79 [95% CI: 1.12 to 6.99], p=0.028). (65) Some authors have suggested that CYP2D6 genotyping is clinically relevant in premenopausal women (66) and others in postmenopausal women. (67)
Several meta-analyses in 2013 and 2014 published inconsistent results. None of the studies included concomitant use of CYP2D6-inhibiting drugs in their analyses. Taken together, these analyses may be considered exploratory because the authors varied inclusion criteria, outcome definitions, and comparisons of interest.
Clinical Utility (impact of using the test on medical decision making and health outcomes)
There is no direct evidence of clinical utility. Ruddy et al (2013) implemented a tamoxifen adjustment algorithm for 99 patients treated at the Dana Farber Cancer Institute. (73) Recommendations to modify tamoxifen therapy were made for 18 patients (18%), all of whom had low endoxifen levels (<6 ng/mL), and 2 of whom also were identified as CYP2D6 PMs. Survival outcomes were not reported.
Two indirect chains of evidence can be constructed. One depends on demonstrating a significant association between in vivo endoxifen levels and clinical outcomes; this evidence is insufficient. The other depends on the association of genotype with clinical outcomes, summarized in the section on clinical validity. There are several limitations to the overall body of evidence, but the largest, most well-designed studies do not support a significant association. As a result, this indirect chain of evidence fails, and therefore the evidence does not support clinical utility.
Published data on the association between CYP2D6 genotype and tamoxifen treatment outcome have yielded inconsistent results. Some inconsistencies in the literature may be due to differences across studies in the types of additional therapies patients received, how many and which CYP2D6 alleles were tested, and coadministered CYP2D6 inhibitors. The largest, most well-designed studies do not support a significant association. Thus, because the impact of testing on net health outcome is unknown, genotyping to manage tamoxifen therapy is considered investigational.
Practice Guidelines and Position Statements
National Comprehensive Cancer Network
Regarding the use of CYP2D6 genetic testing before prescribing tamoxifen, NCCN breast cancer guidelines state, "At this time, based on current data the panel recommends against CYP2D6 testing for women being considered for tamoxifen therapy. Co-administration of strong inhibitors of CYP2D6 should be used with caution." (11)
The American Society of Clinical Oncology
A 2010 guideline update from ASCO states, "The Update Committee recommends against using CYP2D6 genotype to select adjuvant endocrine therapy. The Update Committee encourages caution with concurrent use of CYP2D6 inhibitors." (74)
A 2013 guideline update from ASCO states, "Data from the NSABP-P1 and STAR trials do not support the use of CYP2D6 testing to identify women not likely to benefit from tamoxifen therapy for breast cancer prevention." (75)
Medicare National Coverage
There is no national coverage determination.
Clinical Trials
A search of online site Clinicaltrials.gov identified 3 Phase 3 trials determining CYP2D6 genotyping in patients receiving tamoxifen for breast cancer:
The Eastern Cooperative Oncology Group is conducting a Phase 2 prospective study
CYP2C19 (cytochrome P450, family 2, subfamily C, polypeptide 19) (e.g., drug metabolism), gene analysis, common variants (e.g., *2, *3, *4, *8, *17) (Category Status B Code; bundled when billed)
CYP2D6 (cytochrome P450, family 2, subfamily D, polypeptide 6) (e.g., drug metabolism), gene analysis, common variants (e.g., *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1XN, *2XN, *4XN) (Category Status B Code; bundled when billed)
CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) (e.g., drug metabolism), gene analysis, common variants (e.g., *2, *3, *5, *6) (Category Status B Code; bundled when billed)
Unlisted molecular pathology procedure
Unlisted multianalyte assay with algorithmic analysis
Malignant neoplasm of nipple and breast, code range
Secondary malignant neoplasm of breast
Carcinoma in situ of breast; code range
Carcinoma in situ of other and unspecified female genital organs; code range
Encounter for screening for genetic and chromosomal anomalies code range
Personal history of malignant neoplasm of breast, female or male
Family history of malignant neoplasm of breast
Type of Service
Place of Service
Add to Pathology/Laboratory Section - New medical policy with investigational policy statement. No specific code. Policy approved with 90-day hold for provider notification.
Reviewed and recommended by OAP on November 17, 2011.
Codes 81225 – 81227 added.
Policy renumbered to 12.04.51 (previously 2.04.51) and reassigned to new Genetic Testing category.
Replace policy. Policy updated with literature search. References 25-32, 38, 39, 48-50 added. No change to policy statement.
Update Coding Section – ICD-10 codes are now effective 10/01/2014.
Coding update. CPT codes 83890 – 83913 deleted as of 12/31/12; CPT code 81200 – 81479 and 81599, effective 1/1/13, added to the policy.
Update Related Policies. Add 12.04.91.
Replace policy. Policy updated with literature search through May 13, 2013. Reference 51 added. Reference 10 updated. No change to policy statement.
Annual Review. Policy updated with literature review through March 2014. References 9, 12, 18-19, 34-38, 46, 63-73, 75 added; references 10-11 updated; others renumbered/removed. Policy statement unchanged.
Disclaimer: This medical policy is a guide in evaluating the medical necessity of a particular service or treatment. The Company adopts policies after careful review of published peer-reviewed scientific literature, national guidelines and local standards of practice. Since medical technology is constantly changing, the Company reserves the right to review and update policies as appropriate. Member contracts differ in their benefits. Always consult the member benefit booklet or contact a member service representative to determine coverage for a specific medical service or supply. CPT codes, descriptions and materials are copyrighted by the American Medical Association (AMA).


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12578 reviews
By installing you agree to the Terms of Use and other terms
PublisherVoxer Inc.
Download size6 MB
Last updated8/20/2014
Works with
- Windows Phone 8.1
- Windows Phone 8
App requires
- contacts
- phone identity
- video and still capture
- location services
- maps
- music library
- photos library
- media playback
- microphone
- data services
- push notification service
- movement and directional sensor
- VOIP calling
- web browser component
- camera
- HD720P (720x1280)
- WVGA (480x800)
- WXGA (768x1280)
Supported languages (1)
English (United States)
Turn your Windows Phone into a walkie talkie with Voxer. People can hear your voice in real-time as you talk, and every message is recorded - in case you're busy or want to listen to it later. You can also send text, photos, and share your location. Voxer allows you to easily and instantly communicate with a group of people or one-on-one. Forget about separate phone calls, voicemails, text messages and emails. Use Voxer on any data network - 3G, 4G or Wifi. Join the millions of people worldwide who are using Voxer to: • Enjoy live Walkie Talkie PTT (Push-to-Talk) on a smartphone • Talk with friends on Windows Phone, Android and iPhone • Send voice, text, photos and share location • Play messages back later - they're all recorded • Choose Favorite chats for easy playback • Chat with one friend or with a group • Create messages even when offline • Get notifications for new messages • Avoid annoying advertisements • Works on any cellular data network and WiFi – good for international use *** NY Times review, September 5th, 2012, "Ladies and gentlemen, we have a winner. Voxer is free. It's for both Apple and Android devices. It's packed with features. And it's self-explanatory." - David Pogue*** *** CNET review, January 8th, 2013, "This is our favorite way to communicate quickly" *** Voxer turns your device into the ultimate PTT (push-to-talk) real-time walkie talkie. ━━━━━━━━━━━━━━━━━ Any questions? • Like us on Facebook @ fb.com/voxer • Follow us on Twitter @ twitter.com/voxer • Check out support.voxer.com • Send us your feedback directly from Voxer: select "About Voxer" -> "Send Feedback" Bug fixes
6/25/2015Love it
6/25/2015Great and fun
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6/23/2015I like it
6/23/2015Some bugs
6/23/2015I like voxer. It's a good app.


text: Remember a company called Seattle Film Works that sold film that gave you slides and prints? I've been told that it's movie film. My cousin told me that some companies bought leftover ends of movie film and repackaged it as 35mm film. Don't know if it's true, but I've been told that movie film stock is on a thicker base and can be hard on 35mm cameras. Can APUGers verify that?


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The vegetable-herb coating gives the roast extra flavor. This is an easy holiday entrée.
YIELD: Makes 8 Servings
Puree onion, carrot, celery, garlic cloves, oil, flour, rosemary, salt and pepper in processor. Place beef in roasting pan. Rub beef with vegetable and herb puree, covering completely. Let beef stand 1 hour at room temperature.
Preheat oven to 500°F. Roast beef 20 minutes. Reduce oven temperature to 375°F. Continue roasting beef until thermometer inserted into center registers 125°F, about 1 hour 45 minutes longer. Remove roast from oven. Let stand 20 minutes. Slice roast and serve.


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Terrifying moment Brixton shopkeeper is threatened by gun-toting armed robbers
Video:Police have released CCTV footage of gun-toting raiders rushing into a Brixton convenience store and threatening the shopkeeper.
Prison guard killed in brutal attack at court has saved five lives by donating her organs
The family of a prison officer who died after a brutal attack at Blackfriars Crown Court today spoke of their pride as they revealed her donated organs have saved five lives.
Uber accident victim offered £35 refund after minicab crashes on M4 and bursts into flames
An executive has hit out at Uber for offering a £35 refund after his minicab crashed on the M4 and erupted in a ball of flames.
London's best: bright soles
Tuesday 07 July
Foot fault: Roger Federer's Nike Zoom Vapor 9 Tour, £100 (nike.com)


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Dr. Chan is an extremely competent and personable surgeon. He performed hip surgery on my wife in 2009. The results have been dramatic. My wife has experienced no problems since the surgery and has walked with comfort since then. We cannot express enough appreciation to Dr. Chan for making such a huge difference for us. We highly commend him.
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Dr. Chan successfully preformed my 2 full knee replacements. Recovery on left knee was progressive and without infection or other complications; leaving me a few months later with 'full rotation' in my left knee! 6 months later I'm now recovering from a full right knee replacement and would definitely recommend Dr. Chan. While conducting himself in a very professional manner, Dr. Chan also displays a genuine, keen interest in his patients while it's apparent he enjoys and takes great pride in his work.
Was this rating useful? 0 [[ userState['ratings'][1332797].votes_count ]]
I had hip replacement in March with excellent results. Dr. Chan is an extremely capable surgeon and his staff was helpful and friendly. I would very highly recommend him. Altogether a totally positive experience.
Was this rating useful? 2 [[ userState['ratings'][1332796].votes_count ]]
Dr. Chan is a good doctor. Listens to a patient's concern and then gives his diagnosis. His receptionist on the other hand needs some customer service lessons. Typical receptionist who seem to hate her job.
Was this rating useful? 0 [[ userState['ratings'][1332795].votes_count ]]
Dr. Chan is very thorough in his examination and explanation of my knee. Gave me the choice to wait or proceed. I chose to proceed with the surgery. Best decision. Dr. Chan did a great job on my knee (torn meniscus and clean up). I highly recommend him. Wait time was not too bad. At the same time I also saw him for my shoulder. He suggested a non-surgical approach and that was the best decision. My shoulder is doing quite well now with treatment instead of surgery.
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Made me suffer needlessly for 2 yrs. Went to another surgeon and got the surgery I needed in a few weeks which is unreal for BC. I was in severe pain and he totally ignored this and told me I was imaganing it. I had a big surgery which no one will do unless it's needed and it was done quickly. The pain has been addressed and I hope he is never in this position. I lost 2 yrs of my life because of him. You can read my mind.
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Dr. Chan is very helpful and polite. He explains in details before and after my L. foot surgery in 2009.
Was this rating useful? 0 [[ userState['ratings'][1332792].votes_count ]]
Dr. Albert Chan did my knee 20yrs ago when he worked out of the pan am clinic in Winnipeg. He was extremely reassuring and did a awesome ACL reconstruction (double grafted! even back then). I still play soccer and owe a lot to him. Very nice person.
Was this rating useful? 0 [[ userState['ratings'][1332791].votes_count ]]
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text:
U.K. singer Lily Allen is the daughter of the notorious British actor/comedian Keith Allen, and her father's sharp sense of humor is reflected in the music on her highly acclaimed 2006 debut full-length, ALL RIGHT STILL. Following the runaway success of the single "Smile"--which hit the top spot on the U.K. singles chart--the album is blend of pop-reggae, hip-hop, and U.K. R&B delivered with witty lyrical barbs and a chart-friendly pop sheen. While her brash outspokenness has made her a media fixation in England, her eclectic party jams have positioned her as something of a British answer to Gwen Stefani.
1. Smile 3:17 2. Knock ''Em Out 2:53 3. LDN 3:10 4. Everything''s Just Wonderful 3:28 5. Not Big 3:16 6. Friday Night 3:06 7. Shame for You 4:06 8. Littlest Things 3:02 9. Take What You Take 4:06 10. Friend of Mine 3:57 11. Alfie 2:45 12. Nan You''re a Window Shopper 2:50 13. Smile Version Revisited 5:44
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text:
Originally written on Fox Sports | Last updated 10/27/12
Brooklyn Nets All-Star Deron Williams said Saturday that Raymond Felton is a better playmaker than the point guard he replaced in New York, Jeremy Lin. Lin outplayed Williams last Feb. 4 in a stunning performance off the bench, starting a phenomenon that became known as Linsanity. But the Knicks opted not to match the $25.1 million deal Lin signed with Houston, having already completed a sign-and-trade deal with Portland to reacquire Felton. Felton played well in a previous stint with the Knicks. ''I would say Raymond Felton is a better point guard than Jeremy Lin, in my opinion,'' Williams said at the Nets' practice facility. The Nets host the Knicks on Thursday in their first game at the new Barclays Center. It would've been hard to imagine Lin not being there after the 10 games that started when he scored 25 points in a 99-92 victory over the Nets at Madison Square Garden. Williams scored 21 points and shot just 7 of 19 that night, though made amends later in the month when ...
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text:
no 7600 drivers on linux?
I installled the lates nvidia driver rpm and I cannot see an entry in the list of drivers for 7600. What am I doing wrong?
Re: no 7600 drivers on linux?
Which NVIDIA Linux graphics driver release did you install and which list are you referring to? The GeForce 7600 is supported by 1.0-9746 (see http://www.nvidia.com/object/linux_d..._1.0-9746.html and http://us.download.nvidia.com/XFree8...ppendix-a.html).
Re: no 7600 drivers on linux?
after I have installed the rpm,
I click on the redhad and go to system settings
from there I choose display,
when I try to select the video card from the list, it only has a few nvidia cards listed and the 7600 GT is not listed.
Am I doing this wrong?
Re: no 7600 drivers on linux?
RedHat's utilities do not provide an accurate list of NVIDIA GPUs supported by any given NVIDIA Linux graphics driver release; please see the README for information on how to configure your X server to use the NVIDIA X driver.
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text:
Razorback linemen shed pounds with a little extra work
Posted: August 14, 2014 at 3:23 a.m.
Motorists and pedestrians around the corner of College Avenue and Maple Street were treated to quite a spectacle a few weeks back.
This story is only available from our archives.
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SEC's TV network set to roll
If you live in Arkansas and have a television, you should have access to the SEC Network when it debuts at 5 p... Read »
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Singers shine in Gridiron's return
About 75 area lawyers -- and some key deputies -- have pulled together the latest Gridiron show after a four-year hiatus, and, despite rolling in short at just over one hou... Read »


text: Deals Friday stumper: Find all of Apple's 23 acquisitions from the past 16 months Image Credit: J. O'Dell / VentureBeat February 28, 2014 4:04 PM Jordan Novet 0 At Apple's annual meeting in Cupertino, Calif., today, chief executive Tim Cook dropped a curious factoid: In the past 16 months, Apple has bought 23 companies. Like Cisco, IBM, Salesforce.com, Oracle, Yahoo, and other aging tech giants seeking to stay relevant, Apple has been on an acquisition binge. The mobile device, PC, and software maker keeps lots of cash on hand. Enough cash to round up a whole flock of acqui-hires, technology buys, and other M&A deals. We couldn't help ourselves. We poked around and came up with documentation for at least 16 of the said 23 purchases. Here are the ones we're sure about: 1. SnappyLabs, maker of a mobile camera app. 2. Note-taking app company Catch. 3. Mapping company BroadMap. 4. Social media analytics company Topsy. 5. PrimeSense, the company that devised the technology underlying Microsoft's Xbox 360 Kinect. 6. Productivity app maker Cue. 7. AlgoTrim, a mobile data compression company. 8. Public transportation app maker Embark. 9. Matcha, the company behind an app showing stuff you can watch. 10. Passif Semiconductor, a company that made low-power chips for mobile devices. 11. Public-transportation app maker HopStop. 12. Map data company Locationary. 13. WiFiSlam, a company that figured out a way to pinpoint people's locations inside buildings using a Wi-Fi signal. 14. Web development company Particle. 15. The engineering team behind photo-sharing app maker Color Labs. 16. TestFlight maker Burstly. Beyond these 16, we've come across a few other companies Apple might have acquired in the 16-month range, but we don't have official confirmation for them: 17? Grokr, a company that came up with, a predictive search app. 18? Basis Science, a company that makes health-tracking watches. It could be of use to Apple as it reportedly works on an "iWatch." We know we're missing companies here. So help us, please, and tell us what we left out. Send us mail at email@example.com. Oh, and if you know someone who knows someone whose company just got bought by Apple, tell us that, too. More information: Apple Catch.com Topsy Labs Color Apple designs and markets consumer electronics, computer software, and personal computers. The company's best-known hardware products include the Macintosh line of computers, the iPod, the iPhone and the iPad. Apple software includes t... read more » Catch.com develops mobile and web applications that make it simple to capture, organize, and share information on the go and keep it synchronized in the cloud. Catch.com offers note-taking and geo-tagging applications for Android and i... read more » Search and Analyze the Social Web. Topsy is a social analytics company that gives you instant answers to critical business questions through real-time analysis of public conversations. Operating the world's only index of the public soc... read more » COLOR is a technology company that creates mobile applications for iPhone and Android devices. We believe in the opportunity the mobile revolution presents and are excited about developing products that transform the way people share t... read more » Powered by VBProfiles


text:
Pear Bureau Northwest Presented Awards to 39 Retail Produce Personnel from Across the U.S. and Canada Portland, Ore. (June 15, 2015) – Pear Bureau Northwest is pleased to announce the 39 winners of its second annual "Pear Up with USA Pears" display contest. The contest invited all retailers from across the U.S. and Canada to build an eye-catching display that features Green Anjou, Red Anjou, and Bosc pears at minimum, with inclusion of other varieties of USA Pears encouraged. To qualify for the contest, the display was required to be maintained for at least one week during the January –…
PORTLAND, Ore. (June 9, 2015) – The annual meeting of Northwest pear growers was conducted last week in Portland, with anticipated projections on the 2015 fresh pear harvest set at nearly 20.4 million standard box equivalents which equates to approximately 451,000 tons of fresh pears. The projection is 2% higher than the five-year average, and 2% lower than last year's crop. The estimate was collected from fresh pear growers in Wenatchee and Yakima, Washington and Mid-Columbia and Medford, Oregon growing districts. With relatively mild winter and warm spring conditions in the regions, harvest is expected to be five to seven…
Pear Bureau Northwest Announces Winners in 2014 "Pear Up with USA Pears" Display ContestAwards presented to 40 retail produce personnel from across the US and Canada
Pear Bureau Northwest Promotes Bob Koehler to Lead Regional Marketing ManagerIndustry veteran to develop national marketing strategies
Pear Bureau Northwest Promotes Bob Koehler to Lead Regional Marketing ManagerIndustry veteran to develop national marketing strategies
2014 Revised Crop Estimate ReleasedNorthwest pear growers forecast a larger sized crop from Washington and Oregon than originally anticipated
2014 Northwest Pear Crop Estimates ReleasedNorthwest pear growers forecast a full-size crop from Washington and Oregon
Fresh Pear Consumption Associated with Better Diet Quality and Lower Risk of ObesityWhen compared with non-consumers, fresh pear consumers have a better nutrition profile
Pear Bureau Names Winner in Canadian National Culinary Student CompetitionNew Brunswick student earns highest marks
Introducing the Pear Up with USA Pears Display ContestGrocers of all sizes have a chance to win $11,250 in prizes
Ingles Named 2013 Pear Retailer of the YearNorthwest pear growers forecast a full-size crop from Washington and Oregon
Estimate for 2013 Northwest Pear Crop ReleasedNorthwest pear growers forecast a full-size crop from Washington and Oregon
Regional Finalists Named in Canadian Culinary CompetitionFive culinary students will face off in Toronto on April 16 for the National Grand Prize
USA Pears Gain Access to ChinaChina expected to emerge as top export market
Introducing Pear WorldPlayful new pear-themed website will educate and engage children
Pear Bureau Northwest Awarded 2012 Specialty Crop Block GrantWSDA approves $75,000 grant project
Northwest Fresh Pear Industry Forecasts Size of 2012 HarvestGood-sized crop of excellent quality expected from Washington and Oregon
Pear Bureau Northwest Promotes Bob Koehler to Lead Regional Marketing ManagerIndustry veteran to develop national marketing strategies
USA Pears Names Grand Prize Winner in Canadian Culinary Student Recipe CompetitionStudent from BC wins top honors
This Holiday Season, The Time is Ripe for PearsNational Pear Month celebrates the versatility of pears
Fulfill MyPlate Guidelines with USA PearsIns-pear-ation to meet MyPlate guidelines
White Fleshed Fruits and Vegetables Lower Stroke RiskA pear a day could keep strokes away
Pear Bureau Helps Lead MyPlate Promotion EffortsPear Bureau named USDA National Strategic Partner
Kevin Moffitt Appointed to Lead World Apple and Pear AssociationMoffitt steps in for two-year term
Pear Bureau and Schoolmenu.com Share School Nutrition InformationPear Bureau Northwest promotes child nutrition with Schoolmenu.com
Pear Bureau Northwest Releases Fresh Pear Crop Estimates for 2010-2011 SeasonThe forthcoming pear harvest's yield is estimated to be in line with five-year average
USA Pears Names Winner of Nationwide Culinary Student ContestThree student finalists dished up their pear recipes for judges at Le Cordon Bleu College of Culinary Arts in Portland, Ore.
Kevin Moffitt Appointed Chairman of US Agricultural Export Development CouncilPear Bureau Northwest President and CEO will bridge communication between organization members and government decision-makers
USA Pears Gives Fans a Chance to Meet Pop Band Honor Society in HollywoodExciting partnership offers fans an opportunity to win a trip for four to Hollywood to meet Honor Society!
Northwest Fresh Pear Crop Estimates Released for 2009 SeasonInitial Estimates Point to Above Average-Sized Crop from Oregon and Washington
Pear Bureau Northwest President Named Produce Industry Top 25 LeaderProduce industry trade publication "The Packer" honors Kevin Moffitt for exceptional leadership


text:
Mike Pierce recalls horrific training incident with Rick Story
MMA gear now available at the UG Store
tags: Mike Pierce (detail) Ricky Story
Recent Comments »
11/27/11 7:47 AM by RoidsGracie
Some highlights of that article: - What Mike Pierce said about me hitting Abel when he was on a knee saying stop is BULL SHIT. Abel wasn't some random person off the street either. At the time he was 1-1 as a professional and had been training with us for 3 months. He was a 4 time All-American for William Penn college in Iowa and actually beat me at nationals my first match my junior year at Southern Oregon University. What Mike also decided to forget to say is how many times Abel had tapped him that week in training (I think 2 by guillotine). What Mike also forgot to admit was how well Abel did in sparring against Brad Blackburn (at the time current UFC welterweight). Abel was new to our team but not new to the sport and not a poor defenseless kid. Abel did have Vertigo and had taken time off. Pat would not let him sparr without a doctors note saying he was cleared. I had talked with Abel before the session and asked him how his Vertigo was doing, he said he was cleared but to be safe I told him I would only throw body shots. - This all happened around the time when Mike was preparing for his fight with Julio Paulino. I helped him train for this fight just like most of his other ones. He came out of that fight with a little bruise on his cheek and no other damage. I was not there but Pat had talked with Mike and said "since you didn't take any damage we are going to need you to be back in the gym on Monday to help Ricky for his fight in three weeks." Mike no-shows for an entire week. Pat and myself tried to call but typical non-team player he was he didn't answer his phone. Mike shows up on the following Tuesday I believe weighing almost 200lbs. Pat told Mike he needed to be at 190lb. training weight to be a good practice partner for me. Mike came in the next day weighing only a pound lighter, Pat told him it was the last time he could train if he wasn't going to make weight because he needed to be at a realistic weight for me. Pat told him to not show up until he was. Well that was the end, Mike never came back. - These are some of the reasons why Pat and Me didn't want Mike on our team anymore. Mike and one of our teammates were told to go do a specific workout on the track and to do it with each other to help push themselves. Mike ends up taking his girlfriend to the track worked out by himself and left our car-less teammate who lived less then two minutes away high and dry to find his own way to the track. When confronted his response was something along the lines of him not being responsible for our teammate which I believe is really messed up. - Pat told me about a time when they were at the airport and there was a lady on the ground crying looking through the contents of her dumped bag for a passport or something and Mike pointed and was laughing at her, what if something was seriously wrong with her? There was one time when Mike came into the practice room and told Pat and Me that his girlfriends child was retarded and locked the kid in the room because he was getting annoyed and then laughed. These are isolated events that stick out in my mind but know there are tons more, but all of these hopefully paint a little bit of a picture of what kind of a person Mike is behind the interview questions or cameras.
11/27/11 7:27 AM by HarryFRUK
I understand Rick, But he needs to learn to use paragraphs.
11/27/11 6:44 AM by jtown2
thehorrorstory-unknown.blogspot.com/2011/11/response-to-mike-pierces-interview.html In short Story says It never happened Abel is no rookie Pierce is not a team player and a dick of a person. All in all I don't care if it happened Pierce should not have broke the gym rule. Let em beat each other up.
11/27/11 4:59 AM by GriffinQ
Think Story could have been more mature in his response(ie not trying to do a character assassination on Pierce), but I guess Pierce really didn't hold his tongue about Story at all...weird situation, the truth is probably more somewhere in the middle. Regardless...I was a fan of watching Story fight before this, and I'll be a fan of his after. I wasn't a huge Pierce fan, because of his openly derogatory remarks about Brazilians(I'm not a fan of most of the stuff Chael says about them either, for the record), but the guy is an entertaining fighter and I do like watching him fight. Hopefully the two of them can settle this on an upcoming card.
11/27/11 4:32 AM by BrewBarry
Story's response: http://thehorrorstory-unknown.blogspot.com/2011/11/response-to-mike-pierces-interview.html
11/26/11 2:11 AM by Erik Tracey
11/26/11 1:28 AM by DJLastCall
I can say with 100% certainty, that the oter side of this story......is exactly the same as Pierce's. Except, White and Story would be laughing when they told it.
11/25/11 11:16 PM by sickdarce
11/25/11 11:13 PM by Bipolar

DallasVanWinkle - I live in the area and had considered checking out the gym, unfortunately I have heard a lot of bad things about Pat and this really just confirms it.

Rick seems like he was a decent kid, he probably got taken advantage of by Pat. Don't blame Rick you guys, he trusted his coach and his coach took advantage of him.

Super fucked up.

Don't blame Rick Story? He got taken advantage of? I hope you're not serious. Rick is a grown man, not a 16 year old kid. Unless he is clinically retarded, which is very possible, he is 100% responsible for his part in this garbage.
11/25/11 11:13 PM by SomeoneToDoYourDirtyWork
I have done some training in Oregon and have heard nothing but bad things about the owner/trainer of Brave Legion, from multiple sources...Pierce seems to confirm now....sad....just sad....giving a loud mouthed ego-maniac new guy the business is one thing....this is another....


text:
Alt+F1: 51 - British GP Prerace
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Her Story is a bold and largely successful experiment in interactive crime fiction.
Rocksteady's gorgeous-looking third Arkham game refines its open-world format a bit and lets you drive a whole hell of a lot of Batmobile.
It's squid kids and ink blasting abound in Nintendo's exceptionally fun new online shooter.
Franchise »
Arkham Knight, developer Rocksteady's return to the Batman series, takes place one year after Arkham City. It promises to expand the open world from the previous game, allowing players to drive the Batmobile through Gotham City's streets.
Infinite Crisis was a short-lived DC comics-based MOBA, featuring heroes and villains from throughout the multiverse, including weird alternate versions of well-known characters. It released in March of 2015 and was shut down that August.
Two of DC's finest heroes battle their respective villains in this mobile game.
Young Justice: Legacy is a game based on the Young Justice animated cartoon show. It is best known for its long, troubled development cycle.
Two years after beginning his crime-fighting career, Batman faces his toughest challenge ever when the crime lord known as Black Mask hires the eight deadliest assassins in the DC Universe to kill the vigilante who has been interfering in his operations. Developed by WB Games Montréal.
Mobile game in the vein of Arkham City Lockdown
A Scribblenauts game that features DC Comics characters. About 2,000 characters in total, supposedly all of them. Also included is a Hero Creator that lets players make their own Hero and a procedural puzzle generator that makes a new puzzle every time a map is loaded.
Official mobile game based on the 2013 blockbuster film.
Game based on the movie of the same name for iPhone & Android.
The DC Universe's most powerful heroes and villains collide in this 2.5D fighting game from the creators of the Mortal Kombat series.
A completely separate beast from its big console counterpart, Injustice: Gods Among Us for mobile is a fighting game that can unlock features in the console versions.
A variety of HeroClix scenarios that can be played out using special HeroClix in the real-world.
Justice League: Earth's Final Defense is an mobile (iOS/Android) brawler video game.
Sequel to 2008's LEGO Batman, Batman and Robin are forced to work together alongside the likes of Superman, Wonder Woman and Green Lantern to help stop the combined tyranny of Lex Luthor and The Joker.
Tim Drake has been pulled into one of Klarion's pocket dimensions and must find a way to escape with some help from his teammates
Freelance vigilantes in superhero garb take on psychopathic criminals wearing clown makeup in this (now free-to-play) Batman-themed multiplayer first-person shooter.
Online card game tie-in to the film.
Infinity Blade meets Batman in this prequel spin-off of Batman: Arkham City.
The tie-in videogame to the 2011 Green Lantern movie. This brawler depicts a clash between the Green Lantern Corps. and their predecessors as guardians of the universe, evil robots known as the Manhunters.
An MMO for the PC and PlayStation 3 that allows you to fight for and alongside the forces of good or evil from the DC Comics Universe.
Team up as Batman and one of four superheroes in this 2D side-scrolling action-adventure game based on the animated series of the same name.
Batman: Arkham Asylum puts you behind the cowl of the iconic Dark Knight, fighting his way through Arkham Asylum to stop the Joker from enacting a sinister plot that would have grave consequences for Gotham City.
The second episodic Watchmen game picks up where the first one left off with the story of Night Owl and Rorschach pre-Watchmen (the film and book).
Justice League: Heroes United for the arcade by Global VR
The Mortal Kombat and DC Comics universes collide in Midway's first crossover Mortal Kombat game developed for the Xbox 360 and PlayStation 3.
LEGO Batman: The Video Game is an action adventure platformer focused on the combination of the popular Batman universe and the continued licensing of Lego-styled video games.
A 2008 pinball table from Stern, based on the movie of the same name.
Super Returns is an open world tie-in to the film. It features story missions based on saving the city of Metropolis, and 80 square miles of free roaming goodness. Also, the final boss battle is a tornado.
Take control of Robin and save the Teen Titans from the Brotherhood of Evil.
Justice League Heroes is an Action-RPG that allows you to play as members of the Justice League of America as they work together to take down the various villains in the game.
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text:
Been away hunting A-hole poachers, but back for now since I think I am sick AGAIN with the flu and sorting through my G3 parts lot I got in a few weeks ago.
I have demilled a few front sections and have a few good barrels for a build or 4 but I also got a few other parts that look like they were going to be pistol or short barrle rifle builds, just curious what I might could do with these parts since I doubt I could get any thing for them on Gunbroker.
The carrier on the far left is full size but the other one has been cut down, I am assuming for one of the short barrels. I am building one or two full size rifles out of the other front sections I got but if any of these parts could become a 53, that could be cool but I really can't find much info on these short rifle builds. I did see the barrel on the HK53 is 8.5 inches but were is that measurment taken from, the OAL or from the front of the chamber forward.
Also, I chimed in on a few other threads during the holidays while bedridden but forgot to subscribe to them so if anybody can help me find myself, I would appreciate it (still kinda new to the whole forums thing, sorry ).