text:
Were there human offspring of fallen angels?
As we recall from Untold Garden of Eden, there could have been angels
who fell just around the time of Adam. The reason: envy and jealousy.
These angels were to bow down to Adam, and serve under him. Some
groups wanted no part of that. Satan, I believe, was among one group of
these fallen angels. From the research, two or three distinct groups of fallen
angels seem to come up in ancient literature, again and again.
First, we have Satan and his group of strictly non-corporeal angels (i.e. the
"sons of heaven"), who probably fell around the time of Adam.(1) Second,
we have the group of angels known as the Nephilim (i.e. "strangers"), who
also fell around this time.(2) Their physical make up, however, seemed to
be a lot closer to human beings. Upon their fall, and unlike Satan and his
fallen brigade, these Nephilim were much more able to take on human
form. Their punishment was to live on earth like anyone else, be subjected
under Adam's authority, and serve him in the workings of the Garden.(3)
The third and final group of angelic beings would fall later on, a few form,
and would fall in much the same way the Nephilim did.(4)
After the fall of Adam and Eve, the Nephilim were no longer subjective to
Adam's authority. The serpent, of whom had many names (e.g. Nachash,
Azazel, or Amalek), could have worked to further seduce Eve, as well as
other women of the day, to produce more offspring. The Nephilim could
have also picked up on this, and began to mate with women themselves.
Eventually, these offspring would form into individual groups (or nations) of
Cain, another mixed offspring, began to have family of his own. Beyond
Cain, beyond these other offspring of the serpent, there could have even
been groups of people around, known as the Chay (beasts) of the Field,
The Owph (fowl) of the Air, the Remes (creeping thing) that Creepeth, and
Bahemah see "Birds" and "Beasts").
These groups of people lost their roles they might have had in the Garden
after the fall. All of them, along with other Adamites, could have begun to
follow their own paths in this world. This allowed a number of individuals
the opportunity to associate with these fallen angels.
Although, in the end, there is nothing wrong with groups of people coming
together and having children, but mixing with these fallen angels would pose
a problem for their descendants.
The Nephilim were endowed by God with a great deal of previously
unheard-of knowledge: herbalism, divination, and astrology, to name a few.
They used this knowledge to seduce women into fulfilling their earthly,
sexual desires.(6) Many women of the day began to be seduced by the
overwhelming stature, charm, and knowledge of these Nephilim, and
bartered their bodies for it. Many offspring born through these cohabitations
became known as the biblical "giants."(7)
The descendants of Cain (the Cainites) began to mingle with other groups
of people, as well. What began a fairly simple and orderly world was now
becoming a lot more complex. The Nephilim used their power and
knowledge to increase their position over the populous, which, in turn,
allowed everyone to become very sinful in their ways.
Approximately 500 years after the creation of Adam, the Nephilim were
producing hybrid offspring on a grand scale:
First, they were called Nefilim, the fallen, at the time they were dropped
down from heaven. After they joined up with the females of human
kind and had children from them, the children were called Anakim.(8)
The Zohar:
40 Shlach Lecha 10
This was echoed in Genesis:
Genesis (KJV)
6:1 And it came to pass, when man began to multiply on the face of
the earth, and daughters were born unto them,
6:4 There were giants (Nephilim) on the earth in those days...
Intermingled in these confusing verses of Genesis we could have reference
to another group of individuals - bent on the same outcome as the Nephilim.
The Nephilim fell because they were jealous of Adam, around the time of
Eden, and wanted to bring him down. Almost 500 years after this
happened, still another group of angels - the Watchers - began to crumble
in their morality. The Watchers (also mentioned in Daniel 4:13 and 17) were
another group of large angels who were, apparently, unscathed by the fall of
Adam. These angels, however, were soon to succumb to the same fate as
the Nephilim.
The Watchers (a.k.a. "Sleepless Angels," "Sons of God") were assigned to
"watch" over mankind: instruct them in good or wholesome ways of living.
(9) They had the tasks of overseeing and assisting human beings in many of
worldly decisions and tasks. They eventually began to notice how sinful
mankind had become, because of the moral departures fueled by the
Nephilim. These angels also began to complain to God:
And God said unto them... "I created him (Adam) out of the dust... and I
will not make my handiwork a laughingstock for his enemies." And those
angels said... "knowest that we have reviled Adam." And God answered
them on behalf of Adam... "You have I created out of fire and air with the
one intent (that ye should) praise (Me). Him have I created of twice as
many elements as you - of dust and water, and of wind and fire... And if
his heart inciteth him to good, he walketh with good intent; and if the
devil seduceth him, he walketh with him on an evil path. As for you, ye
have no other object in your minds but praise of Me... And now, why do
ye magnify yourselves above Adam? If ye were as he is... ye would have
transgressed My commandment more than he hath done..." And the
angels said unto Him... "we will not oppose Thy word; for we are
spiritual beings for life, and he is a creature of dust (doomed) to folly..."
And straightway there were given unto them... flesh, and blood, and a
heart of the children of men.(10)
Kerba Nagast,
Concerning the Angels
Apparently, the Watchers wanted to prove something to God. They
thought, with their superior intellect they would not have the weakness and
ignorance to do anything like their angelic predecessors. Even though they
descended to the earth a good number of times, and taught people upright
and worthy sentiments, they could not understand how worldly temptation
might change anyone under it. When God did allow them to descend, they
didn't fair much better.
That brings us to the second part of Genesis Six, which can be a most
confusing verse without the above information. If we include the above
information, it makes much more sense:
Genesis (KJV)
6:2 That the sons of God (the Watchers) saw the daughters of men
that they were fair, and took them wives of all they chose.
6:4 There were giants (the Nephilim's offspring) in the earth in those
days (of the Watcher's descent); and also after that (after the time of their
descent), when the sons of God (the Watchers) came into the
daughters of men, and they bare children to them, the same
(children of the Watchers) became the mighty men which were
of old (or, from these angels who were of old), men of renown (or, men
who "made a name for themselves").
Even the Watchers blew it! Instead of showing God that they could handle
this brave new world, they fell - just like the Nephilim. This is probably one
reason why they were lumped together with the Nephilim in this verse.
They fell to these same temptations, and also had mixed offspring. They
also provided their women with a good deal more of tidbits of their
forbidden knowledge. Immorality was everywhere, thanks to the
sacrilegious and indecent behaviors of all these fallen angels.
The descendants of the Nephilim and Watchers, as stated, were known as
"giants" or "mighty men" because there were indeed thus. The hybrid
offspring of the Nephilim were up to nine feet tall, those of the Watchers
twelve to fourteen.(11) These human-angelic unions produced other strange
and, ultimately, compromising genetic possibilities. Among them, offspring
who had a brilliant, "angelic-like" countenance, as well as six fingers and
Along with physical attributes, there were mental attributes which seemed to
have been passed down. As we recall from Cain: Seed of the Serpent, there
was this prophecy of God:
And I will put enmity between thee and the woman, and between thy
seed and her seed; it shall bruise thy head, and thou shalt bruise
his heel.
Genesis 3:15 (KJV)
Many of these offspring began to despise, or have enmity, towards God and
his followers, just like their angelic ancestors did.
Now, the Nephilim and Watchers were in the same "boat" as Satan: all of
them lost their authority in the angelic realm, and were condemned to live
out the rest of their lives as mortal beings. Their reward was given to them
in this world, already. They had no other chance for redemption.(13)
On the other hand, they were also well aware of the above prophecy: a
"savior" would eventually put an end to their temporary domination over
the world. They had fallen enough already, and did not want to go down
any further. Perhaps, they thought, since they already made Adam fall, they
could destroy the chances of Adam's seed to produce the "promised one"
(in Genesis 3:15). This could allow them avoid their own judgment, and
their destiny.
Maybe they could somehow destroy all the descendants of Adam. Maybe,
by inserting their own seed into any and every woman around, the
"crusher" of the serpent's head (who would eventually be Jesus Christ)
would never be born. This prophecy of God would not be fulfilled, and
their own terrible destiny would be avoided. This became another reason to
sexually infiltrate the world with their own angelic sperm! What did they
have to lose, besides everything they had already lost?
God, however, would not go down that easily.
He told everyone who really cared about following His laws that there
would be a flood on the horizon, a world-wide flood which would punish
those destroying the world in this way. There would, as well, be a way out
for these compromised seeds of Adam.(14) There would be an opportunity
to preserve his seed till the time when one of the pure blood (Jesus' mother
Mary) would deliver the Christ child.
God, the merciful God He was and is, gave everyone of the day a chance
for repentance. He did not want anyone to go down, but, also, realized
there must be punishments for those who contribute to wrong-doing. The
time was nigh for change.
He probably tried to show the disobedient horrible signs and wonders, so
they could understand that He wasn't kidding:
... and God did this mighty act, in order to terrify the sons of men, that
there might be nor more evil upon the earth. And still the sons of men
would not return from their evil ways, and they increased the anger
of the Lord as that time, and did not even direct their hearts to all this.
The Book of Jasher,
Obviously, the corruption of these angels was everywhere, immorality was
so rampart that the people really didn't care. Their angelic-human offspring
did not want anyone to live a pure, descent life. The world was almost
completely swallowed up by those who had blood of these angelic humans,
or those who followed their corrupt ways.
There were a few - only a few - who tried to remain moral. They tried to
keep physically pure, because they knew, for Christ's sake, they had to
keep it that way. They wanted their promised seed - the "chosen" seed of
Adam - to survive.
There is a great deal more about this in the book The Rise of Mystery
Babylon, which goes into detail about how life was lived back then, and
why things became so drastic in Noah's day that a flood had to take place.
We will see, in Other Flood Survivors, what happened next.
The Circle of the Refaim
actually exists today in the Middle-East -
a collection of huge stones attributed to these
hybrid human beings
(1) Saltair na Rann, 1729-52, 1777-84, 1821-44, 1865-80, trans. David
Greene; The Armenian Apocryphal Adam Literature, History and Sermon:
Concerning the Creation of Adam and the Incarnation of Christ Our God 1-
5, trans. William Lowndes Lipscomb (Ann Arbor, Michigan: University
Microfilms International, 1983), 261.
(2) Louis Ginzberg, Legends of the Jews: Volume 1, trans. Henrietta Szold
(Baltimore, Maryland: The Johns Hopkins University Press, 1909), 151.
(3) Pirke De Rabbi Eliezer, Chapter 22: The Fall of the Angels [26A. i.],
trans. Gerald Friedlander, 160.
(4) Book of the Glory of Kings (Kerba Nagast), 100, Concerning the
Angels who Rebelled, trans. Sir. E. A. Wallis Budge (London: Humphrey
Milford, 1932).
(5) Josephus, Jewish Antiquities, Book 1, 72-76, trans. H. ST. J.
Thackeray (London: William Heinemann Ltd. 1961), 35; Chris Ward, The
Origin of Demons, 2, http://www.adamqadmon.com/watchers/nephilim019.
html (accessed Dec. 5, 2000); The Book of the Cave of Treasures, The
First Thousand Years: Adam to Yared (Jared), The Rule of Enoch (notes),
trans. Sir E. A. Wallis Budge (London: The Religious Tract Society, 1927),
(6) Barhebraeus' Scholia on the Old Testament Part I: Genesis – II
Samuel, Genesis 6:3, trans. Martin Sprengling and William Creighton
Graham (Chicago, Illinois: University of Chicago Press, 1931), 35.
(7) The Book of Enoch, 106:7, trans. R. H. Charles (Montana: Kessinger
Publishing, 1912).
(8) The Zohar, Volume 18, Shlach Lecha, Section 10. The spies, 73,
(accessed Feb. 24, 2010).
(9) Paula O'Keefe, Leviathan Chained, 2, http://www.adamqadmon.
com/nephilim/leviathanchained.html (accessed Dec. 6, 2000).
(10) Book of the Glory of Kings (Kerba Nagast), 100, Concerning the
Angels who Rebelled, trans. Sir. E. A. Wallis Budge (London: Humphrey
Milford, 1932).
(11) The Midrash Rabbah, Bereshith (Genesis) 26:7, Deuteronomy 1:28,
trans. Rabbi Dr. H. Freedman and Maurice Simon (London: The Soncino
Press, 1961); The Babylonian Talmud, Jews' College/Soncino English
Translation, Yoma 10a, http://www.halakhah.com/pdf/moed/Yoma.pdf
(accessed Dec. 30, 2010); Charles DeLoach, Giants: A Reference Guide
from History, the Bible, and Recorded Legend (Metuchen, N. J.: The
Scarecrow Press, Inc., 1995), 46; Jonathan Gray, Lost World of Giants,
(Teach Services, Inc., 2006), 46.
(12) 2 Sam. 21:20; I Chron. 20:6.
(13) The Third Book of Adam and Eve (The Conflict of Adam and Eve
with Satan), Chapter 4, trans. S. C. Malan (London: Williams and Norgate,
(14) James L. Kugel, Traditions of the Bible (Cambridge, Massachusetts:
Harvard University Press, 1998), 217.
Copyright 2013, Brett T., All Rights Reserved


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text:
Filed January 28, 2008
In re Steven Sosman
Commission No. 06 CH 83
Synopsis of Hearing Board Report and Recommendation
NATURE OF THE CASE: 1) failing to act with reasonable diligence and promptness in representing a client; 2) failing to refund promptly any part of a fee paid in advance that has not been earned; 3) failing to respond to a lawful demand for information from a disciplinary authority; 4) engaging in conduct prejudicial to the administration of justice; and 5) engaging in conduct which tends to defeat the administration of justice or bring the courts or legal profession into disrepute.
RULES DISCUSSED: 1.3, 1.16(e), 8.1(a)(2), and 8.4(a)(5) of the Illinois Rules of Professional Conduct and Supreme Court Rule 770.
RECOMMENDATION: Two-year suspension and until further order of the Court.
DATE OF OPINION: January 28, 2008.
HEARING PANEL: Michael C. Greenfield, Chair, Jay A. Frank, and K.F. Kitchen, II.
ADMINISTRATOR'S COUNSEL: Robert J. Verrando.
|In the Matter of:
No. 6182397.
Commission No. 06 CH 83
The hearing in this matter was held on June 27, 2007, at the offices of the Attorney Registration and Disciplinary Commission, Chicago, Illinois, before a Hearing Board Panel consisting of Michael C. Greenfield, Chair; Jay A. Frank, lawyer member; and K.F. Kitchen, II, public member. Robert Verrando represented the Administrator. Respondent, Steven Sosman, failed to appear for the hearing and was not represented by counsel.
On November 30, 2006, the Administrator filed a two-count Complaint alleging that Respondent neglected a matter, failed to return unearned fees, and failed to cooperate with the Attorney Registration and Disciplinary Commission (ARDC). On January 24, 2007, Respondent was personally served with a copy of the Administrator's Complaint at his registered home address in Wisconsin. On March 5, 2007, the Chair entered an order setting the matter for a pre-hearing conference on April 18, 2007. On the same day that the order was entered, the Clerk of the Commission mailed a copy of the order to Respondent at his registered work address in Chicago and his registered home address in Wisconsin. Respondent failed to participate at the April 18 pre-hearing conference. Because Respondent failed to file an Answer or other
responsive pleading, the Chair granted the Administrator's Motion to Deem the Allegations of the Complaint Admitted pursuant to Commission Rule 236 and limited the evidence to be presented at the hearing to matters of aggravation and mitigation. In addition, the Chair scheduled the hearing for June 27, 2007. On April 19, 2007, the Clerk of the Commission mailed a copy of this order to Respondent's registered Chicago and Wisconsin addresses.
On the day of the hearing, June 27, 2007, the Chair was presented with a fax that contained Respondent's emergency motion to continue the hearing. The document indicated it was received at approximately 8:00 a.m. that morning. (Tr. 4). In the motion, Respondent stated that he had not received actual notice of the hearing until his father told him of it three days earlier after his father received a call on his cell phone. The motion further stated that mail was erroneously returned from Respondent's Chicago office and he would be unable to attend the hearing due to his father's medical condition.
On June 13, 2007, Erin McCann, an investigator with the ARDC, was assigned to contact Respondent and determine if he would appear at the hearing. (Tr.17-18). Ms. McCann proceeded to the address that Respondent identified as his office when he registered with the ARDC: 1400 West Devon, Suite 233, Chicago. There, Ms. McCann found a UPS store. (Tr. 18). Ms. McCann learned that Respondent maintained only a mailbox (number 233) and not an office at that address. (Tr. 18). Respondent was able to receive mail at the mailbox until May 25, but rarely, if ever, picked up the mail. (Tr. 19). Because Respondent had not paid his rental fee for the mailbox, it was not currently active. (Tr. 19). Ms. McCann also spoke with the owner of the building and confirmed that Respondent did not rent and never had rented an office in that building. (Tr. 18-19).
On June 14, 2007, Ms. McCann tried to contact Respondent on the cell phone number he had provided. (Tr. 20). The message identified the phone as that of Respondent's. (Tr. 20). However, a full voice mailbox prevented her from leaving Respondent a message. (Tr. 20). Ms. McCann tried to reach Respondent by phone again on June 19th and June 21st with the same result. (Tr. 21-22).
On June 26, 2007, the day before the scheduled hearing, Ms. McCann received a phone message from Respondent stating he had received her earlier message, but was unable to get back to her because he was on trial. He then stated that his father told him he had a hearing, but Respondent knew nothing about it. He concluded by stating that his father was possibly having heart surgery and requested that Ms. McCann return his call. (Tr. 22).
Ms. McCann returned Respondent's call later that day. (Tr. 23). During this phone conversation, Respondent confirmed that he had received a copy of the Complaint, confirmed his registered addresses in Chicago and Wisconsin, and stated he received an order assigning hearing board members. (Tr. 23 - 24). Respondent told Ms. McCann that he could not attend his disciplinary hearing because his father was having surgery and he needed to be with him. (Tr. 23). At Ms. McCann's request, Respondent provided her with his father's phone number. (Tr. 23). Ms. McCann testified that was the first time they had been provided with Respondent's father's cell phone number. (Tr. 24).
Ms. McCann contacted Mark Sosman, Respondent's father, who indicated that he was not scheduled for heart surgery that day, but did have a doctor appointment. (Tr. 26). Mr. Sosman told Ms. McCann that he had received a phone call for Respondent, but did not recall any details. Mr. Sosman had no knowledge of Respondent's disciplinary hearing. (Tr. 27-28).
The Chair denied Respondent's motion for continuance.
The Administrator presented the testimony of Erin McCann (presented above) and John Mashni. Administrator's Exhibits 1 - 4 were admitted into evidence. (Tr. 46).
Counts I and II
On May 9, 2006, Respondent agreed to represent John Williams in a criminal matter. At the time of his arrest, Mr. Williams qualified for and chose to be placed on house arrest in lieu of incarceration at the Cook County jail pending trial. Mr. Williams retained Respondent to represent him in the criminal matter and to assist him in obtaining permission to work outside of his home while on house arrest. Mr. Williams also advised Respondent he was scheduled for arraignment on May 26, 2006.
Respondent requested a $1,500 retainer, but agreed to accept $500 to begin the representation Between May 9, 2006, and May 15, 2006, Mr. Williams paid Respondent a total of $500.
Respondent did not appear at the scheduled arraignment on May 26, 2006, and the court continued the matter to June 8, 2006. Respondent advised Mr. Williams in a telephone conversation that he failed to appear because he was "running late." Mr. Williams told Respondent that the court continued the matter to June 8, 2006, and again inquired about working outside of his home while on house arrest. Respondent stated that he would go to the Sheriff's office to seek such permission on the next court date.
On June 8, 2006, Respondent again failed to appear. During a telephone conversation with Mr. Williams, Respondent stated he forgot about the court date. Mr. Williams then advised Respondent that the court continued the matter to June 15, 2006.
On June 15, 2006, Respondent appeared on Mr. Williams' behalf and obtained a continuance until July 19, 2006. At no time after June 15, 2006, did Respondent appear on Mr. Williams' behalf or proceed in any other matter on his behalf. Respondent did not provide sufficient services to justify the fee he received from Mr. Williams.
On August 31, 2006, Mr. Williams telephoned Respondent to discuss his case and to express his dissatisfaction with Respondent's representation. Respondent advised Mr. Williams to seek representation from a public defender.
On July 24, 2006, Mr. Williams submitted a Request for Investigation to the ARDC regarding Respondent's conduct. On July 28, 2006, and August 22, 2006, Counsel for the Administrator sent letters to Respondent's registration addresses, requesting that he provide information regarding his representation of Mr. Williams. At no time did Respondent respond to the Administrator's letters or requests for information. (Adm. Exs.1 and 2).
Evidence Offered in Aggravation
John Mashni
John Mashni testified that he retained Respondent to represent him in a misdemeanor battery case and a related civil matter against Mr. Mashni and his parents. (Tr. 30). Respondent asked Mr. Mashni to pay him in cash because he was in the process of a divorce and wished to hide his money from his wife. (Tr. 31). Mr. Mashni paid Respondent a total of $1,000 for representation in the civil matter. (Tr. 32-33). At Respondent's direction, Mr. Mashni made an additional payment by check payable to another attorney, Linda Speck. (Tr. 34).
On several occasions, Mr. Mashni tried calling Respondent to determine the status of his case but was not able to reach Respondent or to leave a message because the voicemail was always full. (Tr. 35). The only time Mr. Mashni was able to discuss his case with Respondent,
was when Respondent would come into Mr. Mashni's liquor store. (Tr. 35). Respondent came in approximately every other day and took liquor from Mr. Mashni in lieu of money as payment for legal services. (Tr. 35, 43). Mr. Mashni also testified that on one occasion Respondent took Mr. Mashni's Vicodin, a drug Mr. Mashni obtained by a doctor's prescription. Respondent told Mr. Mashni that he had filed an Answer and discussed his strategy in the case. Based on these representations, Mr. Mashni believed that Respondent was diligently working on his case. (Tr. 35-36).
Due to Respondent's repeated failure to appear and his failure to comply with various orders in Mr. Mashni's cases, the judge presiding over the case issued an order commanding Mr. Mashni, his parents and Respondent to appear in court on August 23, 2006. (Adm. Ex. 3, p. 20). Respondent failed to appear. Accordingly, the court issued an Order of Attachment for Respondent. (Adm. Ex. 3, p. 26). The court later vacated the order of attachment and forwarded the orders to the ARDC. (Adm. Ex. 3). Mr. Mashni and his family hired another attorney to represent them in this matter. (Tr.36). To date, Respondent has not refunded Mr. Mashni any of the money he paid Respondent. (Tr. 37).
Prior Discipline
As a result of neglecting four client matters, converting client funds, lying to the ARDC, and soliciting a personal injury matter, the Illinois Supreme Court suspended Respondent from the practice of law for twenty-four months and until Respondent made restitution to two clients. In re Sosman, 90 CH 489, M.R 10195 (June 23, 1994). However, Respondent did not make restitution until September 1998 thereby extending his suspension for an additional two years.
In attorney disciplinary proceedings, the Administrator must prove the alleged misconduct by clear and convincing evidence. Supreme Court Rule 753(c)(6); In re Ingersoll, 186 Ill.2d 163, 168, 710 N.E.2d 390 (1999). Upon consideration of the Administrator's Complaint, the order entered deeming the allegations of the Complaint admitted and Administrator's Exhibits 1 through 4, we find that the Administrator proved by clear and convincing evidence that the Respondent engaged in the acts and committed the misconduct alleged in the Administrator's Complaint.
Specifically, we find that Respondent engaged in the following misconduct:
failed to act with reasonable diligence and promptness in representing a client in violation of Rule 1.3 of the Illinois Rules of Professional Conduct ("Rules");
failed to refund promptly any part of a fee paid in advance that has not been earned in violation of Rule 1.16(e) of the Rules;
failed to respond to a lawful demand for information from a disciplinary authority in violation or Rule 8.1(a)(2) of the Rules;
engaged in conduct prejudicial to the administration of justice in violation of Rule 8.4(a)(5) of the Rules; and
engaged in conduct which tends to defeat the administration of justice or to bring the courts or the legal profession into disrepute in violation of Supreme Court Rule 770.
The purpose of the attorney disciplinary system is not to punish an attorney for misconduct. Rather, the goal is to protect the public, maintain the integrity of the legal profession, and safeguard the administration of justice. In re Spak, 188 Ill.2d 53, 67, 719 N.E.2d 747 (1999). In determining the appropriate sanction, the nature of the misconduct, the aggravating and mitigating factors, the deterrent value of the sanction, and whether the sanction
will help preserve public confidence in the legal profession are to be considered. In re Gorecki, 208 Ill.2d 350, 360-61, 802 N.E.2d 1194 (2003). Although each disciplinary case "is unique and must be resolved in light of its own facts and circumstances," the sanction imposed should be "consistent with those imposed in other cases involving comparable misconduct." In re Howard, 188 Ill.2d 423, 440, 721 N.E.2d 1126 (1999); In re Chandler, 161 Ill.2d 459, 472, 641 N.E.2d 473 (1994).
In this matter, Respondent neglected a criminal matter, failed to cooperate with an ARDC investigation, and lied to the ARDC in connection with its investigation. In support of his recommending a one-year suspension and until further order of the Court, the Administrator relies on the following cases: In re Ring, 141 Ill.2d 128, 565 N.E.2d 983 (1991) (Respondent suspended from the practice of law for 6 months for failing to pursue a client's criminal appeal); In re Houdek, 113 Ill.2d 323, 497N.E.2d 1169 (1986) (Respondent suspended for 24 months and until further order of the Court for neglecting a case, failing to correct the neglect or make restitution, conversion and misrepresenting the status of the case to the client); In re Jaffe, 00 CH 17, M.R. 17654 (November 28, 2001) (Respondent suspended for 18 months and until further order of the Court for neglecting two maters, misrepresenting the status of the cases to the clients, failing to make restitution and failing to participate in the disciplinary proceedings); and In re Hultquist, 01 SH 77, M.R. 18297 (September 20, 2002) (Respondent suspended for three years and until further order of the Court for neglecting one case, failing to sufficiently communicate with his client and failing to return unearned fees).
Neglect of a legal matter is in itself sufficient ground for suspension. In re Houdek, 113 Ill.2d 323, 327. The length of suspension is based upon the aggravating and mitigating factors.
In re Samuels, 126 Ill.2d 509, 529, 535 N.E.2d 808 (1989). Because Respondent failed to participate, we were presented with no evidence in mitigation.
In aggravation we consider Respondent's previous discipline for similar misconduct. See In re Levin, 118 Ill.2d 77, 88, 514 N.E.2d 174 (1987); In re Broverman, 40 Ill.2d 302, 308, 239 N.E.2d 816 (1968). In 1994, Respondent was suspended for two years for neglecting a client matter, failing to adequately inform his client of the status of the case and failing to return unearned fees. Respondent's failure to make the mandated restitution until 1998 extended his suspension until that time.
We are also mindful that "more severe discipline is appropriate to deter neglect in criminal cases than in civil cases." In re Hall, 95 Ill.2d 371, 375, 447 N.E.2d 805 (1983); In re Weinberg, 119 Ill.2d 309, 315, 518 N.E.2d 1037 (1988). A criminal case warrants more severe discipline because the loss of a criminal case is less likely to be subject to monetary valuation than the loss of a civil suit for damages. See In re Weinberg, 119 Ill.2d 309, 315.
Uncharged misconduct may be considered in aggravation when it is similar to the current charge and established by the evidence in the record. In re Stormant, 203 Ill.2d 378, 400, 786 N.E.2d 963 (2002). Here, we find Mr. Mashni credible. As with Mr. Williams' case, Respondent repeatedly failed to appear in court on Mr. Mashni's behalf. Respondent also responded dishonestly to Mr. Mashni's demand for information on the status of his case and failed to return unearned fees. The Complaint charges Respondent with this very misconduct. Where, as here, uncharged conduct is similar to the current charges and is established by evidence in the record, it is illustrative of a respondent's pattern and practice of misconduct and appropriately considered in aggravation. See Stormant, 203 Ill.2d 378, 400 and In re Elias, 114 Ill. 2d 321, 336-37, 499 N.E.2d 1327 (1986).
A respondent's lack of participation in these disciplinary proceedings is yet another serious aggravating factor and demonstrates that the attorney is unwilling or unable to meet professional standards of conduct. In re Houdek, 113 Ill.2d 323, 327. Here, Respondent failed to participate in these proceedings and minimally participated in his prior disciplinary proceedings. In both matters, Respondent's failure to participate resulted in orders being entered against him deeming the allegations of the Complaint admitted and barring him from presenting any evidence at the hearing. In both matters, Respondent's first effort to participate in the proceedings occurred the morning of the hearing by way of a request for a continuance.
Respondent's behavior shows not only a pattern of neglecting his clients, but also a pattern of failing to fully and candidly participate in his disciplinary proceedings. This is further evidence that Respondent is unable to conform his conduct to the rules of professional conduct. Respondent's prior four-year suspension failed to deter commission of the very same misconduct charged in this case. Thus, we are of the opinion that the Administrator's recommendation of a one-year suspension and until further order of the Court is too lenient a penalty in view of respondent's recidivism, his total disregard of his duty to cooperate with the ARDC, and his less than candid dealings with his clients and the ARDC. We would expect that an attorney who has been suspended from the practice of law for four years for neglecting client matters and failing to cooperate with the ARDC would have a heightened awareness of the necessity to conform strictly to all of the requirements of the Rules of Professional Conduct.
Other cases involving comparable misconduct have imposed a suspension of more than one year. In In re Hultquist, 01 SH 77, M.R.18297 (September 20, 2002), the respondent neglected a client matter, failed to return unearned fees, and failed to cooperate in his disciplinary proceedings. The respondent was suspended for three years and until further order
of the Court. Similarly, in In re Houdek, 113 Ill.2d 323, 497 N.E.2d 1169 (1986), the respondent neglected a client matter, delayed in responding to the ARDC and then answered falsely with fabricated evidence, and failed to participate in his disciplinary proceeding until he after he was suspended. Houdek was suspended for two years and until further order of the Court Significantly, unlike Respondent, neither Hultquist nor Houdek had been previously disciplined for neglecting client matters.
We agree with the Administrator that an "until further order of court" provision is necessary. This condition is properly imposed on a recidivist to ensure that a respondent is not reinstated until the Court "is satisfied that he will not engage in similar misconduct in the future." In re Levin, 101 Ill.2d 535, 543, 463 N.E.2d 715 (1984). Additionally, noncooperation in the disciplinary process demonstrates that the attorney is unwilling or unable to meet professional standards of conduct and warrants an "until further order of court" sanction. See In re Houdek, 113 Ill.2d at 327.
Accordingly, for the reasons stated herein, we recommend Respondent be suspended for two years and until further order of the Court.
Date Entered: January 28, 2008
|Michel C. Greenfield, Chair, with Jay A. Frank and K.F. Kitchen, II concurring.


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Advice was provided on special tax district
LA MESA The La Mesa City Council decided last week that it will end the contract of a consultant who was providing assistance on formation of a property-based improvement district in the downtown village area.
After district formation committee members Lynn McRae and Bill Rattan gave an update, which included information about several zoning changes and the elimination of houses of worship and La Mesa-Spring Valley School District property from the proposed special tax district, the council voted 4-1 to stop funding consultant Ed Henning.
Henning, whose contract was for $28,000 to help move the self-imposed taxation plan along, will not get the final $6,500 in the contract; that money will go into the city's parking fund.
Ed Henning and Associates was hired in October 2009 to assist property and business owners to understand the financing mechanisms that may be available to them for developing a maintenance district. La Mesa hired Henning to help forge "a lasting public-private partnership that will revitalize the downtown village and keep it attractive and vibrant well into the future," the city's website notes.
The city of La Mesa has committed to invest up to $5 million in a major downtown rejuvenation — including lighting, parking, sidewalk fixes and redesigned landscaping.
An overhaul of the downtown area's main street of La Mesa Boulevard is planned to start in January. A streetscape project has been in the works since March 2008 when the City Council authorized the allocation of $300,000 from the Downtown Parking Fund to prepare the Downtown Village Streetscape Improvement Program to revitalize public infrastructure downtown.
As originally proposed, the property-based district, or PBID, encompassed 133 property owners with 182 parcels in three zoned areas. It has dwindled to 80 parcels in one zone.
"He doesn't get this money unless he gets work, so if we don't need it done, then his contract's done," Councilman Ernie Ewin said after the meeting regarding the Henning contract.
"Some people are saying that if we don't pass the PBID, the streetscape project won't happen. That's just not true. We're going to do the streetscape whether the PBID passes or not. The council has a shortage of patience, we want to keep moving ahead. We've been waiting and waiting to hear (from the PBID committee) but meanwhile we've got a streetscape that's moving ahead."


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• Author: Dan Brown;
• Genre/Subject: Thriller;
• Language: English;
• PDF Pages: 427;
• File Size: 1 MB;
Dan Brown is one of the best and most controversial mystery-thriller writers. In 2000, his novel Angels and Demons was first released and it became a successful bestselling book. Here Robert Langdon makes his first appearance and he will still be the protagonist of another Brown's works: Da Vinci Code (2003) and The Lost Symbol (2009). The three of them share a lot of common elements: conspiracy theory, secret society, ancient church history, architecture, and symbolism. A movie adaptation based on this book was released in 2009.
Amazon.com Review:
It takes guts to write a novel that combines an ancient secret brotherhood ,..., mysterious ambigrams, a plot against the Vatican ,... It takes talent to make that novel anything but ridiculous. Kudos to Dan Brown (Digital Fortress) for achieving the nearly impossible ...
Harvard symbologist Robert Langdon is shocked to find proof that the legendary secret society, the Illuminati ... is alive, well, and murderously active. Brilliant physicist Leonardo Vetra has been murdered, his eyes plucked out, and the society's ancient symbol branded upon his chest. His final discovery, antimatter, the most powerful and dangerous energy source known to man, has disappeared ... Langdon and Vittoria, Vetra's daughter and colleague, embark on a frantic hunt through the streets, churches, and catacombs of Rome, following a 400-year-old trail to the lair of the Illuminati, to prevent the incineration of civilization.
... Brown manages to hurl the reader headlong into an almost surreal suspension of disbelief. While the reader might wish for a little more sardonic humor from Langdon, and a little less bombastic philosophizing on the eternal conflict between religion and science, these are less fatal flaws than niggling annoyances ...--Kelly Flynn
Free download Dan Brown's Angels and Demons PDF eBook:
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When Chip Kelly coaches his first game on the Eagles' sideline, Bill Belichick will be standing across the field.
The Eagles will open the 2013 preseason the weekend of Aug. 8-11 against the Patriots at the Linc, the NFL announced Thursday.
Kelly and Belichick have known each other for years, and Belichick has brought Kelly into the Patriots' facility in the past to tutor him and the other New England coaches on the intricacies of the unique up-tempo offense he ran at Oregon.
The Eagles also have a home preseason game the weekend of Aug. 15-19 at the Linc against the Panthers, with head coach Ron Rivera and defensive coordinator Sean McDermott.
The final two preseason games will be on the road – Week 3 at Jacksonville (Aug. 22-25) and Week 4 against the Jets (Aug. 29-30).
Exact dates for all the games will be finalized in the next few days.
This will be the 13th consecutive year the Eagles will finish the preseason against the Jets and the 29th time in the last 29 years the Eagles have faced the Jets in the preseason. They didn't meet in 2000 but played twice in 1992, including the Hall of Fame Game in Canton, Ohio.
The Eagles faced the Patriots last year in Foxboro and played the Panthers in the 2007 and 2008 preseasons, both at the Linc.
Although the Eagles have played the Jaguars recently in the preseason – 2008 and 2009 – they haven't played a preseason game in Jacksonville in 40 years, since Aug. 4, 1973, when they beat the Bills 13-6. They also had a preseason game in Jacksonville on Sept. 6, 1958, losing to the Redskins 35-31.
The full 2013 NFL preseason schedule is available here.
The 2013 regular-season schedule is expected to be released on April 16.
Eagles to open 2013 preseason vs. Patriots
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When Chip Kelly coaches his first game on the Eagles' sideline, Bill Belichick will be standing across the field.


text: January 01, 2007 Med Ed Report Curry Rockefeller Group adds Troy-Ott as project director Share this article: facebook twitter linkedin google Comments Email Print The Curry Rockefeller Group has added Patti Troy-Ott, MA, as project director. Troy-Ott joins the CRG from the Sisters of Mercy Regional Community of New York in Hartsdale, where she served for six years as director of development. From the January 2007 Issue of MMM »


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RISMEDIA, May 14, 2011—"NAR research has consistently shown that there is a considerable and growing market for green buildings, and many of today's consumers want homes and communities that are more resource efficient and sensitive to the larger environment," says NAR President Ron Phipps. "NAR's Green Designation helps REALTORS® meet that consumer demand for green building practices. These revisions will help REALTORS® continue to bring value to buyers and sellers who value eco-friendly and energy-efficient homes."
Because of high member demand for the residential aspect of the curriculum, the commercial and property management electives will no longer count as credit toward the designation but will be made available to members interested in those areas of study. The changes will include replacing the two-day core course and one-day elective courses with three one-day courses:
• Green 100: Real Estate for a Sustainable Future (day 1)
• Green 200: The Science of Green Building (day 2)
• Green 300: Greening Your Real Estate Business (day 3)
Students will need to complete all three days to earn NAR's Green Designation. The updated program will be launched in late summer 2011. Until then, NAR's Green Resource Council has reduced the prices of the existing online core and elective courses. The core course was $295 and is now $230; the residential elective was $125 and is now $99; and total cost for the full designation was $420 and is now $329.
NAR's Green Designation was peer-reviewed by the Environmental Protection Agency and the U.S. Green Buildings Council, and received the 2009 Award of Excellence from the American Society of Association Executives. The Green Resource Council has forged strategic relationships within the green industry to create awareness of the designation, advance its mission, and provide continued education to the designee base.
The National Association of REALTORS®, "The Voice for Real Estate," is America's largest trade association, representing 1.1 million members involved in all aspects of the residential and commercial real estate industries.
For more information please visit www.realtor.org.
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This view shows enzymes only for those organisms listed below, in the list of taxa known to possess the pathway. If an enzyme name is shown in bold, there is experimental evidence for this enzymatic activity.
Synonyms: galactitol catabolism
|Degradation/Utilization/Assimilation → Secondary Metabolites Degradation → Sugar Derivatives Degradation → Sugar Alcohols Degradation
Some taxa known to possess this pathway include : Escherichia coli K-12 substr. MG1655
Expected Taxonomic Range: Proteobacteria
Of the ten existing hexitols ( allitol, D-altritol, L-altritol, D-sorbitol, L-sorbitol, D-mannitol, L-mannitol, D-Iditol, L-iditol and galactitol) only three occur naturally - D-mannitol, D-sorbitol (also known as D-glucitol), and galactitol (owing to symmetry, D- and L-galactitol are identical). Each of these can be utilized by bacteria as a total source of carbon and energy.
All three naturally-occurring hexitols can be utilized by bacteria as a total source of carbon and energy. Each of these hexitols enters the cell via a specific phosphotransferase system, so the first intracellular species is the 6-phospho-derivative [Lengeler75] (note that due to symmetry of D-mannitol and galactitol, their phosphorylation at either end produces the same molecule. When these molecules are phosphorylated at the 6 position by the PTS system, the resulting molecules are named D-mannitol 1-phosphate and galactitol 1-phosphate, respectively, by conventional nomenclature rules).
In all three cases this sugar alcohol phosphate becomes the substrate for a dehydrogenase that oxidizes its 2-alcohol group to a keto group. In the cases of D-mannitol and D-sorbitol, the resulting keto sugar phosphate is β-D-fructofuranose 6-phosphate, an intermediate of glycolysis, and hence it flows through the pathways of central metabolism to satisfy the cell's need for precursor metabolites, reducing power, and metabolic energy.
In the case of galactitol 1-phosphate, however, the product of the dehydrogenation is D-tagatofuranose 6-phosphate, which becomes the substrate of a kinase and subsequently an aldolase (in a pair of reactions that parallel those of glycolysis) before it is converted into intermediates ( D-glyceraldehyde 3-phosphate and glycerone phosphate) of glycolysis [Nobelmann96].
Superpathways: superpathway of hexitol degradation (bacteria)
Unification Links: EcoCyc:GALACTITOLCAT-PWY
Created 14-Oct-1996 by Riley M, Marine Biological Laboratory
Revised 09-May-2006 by Ingraham JL, UC Davis
Lengeler75: Lengeler J (1975). "Nature and properties of hexitol transport systems in Escherichia coli." J Bacteriol 124(1);39-47. PMID: 1100608
Nobelmann96: Nobelmann B, Lengeler JW (1996). "Molecular analysis of the gat genes from Escherichia coli and of their roles in galactitol transport and metabolism." J Bacteriol 1996;178(23);6790-5. PMID: 8955298
Atsumi10a: Atsumi S, Wu TY, Machado IM, Huang WC, Chen PY, Pellegrini M, Liao JC (2010). "Evolution, genomic analysis, and reconstruction of isobutanol tolerance in Escherichia coli." Mol Syst Biol 6;449. PMID: 21179021
Babul78: Babul J (1978). "Phosphofructokinases from Escherichia coli. Purification and characterization of the nonallosteric isozyme." J Biol Chem 1978;253(12);4350-5. PMID: 149128
Baez07: Baez M, Cabrera R, Guixe V, Babul J (2007). "Unfolding pathway of the dimeric and tetrameric forms of phosphofructokinase-2 from Escherichia coli." Biochemistry 46(20);6141-8. PMID: 17469854
Baez08: Baez M, Merino F, Astorga G, Babul J (2008). "Uncoupling the MgATP-induced inhibition and aggregation of Escherichia coli phosphofructokinase-2 by C-terminal mutations." FEBS Lett 582(13);1907-12. PMID: 18501195
Baez09: Baez M, Babul J (2009). "Reversible unfolding of dimeric phosphofructokinase-2 from Escherichia coli reveals a dominant role of inter-subunit contacts for stability." FEBS Lett 583(12);2054-60. PMID: 19465020
Baez11: Baez M, Wilson CA, Babul J (2011). "Folding kinetic pathway of phosphofructokinase-2 from Escherichia coli: a homodimeric enzyme with a complex domain organization." FEBS Lett 585(14);2158-64. PMID: 21627967
Baez12: Baez M, Wilson CA, Ramirez-Sarmiento CA, Guixe V, Babul J (2012). "Expanded monomeric intermediate upon cold and heat unfolding of phosphofructokinase-2 from Escherichia coli." Biophys J 103(10);2187-94. PMID: 23200052
Baez13: Baez M, Cabrera R, Pereira HM, Blanco A, Villalobos P, Ramirez-Sarmiento CA, Caniuguir A, Guixe V, Garratt RC, Babul J (2013). "A ribokinase family conserved monovalent cation binding site enhances the MgATP-induced inhibition in E. coli phosphofructokinase-2." Biophys J 105(1);185-93. PMID: 23823238
Benavente15: Benavente R, Esteban-Torres M, Kohring GW, Cortes-Cabrera A, Sanchez-Murcia PA, Gago F, Acebron I, de las Rivas B, Munoz R, Mancheno JM (2015). "Enantioselective oxidation of galactitol 1-phosphate by galactitol-1-phosphate 5-dehydrogenase from Escherichia coli." Acta Crystallogr D Biol Crystallogr 71(Pt 7);1540-54. PMID: 26143925
Bissett80: Bissett DL, Anderson RL (1980). "Lactose and D-galactose metabolism in Staphylococcus aureus. III. Purification and properties of D-tagatose-6-phosphate kinase." J Biol Chem 255(18);8745-9. PMID: 6251066
Bissett80a: Bissett DL, Anderson RL (1980). "Lactose and D-galactose metabolism in Staphylococcus aureus. IV. Isolation and properties of a class I D-ketohexose-1,6-diphosphate aldolase that catalyzes the cleavage of D-tagatose 1,6-diphosphate." J Biol Chem 255(18);8750-5. PMID: 7410392
Blankenhorn99: Blankenhorn D, Phillips J, Slonczewski JL (1999). "Acid- and base-induced proteins during aerobic and anaerobic growth of Escherichia coli revealed by two-dimensional gel electrophoresis." J Bacteriol 181(7);2209-16. PMID: 10094700
Bochkareva02: Bochkareva ES, Girshovich AS, Bibi E (2002). "Identification and characterization of the Escherichia coli stress protein UP12, a putative in vivo substrate of GroEL." Eur J Biochem 269(12);3032-40. PMID: 12071968
Brinkkotter00: Brinkkotter A, Kloss H, Alpert C, Lengeler JW (2000). "Pathways for the utilization of N-acetyl-galactosamine and galactosamine in Escherichia coli." Mol Microbiol 2000;37(1);125-35. PMID: 10931310
Brinkkotter02: Brinkkotter A, Shakeri-Garakani A, Lengeler JW (2002). "Two class II D-tagatose-bisphosphate aldolases from enteric bacteria." Arch Microbiol 177(5);410-9. PMID: 11976750
Cabrera02: Cabrera R, Guixe V, Alfaro J, Rodriguez PH, Babul J (2002). "Ligand-dependent structural changes and limited proteolysis of Escherichia coli phosphofructokinase-2." Arch Biochem Biophys 406(2);289-95. PMID: 12361717
Cabrera06: Cabrera R, Caniuguir A, Ambrosio AL, Guixe V, Garratt RC, Babul J (2006). "Crystallization and preliminary crystallographic analysis of the tetrameric form of phosphofructokinase-2 from Escherichia coli, a member of the ribokinase family." Acta Crystallogr Sect F Struct Biol Cryst Commun 62(Pt 9);935-7. PMID: 16946484
Cabrera08: Cabrera R, Ambrosio AL, Garratt RC, Guixe V, Babul J (2008). "Crystallographic structure of phosphofructokinase-2 from Escherichia coli in complex with two ATP molecules. Implications for substrate inhibition." J Mol Biol 383(3);588-602. PMID: 18762190
Cabrera10: Cabrera R, Babul J, Guixe V (2010). "Ribokinase family evolution and the role of conserved residues at the active site of the PfkB subfamily representative, Pfk-2 from Escherichia coli." Arch Biochem Biophys 502(1);23-30. PMID: 20599671
Cabrera11: Cabrera R, Baez M, Pereira HM, Caniuguir A, Garratt RC, Babul J (2011). "The crystal complex of phosphofructokinase-2 of Escherichia coli with fructose-6-phosphate: kinetic and structural analysis of the allosteric ATP inhibition." J Biol Chem 286(7);5774-83. PMID: 21147773
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The birth and growth of Burroughs Wellcome & Co.
4 November 2008. By Penny Bailey
When Silas Burroughs invited Henry Wellcome to join him in business in London in 1879, modern drug production was an undeveloped field. But the discoveries of Pasteur, Lister and Fleming were just around the corner - and just over a decade later, Burroughs Wellcome & Co. would be the first drug company to employ research scientists to develop new therapies. For the time being, however, there was a more immediate opportunity to hand.
Over 20 years previously, the British artist and explorer William Brockedon, exasperated by the poor quality of the graphite in the pencils he used for his sketches, had invented a mechanised method of crushing graphite to a fine powder then compressing it to produce better-quality lead. In 1843, he was granted a patent for his invention, and the drug firm John Wyeth and Brother hired him to make compressed medicines using the same technique.
The compressed pills made by Brockedon's machine offered a much safer, standardised dose than medicines prepared by pestle and mortar, and soon became popular. Other American manufacturers jumped on the bandwagon and attempted to improve production methods.
A marketing opportunity
Across the Atlantic, things were very different. There were few manufacturing drug companies in England, very few medicines were produced on a large scale, and pharmacists still used the traditional, time-consuming and less precise pestle-and-mortar method to prepare medicines.
Here was a virgin market, and Burroughs - who was Wyeth's sole agent in London and had been importing and marketing pharmaceuticals since 1878 - realised that he might be able to make his fortune by importing the compressed pills and marketing them in England and Europe. He wrote to Wellcome to invite him to join the venture. Ever cautious and attentive to detail, Wellcome insisted that Burroughs obtain Wyeth's consent to the partnership before signing. In April 1880 he received a contract from McKesson & Robbins giving him exclusive agency to sell their products in "Europe, Asia, Africa, East Indies and Australia". He arrived in London in May 1880.
The deed of partnership between the two men was executed on 27 September 1880, and they set up offices in Snow Hill. Burroughs and Wellcome were both consummate salesmen and publicists, and the company flourished in its first year of trading.
In 1883, the expanding firm acquired larger offices in Snow Hill, which was one of the first business houses in London to introduce the new 'Edison Electric Light'. These premises remained the headquarters of the new drugs company for nearly 60 years, until they were destroyed by bombs during the Blitz in 1941.
Heavy stamp duty on imports from America made importing the pills costly, so the partners took another novel step - at a time when there were few manufacturing pharmacists in Britain - in deciding to manufacture their own pills.
In 1883, they purchased their first factory at Bell Lane Wharf in Wandsworth, and Wellcome bought the machinery needed for making compressed medicine tablets from Wyeth in America to produce pills for the British and European markets. By 1882 Burroughs Wellcome & Co. were up and running as drug manufacturers, and by his 30th birthday Wellcome was a wealthy man.
The company's compressed drugs were an instant success in Britain, and Burroughs and Wellcome soon needed a bigger factory. They purchased the Phoenix Paper Mills site at Dartford, and used Thames barges for transport. This site remained the firm's production centre until the 1980s.
In 1888, frustrated by the limitations of Wyeth's machine, which was slow and unreliable, Wellcome put together a team of engineers to design a better one. The result was machinery that could produce 600 compressed pills per minute, each pill bearing an unprecedented standard of precision and giving Burroughs Wellcome & Co. a clear lead over their competitors.
The British competition soon woke up to the success of Burroughs Wellcome & Co., and other manufacturers began to make imitations of compressed convenience products.
To eliminate the competition, in 1884, Wellcome registered as a trademark one of the most famous and powerful brand names in business history, 'Tabloid' - a word he coined by blending the words 'tablet' and 'alkaloid' - to denote his firm's pills.
Over the next few years Burroughs Wellcome & Co. fought and won legal battles to prevent other firms using the same name. In 1904 Burroughs Wellcome & Co. v. Thompson & Capper made history as the 'Tabloid' case. The prosecution argued that doctors prescribed 'tabloid' products because they had faith in the purity and accuracy of Burroughs Wellcome & Co products. And the judge ruled that 'tabloid' specifically referred to the products of that firm.
Not only did the 'Tabloid' brand name prevent the competition from taking a slice of the market, its associations with quality and precision also made it an effective marketing tool. The name was applied to the full range of the company's products, including 'Tabloid' first aid kits and medicine chests, the 'Tabloid' photographic developer and even 'Tabloid' Tea.
The term has now passed into general use to mean anything in compact form, in particular a 'condensed' newspaper format. But it is still technically the property of Burroughs Wellcome & Co.
Silas Burroughs died of pneumonia in 1895 and full control of the business passed into the hands of Wellcome, who could now shape the company according to his own wishes. The next 20 years, until the outbreak of World War I, were a period of massive expansion for the company.
The first overseas branch had opened in Sydney in 1898. By 1912 another seven branches had opened in New York, Montreal, Buenos Aires, Cape Town, Milan, Shanghai and Bombay.
The success of the company, and the pioneering research laboratories he set up in England and Africa, ensured that Wellcome became the leading figure in the British pharmaceutical industry.
Employee welfare
From the start, Burroughs and Wellcome took a keen interest in the welfare of their employees, and introduced an eight-hour working day. This meant employees could take time off to attend evening classes in any subject of their choice, paid for by the company.
To encourage his employees to enjoy their leisure time and develop healthy interests, Wellcome established the Wellcome Club and Institute in 1898, in Acacia Hall, a spacious manor house in nine acres of land in Dartford. Acacia Hall was equipped with a library, gymnasium, events hall, tennis courts and a lake, and housed clubs and societies catering for a wide range of interests, including football, cricket, tennis, swimming, photography and literature. An especially created Entertainments Committee arranged an annual events programme, which included musical and literary evenings, and day trips to the seaside.


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The Computer, Communication, Information Technology and Training (C2ITT) department at Air Station Miami provides IT (and related) support functions for Coast Guard members assigned to the Air Station. Services within the department include cell phone custodian, Command Security Officer, General Military Training, Operational Security, and software/operating system modernization and update.
The C2ITT Offices are located in Rm 256 of the Operations building, and open Monday through Friday from 0730 to 1530. If you require any assistance during business hours, please call 305-953-2100 and follow the menu instructions.


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FiiO E6 Portable Headphone Amplifier
supply port: DC 5V/500mA
- Suitable for MP3/MP4/cell phone/laptop etc.
- Package includes:
- 1 x E6 amplifier
- 1 x USB charging cable (49cm length)
- 2 x 3.5mm audio cable (7
free shipping
(34 Reviews)
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Fiio E11 Portable Headphone Amplifier - Black (1 x BL-5B)
- S/N ratio: 98dB
- Interference: 60dB
- Powered by 1 x BL-5B battery (included)
- Capacity: 800mAh
- Accessories:
- 1 x Silicone ring
- 1 x English manual
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Attendance for IRDC 2011 was up 12% over 2010, making it one of the strongest years in the event's 11-year history. The conference was held September 7-9 at the Parc 55 Wyndham in San Francisco, steps from Union Square, the heart of the city's retail center.
Joie de Vivre Hospitality's Chip Conley drew high praise for his opening keynote presentation, suggesting ways to mind-read your customers to go beyond their expectations.
Conley's talk was followed by two days of networking events, roundtable discussions and sessions on topics such as designing for millennial shoppers, unifying in-store technologies and recalibrating design strategies in the wake of the recession.
Closing keynoter Rob Forbes, who founded Design Within Reach and recently launched PUBLIC bikes, shared his personal photos of startups, street scenes and other unexpected sources of inspiration for retail designers.


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Games Download - Fobito
by Fobito
Developer Notes
If you need to discover new games, this application is what you are looking for. You will be delighted with what Fobito offers you daily. You can follow which games your friends play and the games they set up in their mobile phones. You can meet new friends and have a chance to share your games....


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Young man found dead in car in St. AlbansFebruary 26,2013Young man found
dead in car
ST. ALBANS Police in St. Albans are investigating the death of a 17-year old male found slumped inside of a motor vehicle at a park-and-ride area.
Police said a caller alerted them at about 5:45 p.m. Sunday that he knocked on the drivers window in an attempt to rouse the teen, but had no success.
Police found the young man slumped over the steering wheel. After failed attempts to awaken him, a police officer smashed out the front passenger window. He discovered that the teen wasnt breathing and had no pulse. He was taken to a hospital.
The deceased was identified as Logan Newell of Georgia, Vt. No evidence of foul play was detected and Newells cause of death remains unknown.MORE IN Vermont NewsMONTPELIER Senate lawmakers gutted a bill intended to offer protections for landowners who want... Full StoryINDIANAPOLIS Donald Trump virtually clinched the Republican nomination for president Tuesday... Full StoryMONTPELIER The Vermont House on Tuesday soundly rejected a Senate proposal to legalize... Full Story
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Wednesday, January 30, 2013
Dr. George B. (Barney) Forsythe, Westminster College president, has been appointed as a member of the Presidents Council of the National Collegiate Athletic Association (NCAA).
The organization supervises and sets rules for all Division 3 athletic programs.
"I am honored," Forsythe said, "to assume a leadership role in an organization that plays such a significant role in the lives of so many of our Westminster students. Our student athletes compete fiercely because they are so passionate about their sport. Yet they bring that same passion and discipline to their studies, making them some of our most outstanding students."
The Presidents Council provides leadership to the NCAA.
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Houston, TX, March 09, 2012 --(PR.com)-- Harry Dent, best-selling author whose latest book, "The Great Crash Ahead" likens government stimulus to using crack, will appear live on Tim Connolly's Winning Strategies on Friday, March 9 at noon CT. Mr. Dent says in his new book that we are in for more market gloom until baby boomers' kids have kids and start spending to raise them. Mr. Dent anticipates this downward economy will last about a decade starting from when the financial crisis began three years ago. Winning Strategies is co-hosted by Tim Connolly and Envision Capital Founder and CEO Marilyn Cohen. Listen live on www.winningstrategies.net or at CRN Digital Talk Radio Network (CRN 4), nationally broadcast coast to coast by affiliate stations listed at www.crntalk.com. Winning Strategies is sponsored by Corporate Strategies, LLC, a First Data institutional representative (www.corporatestrategies.net).
Previous guests of Tim Connolly's Winning Strategies (formerly Corporate Strategies) have included former SEC Chairman Arthur Levitt, Changewave's Tobin Smith, CNBC "Mad Money" Host Jim Cramer, Gamco's Mario Gabelli, Muriel Siebert, U.S. Senator and Presidential Candidate John McCain, Texas oilman Lester Smith, ATP Oil & Gas CFO Albert Reese, CEO of Huntsman Corporation Jon M. Huntsman, Consolidated Graphics CEO Joe Davis, Enterprise Products late CEO Dan Duncan, Celgene's CEO John Jackson, Landry's CEO Tilman Fertitta, former Compaq CEO Eckard Pfeiffer, Money Manager Louis Navellier, and many others.
About Harry Dent
Mr. Dent is the developer of "The Dent Method" – an economic forecasting approach based on changes in demographic trends. His book – The Great Crash Ahead – says demographics are the cause of this downturn. Baby boomers – all 80 million of them – have finished buying housing and aren't buying much of anything more. After baby-boomers' kids leave home, they begin paying down debt and saving for retirement, which means spending less. When the baby boomers' kids have kids, that's when they spend. A Harvard MBA, Dent expresses little patience for Keynesian-like stimulus by the government. He likens QE2 to using crack and lowering short term rates to using speed. Other prophetic books written by Mr. Dent include "The Great Depression Ahead" (2009) and "The Next Great Bubble Boom" (2006).
About Marilyn Cohen and Envision Capital (www.envisioncap.com)
Marilyn Cohen, Founder of Envision Capital Management, Inc., has been a Forbes magazine columnist and is a sought after expert appearing on Nightly Business Report, CNBC, Fox Business News, National Public Radio and others as well a frequent authoritative source for the Wall Street Journal, New York Times and Barron's. Marilyn is also one of the financial community's most respected fixed income securities experts and has written two books on the subject: Surviving the Bond Bear Market: Bondland's Nuclear Winter and Bonds Now. Her firm, Envision Capital Management®, Inc. manages portfolios of fixed income securities for individuals.
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Click here to read the full story: Best-Selling Author Harry Dent to Appear on Tim Connolly's Winning Strategies on Friday, March 9 at 12:00 p.m. CT
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It's practicable, but there's more to it.What is Texa's FRAP law? is it practicable or possible?
In particular, if the outside lane is less than 14' wide -- you can ride anywhere you want in it. And most lanes are less than 14' wide, and the lane he was riding on was less than 14' wide.
He also wasn't convicted of violating this law. His court cases have generally been about impeding traffic (basically not going fast enough) and the latest was reckless driving.
OK, but the fact of the matter is that there's no law in Texas that makes this illegal under the circumstances that Bates was in. "Reckless driving" certainly wasn't a good fit, but the judge went for it anyways.I do not think a cyclist should remain in the left tire track or side of the lane when there is no obstruction to prevent from riding on the right side.
That is always true. Rosa Parks wasn't the first person to stand up for black rights -- many had tried before her and gotten beaten, incarcerated, whatever. She was just one of the ones that succeeded and paved the way for future changes.It is one thing to assert your rights to the roadway, but if you're militant about it as chipseal is, even if you are doing so within the limit of the law it can still result in bad consequences.


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May 5, 2016
Another accident in Eastern Carolina claims the lives of two more teenagers.
Farmville police say 19 year-old Christopher Pittman of Farmville was headed South on 258 at a high rate of speed when he lost control of his car and slammed into a utility pole Wednesday night. He and his passenger, 18 year- old Joshua Bynum, a Farmville Central 10th grader, both died. Earlier this week, two Onslow County high school students died in a car crash where authorities say the driver tried to pass in a no passing lane.
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Bridging the Gap, Improving the Emotional Connection at Work
by Marshall Brown - Apr, 2013
Bridging the Gap, Improving the Emotional Connection at Work Overwork, anxiety and lack of challenge and recognition has colored the overall emotional connection of workers to their jobs during the economic recession of the past few years, according to a Towers Perrin study. Workers' attitudes are going to need more than just an economic recovery to emerge feeling positive about their work life. Here are some pointers g...
Social Media Don'ts for Job Seekers
by Jessica Holbrook Hernandez - Apr, 2013
Whether we like it or not, our social media profiles are part of our digital resume. In the same way we stay glued to Facebook for updates from our friends, family, and favorite celebrities, employers look at our social media profiles for clues into our character and qualifications. Strengthen the likelihood of landing the job you want by avoiding these social media don'ts for job seekers: Don't post questionable photos or...
How to be "Interview Ready"
by Barbara Safani - Apr, 2013
You only get one shot at making a first impression. Small mishaps that might be overlooked if they happen occasionally when you are already an employee are considered big mishaps during a job interview where there is no previous behavior to compare the interview behavior to. Here are 5 things to remember on interview day. 1. Arrive at the interview destination 10-15 minutes early. Cutting it too close to the scheduled time or...
How Age & Experience Can Help You Land A Job
by Jacqui Barrett-Poindexter - Apr, 2013
A plethora of articles are written about the value of boomers looking younger and behaving more youthfully to succeed in the perceived (and sometimes very real) youth culture of job search. This runs the gamut from dressing more hip, brightening dreary hair, honing your tech savvy, and going from flabby to fit. Many of these tips are crucial to remaining competitive in a particularly tough job market. Unfortunately, this...
How To Get Promoted: Smart Steps You Can Take Now
by Michelle Dumas - Apr, 2013
It's good to be you. You're gainfully employed. You're not worried that your job is threatened by the economy, your performance or the designs of others. Yet…something's missing. Although not unhappy in your current job, you don't necessarily see it as being the pinnacle of your career aspirations either. In short, you're hankering for a promotion. Of course, as is the case with so many things in life, getting one...
How to Change Careers
by Thomas J. Denham - Apr, 2013
The bad news is that changing careers is one of the most difficult challenges we face in adulthood. You may be asking: How do I reinvent ourselves after all these years? The good news is that changing career is not only acceptable it may keep you more marketable by further developing your skills sets. More and more Americans are doing it. There is no magic to changing jobs and careers. There is a three step sequential proc...
New City And No Job? 5 Steps To Finding Work
by Mary Sherwood Sevinsky - Apr, 2013
I have had a couple of clients ask me how to network in a new city. Career change is hard enough, let alone finding work in an unfamiliar area. 5 Steps To Finding Work In A New City First, let me recommend you have your career goal in mind and, preferably, at least partially achieved. It surprises me how many people move without having a job or even the prospect of a job – not the independently wealthy, mind you, just...
10 Items That Should be Removed From Your Resume Pronto!
by Barbara Safani - Apr, 2013
Sometimes people list pieces of information on their resume that no longer have a place there because they are outdated or irrelevant. Here are a few of my favorites. Are you guilty of any of these or are there any others you would add to the list? 1) Your SAT or GMAT scores 2) Your dated GPA from 10+ years ago or the fact that you graduated cum laude 3) The fact that you are an Eagle Scout 4) A hobbies list that rea...
A Parents' Guide to Career Development
by Thomas J. Denham - Apr, 2013
One of the most valuable things parents can do to help a student with career planning is listen: be open to ideas, try to help your student find information, and be nonjudgmental. Here are 10 ways you can help: 1. Encourage your child to visit the career center (and you go too!) Next time you visit campus, drop into the career services office and pick up a business card from one of the career counselors. When you...
I Don't Know What I Want, But This Ain't Doing It
by Thomas J. Denham - Apr, 2013
Are you getting what you want out of life? Do you really know what you want? Are you so caught up in the "busy"-ness of mere day to day living that you sometimes feel you are achieving empty victories? Have you ever asked yourself whether or not you have a clear sense of direction and purpose that inspires and energizes you? Or are you uncertain about what you really want out of life and a career? You are not alone. Un...
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We've decided that we need some help bringing people all the fabulous inspiration that we envision at Card Annex, and so we are having a design team call!
If you'd like to share your cards, and get exposure, links, and free product, the Card Annex design team is for you! Unlike Nally Studios' other teams, this team will involve no writing – all that is required of the Card Annex team is supplying projects and accompanying supply lists. The design team's term will be for the 2013 calendar year. Continue Reading →


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Compassionate Leadership - Cultivating the Leaders of Tomorrow
The escalating crises in the world today offer two choices: continuing violence and conflict, or finding a way to move forward towards peace and greater understanding. Never before has the world needed more capable leadership than we do now, and no generation will be more affected by these choices than the generation emerging into political maturity.
In a groundbreaking dialogue held at New York University on Wednesday, September 24, 2008, three influential leaders -- Her Majesty Queen Noor of Jordan; Rabbi Irwin Kula, author of the award winning book, Yearnings: Embracing the Sacred Messiness of Life, and President of The National Jewish Center for Learning and Leadership; and the Sakyong, Jamgon Mipham Rinpoche, a prominent Tibetan Buddhist lama -- addressed the challenge in a public talk on the power and practice of compassionate leadership Probing their own traditions and experiences, they examined how their different paths can contribute to a shared vision of interdependence and global connection.
"Today we live in a moment of division, with polarized leaders and polarized followers," said Rabbi Kula. "What would it mean to lead with compassion? Why do we rarely think of compassion as a necessary quality of strong leadership? How would the process and content of leadership be different if compassion was a central quality of leadership? These are some of the questions we hope to explore with tomorrow's leaders."
The event was hosted by John Sexton, President, New York University; Ellen Schall, Dean and Martin Cherkasky Professor of Health Policy and Management, the Robert F. Wagner Graduate School of Public Service at NYU; and NYU Wagner's Research Center for Leadership in Action (RCLA).
To view the webcast, visit RCLA at http://wagner.nyu.edu/leadership/news/compassionate_leadership.php


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Travel Guide: Bowls
Updated: December 11, 2006, 7:48 PM ETBy Ron Berler and Bill Evans | Special to ESPN SportsTravel
Look for vacation packages to selected bowl destinations Check for tickets to selected bowls -- including BCS -- via StubHub
Whether you're following your alma mater, looking to catch some bowl football, or just want a winter escape to a warm climate, we've got your one-stop shop to get you started on your bowl travel.
Below find primers on each of the cities which are hosting bowl games this season. Look for flights and hotels, gather up information on the stadiums, and find tips for ...
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Micron Technology Inc.'s Hold Recommendation Supported
TheStreet) -- Micron Technology (Nasdaq: MU) has been reiterated by TheStreet Ratings as a hold with a ratings score of C. The company's strengths can be seen in multiple areas, such as its revenue growth, solid stock price performance and compelling growth in net income. However, as a counter to these strengths, we find that we feel that the company's cash flow from its operations has been weak overall.Editor's Note: Any reference to TheStreet Ratings and its underlying recommendation does not reflect the opinion of TheStreet, Inc. or any of its contributors including Jim Cramer or Stephanie Link. NEW YORK (
--Written by a member of TheStreet Ratings Staff. STOCKS TO BUY: TheStreet Quant Ratings has identified a handful of stocks that can potentially TRIPLE in the next 12-months. Learn more.
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- The revenue growth came in higher than the industry average of 13.9%. Since the same quarter one year prior, revenues slightly increased by 6.7%. Growth in the company's revenue appears to have helped boost the earnings per share.
- Powered by its strong earnings growth of 112.50% and other important driving factors, this stock has surged by 158.06% over the past year, outperforming the rise in the S&P 500 Index during the same period. Regarding the stock's future course, our hold rating indicates that we do not recommend additional investment in this stock despite its gains in the past year.
- MICRON TECHNOLOGY INC reported significant earnings per share improvement in the most recent quarter compared to the same quarter a year ago. This company has reported somewhat volatile earnings recently. But, we feel it is poised for EPS growth in the coming year. During the past fiscal year, MICRON TECHNOLOGY INC swung to a loss, reporting -$1.04 versus $0.15 in the prior year. This year, the market expects an improvement in earnings (-$0.26 versus -$1.04).
- The return on equity has improved slightly when compared to the same quarter one year prior. This can be construed as a modest strength in the organization. Compared to other companies in the Semiconductors & Semiconductor Equipment industry and the overall market, MICRON TECHNOLOGY INC's return on equity significantly trails that of both the industry average and the S&P 500.
- Net operating cash flow has declined marginally to $624.00 million or 9.03% when compared to the same quarter last year. In conjunction, when comparing current results to the industry average, MICRON TECHNOLOGY INC has marginally lower results.
--Written by a member of TheStreet Ratings Staff. STOCKS TO BUY: TheStreet Quant Ratings has identified a handful of stocks that can potentially TRIPLE in the next 12-months. Learn more.
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UK HealthCare Publications »
Advances & Insights »
Cancer »
July 2007
Breast cancer is the second-leading cause of cancer-related deaths among women in the United States, with more than 40,000 dying annually of the disease. The good news is, the death rates are declining—down 24 percent between 1989 and 2003. Early detection and improvements in therapy have contributed greatly to the decline in mortality.
Several recent studies...call into question who should be screened as well as how and when.
Several recent studies...call into question who should be screened as well as how and when.
The main screening techniques for breast cancer are monthly self-examination or clinical breast exams by a physician; mammograms; and magnetic resonance imaging (MRI) scans. In addition, there are the enhancements of computer-aided detection (CAD) for mammography and digital mammography.
While the news of better survival rates is welcome, several recent studies into screening techniques for breast cancer may have created confusion among women. They call into question who should be screened as well as how and when.
Mammography has been clearly shown to reduce breast cancer deaths among women 50 to 70 years of age.
Mammography has been clearly shown to reduce breast cancer deaths among women 50 to 70 years of age.
The most common breast cancer screening tool is mammography. It has been clearly shown to reduce breast cancer deaths among women 50 to 70 years of age. However, there is still a debate over how beneficial mammograms are to women under 50, where only 25 percent of the cancer cases are diagnosed. The American Cancer Society recommends yearly screening mammograms beginning at age 40. The American College of Obstetricians and Gynecologists' guidelines are mammograms every one to two years.
Recently, however, the American College of Physicians issued its recommendations, saying screening mammograms for women under 50 should be done on an individualized basis, after a physician assesses a woman's breast cancer risk. At issue are the risks of false-positive results, false reassurance, procedure-associated pain and the possible treatment for lesions that would not have become cancerous.
CAD, a technique designed to improve interpretation of mammograms, can actually degrade the performance of the mammograms, according to a multi-facility study reported April 5 in The New England Journal of Medicine (NEJM). The study involved more than 429,000 mammograms and 2,351 cases of cancer that were detected at 43 facilities in the Breast Cancer Surveillance Consortium. Researchers found that this tool not only failed to increase the cancer-detection rate but also resulted in significantly more false positives and unnecessary biopsies.
Digital mammography, another computer-based advance, appears to improve the accuracy of examination in younger women with dense breasts, according to a 2005 study in the NEJM. Digital mammography takes an electronic image of the breast and stores it directly in a computer, allowing the recorded data to be enhanced, magnified or manipulated. Film mammography units use film to both capture and display the image.
"Mammography...is least effective in the screening of dense breasts...which ...are a substantial risk factor for breast cancer." – Ferris M. Hall, MD
"Mammography...is least effective in the screening of dense breasts...which ...are a substantial risk factor for breast cancer." – Ferris M. Hall, MD
In an editorial accompanying the CAD mammography study, Ferris M. Hall, MD, a diagnostic radiologist, suggested that a combination of genetic risk profiling and MRI screenings would be a more valuable tool than mammography.
"Mammography is an inherently poor, two-dimensional projectional method being used to diagnose small, three-dimensional cancers," he wrote. "It is least effective in the screening of dense breasts, which, as emphasized in another recent study, are a substantial risk factor for breast cancer."
The American Cancer Society recently released guidelines recommending that women at high-risk of developing breast cancer undergo MRI scans along with their annual mammograms. The high-risk group includes women with at least one of the following: the BRCA1 or BRCA2 gene mutation, a first-degree relative with one of the mutations or a lifetime breast cancer risk of 20-25 percent or higher based on family history or other factors.
In particular, women newly diagnosed with breast cancer would benefit from MRI scans of the opposite breast, according to a new national study sponsored by the National Cancer Institute and conducted by doctors of the American College of Radiology Imaging Network. The study, published in the NEJM, showed MRI scans detected more than 90 percent of cancers in the opposite breast that were missed by mammography.
For more information, see:
For more information, or to make an appointment with a UK HealthCare physician, please call UK Health Connection at 1-800-333-8874.
Mammography isn't a perfect test, but I think that's what people expect it to be. If you look at the sensitivity of mammography in general, we know that it can miss up to 10-15 percent of breast cancers. This is usually because of the density of the breast tissue, which makes it harder to see smaller cancers, or because of the presence of invasive lobular cancer, a type of cancer that grows in sheets of cells that are more difficult to detect with a mammogram as it can mimic normal breast tissue.
"Both the American Cancer Society and the American College of Radiologists recommend annual mammograms for women 40 and over."
When we look at a screening tool we have to assess how effective it is in picking up cancers versus the number of false positives and negatives that result from it. Routine annual mammograms for women under 50 have always been controversial because it's difficult to determine the benefit unless a woman is in a high-risk group.
However, data has shown that there is a moderate decrease in mortality when younger women have mammograms. And we do know that these women tend to have more aggressive breast cancers, so early detection is important. Both the American Cancer Society and the American College of Radiologists recommend annual mammograms for women 40 and over. Those are the guidelines I follow as well.
Mammography does a good job in detecting ductal carcinoma in situ, or DCIS, an early type of breast cancer that is confined to the milk ducts and associated with micro-calcifications. There has always been a controversy within the medical community about how aggressively to treat these cancers. Some never go beyond the duct while 15-50 percent can break out of the duct and become invasive carcinomas, depending on the histologic grade of the DCIS. Picking up cancers that might not develop any further doesn't really impact survival rates, but most women wouldn't want to take the risk of foregoing treatment.
CAD is designed to help radiologists read mammograms by marking suspicious spots on the image. UK has had CAD for several years, and the software has improved over time. It's used most commonly in conjunction with digital mammography.
"CAD is not making the decision to call a woman back for biopsy or further testing; the radiologist is."
While the study in The New England Journal of Medicine reports that CAD didn't improve detection of invasive cancers, it did show that it picked up more DCIS. I find that CAD is useful in picking up calcifications. The majority of calcifications that develop in the breast tissue are from benign causes. However, we often end up doing a biopsy when we find them because it can be difficult to tell the benign forms from those associated with cancer. Only about 20-30 percent of the biopsies we recommend will reveal the presence of cancer.
We have to remember that CAD is not making the decision to call a woman back for biopsy or further testing; the radiologist is. Furthermore, the majority of what CAD marks on the mammogram will turn out to be nothing, and we make the decision based on comparison to prior mammograms.
More and more women are asking for an MRI screening, but not everyone needs one. Like other tools, it has its limits. We often use MRI when a woman has been diagnosed with breast cancer because it sometimes shows the extent of the disease better than a mammogram and may change the surgical options—for example, from a lumpectomy to a mastectomy.
Also, in those patients recently diagnosed with a breast cancer, up to 5 percent of the time we're seeing an abnormality in the other breast with MRI that we didn't see on the mammogram. MRI is also useful to monitor shrinking in large tumors as the patient undergoes chemotherapy prior to surgery.
Sometimes a woman will present with a palpable axillary lymph node in which biopsy shows metastatic breast cancer, yet we see no abnormality on her mammogram or even an ultrasound. We do an MRI in those instances.
Many women want an MRI because they can't tolerate a mammogram. Mammograms aren't comfortable, but they shouldn't be intolerable if you have a good technologist. MRIs aren't the most comfortable test, either. You're lying on your stomach with your breasts in a coil device that applies light compression and your hands are stretched above your head. We give you an IV to administer contrast and tell you not to move for 30 minutes.
If a woman has a 25-percent or greater risk of breast cancer, I would recommend a breast MRI screening in addition to a yearly mammogram. If the risk is 15-24 percent, she should talk to her doctor about getting an MRI. But even in this group, women still need an annual screening mammogram. Below 15 percent risk, a breast MRI is not recommended.
One of the most exciting technologies on the horizon is digital tomosynthesis, which takes a three-dimensional picture of the breast using an X-ray. It's very exciting because it holds promise for showing a better view of the breast and eliminating the problem of overlapping tissue, one of the major reasons for calling women back for further imaging. There is also less compression and less discomfort. Right now, tomosynthesis is used only in research but it should be available within the next five years.
Dr. Moore is director of breast imaging at the UK Comprehensive Breast Care Center and assistant professor of diagnostic radiology in the UK College of Medicine.
Each issue of Advances & Insights summarizes an important piece of medical news, accompanied by commentary from a UK expert.
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