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Phoenix Valley
From PWpedia
This dungeon is chock-full of wraiths that are just itching to be wiped out by you and your squad members. Fun and great EXP are there for the taking as you cleave your way through wraith after wraith!
Levels 30-84 were introduced on May 3, 2011 (see here) and levels 85-105 were later added on June 7, 2011 (see here).
Basic Info
Phoenix Valley is broken up into seven different level ranges:
- 30 - 44
- 45 - 59
- 60 - 74
- 75 - 84
- 85 - 94
- 95 - 100
- 100 - 105
To enter Phoenix Valley, all you have to do is talk to Khoan the Survivor at any one of the major cities. Make sure you have either an Elite Golden Silkworm or Hyper EXP Stone before you enter the instance.
Note: You can pick up the "token" once per day, which resets at midnight server time.
Squad Setup
First off, do not take the quest until your squad is set up and ready to go in. This is a timed instance, so if anyone in the squad takes the Phoenix Valley token (the item is timed at 15 minutes) from the NPC before all players are ready chances are someone in the squad will be kicked out before the run is over with. If squad members get killed and leave the dungeon after the token has disappeared they will not be able to get back into the dungeon even if they are still in the squad.
As of now anyone with decent gear and good knowledge of their class can solo or duo Phoenix Valley. But in later levels or just for fun, a good squad should consist of:
1 Tank
1 Healer
2 AOE DDs
A back-up healer or an extra AOE DD might be a good idea if a player is poorly geared or has no knowledge of PV.
Squad Rolls
Simple you keep the mobs on you and off your squad. A Seeker or Blademaster may be used in place of a Barbarian if one is not found.
It should be noted that when the tank is pulling he will have to stop at certain places for the squad to kill the mobs, the whole instance cannot be done all in one pull. A good tank will be able to do low level PVs in maybe 3-4 pulls, however if you are a tank new to PV or just don't have the gear to stand multiple hits, you may want to limit your pulls. Oh and for the love of all things related to gaming please read up on Aggro!
Watch one of the many videos on YouTube (make sure you search for the right level range) to get an idea of were you should stop with the mobs in a run. If you are using a search engine to look for videos make sure to add "squad" or "party" to your search, or lot of solo videos tend to pop up otherwise.
Your healing is essential in order for the squad to live!
Cleric: Start out with about 3 stacks of Ironheart Blessing on the tank before he dives into the mobs. When he stops, up goes Chromatic Healing Beam (lower level PVs) or Regeneration Aura aka BB (Level 59 skill).
Note: I personally recommend you tell your squad you need chi every time a wave of mobs is killed. Most tanks that have not played a cleric before don't know (or just flat-out forget) that BB takes 2 sparks and without the halved damage and healing factor it carries, squad wipes are imminent.
Mystic: This class will most likely play back-up healer and won't be much help as a solo healer until level 39 when they earn their AOE heals, but alas, clerics can be hard to find sometimes. Dig out Salvation to stick its buffs on the tank before he enters the fray. When he stops, dish out all the AOE healing you've got. If you're confident in your skills you may switch between your Salvation for protection and Storm Mistress for AOE damage. Otherwise just stick with Salvation.
Damage Dealers
All classes make good contributions to AOE damage in Phoenix Valley. But most will not learn good AOE skills until after their Level 59 Cultivation.
Main AOE DDs: Blademaster, Wizard, Archer, Psychic, Seeker
The big guns of all out AOE damage. Most will need chi to execute their AOE skills.
Secondary AOE DDs/Support: Venomancer, Assassin, Mystic
These classes may not make as much damage as fast in the AOE category, but they are great to bring along for both AOE and support. The buffs and support skills these classes can provide are a good boon in any squad.
Only a few minor details to note here that need some reminding:
Psychics: You are able to control your Aggro. Attracting mobs too much? Use White Voodoo.
Assassins: X-nay on the APS except at the boss. APS in big mob pulls does the squad no good. Even if your AOE skills don't do nearly as much damage as the big magic guns the debuff off of Subsea helps the other members of your squad to take out the pulls even faster.
Mystics: I'm afraid your Devil Chihyu does you no good here. Storm Mistress is a much better choice for Phoenix Valley when it comes to full out multiple mobs.
Venomancers: Noxious Gas (Level 39 skill) is your friend, not only your pet. Spam it.
All in all there really isn't much to running Phoenix Valley. You get in, kill everything, and get out. At the end of the run just quit the squad in order to leave or open your quest list to exit to a main city of your choice. Oh...and..um...just don't die.
Instance Layout
NOTE: If the images don't show up on your screen, try refreshing the page.
To start the instance after everyone is in, the squad leader must talk to this NPC in order for the mobs to spawn.
The dungeon has a different layout for about every 2 level ranges. They are basically old copy and pastes of the original FB19 dungeon instances with a few changes. Areas have been sealed off that cannot be enter (it wouldn't part of the run anyway) but you will still start at the same point as in the original instances. Mobs that can pose a threat have been marked.
PV Levels 30-44 and PV Levels 45-59
Note: This image has been rotated upside-down for convenience.
PV Levels 60-74 and PV Levels 75-84
Note: This image has been rotated upside-down for convenience.
PV Levels 85-94 and PV Levels 95-100
Note: This image has been rotated upside-down for convenience.
The Level 100-105 run is copied off of the FB59 map.
As you can see the map has been marked a bit differently. Yes, there are mobs of the same type in this map was well but at this level it really is not much of a concern because everyone uses the same near endgame gear that this pretty much applies to everyone that is level 100 and up. Random squads for this PV are rare to see as it tends to be soloed the most or that players from the same faction and friends will likely be squading for this.
The bosses in every level range is different, but insanely easy to kill. The mobs are the hardest part of a run.
Dahhak Skinwing (Level 45), PV 30-44
Sliver Nova (Level 85), PV 75-84
Plume Helios (Level 95), PV 85-94
Shauk-Aranos (Level 105), PV 95-100


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Autism is the fastest growing developmental disability in the U.S. Researchers thought of it as a life-long disorder, but that might not be the case.
Jack's mom Leslie Griggs knew something was different about her son.
"He wasn't making a lot of eye contact. He didn't have any words," she said.
Jack has autism. Griggs says daily therapy sessions have made all the difference for him.
"He seems like he's more aware of us being in his world. He's not in his own little world anymore," she said.
While Jack has shown big improvements, a new study suggests some kids may actually "outgrow" the disorder. Researchers looked at 34 patients with autism who were diagnosed by age five, but now appear to function normally. The study found they no longer meet the criteria for autism. In fact, in tests looking at socialization and communication, the autism patients performed just as well as typical children.
"Now I can say there's a chance that your kid might outgrow it," said Dr. Chaouki Khoury, Director of Our Children's House at Baylor in Dallas, Texas.
Khoury says he's encouraged by the new study, even though the research did not examine why the patients seemed to "outgrow" the disorder.
"How do you outgrow biting your nails? You learn not to bite them. So outgrowing a behavioral problem is basically learning a different behavior that takes over," Khoury explained.
Some believe it's the intensive therapies that cause the dramatic improvements, others think the kids may be on a different part of the autism spectrum that predisposes them to outgrow the condition without therapy.
Griggs hopes with therapy Jack will "swing" into even bigger improvements and possibly outgrow his autism.
"Every parent, I think, hopes the diagnosis will fall off," she said.
Researchers are now analyzing data to see if there is a link between certain types of therapy and optimal outcomes. Based on previous studies, some believe between 10 and 20 percent of children who were diagnosed with autism may achieve optimal outcomes.

subset: commoncrawl


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Bathing Beauty Swim Bag Set
Before you head off on that beach getaway, be sure you've got everything. And by everything, I mean this: a cute, two-piece bag set that includes a bathing suit pouch (complete with separate sections for wet and dry suits) and a sunscreen pouch to stash your very-necessary SPF and other beauty essentials. In three colors.
$60 at neimanmarcus.com


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WESTLAKE -- Cleveland Metroparks Rangers have made an arrest in the fatal car crash that killed William Fekete, 22, of Elyria.
Ryan Fye, 20, the driver of the vehicle, faces one count of aggravated vehicular homicide and one count of aggravated vehicular assault, both felonies.
Rangers said that on March 23 at 4:18 p.m., ranger dispatch received a report of an automobile accident on White Oak Lane in the Bradley Woods Reservation.
Fye, who was driving a 2005 Mitsubishi Lancer Evolution, is believed to have been traveling westbound at a high rate of speed when he lost control of his vehicle and crashed into a tree.
Fekete was one of four passengers in the car at the time.
Related article: Westlake: 1 killed, 2 injured in Metroparks crash
The case has been turned over to the Cuyahoga County Prosecutor's office.
If found guilty, Fye faces a maximum sentence of 1-5 years for aggravated vehicular homicide, 6-18 months for aggravated vehicular assault and mandatory revocation of his driver's license.
There was no evidence of alcohol or drug use.


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Wednesday, January 16, 2008
Campaigning in Prestonsburg, 7-22-06.
Today 7-22-06, Kenneth Stepp and Wilma Stepp were campaigning in Prestonsburg at the Fifth Congressional Democratic Womens' Clubs Convention at the Prestonsburg Inn. We hope to make it to meetings of the remaining Democratic Womens' Clubs in the Fifth Congressional District that we haven't visited yet. We have been to Democratic Club meetings in Pulaski, Laurel, Johnson, and Floyd Counties. My wife Wilma took pictures, and we hope to have them on the internet posted here, soon. Kenneth Stepp.
Posted by Kenneth Stepp at 5:46 PM
1 comment:
Why the fuck do you speak in the third person, Bob Dole?
"Bob Dole's going to do this.."
- Monday, July 24, 2006
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3 posts • Page 1 of 1
- chrischaos88
- Posts: 38
- Joined: Fri Sep 06, 2013 3:11 am
- Location: New Jersey
This investigation was of an old railroad tunnel that has been closed since the 1960's. This tunnel travels under homes and the cemetery. But the oddest thing about the tunnel is that there is a cemetery built on top of a cemetery and supposedly there are rooms that have collapsed in the tunnel in which the caskets have fallen into. Supposedly you can venture into the rooms and take souvenirs of whomever and whatever is in the caskets. Also there have been reports of wild dogs that roam through the tunnels. So with this information in hand we ventured off to these tunnels to find the truth.
Upon arriving we had difficulty in finding where to enter, so we split up into two groups in an attempt to find the opening. It took a few tries to find the entrance, walking across heavy traffic and on some private property, but we finally found it after traipsing thru some mud and a flooded area. The path does begin along the cemetery which was a little tricky to find since we had to trespass and go on private property (a storage facility) to find the old railroad path. It was dark and muddy and a little chilly. So we called the other half of the team and met up and then walked to the mouth of the tunnel. Luckily the fence that was to seal off the entrance was open and no obstructions were blocking the entrance. The path was very dark leading to the opening and it was a very impressive opening. A ton of mud and about 3-5 inches of water for about 20 feet slowed us down until we got to the service walkway. We used planks that were found in the tunnel to get to this point. The tunnel was pitch black, but we had 4 flashlights, one for each of us. The tunnel was about 1.5 miles long from Fairview to Edgewater and the tracks (rails) were pulled up but the ties were still there. Approximately in the center of the tunnel there is a vent that was to allow all the steam and what not escape the tunnel when it was up and running, it actually exits in someone's backyard. Trying to look up and see out the vent was challenging due to all the water dripping down from it. You can actually see the vent on Google maps. Walking thru the tunnels we found common trash and a basketball in the tunnel...and a lot of water. About halfway thru we did turn off the flashlights and took out an audio recorder in an attempt to see if we could capture some sort of voice or other sounds. We also noted that there were no openings, doors or hidden rooms like others reported. We walked the whole tunnel but it was flooded by up to at least 4 feet of water at the Edgewater side, so we had to return in the direction that we came from. We wanted to exit but couldn't due to the deep water on this side, so we turned around and walked back the other way. Upon exiting the tunnels we realized how black and dirty we were due to all the soot in the tunnel, filthy!
So in summary the end results were we found NOTHING supernatural, no doors, no chambers, no bones, no skeletons, nor no caskets or hounds of hell. We did some sample audio recordings but didn't catch anything strange nor any EVPs. The biggest threats you may have to worry about if you visit this location would be: bums, crackheads, getting muddy/wet in the tunnel or the police if they decide that you are trespassing.
Facebook Page:
The vid from the OP - interesting little titbit!
- dudeman351
- Posts: 117
- Joined: Thu Aug 08, 2013 11:49 pm
- Location: Occupied Confederacy
Thanks for the memories. I lived in Fairview from when I was born til we moved to Florida when I was 11. In fact my best friend back then who is now the chief of police, older brother took us in there once. It scared the hell outta me being I was about 7. There are also missle silos in Fairview in some back yards(another friend) Glad I got outta that area when I did. Long live the Confederacy!!!
3 posts • Page 1 of 1
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Neil Everett angry with ESPN over lack of Jason Bitsko death coverage (Video)
ESPN on-air personality Neil Everett took a very brief but very blatant shot at his employer during Thursday morning's edition of SportsCenter. Everett was clearly upset over the lack of coverage ESPN gave to Jason Bitsko, the 21-year-old Kent State football player who was found dead in his off-campus apartment on Wednesday. Bitsko, who received…Read More


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Wise Kids
Been busy with kids in my building lately. Two in particular. Advik and Rishika. Very intelligent kids. Babies, rather. Advik is 8 months old and Rishika completed exactly 2 months today. They are adorable. And they both are sooooo delighted to see me every time. That's probably because of all the Reiki they've received from me, but it could also be due to the fact that I wear specs.
So anyway, I've been busy with them. Returned home just a few minutes ago. A little short of time today. So keeping it short and sweet. Sharing this picture someone posted on Facebook today. Take a printout of this picture and stick it in your bedroom, and that's all you'll probably ever need to know, to live life... REALLY live it I mean.
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US Mega Material Girl who manages to continually reinvent herself, so remaining perennially popular with her adoring fans. With a seemingly endless catalogue of hits, no other act has had more US Top Ten singles on Billboard's Hot 100 chart. Madonna has also sold over 300 million albums over the course of her extraordinary career, and she holds the record for the most successful tour by a solo artist in history.
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|Impact of the NK cell receptor LIR-1 (ILT-2/CD85j/LILRB1) on cytotoxicity against multiple myeloma.
MedLine Citation:
|PMID: 22844324 Owner: NLM Status: MEDLINE
|The role of different receptors in natural-killer- (NK-) cell-mediated cytotoxicity against multiple myeloma (MM) cells is unknown. We investigated if an enhancement of NK-cell-mediated cytotoxicity against MM could be reached by blocking of the inhibitory leukocyte immunoglobulin-like receptor 1 (LIR-1). Our investigations revealed high levels of LIR-1 expression not only on the NK cell line NK-92, but also on myeloma cells (MOLP-8, RPMI8226) as well as on a lymphoblastoid cell line (LBCL; IM-9). Subsequent cytotoxicity assays were designed to show the isolated effects of LIR-1 blocking on either the effector or the tumor side to rule out receptor-receptor interactions. Although NK-92 was shown to be capable of myeloma cell lysis, inhibition of LIR-1 on NK-92 did not enhance cytotoxicity. Targeting the receptor on MM and LBCL did not also alter NK-92-mediated lysis. We come to the conclusion that LIR-1 alone does not directly influence NK-cell-mediated cytotoxicity against myeloma. To our knowledge, this work provides the first investigation of the inhibitory capability of LIR-1 in NK-92-mediated cytotoxicity against MM and the first functional evaluation of LIR-1 on MM and LBCL.
|Silke Heidenreich; Christine Zu Eulenburg; York Hildebrandt; Thomas Stübig; Heidi Sierich; Anita Badbaran; Thomas H Eiermann; Thomas M C Binder; Nicolaus Kröger
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Publication Detail:
|Type: Journal Article Date: 2012-07-10
Journal Detail:
|Title: Clinical & developmental immunology Volume: 2012 ISSN: 1740-2530 ISO Abbreviation: Clin. Dev. Immunol. Publication Date: 2012
Date Detail:
|Created Date: 2012-07-30 Completed Date: 2013-01-31 Revised Date: 2013-07-12
Medline Journal Info:
|Nlm Unique ID: 101183692 Medline TA: Clin Dev Immunol Country: Egypt
Other Details:
|Languages: eng Pagination: 652130 Citation Subset: IM
|Clinic for Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Export Citation:
|APA/MLA Format Download EndNote Download BibTex
|MeSH Terms
Antibodies, Blocking / immunology
Antibodies, Monoclonal / immunology
Antigens, CD / immunology*
COS Cells
Cell Line
Cercopithecus aethiops
Cytotoxicity, Immunologic*
Killer Cells, Natural / immunology*, metabolism
Multiple Myeloma / immunology*
Receptors, Immunologic / antagonists & inhibitors*, immunology*
Reg. No./Substance:
|0/Antibodies, Blocking; 0/Antibodies, Monoclonal; 0/Antigens, CD; 0/LILRB1 protein, human; 0/Receptors, Immunologic
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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The NBA draft is tonight and I couldn't think of a better way to make my entry into the world of blogging than giving my two cents about the draft and what tonight's happenings mean for the 2008-09 Fantasy season and beyond. Some of the guys here at CBSSports.com in the Fantasy group have told me for a while how much of a loser I am for not having one and I have to say they are right.
This seems like a lot of fun.
For one thing, I can use the word "I" all that I want to. If you're counting, that's six "I's" already in this blog. You may or may not have any idea how huge that is for writers. We are programmed to believe that every time you write in the first person, an orphan puppy dies.
Honestly, that's because people could usually care less what your personal opinions are even when you're the person writing a piece about something. 'Just give me the goods and leave yourself out of it, thank you very much.' But if you're reading this, my blog, there's a good chance you want to know what I think -- and that's awesome.
So let's get to the point. Draft day has already been pretty busy and it really all started last night with the news about Jermaine O'Neal being traded to the Pacers in exchange for T.J. Ford, Rasho Nesterovic, the 17th pick in the draft and a player to be named later.
That figures to be a good deal for both sides as it will allow Jermaine O'Neal to play for a contender again, which will in turn re-energize him and turn into a prominent Fantasy option once again. Not to mention that O'Neal would likely play center for the Raptors and with his 20-and-10 potential he'd instantly become an elite No. 1 Fantasy pivot.
The Pacers get T.J. Ford, who is an assist machine that makes the players around him better. That's something that should make the young players around him more productive with a facilitator around to help them in their growth. Danny Granger becomes the No. 1 Fantasy option, a process that already began last season and Ford's presence also means the end for Jamaal Tinsley's nightmare in Indiana. He'll likely have to be dealt, but would become a candidate for a bounce-back season in a good situation. Perhaps a team like the Miami Heat could use him if they don't end up with Rose or O.J. Mayo tonight.
The Raptors now have perhaps the top offensive front court in the Eastern Conference in my opinion. Chris Bosh and an invigorated O'Neal will compete with Kevin Garnett/Kendrick Perkins, Dwight Howard/Rashard Lewis or even Al Horford/Josh Smith.
Another team that deserves some consideration now when it comes to considerable lineups in the Eastern Conference are the Milwaukee Bucks after the sweet deal they pulled off this afternoon. They snagged the best player off my favorite team, Richard Jefferson and all it cost them was an expiring contract (Bobby Simmons) and an over-hyped seven-footer (Yi Jianlian).
That means Milwaukee's starting lineup next season will be: Mo Williams (PG), Michael Redd (SG), Richard Jefferson (SF), Charlie Villanueva (PF) and Andrew Bogut (C). That's pretty solid 1-5 and they also boast a decent bench with revelation Ramon Sessions and swingman Charlie Bell. The one concern I have for Jefferson is that he'll be playing alongside more scorers in Milwaukee than he had been in New Jersey. But he'll be No. 2 in the Bucks' pecking order behind Redd and possibly even 1-A or 1-B in the long run. Charlie Villanueva's red-hot second half may have made it a lot easier for the Bucks to part ways with their first round pick of exactly a year ago. He'll have his Fantasy appeal re-adjusted to that of a promising young forward with 15-and-8 potential this season.
The Nets are clearly in rebuilding mode now, full speed ahead in the post-Jason Kidd era. Their starting lineup next season figures to be: Devin Harris (PG), Vince Carter (SG), Yi Jianlian (SF), Nenad Krstic (PF) and Josh Boone (C). Nets president Rod Thorn was on WFAN in New York this afternoon and said the move gives them size, something they have been lacking.
With all due respect to Mr. Thorn, who I think is one of the brightest minds in basketball, this move was made looking at the 2010 season and had nothing to do with Yi's size, something he was unable to use in his rookie season with the Bucks, where he was considered too much of a lightweight to play power forward. In 2010, the Nets hope to be moving into their new building in Brooklyn and that's the year Bobby Simmon's big contract comes off the books. Some big names the Nets will be able to go after in that offseason? LeBron James, Dwyane Wade and Chris Bosh.
The other big news of the day was the reported deal that had the Sonics trading the No. 4 pick tonight to the Clippers for their No. 7 pick and a protected 2009 first-rounder. That one is still in the works and really hinges on what the first four picks in the draft are. If the Sonics see something they like there, they'll hang on to their pick.
This should be fun. I'll chip in from time to time during the draft.


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volume 2(1) | Fri, November 27, 2015 | ISSN: 2035-6447
Papers > Articles
Center for Thoracic Surgery, University of Insubria, Varese, Italy
VATS has multiple indications, for diagnosis and treatment of many different thoracic diseases, the commonest being lung wedge resection, pleural and mediastinal biopsy, treatment of pneumothorax, pleurectomy. Moreover, in recent years a few surgeons have performed routinely major lung anatomic resections by the VATS approach, including segmentectomy, lobectomy and pneumonectomy.
In our experience and in the reviewed literature, the most frequent complications after VATS procedures are: prolonged air leak, bleeding, infection, post-operative pain, port-site recurrence and the need to convert the access into thoracotomy. Their rate of occurrence is generally low and VATS procedures are considered safe and effective, as witnessed by the fact that they constitute about one third of all thoracic surgical procedures.
Key words: Video-assisted thoracoscopic surgery, complications, bleeding, surgical site infection, air-leak, lung surgery.
Abbreviations:VATS = Video-assisted thoracoscopic surgery;
Video-assisted thoracoscopic surgery (VATS) procedures have proved to be safe and effective for treatment of a large variety of thoracic diseases, with low perioperative complication rates as reported in several large series of patients. Fifteen years after the beginning of the widespread application of VATS, this paper reviews the complications associated with VATS procedures
In three large studies published in 1996 the overall complication rates after a variety of VATS procedures were respectively 4%,(1) 4.3%(2) and 3.7%(3), with no reported deaths attributable to the VATS technique. Similarly, in the very large series reported by the Video Assisted Thoracic Surgery Group (55 surgeons from 40 institutions who performed general thoracic surgery as the majority of their practices)4, the complications observed in 1,358 patients undergoing VATS procedures were: air leak longer than 5 days in 3.2% of patients; atelectasis in 1.4%; arrhythmia in 1.3%; bleeding in 1.2% (one third required transfusion); pneumonia in 1.1%; prolonged ventilator dependence in 1.0%; empyema in 0.6%; wound infection in 0.4%. There were no intraoperative deaths, and the total postoperative mortality rate for the 1,358 patients was 2.0% (27 patients). Causes of deaths were sepsis in seven patients, respiratory insufficiency in four, progression of malignancy in three, pneumonia in two, renal failure in two; hepatic failure, cardiac arrest, pulmonary embolus, and stroke occurred each in one patient.
In our center for thoracic surgery at the University of Insubria in Varese, after reviewing 721 consecutive VATS procedures performed from 1996 to 2005, we recorded the following complications: prolonged air leak in 4.7% of patients; pneumonia in 2.4%; bleeding (with blood transfusion) in 1.5%; wound infection in 0.9%. Conversion to thoracotomy was necessary to complete the procedure in 2.2% of cases; the perioperative mortality was nil.
Table 1 summarizes the main complications observed in seven large series of VATS procedures and shows that the most prevalent are prolonged air leak and bleeding, while other complications are infrequent1-3,5-7. We will analyse separately the prevalence and feature of these complications of VATS , as related to the specific procedures.
Prolonged air leak is the most prevalent complication of VATS and is more likely to occur after resection of lung nodules and bullae
After VATS lung biopsy, moderate air leakage from parenchyma which has been sutured or biopsed or traumatized by instruments occurs frequently. The thermal injury of electrocautery may also predispose to prolonged air leak. As most patients can be discharged within 48 hours, persistent air leak should be avoided. Endoscopic stapling instruments of various sizes may be used to staple and resect leaking parenchyma. In the operating room, as the lung is inflated, staple lines should be visualized for bleeding and air leak. Even after complete control of air leakage, at the end of each VATS procedure it is advisable to place routinely a chest tube, under direct vision, to provide drainage of any subsequent air and fluid losses. As pointed out by Adebonojo the definition of "persistent air leak" is arbitrary.8 Indeed, postoperative air leak has been reported with many different lengths of leakage (5 to 10 days), which makes comparison of results difficult.
In different large series prolonged air leak was reported respectively in 3.2%4, 3.7%9, 4.7%10, 6.7%.3 In our experience air leak longer than 7 days after 721 VATS procedures occurred in 4.7%.
VATS usually offers an excellent visibility of the operative field, thus intrathoracic haemorrhage is rare. Bleeding occurs infrequently when an experienced surgeon performs the procedure; it is more likely to occur in patients with dense adhesions. Bleeding from one of the main pulmonary vessels during VATS, however, can be very dangerous because haemorrhage is sudden and catastrophic and access is limited. Indeed VATS lung resections of any type are contraindicated in patients with tumours near the pulmonary hilum; VATS should be limited to biopsy for diagnosis and a sponge stick should be available to apply pressure immediately for controlling haemorrhage. With bleeding temporarily controlled, a decision is immediately made as to whether thoracotomy is needed. Severe parenchymal haemorrhage may require open thoracotomy and lobectomy for control. Haemorrhage may also derive from trocar site access or from lung biopsy, but these are uncommon events, that are more likely to occur if the patient has a coagulation defect. Depending upon the circumstances, bleeding can be controlled by electro-coagulation, transfixed sutures, metal clips or with the linear stapler. Kaiser et al in 266 VATS reported postoperative bleeding (requiring transfusion) in 1.9% of cases (4 patients required thoracotomy).9 Walker et al reported a postoperative bleeding rate of 0.5%.10 In our series of 721 VATS procedures bleeding occurred in 1.5% (Table 1).
Yim (2)
Jancovici (3)
Inderbitzi (5)
Krasna (1)
Kaiser (6)
Hazelrigg (7)
21 (1.6%)
63 (6.7%)
93 (1.8%)
3 (0.9%)
10 (3.8%)
43 (3.2%)
34 (4.7%)
6 (0.4%)
18 (1.9%)
23 (0.4%)
5 (1.9%)
11 (1.5%)
13 (0.9%)
7 (0.9%)
1 (0.07%)
5 (0.5%)
16 (0.3%)
The literature data about infections complicating VATS procedures are scarce, in spite of the increased application of VATS in recent years. The few studies available refer to heterogeneous patient populations undergoing various VATS procedures, that cannot be easily compared. Thus the incidence of infections in the VATS setting is not well defined.
Rovera et al reviewed 346 consecutive VATS procedures and reported about the risk factors affecting the incidence of surgical infection.11 Patients were divided into two groups: 139 patients undergoing lung wedge resection and 207 patients undergoing intrathoracic biopsy (pleura or mediastinal mass). The following risk factors for infection were assessed: haemoglobin concentration, haematocrit, serum albumin concentration, blood lymphocyte count, length of preoperative stay, duration of surgery, blood transfusion, age, co-morbidity and specifically chronic obstructive pulmonary disease (COPD, measured as FEV1 <70% of expected). Prophylactic antibiotics were given to more than 90% of patients in both series. The endpoint measures were the occurrence of postoperative infection within 30 days (surgical site infection, pneumonia, empyema) and the final patient outcome. The authors found that one or more postoperative infections occurred in 17/346 patients (4.9%, all of whom had received antibiotic prophylaxis). In the VATS lung resection group the total infection rate was 6.5%, and in the VATS biopsy group it was similar (6.3%). The incidence of surgical site infection was similar in two groups (2.8% vs. 1.0%; p = NS) and the incidence of pneumonia was also similar (2.8% vs. 3.4%, p = NS). All postoperative infections (surgical site, pneumonia, empyema) were treated successfully with antibiotic or antifungal therapy and surgical drainage as indicated. No postoperative deaths occurred. The infection rate in the 50 VATS patients with COPD was significantly higher than in controls (14% vs 4.9%; p <0.01). COPD was the only univariate predictor of postoperative infection. Indeed FEV1 <70% of predicted was observed much more frequently in infected patients than in non-infected patients (58% vs. 25%; p <0.05) (Table 2).
Surgical site infection no. (%)
4 (2.8%)
2 (1.0%)
6 (1.7%)
Pneumonia no. (%)
7 (3.4%)
11 (3%)
Empyema no. (%)
1 (0.7%)
4 (2.0%)
5 (1.4%)
Total no. of infections
9 (6.5%)
13 (6.3%)
22a (6.3%)
Total no. of pts with infections
7 (5.0%)
10 (4.8%)
17a (4.9%)
The surgical incisions of open thoracic operations are among the most painful. They cause reduced lung function, impairment of respiratory effort, atelectasis and ultimately hypoxemia. Moreover, pain causes less patient mobilization and increases the incidence of deep venous thrombosis and of pulmonary embolism. Several traumatic factors are known to contribute to acute pain after thoracic surgery: tissue trauma and drains, rib fracture and injury to intercostal nerves (due to retractor or trocar). The prominent causes of chronic postoperative pain are intercostal neuroma and healing rib fracture. Essentially, in open thoracic surgery pain results from the spreading of retractors.12
It has been experienced worldwide that patients have less pain after VATS procedures than after open thoracotomies. Walker compared the requirement for narcotic pain drugs in 83 VATS major pulmonary resection versus 110 patients who underwent thoracotomy during the same period and found that the VATS group required significantly less morphine (p<0.001).(10) In a randomised prospective trial of lobectomy in 67 patients (47 by VATS and 23 by muscle-sparing thoracotomy) Giudicelli et al reported that postoperative pain was significantly less (p<0.02) after VATS procedures.13 Landreneau et al prospectively evaluated daily narcotic requirements, hospital stay and visual analogue pain scale in 165 patients after muscle-sparing thoracotomy compared with 178 patients after VATS.14 The latter patients had less pain and greater shoulder strength in the first 6 months postoperatively, but after 1 year the difference disappeared.14 The severity and duration of pain after thoracotomy obviously depends on the degree of rib spreading and on the site and modality of thoracotomy incision. Indeed, Nomori et al who compared VATS lobectomy vs. an anterior limited thoracotomy approach, reported that patients in the VATS group experienced much less pain in the first postoperative week, but the difference was not significant subsequently.15
Landreneau et al addressed the problem of chronic pain after pulmonary resection by thoracotomy versus VATS and found that within the first year after thoracotomy there was a significantly grater increase in the pain reported, as compared to VATS. After 1 year, however, they observed no statistically significant difference in either reported pain level or shoulder dysfunction (VATS 22%; thoracotomy 29%), or narcotic usage (VATS 6%; thoracotomy 16%).14
Dissemination of thoracic tumours as a result of biopsy or thoracotomy for resection with curative intent is rare. It has been described that during VATS neoplastic cells can disseminate and implant, causing tumour recurrence at the port site. This complication has been reported following VATS biopsy of lymph nodes and after pulmonary wedge resection. Yim et al16 and Jancovici et al3 noted an increased risk of local recurrence at the thoracoscopy port sites when a retrieval device (glove or bag) was not used. They further noted that recurrence occurred more likely in operations for selected tumour types, namely mesothelioma, metastatic sarcoma and melanoma, or when malignant pleural effusion was present. Mesothelioma is well known to invade thoracic incisions of all types, including thoracotomy, needle biopsy tracks and chest drain sites; similarly, malignant pleural effusions have been shown to implant and cause recurrence in the thoracic wall at the drain sites. In the surgical management of early stage tumours, however, dissemination and chest wall implant of thoracic malignancy resulting for manipulation is a phenomenon rarely observed.
After VATS lobectomy McKenna et al in 1998 reported a very low incidence of this complication: 1/298 patients of his series (0.3%) developed chest wall recurrence in the utility thoracotomy incision.17 Subsequently the same authors reviewed their further experience with VATS lobectomy including 1,100 cases and confirmed that the recurrence rate in the incision was very low (0.57%).18 Also in the experience of the Memorial Sloan-Kettering Cancer Center Thoracic Service the prevalence of port site tumour recurrence was rare: 1/374 patients (0.26%).19
In 321 patients undergoing VATS procedures for various indications Krasna et al reported the need to convert to thoracotomy in 8% of cases.1 Most commonly the conversion to thoracotomy was deemed necessary because of oncological reasons, such as centrally located tumours requiring vascular control or sleeve resection, or unexpected T3 tumours attached to the chest wall, diaphragm or superior vena cava. Abnormal hilar nodes with granulomatous or metastatic disease adherent to the superior pulmonary vein may be better evaluated and more safely resected with thoracotomy. In the experience of Krasna et al about 30% of thoracotomy conversions were for non-oncological reasons, such as pleural adhesions.1 In the series of the Memorial Sloan-Kettering Cancer Center Thoracic Service conversion to open thoracotomy because VATS was not technically adequate occurred in 44/410 patients (11%).19 In our experience of 721 VATS procedures, conversion to thoracotomy was done in 16 patients (2.2%), for one of the following reasons: inability to localize precisely the lesion to biopsy or resect; bleeding that was difficult to control; extensive pleural adhesions.
Lung wedge resectionThe most serious intraoperative complication during VATS lung wedge resection is major bleeding from the lung parenchyma or from injured intercostal vessels. Massive bleeding may require immediate conversion to an open procedure to achieve haemostasis. Yim et al reported bleeding as the third most common complication (after persistent air leak and superficial wound infection), occurring in 6/1,337 (0.4%) patients, 4 of whom required extension of the mini-thoracotomy for control, or re-operation by VATS.2
In the series of Jancovici3 the incidence of bleeding requiring conversion to thoracotomy after VATS lung wedge resection was 12.4% (116/937 patients) and it was 8% (25/321 patients) in the series of Krasna.1
The most common non-fatal complication of VATS lung resection is prolonged air leak, especially after wedge resection for bullous emphysema and for spontaneous pneumothorax. Downey et al reported air leak longer than 5 days in 3.2% of patients,4 while in the study of Jancovici et al air leak for longer than 5 days was seen in 6.7% of patients.3 Kaiser et al observed air leakage longer than 7 days in 3.7% of their patients.9 Yim et al reviewed 1,337 VATS procedures and found that the incidence of prolonged (longer than 10 days) air leak was 1.6%.2 In general most authors agree that air leak longer than 7 days should occur in less than 5% of VATS procedures2-4, 9, 18.
Postoperative infection rate after VATS lung wedge resection is low, as discussed above. In our institution's experience after VATS wedge resection the wound infection rate was 2.8%, the incidence of pneumonia was 2.8% and that of empyema was 0.7%.11 When performing VATS wedge resection of small lung nodules, the difficulty in localizing exactly the nodule within the lung parenchyma may bring about a number of undesirable problems. The first and most frustrating is the inability to identify the nodule, which forces conversion to thoracotomy. Another complication is an incomplete resection of the nodule, the deepest part of which may be left behind, resected only in part. 20 There are many different techniques for the localization of small lung nodules to be resected by VATS: thoracoscopic inspection and probe-palpation, ultrasonography, hook-wire, finger palpation, methylene blue injection and lipiodol injection. In our experience the nodule identification by finger palpation is feasible in the vast majority (94%) of cases.20 Under guidance by the CT-scan images, one of the mini-access incisions is done at the chest wall projection of the nodule. If the lung nodule is superficial, it can be recognized at inspection of the pleural cavity; moreover, visceral pleural retraction or fibrous stigmata are often indirect signs of an underlying deep lung nodule, that can be exactly localized by finger palpation. With the finger palpation technique it is possible to localize most nodules, notably with some exceptions: nodules located close to the hilum or in the very central portion of a lobe (>2.5 cm distant from any visceral pleural surface) and nodules with non-solid consistency (pure bronchiolo-alveolar carcinoma)21, 22. In our institute from 1997 to 2005 we recorded 121 consecutive patients undergoing VATS wedge resection of lung nodules with diameter <3 cm.
In all patients it was possible the mini-invasive approach and the localization by finger palpation. 90 of 121 lung nodules had a diameter <1,5 cm and were resected by VATS, 93% of which were localized by finger palpation. Very small nodules (diameter <0.7 cm; n=9) resulted to be benign lesion (89%); in the group of the small nodules (diameter from 0.7 cm to 1.5 cm; n=81) the 53% resulted to be lung cancer, primary or metastatic. In 6 patients (7%) was necessary the conversion to a mini-thoracotomy to performed wedge resection. In two cases for difficult identification of the nodule, in 3 cases for pleural adhesions and in one case for the position of the nodule (near the aorta). Only in one case there was an histological evidence of malignant infiltration of the resection's limits. 22
Mortality after VATS lung wedge resection is very low in all series, ranging 0%-0.5%. The few cases of death reported were due to: massive bleeding, pulmonary embolism, septic shock, ventricular arrhythmia and respiratory insufficiency 3, 11.
We recently reviewed our institutional series of 254 lung wedge resections by VATS, performed in the years 1998-2005 and did not record any perioperative deaths; the complications observed are listed in Table 3.
Air leak longer than 7 days
Bleeding, with blood transfusion
Wound infection
Conversion to thoracotomy
Perioperative mortality
Major lung anatomic resections (lobectomy and pneumonectomy) are undoubtedly the most difficult operations to perform thoracoscopically. Several years after the first resections the initial concerns regarding the potential for intraoperative accidents have not subsided and have limited the development and acceptance of VATS anatomic lung resections. Many surgeons have done a few thoracoscopic resections, but only in few centers these operations are done routinely (Table 4) 18,23-27.
Among the asserted advantages of VATS major lung resections is the reduction of postoperative pain and of hospital stay; the cosmetic result is also improved. The increased technical difficulty and concern in the longer VATS procedure and the risk of intraoperative accidents, however, have limited the acceptance of VATS lobectomy by the surgical community.
The oncological adequacy of videothoracoscopic major pulmonary resections is still controversial, although most authors admit to use the same oncological criteria employed for conventional surgery. Several reports of VATS lobectomy for cancer show very good 5-year survival. The results of some series are even superior to those obtained with conventional open surgery, but this may be due to patient selection, in the absence of randomization, as will be discussed below. Moreover, Roviaro et al have suggested that the superior outcome could be due to less immunosuppression from the lesser trauma of VATS, with consequent immunological advantage. 27 In their extensive experience of 301 patients undergoing VATS major lung resection, Roviaro et al reported the need to convert to open thoracotomy in 22.8% of cases, because of oncological problems or technical reasons. These authors reported no intraoperative deaths in their series and had 20 patients (8.8%) with postoperative complications that extended the hospital stay. 27
In the literature the overall postoperative morbidity reported for VATS major lung resection ranges 8.8%-15% 18, 23, 27 and the conversion to a standard thoracotomy ranges 0%-22.8% (table 4) 18,23-27. The predominant causes of conversion to thoracotomy are: bleeding, extensive adhesions, dense hilar adenopathy, local extension of disease and intraoperative cardiac complications. The most prevalent intraoperative complications were: injury to a blood vessel, stapling failure, lung injury and nerve injury.28 One of the most dreaded complications of VATS lobectomy is massive bleeding from major pulmonary vessels. Craig and Walker29 and Yim30 reported mechanical failure of vascular staplers during VATS lobectomy, that resulted in massive bleeding; this was controlled by pressing on the bleeder and by immediate conversion to thoracotomy. Yim et al, in their review, reported an overall surgical mortality ranging from 0% to 2% for VATS lobectomy, that compares favourably with the conventional technique.31
In evaluating the results of VATS major lung resections, it is important to point out that these VATS procedures are usually done in highly selected patients, mainly presenting with peripheral lung lesions (most of which are adenocarcinomas) of small size, in early stage of disease; in the 1,100-case series of McKenna et al, 73% of VATS anatomic lung resections were performed in stage I lung cancer.(18) For comparison, it should be noted that the proportion of open thoracotomy lobectomy performed for stage I lung cancer in unselected series is only about 40%.
Mediastinal biopsy
VATS biopsy of mediastinal masses (neurogenic tumours, lymph nodes, anterior mediastinal tumours) provides a convenient way, definitely less traumatic than biopsy by conventional thoracotomy or sternotomy, to obtain an adequate tissue sample for a definitive histological diagnosis. This is especially important if previous diagnostic exams, including fine needle aspiration, were unyielding. Moreover, some selected mediastinal masses, under favourable circumstances, can also be resected and definitively treated by VATS.27 The local complications of mediastinal biopsy are rare. They include the usual complications of VATS procedures, namely prolonged air leak and bleeding; the latter may be severe if superior vena cava hypertension is present. In addition, a rare complication of mediastinal biopsy is chylothorax, caused by laceration of the main thoracic duct. The global incidence of chylothoraxis about 1% in all thoracic procedures. In approximately 50% of cases the treatment of chylothorax is conservative with pleural drainage, total parenteral nutrition and medium-chain triglyceride diet. High flow leak requires surgical closure (ligature or clips) of the thoracic duct, that can sometimes be performed by VATS.32 The review of personal experience with 46 mediastinal biopsies performed by VATS showed only one case of postoperative complication (pneumonia); only in one case it was necessary to convert to thoracotomy to control bleeding from the lymph node biopsy site in a patient with superior vena cava syndrome.
Pleural biopsy
The incidence of complications when samples of pleura are taken for biopsy by VATS is very low. The commonest complication is bleeding from an intercostal vessel or from the chest wall; the need to convert to open thoracotomy is very rare.
Another important potential complication of VATS pleural biopsy is the dissemination of malignant disease in the chest wall incision. Especially pleural mesothelioma is well recognized to invade thoracic incisions of all types; accordingly, local radiotherapy on the chest wall access site is an established routine. In addition, many other histological types of malignant tumours present in pleural effusions are able to metastasise in the mini-thoracotomy and port site chest wall accesses.4
The incidence of surgical infection after VATS pleural biopsy has been studied by Rovera et al in 183 patients over 346 consecutive video-assisted thoracoscopic procedures.11 In 4.8% of patients a surgical infection developed (wound infection: 1%; pneumonia: 3.4%; empyema: 2%).
Effective treatment of pneumothorax can be achieved by several pleurodesis techniques, one of which is pleurectomy. Pleurectomy in fact is associated with the lowest rates of pneumothorax recurrence (<5%).33
In some patients the pleurodesis procedure is limited to pleural scarification by simple cauterization because of ongoing high-dosage anticoagulant treatment.
Prolonged air leak, however, is not infrequent after VATS pleurectomy for pneumothorax: it is reported in 20% of cases.34 Indeed many patients undergoing pleurectomy are emphysematous, with fragile lung parenchyma. Other complications after VATS pleurectomy are uncommon; they include bleeding, persistent chest wall pain, surgical site infection and recurrence of pneumothorax. Some paresthesia at the skin level overlying the pleurectomy is common. Moreover, Roviaro et al reported a 4% incidence of haemothorax; in those patients thoracoscopy for haemostasis was redone.27 In spite of a blood loss of > 500 ml, the point of bleeding could not be located in any of those cases and the operation consisted of the removal of blood clots to clear the pleural space and to allow for pleurodesis to occur.27
In our series of 99 VATS pleurectomies for pleurodesis done in the years 1998-2005, the complications were: air leak for longer than 7 days: 13%; bleeding with blood transfusion: 3%; pneumonia: 2%; wound infection: 1%; conversion to thoracotomy: 1%. In 4/99 patients (4 %) we observed recurrence of pneumothorax; these recurrences were treated either by simple tube drainage or by talc pleurodesis.
Krasna MJ, Deshmukh S, McLaughlin JS. Complication of thoracoscopy. Ann Thorac Surg 1996;61:1066-9.
Yim APC, Liu HP. Complication and failures of video-assisted thoracic surgery: experience from two centers in Asia. Ann Thorac Surg 1996;61:538 -41.
Jancovici R, Lang-Lazdunski L, Pons F, Cador L, Dujon A, Dahan M, et al. Complication of video-assisted thoracic surgery: a five year experience. Ann Thorac Surg 1996;61:533-7.
Downey RJ. Complication after video-assisted thoracic surgery. Chest Surg Clin N Am 1998;8:907-915.
Inderbitzi RG, Grillet MP. Risk and hazard of videothoracoscopic surgery: a collective review. Eur J Cardiothorac Surg 1996;10:483-489.
Kaiser LR. Video-assisted thoracic surgery: current state of art. Ann Surg 1994;220:720-734
Hazelrigg SR, Magee MJ, Cettindag IB. Video-assisted thoracic surgery for diagnosis of the solitary lung nodule. Chest Surg Clin N Am 1998;8:763-74.
Adebonojo SA. How prolonged is "prolonged air leak"? Ann Thorac Surg 1995;59:549-50.
Kaiser LR, Bavaria JE. Complication of thoracoscopy. Ann Thorac Surg 1993;56:796-8.
Walker WS, Pugh GC, Craig SR, Carnochan FM. Continued experience with thoracoscopic major pulmonary resection. Int Surg 1996;81:255.
Rovera F, Imperatori A, Militello P, Morri A, Antonini C, Dionigi G et al. Infections in 346 consecutive video-assisted thoracoscopic procedures. Surgical Infection 2003;4:45-51.
Hazelrigg SR, Cetindang IB, Fullerton J. Acute and chronic pain syndromes after thoracic surgery. Surg Clin N Am 2002;82:849-65
Giudicelli R, Thomas P, Lonjon T, Morati N, Ottomani R, Fuentes P et al. Video-assisted minithoracotomy versus muscle-sparing thoracotomy for performing lobectomy. Ann Thorac Surg 1994;58:712-7.
Landreneau RJ, Mack MJ, Hazelrigg SR, Naunheim K, Dowling RD, Ritter P, et al. Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery. J Cardiovasc Surg 1995;109:1255-6.
Nomori H, Horio H, Fuyuno G, Kobayashi R. Non-serratus-sparing antero-axillary thoracotomy with disconnection of anterior rib cartilage. Improvement in postoperative pulmonary function and pain in comparison to posterolateral thoracotomy. Chest 1997;111:572-6.
Yim APC. Port-side recurrence following video-assisted thoracoscopic surgery. Surg Endosc 1995;9:1133-35.
McKenna RL Jr, Fischel RJ, Wolf R, Wurning P. Video-assisted thoracic surgery (VATS) lobectomy for bronchogenic cancer. Semin Thorac Cardiovasc Surg 1998;10:321-5.
McKenna RJ, Houck W, Beeman Fuller C. Video-assisted thoracic surgery lobectomy: experience with 1100 cases. Ann Thorac Surg 2006;81:421-6.
Parekh K, Rusch V, Bains M, Downey R, Ginsberg R. VATS port site recurrence: a technique dependent problem. Ann Surg Oncology 2001;8:175-178.
Dominioni L, Imperatori A, Rovera F, Dionigi G, Vassallo F. The role of videothoracoscopy in the early diagnosis of lung cancer. Osp Ital Chir 2002;8:248-53.
Dominioni L. Chirurgia Toracica. In: R. Dionigi, editor. Chirurgia. Masson III Ed; 2002. p 857-936.
Rotolo N, Imperatori A, Dominioni L. Identificazione e trattamento dei piccoli noduli polmonari. Proceedings of IV Update in Thoracic Surgery 2-3 December 2005; Varese.
Lewis RJ, Caccavale RJ, Sisler GE, Bocage JP, Mackenzie JW. One hundred video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading. Ann Thorac Surg 1997;63:1415-1422.
Yim APC, Liu HP, Izzat MB, et al. Thoracoscopic major lung resection – an Asian perspective. Semin Thorac Cardiovasc Surg 1998;10:326-331.
Kaseda S, Aoki T, Hangai N. Video-assisted thoracic surgery (VATS) lobectomy: the Japanese experience. Semin Thorac Cardiovasc Surg 1998;10:300-4
Walker WS, Codispoti M, Soon SY, Stamenkovic S, Carnochan F, Pugh G. Long-term outcome following VATS lobectomy for non-small cell bronchogenic carcinoma. Eur J Cardiothorac Surg 2003;23:397-402.
Roviaro GC, Varoli F, Vergani C, Maciocco M. State of the art in thoracoscopic surgery. A personal experience of 2000 videothoracoscopic procedures and an overview of the literature. Surg Endosc 2002;16:881-892.
Mc Kenna RJ. New approach to the minimally invasive treatment of lung cancer. Cancer J 2005;11:73-6.
Craig SR, Walker WS. Potential complications of vascular stapling in thoracoscopic major pulmonary resection. Ann Thorac Surg 1995;59:736-7.
Yim APC, Ho JKS. Malfunctioning of vascular staple cutter during thoracoscopic lobectomy. J Thorac Cardiovasc Surg 1995;109:1252.
Yim APC. VATS major pulmonary resection revisited-controversies, technique and results. Ann Thorac Surg 2002;74:615-23.
Fahimi H, Van Swieten HA. Current management of postoperative chylothorax. Ann Thorac Surg 2001;71:448-451.
Horio H, Nomori H, Kubayasmi R, Naruke T, Suemasu K. Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg Endosc, 2002;16:630-4.
Bertrand Pl, Regard SF, Spaggiari L, Levi SF, Magdeleint P, Guibert L, Levasseur P. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Ann Thorac Surg, 1996;61:1641-5.
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Salem communitywide yard sale announced
SALEM - The Salem Chamber of Commerce annual Spring communitywide yard sale is set April 12-13 in conjunction with the 10th Annual Spring Fairgrounds Flea Market. A map of the city of Salem with a listing of yard sale addresses will be available at area businesses. Contact Salem Chamber of Commerce at (870) 895-5565, by April 4 to be included in the listing.
Deadline announced for Charity of the Year program
YELLVILLE - April 19 is the deadline to apply for area nonprofit organizations to apply for the Arvest Bank 2013 Charity of the Year program. Organizations selected will benefit from the funds raised through the 17th annual Arvest Charity Golf Tournament set Aug. 24 at Twin Lakes Golf Course. Charitable organizations in Baxter, Boone and Marion counties in Arkansas and Howell County, Mo., may apply.
A committee of associates from Arvest Bank in North Central Arkansas and Southeast Missouri will choose up to three charities to receive all tournament proceeds. Final selection is based on past, present and future financial needs, along with other criteria. To qualify, the charity must be a designated IRS 501(c)(3) organization and must submit a letter to the committee explaining why the organization should be selected.
Applications should be mailed to: Arvest Bank Charity Committee, ATT: Tiffany Watkins, P.O. Box 325, Yellville, AR, 72687, or emailed to firstname.lastname@example.com. Call (870) 449-7164 for information.
Second annual Father-Daughter Ball preparations under way for May 11
Plans are under way for the second annual Father Daughter Ball set for May 11 at Vada Sheid Community Development Center. Tickets will be available starting April 15 at Mountain Home Christian Academy, Jessica's Too Bridal and Formal and Mountain Home Chamber of Commerce. An $18 ticket includes a carriage ride, desserts and gift for each princess. There are new age groups and times available for Cinderellas ages 3-21. For information, visit Mountain Home Area 2nd Annual Father Daughter Ball Facebook page or call Jinger Wright at 405-3272 or Robin Robinson at 404-6378.
Vendor space available for Fulton Co. festival
SALEM - Vendor space is available for booths at the 64th annual Fulton County Homecoming Festival set May 24-25 and Street Market set May 25, both in Salem. Any type of marketable item may be sold, but the festival committee reserves the right to refuse items. For information or to reserve booth space, call Tonya Franks at (870) 371-0887 or email email@example.com.
CR Chamber seeks items for auction
CALICO ROCK - The first Calico Rock Chamber of Commerce auction is set 11 a.m. June 8 at the Earl King Park pavilion. The public can check out an array of donated auction items at Dean Hudson's place on the corner of Main and Walnut streets. To donate to the auction, call Kim Meierdirk at (870) 297-3020.


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November 25, 2015
Gov. Bob Riley honors 130,000 Alabamians who served in the conflict, its estimated that 60,000-70,000 are still living.
Riley hosted a special wreath-laying ceremony at a Korean War Armistice Day Commemoration at the state Capitol.
Memorial services were held over the weekend at Arlington National Cemetery and at the Korean War Veterans Memorial.
The Korean War began in June 1950 and ended in July 1953.
Click Here to access the online Public Inspection File
Viewers with disabilities can get assistance accessing this station's FCC Public Inspection File by contacting the station with the information listed below. Questions or concerns relating to the accessibility of the FCC's online public file system should be directed to the FCC at 888-225-5322, 888-835-5322 (TTY), or email@example.com.


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X Factor's 4th Impact break silence on being 'shoved' by Lauren Murray Entertainment
By heatworld heatworld on Wednesday, 17 September 2014 at 21:11
Star Facts
- Louis' real name is Michael Louis Vincent
- He began managing bands at the age of just 15
- Louis has an impressive 28 charting topping number one successes to his name
- Some of the acts managed by Louis over the years include Boyzone, Westlife and Girls Aloud
Born in County Mayo, Ireland, on 5 August 1952, the undisputed king of Irish pop began his career working in a music manager's office in Dublin. After witnessing the astounding success of top UK boy band Take That, Louis decided to put together an Irish boy band of his own. Open auditions advertised in newspapers resulted in the Irish pop phenomenon that was Boyzone. The band was a huge success, selling over 12 million albums worldwide.
From here Louis began the transition from music manager to national celebrity with his first TV appearance as a judge on the Irish version of Popstars. He then went on to star in ITV's Popstars: The Rivals where he became manager of smash hit girl band Girls Aloud, featuring another famous pop TV talent judge Cheryl Cole.
Another big success in the music world was as manager of Westlife, a band that filled the Irish boy band void after the demise of Boyzone. And the money continued to roll in as he took charge of Ronan Keating's solo career.
From 2004, Louis became a household name as a judge alongside Simon Cowell and Sharon Osborne on ITV talent show The X Factor. He's managed the careers of many X Factor contestants ever since, including Jedward, chart toppers G4 (remember them?) and Shayne Ward (remember him?).


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McAfee Reveals Emma Watson as 2012's Most Dangerous Cyber Celebrity Study Finds Women Are More Dangerous Than Men, With Latinas Heating Up The Chart Jimmy Kimmel is the only male to rank in the top 20 Business Wire SANTA CLARA, Calif. -- September 10, 2012 Emma Watson has replaced Heidi Klum as McAfee's 2012 most dangerous celebrity to search for online. For the sixth year in a row, McAfee researched popular culture's most famous people to reveal the riskiest Hollywood actors, athletes, musicians, politicians, designers, and comedians on the Web. The McAfee Most Dangerous Celebrities^TM study ^ found that women are more dangerous than men with Jessica Biel taking the number two spot and Eva Mendes coming in third. Latina women have proven that they are on fire and make up five of the top ten spots. After Mendes, Selena Gomez, Shakira and Salma Hayek take the fourth, seventh and ninth spot and Sofia Vergara rounds out the top 10 list. Funnyman Jimmy Kimmel is the only male to make the top 20 list this year. (Photo: Business Wire) (Photo: Business Wire) Cybercriminals follow the latest trends, often using the names of popular celebrities to lure people to sites that are actually laden with malicious software that are designed to steal passwords and personal information. Anyone looking for the latest videos or files to download could end up with a malware-ridden computer along with the trendy content. This year, searching for a celebrity name with "free downloads" and "nude pictures" as part of the search term resulted in the highest result of risky sites. "In today's celebrity culture, consumers expect to be able to go online to catch up with the latest photos, videos, tweets, and stories about their favorite celebrities. Due to the richness of the data and the high interaction, often times consumers forget the risks that they are taking by clicking on the links," said Paula Greve, director of web security research at McAfee. "As the sophistication and expectations of consumers with respect to their online experience has increased, so has the level and ability to deliver malware either by malvertising, exploiting the user's browser without their awareness, or masking malicious URLs behind shortened URLs." Emma Watson Searches Yield Nearly a One-in-Eight Chance of Landing on a Malicious Site Fans searching for "Emma Watson and free downloads," "Emma Watson and nude pictures," "Emma Watson and fakes," and "Emma Watson and busted" are at risk of running into online threats designed to steal personal information. Clicking on these risky sites and downloading files like pictures and videos exposes surfers or consumers to the risk of downloading viruses and malware. McAfee research found that searching for the latest Emma Watson pictures and downloads yields more than a 12.6% chance of landing on a website that has tested positive for online threats, such as spyware, adware, spam, phishing, viruses and other malware. The study uses McAfee® SiteAdvisor® site ratings, which indicate which sites are risky to search for celebrity names on the Web and calculate an overall risk percentage. The top 10 celebrities from this year's study with the highest percentages of risk are: Position Celebrity Emma Watson – Best known for her role as Hermione Granger in the "Harry Potter" franchise, the British actress tops the list as the 1 2012 Most Dangerous Celebrity. Watson continues to star in feature films including "My Week with Marilyn" and "The Perks of Being a Wallflower" and is an ambassador for Lancôme. Jessica Biel – The 2009 Most Dangerous Celebrity rose two spots 2 this year from coming in at number 4 in 2011. Biel continues to be in the spotlight with fiancée Justin Timberlake and her role in 2012's "Total Recall." Eva Mendes – A new addition to the list, Mendes has starred in 3 films including "2 Fast 2 Furious" and "Hitch." She is currently in the news for her fling with Ryan Gosling. Selena Gomez – The tween musician and actress is best known for her role as Alex Russo on Disney's "Wizards of Waverly Place" and for 4 dating teen heartthrob Justin Bieber. She has been cast in the upcoming film "Parental Guidance Suggested" and was recently named one of Forbes' Top 10 Best Social Media Superstars. Halle Berry – The Academy Award winning actress is famous for her 5 stand out roles in action and horror films including "Catwoman" and "Gothika". Berry is in the spotlight for her custody battle with baby daddy Gabriel Aubry. Megan Fox – The sexy actress rose 9 spots compared to her number 15 6 spot last year. She is currently in the news for her pregnancy with husband Brian Austin Green and will be seen in the upcoming film "This is 40". Shakira – The belly-dancing singer/songwriter best known for her songs "Hips Don't Lie" and "Whenever, Wherever" comes in at number 7 7. She was recently named one of Forbes' World's Most Powerful Women and was ranked number 6 on Forbes' Top 10 Best Social Media Superstars. Cameron Diaz – 2010's Most Dangerous Celebrity fell to eighth 8 place, with searches resulting in slightly fewer risky sites this year. She was most recently in the spotlight for allegedly dating Alex Rodriguez. She is rumored to star in "Expendables 3." Salma Hayek – The actress, producer and director received an Academy Award for her role as Frida Kahlo in "Frida" and recently 9 starred in "Savages." She is currently in the news for her controversial remarks about her Mexican heritage in a Vogue interview. She is married to billionaire François-Henri Pinault. Sofia Vergara – The Columbian actress and model best known for her comedic role as Gloria Delgado-Pritchett on ABC's Emmy Award winning "Modern Family" rounds out the top 10 list. She also 10 starred in the "The Three Stooges" film this year and was recently named one of Forbes' World's Most Powerful Women and highest paid TV actress. She recently announced her engagement to businessman Nick Loeb. Searching for Latinas is Risky Eva Mendes (No. 3), Selena Gomez (No. 4), Shakira (No. 7), Salma Hayek (No. 9), and Sofia Vergara (No. 10) make up 5 of the top 10 most dangerous celebrities on the list. Women are More Dangerous Than Men Jimmy Kimmel (No. 13) is the only man to make the top 20, with Piers Morgan and Brad Pitt dropping off of the list from No. 3 and No. 10 respectively. Beware of the Supermodel Three supermodels have made the top 20 list this year. Searching for downloads of Elle Macpherson (No. 16), Bar Refaeli (No. 17), and Kate Upton (No. 20) can result in landing on a risky site. Musicians are Not Safe Young female artists are definitely a draw to malware and risky websites. Selena Gomez (No. 4), Shakira (No. 7), and Taylor Swift (No. 15) all rank in the top 20. Headlines Don't Equate to Risk Tom Cruise, Katie Holmes, Kristen Stewart, and Robert Pattinson were all absent from this year's top 50 list despite the publicity surrounding the Cruise-Holmes divorce and the Stewart-Pattinson cheating scandal. "Hot movies and TV shows, awards and industry accolades seem to be more of a factor than headline-grabbing activity," said Greve. "Still, searching for any celebrity can bring up risky sites and the public should use caution by not clicking on any page that looks suspicious." From One Year to Another Heidi Klum, Piers Morgan, Mila Kunis, Katherine Heigl, Anna Paquin, Adriana Lima Scarlett Johansson, Brad Pitt, Emma Stone, and Rachel McAdams have all dropped out of this year's top 10 list (Pitt, Stone, and McAdams tied for No. 10 last year). Tips to Stay Protected: *Beware of content that prompts you to download anything before providing you with content. You may want to opt to watch streaming videos or download content from an established site, such as Hulu, Netflix, NBC, or ABCtv. *Free downloads are significantly the highest virus-prone search terms. Anyone searching for videos or files to download should be careful as not to unleash malware on their computer. *Since most people use a variety of devices to search for celebrities, be sure you have up to date, comprehensive security for all of your devices. It's important to have protection, such as McAfee® All Access, on all Internet-enabled devices, including PCs, Macs, smartphones, tablets and netbooks. *A complimentary version of SiteAdvisor software can be downloaded at www.siteadvisor.com. For More Information: *To learn more about the research and the risks of searching for celebrities, go to *Web page - www.mcafee.com/most-dangerous-celebrities *Blog - https://blogs.mcafee.com/consumer/family-safety/dangerous-celebrity-2012 *Blog - https://blogs.mcafee.com/consumer/identity-theft/celebrities-are-lures *To continue the conversation, follow @McAfee on Twitter and tweet your thoughts with the hashtag #riskyceleb. *Web surfers should visit the McAfee Security Advice Center and Facebook page at www.facebook.com/mcafee for information on the latest threats, and tips on surfing safely. About McAfee SiteAdvisor technology McAfee SiteAdvisor technology protects users from malicious websites and browser exploits. SiteAdvisor technology tests and rates nearly every trafficked site on the Internet and uses red, yellow and green icons to indicate the website's risk level. SiteAdvisor site ratings are created by using patented advanced technology to conduct automated website tests SiteAdvisor software works with Internet Explorer and Firefox. About McAfee McAfee, a wholly owned subsidiary of Intel Corporation (NASDAQ:INTC), is the world's largest dedicated security technology company. McAfee delivers proactive and proven solutions and services that help secure systems, networks, and mobile devices around the world, allowing users to safely connect to the Internet, browse and shop the Web more securely. Backed by its unrivaled Global Threat Intelligence, McAfee creates innovative products that empower home users, businesses, the public sector and service providers by enabling them to prove compliance with regulations, protect data, prevent disruptions, identify vulnerabilities, and continuously monitor and improve their security. McAfee is relentlessly focused on constantly finding new ways to keep our customers safe. http://www.mcafee.com Note: McAfee, the McAfee logo, SiteAdvisor and McAfee Total Protection are registered trademarks or trademarks of McAfee, Inc., or its subsidiaries in the United States and other countries. Other names and brands may be claimed as the property of others. ©2011 McAfee, Inc. All rights reserved. Photos/MultimediaGallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50400064&lang=en Multimedia Available:http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50400064&lang=en Contact: DKC Eva Ross, 212-981-5218 email@example.com or McAfee Kim Eichorn, 408-455-2172 email@example.com Follow @McAfeeConsumer
McAfee Reveals Emma Watson as 2012's Most Dangerous Cyber Celebrity
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Clark Pest Control has grown to be the West's largest pest management company with branch offices throughout California and in the Reno, Nevada area.
Current Articles
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Dr. Dini Miller is currently on deck and again one of my favorite topics...Bed Bugs.
Are Bed Bugs related to fleas? No, although it is closely related to the plant pest the Aphid. Bed Bugs originated from caves and have been transported all over the world. In the 40-50's Bed Bugs were essentially eradicated due to the use of DDT, later Bed Bugs developed a resistance to DDT.
So why are Bed Bugs back? People! International travel is a the biggest reason for the comeback. The hands down reason is most likely increased pressure of resistant population.
Poultry Farming...birds raised for meat cannot be treated with pesticides, therefor Bed Bug infestations are all more then common.
Bed Bugs after their feeds leave the host due to the heat, this is where Non-Chemical heat applications come into play. During the day they cluster together in cracks and crevices.
Eggs hatch between 8-9 days, newly hatched Bed Bugs will need their first blood meal within 3 days.
Most inspect for blood spots (red), this is incorrect, you are looking for black spots (dried blood), but most common is the actual bite.
Thank you Dr. Dini Miller for your insight!
Well this morning I came across a very well written article by the Palm Beach Post. This article implies that spiders will NOT bite you " Did you know that spiders don't drink your saliva, bite you or crawl in your mouth and get swallowed as you sleep? If one is found in your tub or sink, it fell in from above while looking for water and did not crawl up from the drain. "
Now for most spiders, its first line of defense is to bite, you reach into a box or other container, not even seeing the spider and you get bit. Now the spider didn't say to itself "ATTACK!!" you caught it by surprise and in its mind it probably saw you as a predator and went into defense mode.
"Spiders are glad to get away from you, so let them. The big three - the wolf, huntsman and nursery-web - spiders might wander into your house or park themselves just outside the door and catch roaches and other unwanted pests before they can enter.
Although these are large, brown, scary-looking spiders, their bites are not dangerous. And if you learn where they hang out, the two of you can get along without any late-night surprises."
Now as we know spiders are venomous, with only a hand full being medically significant, such as, the Black Widow, Brown Recluse and few Tarantulas, the Blue Cobalt is not deadly but does require a trip to the hospital. Bites reactions vary and is based on an individuals reaction. I have been bit by a jumping spider, now some people I have spoke to had no reaction, I had pain for several hours and swelling and redness around the bite.
Again This article is a good article, worth a read, but please do not go out picking up random spiders, you could get bit! I would also like to add that one of the best ways to deter spiders is knocking down webs on a regular basis, if you feel you have an infestation please contact your local pest professional. Clark offers Spider control, call Clark today!
Click here to read the Palm Beach Post article
© 2015 www.clarkpest.com


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Enter here for your chance to win passes to an advance screening of DAWN OF THE PLANET OF THE APES on Tuesday, July 8, at 7 p.m. at the Emagine in Novi.
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- The Big Picture - http://www.ritholtz.com/blog -
Video: Pete Peterson, David Walker on Oil, Health Care, Economy, Equities
Posted By Barry Ritholtz On May 24, 2008 @ 6:30 am In Economy,Energy,Taxes and Policy,Video | Comments Disabled
Another good Friday on CNBC — excellent guests, discussing real issues, and in great detail.
Like the interview two weeks ago with David Einhorn and William Ackman [1], this shows how good finacial television can be when a smart guest discusses weighty topics with sufficient time to go into details beyond bumper sticker.
I don't know much about David Walker [2], but I was very impressed with him. Here's info on the Peterson Foundation [3].
I don't think the videos have as much Walker as they did on TV . . .
Private Equity With Pete Peterson
click for video
Discussing the state of private equity, with Pete Peterson, The
Blackstone Group chairman/co-founder and David Walker former U.S.
Wall Street Star
click for video
Perspectives on the economy, with Pete Peterson, The Blackstone
Group chairman/co-founder and David Walker former U.S. Comptroller
Video: David Einhorn, Greenlight Capital, William Ackman, Pershing Square Capital [1]
Article printed from The Big Picture: http://www.ritholtz.com/blog
URL to article: http://www.ritholtz.com/blog/2008/05/video-pete-peterson-david-walker-on-oil-health-care-economy-equities/
URLs in this post:
[1] David Einhorn and William Ackman: http://bigpicture.typepad.com/comments/2008/05/video-david-ein.html
[2] David Walker: http://www.gao.gov/cghome/dwbiog.html
[3] Peterson Foundation: http://www.petergpetersonfoundation.org/leadership.asp
[4] Image: http://www.cnbc.com/id/15840232?video=751583439
Click here to print.
Copyright © 2008 The Big Picture. All rights reserved.


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About the Department
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Naoko Maeshiba is a director, a choreographer, and a performer from Kobe, Japan. Maeshiba received her M.F.A. in Directing/Asian Performance from the University of Hawai'i at Manoa. Before she began teaching at Towson, she worked at Arena Stage as a directing fellow, ran Tsunami Theatre Company in DC as the co-artistic director/director, and founded Naoko Maeshiba/Kibism (a.k.a. Naoko Maeshiba Performance Collective), an on-going performance lab that investigates the depth of the body. Her solo and ensemble works have been presented in both traditional and non-traditional venues in North America, Europe, and Japan including Joyce Soho (NY), Kennedy Center Millennium Stage (DC), Dance Place (DC), Theatre of Yugen (SF), Warehouse Gallery (DC), Red Room (MD), M25 (Warsaw, Poland), Theatre Jo (Tabor, Czech Republic), and Dance Hakushu (Hakushu, Japan). Amongst her recent works are directing Kaspar by Peter Handke (Main Stage, Towson University, MD), choreographing for Three Sisters (Bell Foundry, Baltimore, MD), conceiving/creating/performing a solo show KAWATOKAWA [river/skin] (Baltimore Theatre Project, MD), and performing the feature role in a full noh play, Atsumori (Bloomsburg Theatre Ensemble, PA). Currently, she is working on a new play, You for Me for You by Mia Chung as a choreographer at Woolly Mammoth Theatre Company in DC.
She has received individual artist grants in theatre direction from D.C. Commissions on Arts and Humanities and NEA, Kennedy Center Local Dance Commissioning Project award, Metro DC Dance Award for excellence in sound design, and individual artist awards in choreography and solo performance from Maryland State Arts Council.
As an educator, she teaches Directing, Ensemble Theatre Lab, Essential Body and graduate courses at Towson University and has led workshops and classes at various organizations and festivals such as Joy of Motion (DC), Ko Festival of Performance in Amherst (MA), Shakespeare Theatre's Southeast Project (DC), Dance Exchange (DC), and Honolulu Theatre for Youth (HI). She is a member of Lincoln Center's Director's Lab and Theatre Nohgaku. Maeshiba is also a certified Feldenkrais practitioner. For more information on her work, please visit www.naokibi.com.
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This does NOT!...
Jeeeze you're right. I'm really hoping the betas were lacking a completed center console. We shall see in February I suppose!
The Motortrend article looks like the alpha interior while the Bunty photo is definitely from a beta visit.
I'm hoping for a combination of the two. The center console similar to the alpha with the dash highlights of the beta. And I think I see forward/reverse buttons on the alpha, so that would be a nice alternative to the steering wheel thing on the beta.
The interior on the prototype was one of the things that originally attracted me to the Model S as being not just the best electric car, but the best car. The console wrapped around the 17" monitor, sheltering it from glare and softening its outline.
The interior on the beta reminds me of an early 80s Aston Martin Lagonda: Angular and simplistic cream-colored surfaces, too-shiny strips of veneer, and an oversized in-your-face digital display.
BUT... the Lagonda has a center console! :-P
The Motortrend article looks like the alpha interior [...] (Jason S)
- is
the Alpha interior that was up on Tesla Motor's website from the reveal of the Alpha in March 2009 until the updated "Model S Facts" page went online shortly before the reveal of the Beta in October 2011.
(sorry for the HTML formatting snafu)
Definitely the alpha. The date on the monitor is April 17,2009
Wow, yet ANOTHER center consul thread
First time i see this...how do you get from alpha interior (very classy) to the beta one?? Did they put an Austin Powers lookalike in charge of interior design?
Wow, yet ANOTHER center consul thread
Gee ... do you think that might tell TM something?
I sure do hope that they've come up with an interior design that is worthy of a spectacular exterior design. The beta interior (even a slightly modified beta) is NOT!
@Nick Kordich reflects my position well when he writes: The interior on the prototype was one of the things that originally attracted me to the Model S as being not just the best electric car, but the best car. [emphasis added] The console wrapped around the 17" monitor, sheltering it from glare and softening its outline.
I think it says the people that don't like it, for whatever reason, are determined.
@ThomasN: As one of the vast majority of reservation holders who "don't like it" [the interior], I am determined to get Tesla to correct a design error that will hurt sales of the car over a longer term than 2012. I'm also a shareholder, so long terms sales matter.
What's maddening is that (to quote) @erik ... "how do you get from alpha interior (very classy) to the beta one?? Did they put an Austin Powers lookalike in charge of interior design?"
That's snarky, I know, but it's also fairly accurate.
What worries me is that TM will deliver the Beta-like interior to Sig holders and early P holders, then finally relent when negative feedback continues, and make a change in 2013/14. Better to do it now so that early adopters are not punished.
I sure do hope they release the final interior design soon, and I also hope it's a significant improvement.
@Soflauthor: "As one of the vast majority of reservation holders who "don't like it" [the interior] ..."
where did you get the statistic that states that "the vast majority of reservation holders [who] don't like it"? Or is this just an opinion. If so, then please don't present it as fact ...
This has been discussed ad nauseam. Based on observations in other areas I presume that they don't employ Austin Powers lookalikes at Tesla. More likely, they did not get around to finish the interior to their own standards before the October 1 event, so they went with something they could quickly implement to show off in the Beta vehicles.
It is disturbing that they did not care to mention that the interior shown in the Betas was actually a stand-in (assuming that it was). Looking at the discussions around the Options & Pricing page, I have a cold comfort in finding that much of the heated debate was entirely pointless and would not have taken place if, e.g., Tesla had accurately communicated the standard features included in the base price at the same time. Similarly, at this point I see no way other than lean back, let the dust settle and breath calmly until Tesla steps up and reveals the official and final interior.
There is nothing wrong with letting Tesla know what we think, one way or the other, just as we did with that dreaded Alpha nose cone, too. Regarding interior in general and center console/cup holders in particular, this should have been accomplished by loads of other threads around these topics:
(in order of appearance)
Caveat: Everything I said in this post is my subjective opinion, based mostly on speculation.
@Softauthor: if the text you emphasized sounds familiar, it's because I was quoting/paraphrasing Elon.
@clea: I have followed the interior debate closely since the beta was introduced. It's readily apparent, if you choose to read the many threads (see @V.B's list above), that the "vast majority" of comments about the beta interior on this forum, at teslamotorsclub.com, and on Tesla's facebook page (when people comment on the interior) are negative or ask for major modifications to design, color choice, etc. Sorry, if you need something more quantitative or a scientific polling approach, but I honestly don't see the point, since this is not a vote, and the final interior is now complete.
@V.B is absolutely correct when he states "at this point I see no way other than lean back, let the dust settle and breath calmly until Tesla steps up and reveals the official and final interior."
I will follow that sage advice, but let's have a reveal sooner, rather than later, so that we'll know what we're buying.
On the recent conference session, Elon responds to a question about the interior by saying that it is essentially finished but TM will improve the fit and finish of the interior.
Yeah, we all know the Beta dashboard was a disappointment. Tesla knows too.
Question is: After finding this out from their customers on Oct. 1, have they been doing anything about it in the last 4 months, or has all the design effort gone into the new Model X prototype?
We'll see soon enough.
Just my 2-cents, sorry, but I think the alpha looks like it has an old fashioned horse collar on it.
Sorry, didn't realize it was so big.
At the risk of being crucified, I prefer the look of the beta to that of the alpha. The alpha looks cramped and needlessly bulky whereas the beta looks minimalistic and open. I would be disappointed if they returned to the alpha look. Tesla is trying to go away from a center stack and consol that is dripping with buttons, toggles and switches and I, for one, am all for it.
I sure do hope they release the final interior design soon, and I also hope it's a significant improvement.
I don't want to rain on most folk's parade, but it is unlikely we will see a significant improvement over the Betas that were at Fremont.
Here's an interview with Elon and CNN Money published in November 2011. At 24 seconds into the video he explains that the Beta "is 99% of the production design".
And I just got a call from my Tesla rep (triggered by my email to him about saddle leather). His bottom line on the interior: what's in the non-engineering betas (i.e., not the old Sig red, not the "engineering" white beta) is close enough to final that, if you took off your glasses, that's what you'll see. I don't know how bad his uncorrected eyesight is, though! Still, I think that definitely rules out a bulky center console from the Model S design.
What did he say about the saddle leather?!
I just hope and pray, for the sake of Tesla, that I am in the tiny minority when it comes to not being in love with the new interior, and they still sell tens of thousands of S's to semi-wealthy people, who don't expect it to be everything they ever wanted in a dream car.
I understand that we'r enot going to be getting anything that looks like the alpha (for instance it doesn't have place for the banana leaf/lacewood/piano black accents). However, I just really really want easy to access cup holders and larger armrests, with a sliding adjustment if necessary.
I also forgot to mention I would absolutely live the push button "shift" controls as seen in the alpha instead of the crappy lever on the stalk. I would also love touchscreen shifting instead.
I know Tesla isn't sort of challenging all the convention of design, but I actually think it would be really cool to have paddles (like psuedo-manual shift paddles for some automatics) for the turn signals instead of the standard lever control.
Just my 2-cents, sorry, but I think the alpha looks like it has an old fashioned horse collar on it. (Mycroft)
Ha! I agree 100%. I was thinking that the rim around the Alpha's screen reminded me of something, but could not figure out what it was. Thank you for opening my eyes, I will sleep better tonight! :-D
[...] semi-wealthy people, who don't expect it to be everything they ever wanted in a dream car. (TikiMan)
I am afraid, your assessment of semi-wealthy people's attitude may be wrong. Those people who can barely afford the Model S will be the most critical. Among all customers those will be the ones who will be most careful and hesitant in allotting their money, so if the Model S does not work for them, they will buy a new Prius or a used BMW instead, depending on their priorities, but will spend less money either way.
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Life With ALS.com
+ Diagnosed Aug 2005
+ Bipap March 2007
+ PEG July 2007
+ Trache and Vent July 2008
Still Living, Loving & Laughing
This is a very common question. Lets say you are an old friend that just found out someone you knew long ago has ALS. You want to go and see them and you don't know what to expect. What do you say? How do you greet them?
This does not only apply to old friends, it is a question I get from people who still live in the same town and visit regularly.
Your concern is a very valid emotion.
Friends and family have a tendency to disappear as the disease progresses. This is very hurtful so anyone that continues to come around is very much appreciated.