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Langerhans Cell Histiocytosis Treatment (PDQ®): Treatment - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Langerhans Cell Histiocytosis Treatment
General Information About Langerhans Cell Histiocytosis (LCH)
Langerhans cell histiocytosis is a disease that can damage tissue or cause lesions to form in one or more places in the body.
Langerhans cell histiocytosis (LCH) is a rare disease that begins in LCH cells (a type of dendritic cell which fights infection). Sometimes there are changes in LCH cells as they form. These changes may cause the LCH cells to grow and multiply quickly. This causes the LCH cells to build up in certain parts of the body, where they can damage tissue or form lesions.
LCH is not a disease of Langerhans cells that normally form in skin.
Scientists do not agree on whether LCH is a type of cancer or is a condition caused by a change in the immune system. LCH is mainly treated with anticancer drugs. Some of these drugs are also used to treat immune system conditions.
LCH may occur at any age, but is most common in young children. Treatment of LCH in childhood is different from treatment of LCH in adults. The treatments for LCH in children and adults are described in separate sections of this summary.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood Langerhans cell histiocytosis. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Family history and having a parent who was exposed to certain chemicals may increase the risk of LCH.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get the disease; not having risk factors doesn't mean that you will not get the disease. Talk with your doctor if you think you may be at risk. Risk factors for LCH may include the following:
- Having a parent who was exposed to certain chemicals such as benzene.
- Having infections as a newborn.
- Having a family history of thyroid disease.
The cause of LCH is not known.
The signs and symptoms of LCH depend on where it occurs in the body.
These and other symptoms may be caused by LCH. Other conditions may cause the same symptoms. Check with your doctor if you have any of the following problems:
In infants, signs and symptoms of LCH may include:
- Flaking of the scalp that may look like "cradle cap".
- Raised, brown or purple spots anywhere on the body.
In children and adults, signs and symptoms of LCH may include:
- Flaking of the scalp that may look like dandruff.
- Raised, red or brown, crusted rash in the groin area, abdomen, back, or chest, that may be itchy.
- Bumps or ulcers on the scalp.
- Ulcers behind the ears, under the breasts, or in the groin area.
Signs and symptoms of LCH may include:
- Swollen gums.
- Sores on the roof of the mouth, inside the cheeks, or on the tongue or lips.
- Having teeth that become uneven.
- Tooth loss.
Signs and symptoms of LCH may include:
- Swelling or a lump over a bone, such as the skull, ribs, spine, thigh bone, upper arm bone, elbow, or eye socket.
- Pain where there is swelling or a lump over a bone.
Lymph nodes and thymus
Signs and symptoms of LCH may include:
- Swollen lymph nodes.
- Trouble breathing.
Endocrine system (including the pituitary gland)
Signs and symptoms of LCH may include:
- Diabetes insipidus. This can cause a strong thirst and frequent urination.
- Slow growth.
- Late puberty.
Signs and symptoms of LCH may include:
- Swollen thyroid gland.
- Hypothyroidism. This can cause tiredness, lack of energy, being sensitive to cold, constipation, dry skin, thinning hair, memory problems, trouble concentrating, and depression. In infants, this can also cause a loss of appetite and choking on food. In children and teens, this can also cause behavior problems, weight gain, slow growth, and late puberty.
- Trouble breathing.
Central nervous system
Signs and symptoms of LCH may include:
- Loss of balance, uncoordinated body motions, and trouble walking.
- Trouble speaking.
- Changes in behavior.
- Memory problems.
Liver and spleen
Signs and symptoms of LCH may include:
- Swelling in the abdomen caused by a build up of extra fluid.
- Trouble breathing.
- Yellowing of the skin and whites of the eyes.
- Itching.
- Easy bruising or bleeding.
- Feeling very tired.
Signs and symptoms of LCH may include:
- Spontaneous pneumothorax (collapsed lung). This condition can cause chest pain or tightness, trouble breathing, feeling tired, and a bluish color to the skin.
- Trouble breathing, especially in adults who smoke.
- Dry cough.
- Chest pain.
Bone marrow
Signs and symptoms of LCH may include:
- Easy bruising or bleeding.
- Fever.
- Frequent infections.
Tests that examine the organs and body systems where LCH may occur are used to detect (find) and diagnose LCH.
The following tests and procedures may be used to detect (find) and diagnose LCH or conditions caused by LCH:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
- Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
Complete blood count (CBC) with differential: A procedure in which a sample of blood is drawn and checked for the following:
- The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
- The portion of the blood sample made up of red blood cells.
- The number and type of white blood cells.
- The number of red blood cells and platelets.
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the body by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
- Liver function test: A blood test to measure the blood levels of certain substances released by the liver. A high or low level of these substances can be a sign of disease in the liver.
- Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
- Water deprivation test: A test to check how much urine is made and whether it becomes concentrated when little or no water is given. This test is used to diagnose diabetes insipidus, which may be caused by LCH.
Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of LCH.
Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidi needle (a long, hollow needle) is inserted into the patient's hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.
Bone scan: A procedure to check if there are rapidly dividing cells in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
Bone scan. A small amount of radioactive material is injected into the patient's bloodstream and collects in abnormal cells in the bones. As the patient lies on a table that slides under the scanner, the radioactive material is detected and images are made on a computer screen or film.
- X-ray: An x-ray of the organs and bones inside the body. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. Sometimes a skeletal survey is done. This is a procedure to x-ray all of the bones in the body.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Computed tomography (CT) scan of the abdomen. The patient lies on a table that slides through the CT machine, which takes x-ray pictures of the inside of the body.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A substance called gadolinium may be injected into a vein. The gadolinium collects around the LCH cells so that they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Magnetic resonance imaging (MRI) of the abdomen. The patient lies on a table that slides into the MRI machine, which takes pictures of the inside of the body. The pad on the patient's abdomen helps make the pictures clearer.
PET scan (positron emission tomography scan): A procedure to find tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
PET (positron emission tomography) scan. The patient lies on a table that slides through the PET machine. The head rest and white strap help the patient lie still. A small amount of radioactive glucose (sugar) is injected into the patient's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.
- Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
- Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through an incision (cut) in the skin or opening in the body, such as the mouth. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for LCH cells. To diagnose LCH, a biopsy of bone lesions, skin, lymph nodes, or the liver may be done.
Certain factors affect prognosis (chance of recovery) and treatment options.
LCH in organs such as the skin, bones, lymph nodes, or pituitary gland usually gets better with treatment and is called "low- risk". LCH in the spleen, liver, or bone marrow is harder to treat and is called "high-risk".
The prognosis (chance of recovery) and treatment options depend on the following:
- How old the patient is when diagnosed with LCH.
- How many body systems the disease affects.
- Whether the disease is found in the liver, spleen, bone marrow, or certain bones in the skull.
- How quickly the disease responds to initial treatment.
- Whether the disease has just been diagnosed or has come back (recurred).
In infants up to one year of age, LCH may go away without treatment.
Stages of LCH
There is no staging system for Langerhans cell histiocytosis (LCH).
The extent or spread of disease is usually described as stages. There is no staging system for LCH.
Treatment of LCH is based on where LCH cells are found in the body and whether one or more body systems are affected.
LCH is described as single-system disease or multisystem disease, depending on how many body systems are affected:
- Single-system LCH: LCH is found in one part of an organ or body system (unifocal) or in more than one part of that organ or body system (multifocal).
- Multisystem LCH: LCH occurs in two or more organs or body systems.
LCH may affect low-risk organs or high-risk organs, depending on where it occurs in the body:
- Low-risk organs include the skin, bone, lymph nodes, gastrointestinal tract, pituitary gland, and central nervous system (CNS).
- High-risk organs include the liver, spleen, and bone marrow.
Recurrent LCH
Recurrent Langerhans cell histiocytosis (LCH) is disease that has recurred (come back) after it has been treated. The disease may come back in the same place or in other parts of the body. It often recurs in the bone, ears, skin, or pituitary gland. LCH often recurs the year after stopping treatment. Recurrent LCH is also called reactivation.
Treatment Option Overview for LCH
There are different types of treatment for patients with Langerhans cell histiocytosis (LCH).
Different types of treatments are available for patients with LCH. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Whenever possible, patients should take part in a clinical trial in order to receive new types of treatment for LCH.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate treatment is a decision that ideally involves the patient, family, and health care team.
Children with LCH should have their treatment planned by a team of health care providers who are experts in treating this disease in children.
Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric healthcare providers who are experts in treating children with LCH and who specialize in certain areas of medicine. These may include the following specialists:
- Primary care physician.
- Pediatric surgeon.
- Pediatric hematologist.
- Radiation oncologist.
- Neurologist.
- Endocrinologist.
- Pediatric nurse specialist.
- Rehabilitation specialist.
- Psychologist.
- Social worker.
- Geneticist.
Some treatments for LCH cause side effects months or years after treatment has ended.
Some treatments cause side effects that continue or appear months or years after treatment has ended. These are called late effects. Late effects of treatment for LCH may include the following:
- Slow growth and development.
- Hearing loss.
- Bone, tooth, liver, and lung problems.
- Changes in mood, feeling, learning, thinking, or memory.
- Risk of cancer related to treatment.
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments.
Nine types of standard treatment are used:
LCH is usually treated with anticancer treatments. These treatments stop the LCH cells from growing and dividing.
Watchful waiting
Watchful waiting is closely monitoring a patient's condition without giving any treatment until symptoms appear or change.
Surgery may be used to remove LCH lesions and a small amount of nearby healthy tissue. Curettage is a type of surgery that uses a curette (a sharp, spoon-shaped tool) to scrape LCH cells from bone.
Radiation therapy
Radiation therapy is a treatment that uses high-energy x-rays or other types of radiation to kill cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the LCH lesion.
Photodynamic therapy
Photodynamic therapy is a treatment that uses a drug and a certain type of laser light to kill cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in LCH cells than in normal cells. For LCH, laser light is shined onto the skin and the drug becomes active and kills the LCH cells. Photodynamic therapy causes little damage to healthy tissue. Patients who have photodynamic therapy should not spend too much time in the sun.
In one type of photodynamic therapy, called psoralen and ultraviolet A therapy (PUVA), the patient receives a drug called psoralen and then ultraviolet radiation is directed to the skin.
Chemotherapy is a treatment that uses drugs to stop the growth of cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly onto the skin or into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cells in those areas (regional chemotherapy).
Nitrogen mustard is a drug that is put directly on the skin to treat small LCH lesions.
Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight disease. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against disease. This type of treatment is also called biotherapy or immunotherapy.
Interferon is a type of biologic therapy used to treat LCH of the skin.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to find and attack LCH cells without harming normal cells. Imatinib mesylate is a type of targeted therapy called a tyrosine kinase inhibitor. It stops blood stem cells from turning into dendritic cells.
Other drug therapy
Other drugs used to treat LCH include the following:
- Corticosteroids are steroids used to treat LCH lesions.
- Bisphosphonate therapy is used to treat LCH lesions of the bone and lessen bone pain.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin and ibuprofen) that are commonly used to decrease fever, swelling, pain, and redness. Sometimes an NSAID called indomethacin is used to treat LCH.
- Retinoids, such as isotretinoin, are drugs related to vitamin A that can slow the growth of LCH cells in the skin. The retinoids are taken by mouth.
Stem cell transplant
Stem cell transplant is a method of giving chemotherapy and replacing blood-forming cells destroyed by the LCH treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
New types of treatment are being tested in clinical trials.
Information about clinical trials is available from the NCI Web site.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the medical research process. Clinical trials are done to find out if new treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for disease are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way diseases will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose disease has not gotten better. There are also clinical trials that test new ways to stop a disease from recurring (coming back) or reduce the side effects of treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options for Childhood LCH and the Treatment Options for Adult LCH sections for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
When treatment of LCH stops, new lesions may appear or old lesions may come back.
Many patients with LCH get better with treatment. However, when treatment stops, new lesions may appear or old lesions may come back. This is called reactivation (recurrence) and may occur within one year after stopping treatment. Patients with multisystem disease are more likely to have a reactivation. More common sites of reactivation are bone, ears, or skin, and diabetes insipidus also may develop. Less common sites of reactivation include lymph nodes, bone marrow, spleen, liver, or lung. Some patients may have more than one reactivation over a number of years.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the disease may be repeated. This is to see how well the treatment is working and if there are any new lesions. These tests may include:
- Physical exam.
- Neurological exam.
- CT scan.
- PET scan.
Other tests that may be needed include:
- Brain stem auditory evoked response (BAER) test: A test that measures the brain's response to clicking sounds or certain tones.
- Pulmonary function test (PFT): A test to see how well the lungs are working. It measures how much air the lungs can hold and how quickly air moves into and out of the lungs. It also measures how much oxygen is used and how much carbon dioxide is given off during breathing. This is also called a lung function test.
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the disease has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Treatment Options for LCH in Children
Treatment of Low-Risk Disease
Skin Lesions
Treatment of childhood Langerhans cell histiocytosis (LCH) skin lesions may include the following:
- Watchful waiting.
- Steroids or nitrogen mustard applied to the skin.
- Chemotherapy, such as methotrexate or thalidomide, given by mouth.
- Photodynamic therapy with psoralen and ultraviolet A radiation (PUVA).
Bone Lesions and Other Low-Risk Organ Lesions
Treatment of childhood LCH bone lesions in the front, sides, or back of the skull, or in any other single bone may include the following:
- Surgery (curettage) with or without steroid therapy.
- Radiation therapy.
Treatment of childhood LCH lesions in bones around the ears or eyes may lower the risk of diabetes insipidus and other long-term problems. Treatment may include:
- Chemotherapy and steroid therapy.
- Surgery (curettage).
Treatment of spine or hip bone lesions that have weakened the bone and may lead to a broken bone in childhood LCH may include:
- Radiation therapy.
- Chemotherapy for lesions that spread from the spine into nearby tissue.
- Surgery to strengthen the weakened bone by bracing or fusing the bones together.
Treatment of two or more bone lesions may include:
- Chemotherapy and steroid therapy.
- Bisphosphonate therapy.
Treatment of combinations of childhood LCH skin, lymph node, pituitary gland, and bone lesions may include:
- Chemotherapy and steroid therapy.
- Bisphosphonate therapy.
Treatment of High-Risk Disease
Treatment of childhood LCH multisystem disease lesions in the spleen, liver, or bone marrow (with or without skin, bone, lymph node, lung, or pituitary gland lesions) may include:
- Chemotherapy and steroid therapy. Higher doses of combination chemotherapy and steroid therapy may be given to patients whose tumors do not respond to initial chemotherapy.
- A liver transplant for patients with severe liver damage.
Treatment of childhood LCH central nervous system lesions may include various combinations of the following:
- Chemotherapy with or without steroid therapy.
- Steroid therapy.
Treatment Options for Recurrent, Refractory, and Progressive Childhood LCH
Recurrent LCH is disease that cannot be detected for some time after treatment and then comes back. Treatment of recurrent childhood LCH in the skin, bone, lymph nodes, gastrointestinal tract, pituitary gland, or central nervous system (low-risk organs) may include:
- Chemotherapy with or without steroid therapy.
- Bisphosphonate therapy.
- Nonsteroidal anti-inflammatory drug (NSAID) therapy with indomethacin.
Refractory LCH is disease that does not get better with treatment. Treatment of refractory childhood LCH in high-risk organs and in multisystem low-risk organs may include high-dose chemotherapy. Treatment of childhood LCH in multisystem high-risk organs that did not respond to chemotherapy may include stem cell transplant.
Progressive LCH is disease that continues to grow during treatment. Treatment of progressive childhood LCH in patients with multisystem disease may include anticancer drugs that have not been given to the patient before.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood Langerhans cell histiocytosis. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment Options for LCH in Adults
Langerhans cell histiocytosis (LCH) in adults is a lot like LCH in children and can form in the same organs and systems as it does in children. These include the endocrine and central nervous systems, liver, spleen, bone marrow, and gastrointestinal tract. In adults, LCH is most commonly found in the lung as single-system disease. LCH in the lung occurs more often in young adults who smoke. Adult LCH is also commonly found in bone or skin.
As in children, the signs and symptoms of LCH depend on where it is found in the body. See the General Information section for the signs and symptoms of LCH.
Tests that examine the organs and body systems where LCH may occur are used to detect (find) and diagnose LCH. See the General information section for tests and procedures used to diagnose LCH.
In adults, there is not a lot of information about what treatment works best. Sometimes, information comes only from reports of the diagnosis, treatment, and follow-up of one adult or a small group of adults who were given the same type of treatment.
Treatment Options for LCH of the Lung
Treatment for LCH of the lung in adults may include:
- Quitting smoking for all patients who smoke. Lung damage will get worse over time in patients who do not quit smoking. In patients who quit smoking, lung damage may get better or it may get worse over time.
- Steroid therapy.
- Lung transplant for patients with severe lung damage.
Sometimes LCH of the lung will go away or not get worse even if it's not treated.
Treatment Options for LCH of the Bone
Treatment for LCH that affects only the bone in adults may include:
- Surgery with or without steroid therapy.
- Chemotherapy.
- Radiation therapy.
- Bisphosphonate therapy.
Treatment Options for LCH of the Skin
Treatment for LCH that affects only the skin in adults may include:
- Surgery.
- Steroid therapy applied to the skin.
- Photodynamic therapy with psoralen and ultraviolet A radiation (PUVA).
- Chemotherapy or biologic therapy given by mouth, such as methotrexate, thalidomide, or interferon.
- Retinoid therapy may be used if the skin lesions do not get better with other treatment.
Treatment for LCH that affects the skin and other body systems may include:
- Chemotherapy.
Treatment Options for Single-System and Multisystem LCH
Treatment of single-system and multisystem disease in adults may include:
- Chemotherapy. A drug that makes the immune system less active may also be used.
- Bisphosphonate therapy.
- Targeted therapy with imatinib mesylate.
For more information about LCH trials for adults, see the Histiocyte Society website.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with adult Langerhans cell histiocytosis. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Changes to This Summary (01 / 30 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Changes were made to this summary to match those made to the health professional version.
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The Children's Oncology Group (COG) is the major group that organizes clinical trials for childhood cancers in the United States. Information about contacting COG is available on the NCI Web site or from the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2013-01-30
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.


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Difference between revisions of "Labs"
m (→Weekly Meeting Minutes)
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= Weekly Meeting Minutes =
= Weekly Meeting Minutes =
* [Labs/Meeting_Minutes/20100329]
* [Labs/Meeting_Minutes/20100329]
= Discussions =
= Discussions =
Revision as of 18:02, 29 March 2010
About Mozilla Labs
Laboratories are where science and creativity meet to develop, research, and explore new ideas. Mozilla Labs embraces this great tradition - a virtual lab where people come together to create, experiment, and play with new Web innovations and technologies.
Anything goes here. Crazy ideas and inspirations are encouraged as we all explore and experiment with brand new ideas in whole new ways. Mozilla Labs is about inspiring and harnessing the intelligence, wisdom, and energy of the Mozilla community; let's imagine the future of the Web, and then let's build it together.
All are welcome. Come play.
- Mozilla Labs - Main Site
- List of Labs Projects
- JS Modules -- wiki: A set of handy code modules useful in Firefox add-on development
Weekly Meeting Minutes
Mozilla Labs is using Google Groups for all its discussions. You can find those groups here:
- Mozilla Labs (general discussion and anything that doesn't fit elsewhere)
- Bespin
- Concept Series
- Jetpack
- Personas
- Prism
- Snowl
- Test Pilot
- Ubiquity
- Weave
- Chris Beard
- Anant Narayanan: Weave, Jetpack
- Atul Varma
- Aza Raskin: UX Thinking & Design, Jetpack
- Chris Hofmann
- Dan Mills: Weave
- Dave Herman: JavaScript
- Dan Walkowski: Weave
- Edward Lee: Weave
- Jinghua Zhang: Test Pilot
- Joe Walker: Bespin
- John Resig: Web Platform Capabilities
- Jono Xia: Test Pilot
- Kevin Dangoor: Bespin
- Michael Hanson: Principal Engineer, Labs
- Mike Connor: Weave
- Myk Melez: Jetpack
- Pascal Finette: Operations, Concept Series
- Patrick Walton: Bespin
- Ragavan Srinivasan: Weave
- Sean Martell: Graphic Design
- Amy Zehren: Personas
- Toby Elliott: Weave
- Zandr Milewski: IT support, Weave
Twitter Accounts
Most Labs projects have a Twitter account - follow us if you're interested in up-to-the-minute news:

subset: commoncrawl


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Click HERE to check out Alex from Cobra Starship's tour diary from their South American tour with Justin Bieber! It's got 15 photos from the tour along with Alex's stories about each.
|November 23, 2011
|November 23, 2011
The 2012 Vans Warped Tour Holiday Gift Packages are on sale now thru December 11th while supplies last! For the second year in a row, Warped is offering this holiday gift package that allows you the first shot at tickets for the 2012 tour!
Included in the $45 package is a general admission ticket commemorative ticket with jump the line privileges, a pair of commemorative Warped Stance socks and a Warped holiday card. The actual show ticket will be sent to you two weeks before the show date AND by ordering by December 11th you are guaranteed delivery of the 2011 commemorative socks and holiday card just in time for Christmas - get the packages HERE!
|November 22, 2011
The Swellers album Good For Me was released in the UK this week with the bonus track 'Never Greener.' Download the song now in The Fueled By Ramen Webstore. *U.S. Customers Only
|November 22, 2011
We are so greatfull that the fans have brought us out to Hawaii ! We had an amazing weekend . I'm really starting to notice the fans singing to all the new music and it's the most amazing feeling. we are making some important decisions about next year and we truly are very appreciative for everything you the fans have supported us in . We love you .
-Sublime with Rome
|November 22, 2011
The Fueled By Ramen Holiday Sale is right around the corner. This year we have many new items including custom hoodies, new t-shirt designs and limited edition items. Click HERE to see a preview of just a few of the new items. The fun begins on November 28th in The Fueled By Ramen Webstore!
Consult the Holiday Shipping Guide to make sure you get your order before December 25th!
|November 21, 2011
Click HERE to check out a gallery of some of Sublime With Rome's favorite live photos from 2011!
|November 21, 2011
The brand new Paramore 'Monster' T-Shirt is available now exclusively from Hot Topic! Order online today and get a second Paramore T-Shirt for 50% off! Great deal, Order HERE!
|November 21, 2011
Gym Class Heroes and Adam Levine performed their song 'Stereo Hearts' last night on the American Music Awards. Click HERE to check out some photos from it!
|November 21, 2011
Click HERE to check out Andrew from A Rocket To The Moon's latest Snoop Bloggy Blog featuring some food-heavy photos of his trip to Las Vegas!
|November 21, 2011
Here are some of the highlights from the second night of The Fueled By Ramen 15th Anniversary concerts at Terminal 5 in New York City featuring Cobra Starship, Gym Class Heroes, The Academy Is..., A Rocket To The Moon and VersaEmerge.
For even more from our 15th Anniversary, order the limited-edition book & DVD now exclusively at FBR15.com.


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Sorry about missing the Linkology post last week. I was too busy preparing for all the LOST madness that was posted this past week! Please forgive me.
Around This Blog:
This past week has been ALL ABOUT LOST! And of course the best way to celebrate the last week and final two episodes of one of the greatest shows ever on television is by having an epic list of T-Shirts!
If you haven't checked out Damon Carlton And A Polar Bear then you are missing out on some of THE BEST LOST T-Shirts around. I'm not kidding.
I ran a short, flash contest that only last 5 hours. All you needed to do was write a LOST themed haiku and you could have won Constant, a LOST/Back To The Future mashup tee from Teefury. There were nearly 40 haiku entries! These two won the T-Shirts:
Walt by cul-de-zack
"Waaaaaaaalt! Waaaaaalt! Waaaaaaaalt! Waaaaaalt! Waaaaaaaalt!â€
Now take a deep breath, Michael.
"Waaaaaaaaaaaaaaaaaaaaaaaaaaaalt! Waaaaaaaaaaaaaaaaaaaalt! Waaaaaaaaaaaaaaaaaalt! Waaaaaaaaaaaaaaaalt! WAAAAAAAAAAAAAAAAAAAAAAAAAALT!â€
Crazy Moms by VoxRobotica
Claire's a Crazy Mom
Just like our French Friend Rousseau
and Jacob's "Motherâ€.
Read ALL of the haiku entires here.
And finally, I wanted to mention some of the blogs that mentioned the 108 LOST T-Shirts to Celebrate The End Including 20 You Can't Buy list! Thanks to:
DarkUFO: The BEST LOST Blog around!
The Honolulu Advertiser: LOST In Hawaii Blog
T-Shirt Blogging Friends:
Nice find by Andy from Hide Your Arms. The shirt is called Form Follows Function and is available now from AIAIAI for € 40.
Our good friend, Macho Slut from Found Item Clothing has put together a nice list of 10 Iron Man Themed T-Shirts! Go check it out! Via Found Item Clothing.
I know that Johnny Cupcakes posted this cupcake cannon video a few weeks ago, but, I noticed that it was on frequent play on ESPN this past week, especially SportsNation. Awesome, Johnny!
Or good buddy, Chris Reimer of Rizzo Tees just landed a pretty sweet gig at Scorch Agency. He is the new Chief Marketing Officer at Scorch. Congratulations, Chris! Everyone else, go and buy some Rizzo Tees to celebrate!
Finally, congratulations to Bo of Loving This Tee for accomplishing something that just 1% of the world populations accomplishes … graduating college!
Other Coty Links:
This is what happens when you combine the iPad and industrial strength Velcro. Conceptualized by Jesse Rosten. Via SwipeTap.
You didn't think the LOST mentions would stop, now did you? Check out this awesome Hip-Hop tribute song to LOST by The Injustice League. Via Tumblr Trends.
I'd never wear this shirt. Via FAILShirt.
Threadless News:
My Threadless picks of the week go to Deadly Goldmine by Andreas Krapf and A Brief History of the World by João Lauro Fonte. Oh and in case you haven't heard, Threadless now has flat rate shipping rates of $5 for the US and $10 for international folks!


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1948 Chevy Pickup - The Middle ManWritten by Gerry Burger on April 21, 2014 Frank Briglia's Mid-Engine Pickup
Frank Briglia has been doing this hot rod thing for a long time, both professionally and as a hobby. In the early days of street rodding Frank was busy building fiberglass '32-34 Ford bodies in his company VWT Fiberglass. After selling that company, he became involved in building Kevlar bobsled bodies with the Jeff Bodine team that eventually led to an Olympic Gold Medal for the team. It seems obvious that Frank Briglia is a talented guy who enjoys good engineering.
And so, when it came time to rebuild his hot rod truck, Frank had a different idea. He wanted to mount a C5 Corvette motor mid-engine style, using the Corvette transaxle and associated independent rear suspension.
Frank located a 420 hp '05 Corvette 5.7-liter engine as well as an '01 Corvette that gave up the 4L60E transaxle. Armed with these parts and some help from Don Cuneo at Chassis Dynamics, a race car fabricator in Oxford, Connecticut, they set about building a tubular sub-frame that would mount the engine, transaxle, and the independent rear suspension. When the sub-frame was complete, Frank grafted it to the stock '48 Chevrolet frame. Stainless steel piping routes the coolant forward to the radiator that remains in the stock location, while the abbreviated stainless exhaust system exits through a custom-rolled rear pan. A Street & Performance wiring harness handles engine management including the drive-by-wire throttle and paddle shifters. All this sounds very exotic, and every bit of it was designed for trouble-free motoring.
Pleased with the all-Corvette driveline, Frank decided a C4 Corvette front suspension would make for a great handling truck. The complete front suspension from a '94 Corvette now mounts to the stock truck frame via Frank's own brackets. A Thunderbird rack-and-pinion turns the chromed plated Z06 Corvette wheels. Adding to the great handling are Nitto tires that are 255/45-17 front and 295/45-18 rear, your basic big 'n' little Vette wheels. Locating the mid-engine added 4 inches to the wheelbase of the truck.
With all the engineering worked out, Frank set about building a body to equal the chassis. The top was chopped 2½ inches eliminating the need for any rubber around the windows in the process. Suicide doors were added by swapping the B-pillar to the A-pillar location. All trim was shaved from the truck, and the front bumper now rides higher and closer to the grille.
The four-inch longer than stock wheelbase meant the bed would have to be longer than the stock half-ton bed. Rather than extend the bed, Frank located a ¾-ton bed and shortened it 6 inches. The Corvette rear suspension is wider than the stock '48 rear, so the bed was also widened 2½ inches. A modified '03 S10 tailgate resides above a handformed rolled rear pan. Scoops on the bedsides exit hot air from the motor compartment. The custom fiberglass tonneau cover also incorporates air ducts for the engine. These scoops are the only hint that the motor may be in the bed of this truck.
When all the panel finishing was complete, a custom DuPont orange was mixed using orange tinting dyes. Frank and Don Drost applied the paint before turning attention to the interior of the truck.
The stock dashboard holds a Haneline insert and Insulshield keeps the cab both quiet and comfortable. The A/C system is from Southern Air and the modern sound system is completely out of sight. Apricot Ultraleather cover the bucket seats that reside on either side of the custom built console. Frank built the shifter that selects Drive, Reverse, Neutral or Park, but if you feel like having a little fun running the truck through the gears, it's as simple as hitting the paddle shifters located directly behind the billet steering wheel.
Frank has owned this truck for over 20 years and this is the third major rebuild. It took about one year for Frank Briglia and friends to complete this latest (and Frank swears the last) rendition of his truck. The engineering throughout the truck is superb and the fit and finish matches the great fabrication work. But the best part of the whole project is the fact this truck is driven, and driven a lot. We met up with Frank at the NSRA Nationals in Louisville, Kentucky, and yes, the truck was driven the 875 miles to the Nats and then back home again. That's roughly 2,000 miles in one week, so should you wonder if this wild mid-engine arrangement works, wonder no more.
The 5.7 liter Corvette engine is located 8 inches into the cab for a true mid-engine design. The super sanitary engine bay includes handformed panels in front of the wood bed and cargo area. The engine was close-coupled to the transaxle with a custom-built bellhousing so no driveshaft is used.
More Photos From This Article View Slideshow
The 2�-inch top chop lowers the silhouette perfectly, while eliminating the rubber gasket around the windshield preserves the viewing area. The only clue about the engine location is subtle scoops on the sides of the bed.The custom-formed console fits perfectly between the bucket seats, and the skull shifter selects only Drive, Reverse, Neutral and Park. Twist Machine paddle shifters on the steering column allow manual selection of the gears.Just behind the billet steering wheel, a set of Twist Machine wireless paddle shifters allow you to run through the gears with the simple push of a finger.The custom-formed console fits perfectly between the bucket seats, and the skull shifter selects only Drive, Reverse, Neutral and Park. Twist Machine paddle shifters on the steering column allow manual selection of the gears.Haneline gauges fill the stock holes in the dash and provide all the vital signs on the 420 horses that live just behind the seats.


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The Goodfoot will have an art opening last Thurs. Feb 28th from 5-11pm. The show will be up until March 25th. This months artists are Alea Bone, Darlene Schaper, Jonny Luczycki and Tara Murino-Brault.
Alea Bone's upbringing as a flower child in the ghetto of East Oakland instilled in her a scrappy, DIY instinct to make use of what is available and scavenge for the rest. Working mainly with reclaimed materials and non-traditional media, she prefers painting on old plywood and incorporates found objects whenever possible to create richly textured assemblages. Alea enjoys blurring the lines between the sacred and the profane, High brow and Outsider art. Though she holds a BFA in Illustration from the Pacific Northwest College of Art, Alea has spent the last 10+ years in a desperate attempt to unlearn the conventions she was exposed to in Art School and get back to her gritty, outsider roots. Inspired by the alternative sub-cultural aesthetics of Day of the Dead, Voodoo, New Wave and Beer, she's still honing her own Funky, Folky style of art on the edge, striving to strike the chord of coolness with a touch of bohemian class and a twist of wit.
Darlene Schaper combines decorative elements and embellishes objects into 3-D sculptural worlds of wonder. Using vintage fur, lace, discarded toys, and much more she reinvents obscure antiques and oddities into precious animals, sculptures, shrines and reliquaries. Her choice of media are items that are on their last stop before becoming landfill from the Goodwill Outlet, curbside on trash day, and craigslist free ads. The Artist intends to inform the viewer through art about our ever growing waste threat and remind us of our connection with the earth and other creatures affected by our actions. Darlene Schaper is a Native Oregonian living in Portland and a graduate of the Pacific NW College of Art. She has been an artist and explorer since she was a child having a great love of nature and its creatures. Everything is wondrous and precious to her and she has spent years collecting obscure antiques, oddities, and natural specimens. Many things she incorporates into her art.
In the second grade Jonny Luczyckistarted selling drawings of Disney characters for quarters at recess and spent his winnings on chocolate milk. At that moment, he knew exactly what he wanted to do with his life. Having always been fascinated with figurative painters and the graphic works of the Art Nouveau illustrators, Jonny's work tends to lean towards deconstructing the classical ways to paint the portrait and focuses on the graphic shapes and colors that surround it. Jonny came up with the style and term Abstrotica over a decade ago, which is his way of trying to invent a new kind of portrait, in hopes of painting something that goes against what we have already seen. He does not want everything in his work revealed at first glance, nor will he try to break down the meaning of his work using artistic adjectives that try to impress or belittle. Jonny's hope is that the viewer can experience a connection with his work and get lost in the layers of design, and if they dont, the following statement may help them. What starts out as a vision soon becomes corroded into a manifesto of lust using line drawings and interactive images as patterns. I create a meditative environment of abstract shapes juxtaposed with classical portrait skills and illustrative line work. I am also an avid plein air painter, which means that I paint landscapes out on location, capturing that moment of light with my brush. I have done this nearly every day for the last five years and have realized that nature is the most amazing teacher out there!
Tara Murino-Brault was born and raised in Chicago. She received her BFA in Graphic Design at The University of Illinois at Chicago and her MFA in printmaking at the Minneapolis College of Art and Design. Currently, she is an artist and educator who resides in the Portland Oregon area. She currently teaches a variety of classes at Portland Community College and is mom to a five-year-old named Gus. Her favorite mediums are all forms of printmaking, carving, and painting in gouache and acrylic. Her favorite dessert is cupcakes. Since the beginning, symbolism has been a prominent theme in my work. Images such as trees, women, animals, and religious icons communicate ideas about cultural power and powerlessness, spiritualism, mortality, and rebirth. I enjoy playing with opposing elements such as light and dark, reason and folly, or good and evil, and the interdependence of each to define the other. With iconic etchings, relief prints, collagraphs and paintings, I create an illustrative approach to communicate at a deeper level and to engage people in a larger narrative beyond the image. Printmaking is my main medium, and I tend towards the practices of both relief and intaglio printmaking. Both processes allow me to produce graphic images with different emphases, one vibrant in layered color, and the other rich with velvety blacks. I enjoy the tactile quality of making prints as well, and find that the physical nature of the process creates an extra layer of definition and meaning in each print.
Check Sun March 3rd for a full catalog of art online here.
Christopher Michael Creath, Christopher Kelleher, Matt Schlosky, Nathan Turner art show at Goodfoot Gallery
current show is there now.
Facebook event here
The goodfoot
2845 SE Stark
Goodfoot on facebook http://on.fb.me/JupSf9
Christopher Michael Creath, Christopher Kelleher, Matt Schlosky, Nathan Turner art show at Goodfoot Gallery
open daily 5-2:30
upcoming art events
Every Sun Drink & Draw - at the Goodfoot


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nuccxoFollow nuccxo
27-year-old Female living in Centereach, New York USA
Hey my name is Nicole, I am 22 years old. This June will be my first Contiki tour and trip overseas. I am super excited for!! I'd love to meet more of my travel buddies for this trip so let me know! June 4th 2011..London + Paris w/ extension
Level 1 Traveler
1 tour
3 countries
Following 0 people
Followed by 0 people


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Search Catalogue
Ursula Mamlokb. 1923
early musical studies in Berlin * emigrated to Ecuador in 1939 * in the same year received a grant for the Mannes School of Music in New York * studied composition with Roger Sessions, Stefan Wolpe and Ralph Shapey * personal use of Schönberg's 12-tone-method, with complex rhythms and varying sound-colours * teached composition at New York University, Temple University and Manhattan School of Music * composed c75 works: solo pieces, chamber and orchestral music * received numerous awards * since 2006 resides in her birth town Berlin again
Selected works by Ursula Mamlok:
Concerto for oboe and chamber orchestra (2003)
Grasshoppers – 6 Humoresques for large orchestra (1957)
Cantata (Psalm I) for voices and piano/organ (1958)
Wind Quintet (1956)
Please also visit Ursula Mamlok's homepage at www.ursulamamlok.com.
Mailing List
Sign up for news updates and offers via emailSIGN UP
Shop for Mamlok
Sheet Music, CDs, downloadsSHOP NOW
Explore our library of 1500 online scoresVIEW SCORES


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Mine is Already Over by Red.
"We're colored people and they call us the human race."
-Toby McKeehan
"There's something deep inside that keeps my faith alive."
-John Cooper
"Tell me it's over I'll still love you the same."
"Anything not saved will be lost."
-My quit screen
I feel like I'm going to Vurp.
Misha had long hair?


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Gov. John Hickenlooper says Visa Inc. plans to expand its Global Technology Center in Douglas County, creating hundreds of new jobs.
The Denver Post reports Visa could receive nearly $5.7 million under Colorado's job growth incentive tax credit for creating up to 406 new, high-paying IT, financial, and client support jobs over the next five years.
Visa anticipates leasing 66,000 square feet of new space and making a $9 million capital investment to accommodate the new hires.
The company reported it had about 8,500 employees worldwide as of September. State officials say that includes 700 people in Colorado.
KKTV firmly believes in freedom of speech for all and we are happy to provide this forum for the community to share opinions and facts. We ask that commenters keep it clean, keep it truthful, stay on topic and be responsible. Comments left here do not necessarily represent the viewpoint of KKTV 11 News.
If you believe that any of the comments on our site are inappropriate or offensive, please tell us by clicking "Report Abuse" and answering the questions that follow. We will review any reported comments promptly.powered by Disqus
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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Sound Four
this wiki
|This is the article on the group of shinobi from Otogakure. If you are looking for the article on the chapter of the manga, head to The Oto Four.
|Sound Four [1]
Sound Four (音隠れの忍四人衆, Otogakure no Shinobi Yonin Shū, Literally meaning: Hidden Sound Shinobi Four People)
|Volume #13, Naruto Chapter #115
|Naruto Episode #68
|Naruto: Ultimate Ninja 2
|Naruto x UT
|Appears in
|Anime, Manga, Game
|Team Info
The Sound Four were Orochimaru's elite bodyguards. (Sakon and Ukon were counted as one entity, due to their kekkei genkai). Each was given a cursed seal by Orochimaru. Kimimaro was also a part of the group for a short time, since he was stronger than all four combined, thus renaming the group to Sound Five. However, an unexpected illness prevented him from participating normally. All five repeatedly referred to their opponents as "trash".
When Orochimaru sent the Sound Four to bring him Sasuke Uchiha, they were all systematically killed by Konoha and Suna ninja. Jirōbō was killed by Chōji, and Kidōmaru was killed by Neji, though the Konoha ninja suffered heavy injuries. Ukon almost killed Kiba, and Tayuya almost killed Shikamaru, but both were stopped and killed by Kankurō and Temari respectively. Kimimaro, after being sent as back-up, almost defeated Rock Lee and Gaara, but died from his illness during the battle.
Sometime before the Fourth Shinobi World War, Kabuto Yakushi took Sakon's Attack of the Twin Demons ability, in which he further used to absorb the abilities of the entire Sound Five, allowing him to use all of their skills against Sasuke and Itachi.
Despite being young, all four of them are strong enough to become Orochimaru's bodyguards, and were all talented with barrier and sealing techniques. Shortly after their introduction during the invasion of Konoha, they used Four Violet Flames Battle Encampment to create a box-like barrier, that causes anything that touches it to burst into flames. When the group later fetched Sasuke, they used the Four Black Fog Battle Formation and Dark Sealing Method to protect Sasuke from harm. As the group later rested, they set up a Barrier Encampment Method. Each member of the Sound Four also had a cardinal direction associated with them; this was probably a reference to their positions when performing techniques as a group: Jirōbō of the South, Kidōmaru of the East, Sakon and Ukon of the West, and Tayuya of the North.[3]
- The recurring symbol on the Sound Four's tunics was the yin-yang, though the yin (black) was missing. The missing yin represented imbalance, alluding to their evil natures and to that of the seals, preventing harmony in life.
- Jirōbō and Sakon (and Ukon) specialised in close-quarter combat, while Kidōmaru and Tayuya specialised in long range combat. Kimimaro was balanced in both types.
- Each member of the Sound Four tends to have a flaw in their personality that slows down the team: Jirōbō gets hungry and stays behind to feed, Kidōmaru tends to play around with his opponents if they interest him, Sakon can easily lose his temper and showcases the fact that he is the strongest of the four by not stopping until his opponents is dead, and Tayuya has a "doesn't want-to-lose" mentality.[4]
- Kidōmaru was the only member to wear an Oto forehead protector.
- The Sound Four were playable characters in Naruto: Gekitō Ninja Taisen! 4, but they only appeared with the Second Stage of the Cursed Seal. Later, the Sound Four were playable characters in the Naruto: Ultimate Ninja 3, 4 and 5 with both regular and Cursed Seal forms playable.


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SCAP Neoprene Skull Cap
The SCAP Neoprene Skull Cap is the ultimate cap for all your underwater expeditions. Made from 1.5 mm. neoprene rubber, the SCAP cap helps to control wet and wild hair and protects your head from the cold. The SCAP cap is designed with a grip zone that holds your hair back and away from your eyes, ensuring that your vision does not get hampered for a hassle-free swim. By trapping a little amount of water and allowing your body to naturally warm it, this cap keeps your head comfortable. An interesting feature of the SCAP cap is that it combines the tie back method, the design of a skull-cap, and bright colors and patterns, making you look stylish as you enjoy the water. Get ready to dive into the pool, armed with your SCAP Neoprene Skull Cap.


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The Division of Hospital Medicine is seeking full-time faculty to join our group. Responsibilities include inpatient management, medical consultation, teaching residents/students, and participating in quality improvement projects. Our Hospital Medicine Division offers an exciting and innovative team culture, nurse practitioner support, and a rich clinical environment. Salary and benefits are competitive.
BC/BE candidates should send curriculum vitae with a letter of interest to:
Physician Recruitment Coordinator
Albany Medical Center, MC 47
47 New Scotland Ave, Albany, NY 12208
email email@example.com
(518) 262-1333
Fax (518) 262-6996


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The 20th Acea Maratona di Roma has already achieved the first objective: 100,000 euro of funds raised through the " Charity Program ".
Since the first edition of the Rome Marathon , dozens of Italian non-profit organization committed themselves to raise funds by subscriptions to RomaFun 5K . Since last year the associations participating in the " Charity Program " have done with the marathon . Runners who have decided to support one of the charities , activate a fundraising , and reached a minimum established by the association, receive a bib. On retedeldono.it , the portal fund-raising partner of Acea Maratona di Roma , and maratonadiroma.it can occur in real-time donations.
Donations to date have reached € 70,000 , to which must be added the 40,000 Rotary International - District 2080 that carries out the project " Run for Polio 2014" for a total of 110,000 Euros . Rotarians have 130 registered runners in the marathon (25 women ), including 96 Italians , 23 Germans, French 8 , an Australian , a Slovak and English, as well as a handbiker , Tonino Boccadamo , and have booked 300 coupon for RomaFun of 5 k


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Joseph DiLeo
this wiki
Joseph "Joe Tuna" DiLeo (1981-2008) is an Enforcer to the Pegorino Family led by Jimmy Pegorino. He is 27 years old and his nickname is 'Tuna'. Luca Silvestri is a Soldier and close friend to Joe DiLeo. He is a waste collector for the bag of diamonds.
Dileo, along with the other members of his sub-crew (Luca Silvestri and Johnny Barbosa), were introduced in the GTAIV mission Taking in the Trash in which Ray sends Niko to assist them in picking up the Diamonds that Johnny Klebitz left in two Algonquin trashbags in the TLAD mission Diamonds in the Rough (which took place at the same time as the TBOGT mission Frosting on the Cake). The foursome were ambushed by unidentified attackers (potentially Gay Tony associates), but escaped. After escaping, Dileo along with the other members betrayed Boccino and Bellic by taking the money for themselves; but Niko killed them and reclaimed the Diamonds for Ray.
Mission Appearances
- Taking in the Trash
- Meltdown (Betrayal/Killed by Niko Bellic)
- After his "death" in Meltdown, his profile on the police database is not listed as deceased, but Luca and Johnny Barbosa are listed as deceased.
- In the mission Meltdown, he calls Niko a "cabbage eating prick", which is an ethnic slur for Eastern Europeans.
LCPD Database information
Surname: DiLeo
First Name: Joseph "Joe Tuna"
Age: 27
Place of Birth: Alderney City, Alderney
Affiliations: Pegorino Crime Syndicate
Criminal Record:
- 1998 - Grand Theft Auto
- 2001 - Promoting Gambling
- 2004 - Armed Robbery
- Alderney-based Italian American hood.
- Involved in small time criminal activities.
- Believed to be trying to work his way up through the Pegorino crime family.
- Works for Ray Boccino and often seen with Luca Silvestri and Johnny "Spaz" Barbosa.


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Get funky this Halloween with our Child Red Michael Jackson Military Jacket Costume. This rock star outfit includes an officially licensed red military style coat with gold screen printed designs. The jacket mimics a double breasted Navy style with long sleeves and twisting decorations. Michael Jackson isn't named the king of pop for no reason. This singer and entertainer defined the music of a generation. The young and old alike love his music and will be sure to recognize one of his most famous performance outfits. MJ's signature military coat look can be enhanced with a few more trademark accessories. A gold sequin glove, black pants, afro wig, aviator sunglasses, and fedora hat can make your little diva go from zero to rock hero in no time flat! Take the stage in style this Halloween with our boy's Michael Jackson costume.
Our Price: $4.99
Our Price: $29.99
Our Price: $3.99


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WASHINGTON (AP) -- The price tag for safeguarding government secrets rose by 12 percent in 2011 to a record $11.4 billion.
The year-to-year estimate covers 41 executive branch agencies, but it excludes money spent by the CIA and five other intelligence agencies, where the amounts of money used to protect secrets are substantial but classified.
In a report to President Barack Obama, the Information Security Oversight Office said the amount spent on protecting secrets has grown more than four-fold since 1995, when it stood at $2.7 billion. A decade ago, the amount spent was $5.7 billion, half of last year's figure.
The oversight office provided no explanation for last year's substantial increase in costs.
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May 6, 2016
Atlanta, Georgia-June 26,2012
A federal agency says it has the legal authority to give Georgia more water from a disputed reservoir, though it has not made a final decision on how much to release.
The U.S. Army Corps of Engineers said in documents released Tuesday that it has the legal ability to give metro Atlanta communities access to 705 million gallons of water per day from Lake Lanier on the Chattahoochee River to meet needs through 2030.
That reservoir is the focus of a long-running legal dispute between Alabama, Florida and Georgia.
In 2009, a federal judge ruled that metro Atlanta had little right to Lake Lanier and threatened to significantly curtail water withdrawals.
But the 11th U.S. Circuit Court of Appeals tossed aside that decision.
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text: You can get yourself on the Nice List this holiday season when you dress your little one up as one of Santa's little helpers! With this Child Unisex Elf Costume, it'll be easy to spread a little holiday cheer this Halloween or Christmas. This ensemble includes a red shirt that looks like a jacket with gold buttons, a brown belt with a gold buckle, and a green collar and sleeve cuffs. The matching green pants are hemmed with red. The cute green and red hat is pointed and has a golden bead on the very tip. Add on some pointed shoes or some pointed ears from our big selection of accessories and you might actually believe that your child works in with Santa in his toy workshop!


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Abbey Smith was honored with the 2011 Outstanding Major in Journalism Award during Honors Day May 17 at North Central College.
Smith is a graduating senior majoring in print journalism and international relations and has been accepted to work with AmeriCorps in Wisconsin after graduation and will be tutoring low-achieving students. She is a graduate of Dodgeville High School.


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Stakeholders in biofuels development in Tanzania have urged the government to speed up formulation of a sound policy and legal mechanism to foster investment in biofuels.
This was said recently in Dar es Salaam by a stakeholder identified as Jansen Shuma when explaining challenges and development of the sector.
He said in different areas where such investments have taken place, the people have already started experiencing environmental, economic and social effects due to inappropriate coordination of biofuels activities between relevant government departments, the investing firms and the absence of a policy to govern biofuel activities.
"Lack of national policy on biofuels development remains a major obstacle towards the realization of the huge potential of biofuel in the country, "he said.
Shuma who is renewable energy expert from Tanzania Tradition energy organization (TaTedo) noted that late last year the Ministry of Energy and Minerals and the Infosys of the Netherlands organised a key stakeholders meeting to develop biofuels policy.
The meeting brought together representatives from the government sectorial ministries, Civil Society Organisation (CSOs) and Academic Institutions.
Specifically, members involved in the workshop came from the Ministry of Agriculture and Food Security, the Ministry of Energy and Minerals, the Ministry of Natural Resources and Tourism, Vice President Office (Department of Environment), Haki Ardhi, TaTEDO, Land Use Planning Dept., Sokoine University of Agriculture, University of Dar es Salaam.
The objective was to put in place a policy to support and regulate the development of a sustainable biofuel industry in Tanzania.
According to him specific objectives were to discuss pillars of the proposed biofuel policy, improve the policy formulations provided in the previous stakeholder meetings, recommend for possible policy objectives and processes which will develop the biofuel industry in Tanzania.
It was reported from the workshop that stakeholders found it difficult to operate in an environment where they were uncertain of the legal framework.
Although seven companies have invested in cultivation of biofuel plants such as jatropha, sugarcane, croton and palm oil, this happened when there guidelines on the investment.
The companies include Agro-Eco-Energy Tanzania ltd, Prokon, Africa Bioenergy, Felisa, Sun Biofuels, Diligent and Kakute.
He said many lessons were learnt through the workshop on biofuel policy in Tanzania, and are concerned with the future of the industry in Tanzania.
He pointed out many policy makers see the development of the bioofuel sector as involving mainly foreign investors.
He said serious efforts were needed to promote local initiatives and investors in the industry, saying this included developing internal market for the biofuel products rather than depending on biofuel investors and markets abroad.


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U.S. Air Force Airman 1st Class Adam L. Brewer and Airman Eric J. Elsenbroek recently graduated from basic military training at Lackland Air Force Base in San Antonio.
They completed eight weeks of training in military discipline, values, physical fitness, and basic warfare.
Brewer is the son of Laura and Dave Brewer of Crestwood and a 2003 graduate of South Oldham High School. Elsenbroek is the son of Eric C. Elsenbroek of Crestwood and a 2006 graduate of Buckner High School.
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Sarah replies:
My girlfriend has been on birth control for a while and recently switched to a new brand. We've been sexually active but I always withdraw, and now she is a week late. Is that a side effect of the new pills or what?
Your partner might be experiencing lateness due to the new brand of pills. More than being just brand names, the different pills have different formulations. So it is possible, especially if it was a major change, that her body is adjusting to the new formulation. However, a withdrawl bleed that's a week late is a bit more than one would probably expect from just a pill change (especially if she has been on the new brand for more than one cycle). At this point, she could take a pregnancy test and expect an accurate result. There are also other things that can cause a bleed to be late. You can find more information about that here: M.I.A or, Dude, Where's My Period?.
Information on this site is provided for educational purposes. It is not meant to and cannot substitute for advice or care provided by an in-person medical professional. The information contained herein is not meant to be used to diagnose or treat a health problem or disease, or for prescribing any medication. You should always consult your own healthcare provider if you have a health problem or medical condition.


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With each year that passes, technology shifts, new trends emerge, and outdated techniques fade away. Now that 2014 is here, let's take a look back at the year we left behind. What were the connector trends in 2013? What changes were made in the connectors industry that will continue to evolve as we head into 2014? Let's take a look.
First, we're seeing an overall improvement in the efficiency of connectors. In order to meet specific requirements for various applications, connectors have become smaller, and lighter, and they are able to operate at higher speeds. Many products were upgraded rather than replaced, so we didn't see many new connector families introduced.
Designers stretched the perceived limits of copper, upgrading high-speed copper I/O and backplane interconnects. We can expect more innovation with this material in the future. Meanwhile, optical alternatives to copper interconnects have been dropping in price and are expected to continue to drop on into 2014.
Other design engineers have been focused on power and the heat that results from power. Using high-conductivity materials and optimized contact geometries, the connectors used in high-current applications are really increasing their power ratings. However, to combat the resulting heat, we're seeing minimized connector profiles and open housings that allow air to circulate.
With the popularity of sleek cell phones and tablets, we're seeing much smaller I/O interconnects. With the little space that's available on these products, you will usually find a micro-USB, a 3.5mm headphone jack, or Apple's lightning connector. In the future, we can expect wireless technologies to further impact I/O panel space.
These connector trends of 2013 are just a few of the many ways we've seen connectors shift and reinvent themselves this past year. Advances in robotics, military and avionics applications, and automobiles have further influenced the industry. Looking ahead to 2014, we anticipate further innovation, as always, so that the electronic connector industry can shift with the rapid demands of the technological markets we serve.


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After I've done my rough sketch, I use an art pen to make the actual map. It's meant to be a pretty map not at all very accurate in terms of place names. ("Cleghorn" was looking for land features more than where nations had their current borders because the world traveller knows those borders don't last forever!)
After I'm satisfied with my map (keep white out handy!) I scan it. I then copy and paste the map portion sans border and banner back onto my blank template (as seen above). Attached is the map once it's been scanned onto the template.
Note I've left blank area's in some of the jungle areas. The reason for this is will be addressed in the next section.


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Roll Control System is the Complete Accessory System for Diving, Fishing and Boating it starts with a Track System that enables you to mount either and Aluminum, PVC or Molded Plastic Track to your boat gunnels, vans, and truck bedsor personnel watercraft. Once you have the basic track you can then mount any ofthe many brackets available to hold Scuba Cylinders, Fishing Rods, Rope Cleats and much more.
These heavy-duty, one-piece injection-molded rod holders lock into mounted aluminum or molded tracks and provide multiple rod holders for trolling or convenient onboard storage. Fishing Rod Holders come in Straight, 30° port or 30° starboard angles available.
This product has a limited warranty of 12 months.


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this wiki
Statistics are used in 3D Universe games to indicate progression in certain areas, or to enumerate certain activities -- for example, a "Longest wheelie" statistic will measure how long a player has sustained a wheelie on a motorcycle; "Packages collected" counts how many Hidden Packages a player has acquired; "Hospital visits" counts how many times a player has been Wasted on their current playthrough, etc.
Many of these statistics are also present in older GTA games, but they are not detailed here.
HUD Stats
Rather than recording progress or activities, these statistics are displayed onscreen during gameplay in the Heads Up Display (HUD), to give the player a greater awareness of the protagonist's condition and situation.
- Health - When the player's health is depleted, they are Wasted, which results in mission failure [if the player is doing a mission at time of death], and the player being sent to hospital to be revived. Health can be regained by eating food, saving, or picking up a health "power-up" or first-aid kit. Entering an Ambulance will also restore a small amount of health.
- Armor - Armor counts as an extra "layer" of health; it can be acquired via an Armor pickup, purchased at an Ammu-Nation store, or, in some games, acquired by entering the Police Enforcer. The exact abilities of Armor vary from game to game -- generally, Armor will absorb all gunfire and explosive damage until it is entirely depleted; damage from falls and vehicle impacts may deplete Armor, or may leave Armor intact and deplete Health. In Vice City, shotgun attacks can reduce health as well as depleting armor.
- Wanted Level - The Wanted Level indicates the level of police interest in the player. If the player commits serious crimes (and the police are aware of them), it will indicate the extent of the crimes, and how much force Police will employ in capturing (or killing) the player. If the police catch the player, they will be Busted.
GTA SA Statistics
GTA San Andreas has a number of additional statistics, viewable either by holding the 'status' button or key, or via the Main Menu. These reflect CJ's physique, physical abilities and expertise; unlike in other GTA games, these change according to the player's actions.
This statistic measures Carl Johnson's body fat. Fat is increased by eating food (including meals during dates), and decreased by exercising, either at a gym or in the world at large, or by not eating for an extended period. Being overweight will naturally change CJ's appearance, dialogue (mostly related to his weight) and eventually lessens most physical capabilities (including health, running speed, jumping, etc.). Having no fat at all is inadvisable, because CJ will instead start to lose muscle if he grows hungry. If he has no muscle to shed, he will then start to lose health.
- Food is available at Well Stacked Pizza Co., Cluckin' Bell, and Burger Shot, and their meals will add either 0, 1, 2, or 3% to CJ's Fat level. Eating 12 meals at these restaurants in one visit will make CJ vomit and not gain any fat.
- For every 150 seconds of running, or every 100 seconds of biking or swimming, CJ will shed 1.5% fat. At a gym, this is much faster - on the treadmill or stationary bike, CJ will shed 2.5% fat every 14 seconds. When lifting weights, CJ will shed 0.5% fat for each repetition. Also, if the player waits 48 ingame hours without eating, CJ will shed fat at a rate of 2.5% per in-game hour.
This measures CJ's muscular development. Muscle influences how much damage CJ deals in melee combat, as well as the respect and sex appeal stats. It also slightly reduces the amount of damage taken from falls. Muscle is increased by working out at a gym, or otherwise exercising (running, riding bikes, swimming). A 100% muscle statistic is detrimental to Sex appeal and will prevent CJ from initiating contact with some girlfriends.
- Using the treadmill or stationary bike at a gym for 14 seconds will gain 1% muscle. Lifting weights will gain 1% muscle for each repetition. 150 seconds of running in-game, or 100 seconds of swimming or biking, will cause CJ to gain 1% muscle.
Respect indicates CJ's level of influence in the Grove Street Families. The more respect CJ has, the more gang members he can recruit, starting with 1 and up to a maximum of 7. Respect is gained upon completing some missions, killing members of enemy gangs or law enforcement, successfully taking over enemy gang territory and spraying over Tags. It is also influenced by CJ's appearance; hairstyle, tattoos, clothing and muscle all offer a small increase to respect. However, wearing green clothes in GSF territory gives a more significant boost. Respect is lost by not wearing green in GSF territory, killing friendly gang members and losing territory to enemy gangs.
Sex Appeal
This statistic indicates how girls will react to CJ. It is influenced by CJ's Vehicle, hairstyle, clothing, tattoos, fat and muscle. Collecting all 50 Oysters can prevent some of the pitfalls of low sex appeal (girlfriends being dissatisfied with CJ's appearance, or potential girlfriends not wanting to talk to CJ). In general, more expensive items offer a more significant increase in sex appeal, especially clothing. Lowriders and sports cars give the greatest boosts to this statistic; any vehicle still provides its increase after Carl exits, as long as he stays within a certain distance of it.
The Stamina statistic indicates endurance with regards to running, swimming, and cycling. Low stamina means CJ will grow fatigued easily and stop sprinting after short distances. Stamina has to be built up over the course of the entire game by exercising. In GTA: Vice City Stories, a stamina bar also exists whenever the player is in the water. If it runs out, the player will drown.
- For every 150 seconds of swimming, or every 300 seconds for running or biking, CJ will gain 5% Stamina. At the Gyms, the treadmill and stationary bike will grant CJ 4% Stamina for every 14 seconds. Completing the Burglar side mission (stealing a total of $10,000 worth of items) will reward the player with infinite stamina, independent of the actual statistic.
Lung Capacity
The Lung Capacity statistic represents how long CJ can hold his breath when diving underwater. An oxygen meter is displayed whenever CJ dives underwater. Lung capacity is increased by swimming underwater for extended periods, and by collecting Oysters. If the player stays underwater long enough for the oxygen meter to deplete, CJ will start rapidly losing health until he either drowns or comes up for air. After coming up for air CJ will not regain lost health if this happens, only oxygen.
Vehicle Skill
In GTA San Andreas, CJ's ability to use different types of vehicles gradually increases based on distance covered. There are seperate skills for automobiles, bicycles, motorbikes and aircraft. Becoming more skilled makes vehicles more responsive, allowing the player to turn more sharply and handle more easily. It also allows CJ to perform higher bunny hops and reduces his chance of being knocked off a bicycle or motorbike by collisions.
Weapon Skill
CJ can become more skilled with various weapons by successfully shooting NPC's or vehicles. Most individual weapons have their own seperate skill to build up, but the Tec-9 and Micro Uzi are grouped together as "Machine Pistols". CJ's skill with each weapon begins as "Poor", then can increase to "Gangster" level, and finally "Hitman" level at maximum. Becoming more skilled improves CJ's accuracy, targeting range, strafe speed, rate of fire (in the case of shotguns), and allows him to move while firing. Additionally, reaching Hitman level with the Pistol, Sawn-Off Shotgun, Tec-9 and Micro Uzi allows CJ to wield two at once. Thrown weapons such as Grenades, melee weapons, Rifles and heavy weapons like the Minigun and Rocket Launcher do not have skill meters.
GTA V Statistics
Player stats are confirmed to appear in GTA V. The stats will include Stamina, Shooting, Strength, Stealth, Flying, Driving, Mechanic, Lung Capacity, and Special. These stats will be different for each protagonists.
- There are cheats for maximum respect, sex appeal, muscle and fat, and for zero fat and muscle. There is also a cheat that allows CJ to remain underwater indefinitely, but does not actually increase lung capacity.
- Gaining weight does not just affect CJ's appearance, it also affects his health, running speed, and sex appeal. CJ's phrases will also change as he hits people or picks up money such as 'I'm just a fat bitch, huh?' or 'Lunch money!'
- When CJ's body fat is at its maximum, you are warned that he runs the risk of a heart attack and to lose some weight, although it is actually not possible for CJ to suffer one through any conventional means.
- Losing or gaining muscle or weight can affect what girlfriends think of you. For example, if CJ gains some weight when he goes to see a girlfriend a cutscene may start depicting CJ's girlfriend making a joke or remark about CJ's weight or muscle, however some girlfriends may like CJ to be fat.
- In GTA San Andreas, when you reach weapon skill Hitman, you receive a pair of Pistols to dual wield, a nod to the Movie and game series Hitman because the main character wields two pistols


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Albert Durer
Kessinger Publishing, Jun 1, 2004 - Biography & Autobiography - 248 pages
Who was Duerer? He has told us himself very simply, and more fully than men of his type generally do; for he was not, like Montaigne, one whose chief study was himself. Yet, though he has done this, it is not easy for us to fully understand him. It is perhaps impossible to place oneself in the centre of that horizon which was of necessity his and belonged to his day, a vast circle from which men could no more escape than we from ours; this cage of iron ignorance in which every human soul is trapped, and to widen and enlarge which every heroic soul lives and dies.
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What is RM Cash
"Customer service is priority #1 at Rocky Mountain ATV/MC. We value our customers and strive to be the best shopping experience- when you buy from us, you are buying lifetime service."
-Dan Thomas, CEO and Founder
We take pride in offering no hassle returns. In the event of a return, please call, email or chat with us to receive a solution to the problem. For apparel that doesn't fit quite right, Click here to see our Fit Guaranteed Program.
We will stand behind all products we sell with regards to manufacturing defects in workmanship and material. Most products are limited to the manufacturer's warranty. However, we will do everything in our power to take care of the problem.
When selecting new motorcycle tires, be sure they meet the requirements of your motorcycle and its expected usage. Please use our vehicle drop down selector at the top of this page to assist you in choosing a tire for your vehicle. Always refer to your owner's manual for correct tire specifications for your vehicle.
|Tire Construction
|Load Rating
|55 (481 lbs.)
|Speed Rating
|W (168 mph)
|Max PSI
|Load Range
|Tread Plies
|2 Nylon 2 Aramid
|Sidewall Plies
|2 Nylon
|8.9 lbs.
|Rim Size
|Tube / Tubeless
Inspect and check tire pressure often. This is the most important tire-maintenance function you can perform. Refer to your machine's documentation for proper maintenance. Always give tires a gentle "run-in" period of 100 miles to get the feel of new tires--this means they should not be subjected to maximum power, abrupt lean-over, hard cornering, etc. Always match the front and rear tires for optimal handling, safety and performance. Mixing radials, or mixing radials with bias or belted-bias tires, may adversely affect handling and stability.
The charts and information on this page do not imply interchangeability. Consult your machine's manual to determine correct replacements, clearances, compatibility and stability, load-bearing capacity, speed rating, radial vs. non-radial, pattern and tread compound requirements, inflation recommendations and front-to-rear tire matching. Wrong selection can result in tire failure or loss of control with serious injury or death.
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Comments On Jan 09, 2014:if you looking for a tire that can cross street track and wet weather this tyre is the one thing that will do it all
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Comments On Oct 29, 2013:All I can saw about all the Q3 is they are better in every way that matters. . They tip in very well and feel better then Q2 while leaned over at speed.
Additional Comments On Oct 29, 2013:This tire has server me well for many years. Now its time to move to the Q3.
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Comments On Jun 22, 2013:These tires performed incredibly well during the early part of their lives. Now, the front is showing strange wear that looks like cupping near grooves. Tires were balanced and checked again recently, and balance is on. Never saw this on any Avon Azzaro's previously. Won't buy Dunlops again. Just bought a set of Michelin Road 2's.
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Comments On Jun 18, 2013:Great front tyre excellent grip. I run a Q2 front and Roadsmart rear works great, i wear out 2 rears to 1 front. Great i love it.
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Comments On Nov 22, 2012:Had the sportmax Gp Racer tyre before these and the Q2's have not let me down excellent through corners and great for australian conditions.
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Comments On Jul 11, 2012:I use the Dunlop Q2's for canyon riding and they hold up very well, great feel through the front end and the rear grabs like no tommorow for apex acceleration, i would recomend these.
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Comments On Jul 06, 2012:Like everyone else, I feel that you can't beat the q2 based on price and performance... I am on my 3rd set and will stick with them until I can find a better deal or price
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Comments On Dec 01, 2011:Great turn in, sticks like glue and last a long time for a true sport tire.
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Comments On May 12, 2010:GOOD TRACTION
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Welcome to Tuttle Chiropractic!
Looking for a great Chiropractor in Peoria? You've come to the right place. We are experts in the treatment of back pain, disc herniations, neck pain, headaches, migraines, whiplash, sciatica, arthritic joint problems, spinal stenosis, pregnancy pain and pediatric spinal issues.
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We welcome you as a patient and appreciate the opportunity to provide you with quality personalized chiropractic care. Our staff is dedicated to offering quality health care services for you and your family. We strive to deliver competent, courteous, convenient and cost- effective care that gets results. We accept most insurance plans.