text:
TulipsLate April to early May - Actual bloom time may vary
From late April to early May, tens of thousands of tulips flower all at once across the Garden grounds.
Mid-spring at the Garden is full of fresh, bright color. One of the stars of the season is undoubtedly the tulips. With over 10,000 tulip bulbs planted for spring, the breathtaking colors are worth the winter's wait. These versatile plants can be spotted across the landscape in various gardens from late April to early May.
The Home Gardening Center's Cutting Garden offers broad strokes of yellow, white, and cream cultivars including 'Akebono', 'Maureen', and 'Sweetheart'. The trial beds offer fiery, hot-colored displays in the front plantings and back beds filled with a palette of pale pinks, corals, and creams.
Redesigned by Piet Oudolf in 2013, the Seasonal Walk features thousands of freshly planted bulbs including three species tulip cultivars. 'Little Beauty' and 'Little Princess' may be short in stature, but they will add vivid pink and orange spring color to the new installation.Tulips decorate other areas of the Garden as well. Be sure to visit the Perennial Garden, Rock Garden, and Children's Adventure Garden for their delightful offerings of spring color.
Where You Can Find Tulips:
Other Plant Collections You May Like:
Daffodils (Spring)
Flowering Cherries (Spring)
Magnolias (Spring)
Daylilies (Summer)
Waterlilies and Lotuses (Summer)


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John B. Fenn
Born: 15 June 1917, New York, NY, USA
Died: 10 December 2010, Richmond, VA, USA
Affiliation at the time of the award: Virginia Commonwealth University, Richmond, VA, USA
Prize motivation: "for their development of soft desorption ionisation methods for mass spectrometric analyses of biological macromolecules"
Field: physical chemical methodology
Prize share: 1/4
Dabble in the latest techniques in forensic science.
All you want to know about the Nobel Prize in Chemistry!
Read more about the Nobel Prize in Chemistry.

subset: commoncrawl


text:
Product Description
High Quality, 100% Pure Whey Protein Isolate!
Protein is the most important of the three macro-nutrients and should be taken by everyone - you don't have to be a bodybuilder or athlete to benefit from protein! Whether you're on a diet and using protein to help replace heavy high carb and high fat meals, or an athlete training for muscle size, or an active individual with a busy lifestyle that leaves you missing meals, incorporating IsoMorph 28 pure whey isolate into your diet provides an easy, inexpensive way to increase your intake of protein.
IsoMorph 28 is pure whey protein isolate from processed micro & ultra filtered whey protein isolate, ion exchange whey protein isolate, and hydrolyzed whey protein isolate. Most of the companies that sell whey protein do not actually manufacture it; APS manufactures IsoMorph 28 in our own GMP facility so we can offer the purest whey protein possible.
IsoMorph 28 offers the fastest absorption possible because we use very small protein molecules - 18x smaller than the proteins used in most of the protein powders available (1000 Daltons vs. 18,000 Daltons).
IsoMorph 28 pure whey isolate offers a high amino acid profile and contains quad-processed, superior quality whey protein isolate to propel you towards your fitness goals. 90% protein by weight, IsoMorph provides 28 grams of protein per scoop, its low in fat with only 5 grams, its low carb with just 4 grams and its lactose free.
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IllPumpYouUp.com Video Review
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Total Fat - 1g 1%
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Cholesterol - 5mg 2%
Sodium - 80mg 3%
Potassium - 200mg 6%
Total Carbohydrate - 4g 1%
Sugars - 2g
Protein - 28g 56%
Calcium - 100mg 10%
Ingredients: Contains processed micro & ultra filtered whey protein isolate, ion exchange whey protein isolate, and hydrolyzed whey protein isolate, natural and artificial flavors, xanthan gum, cellulose gum, naturally sweet blend of erythritol, maltitol, maltodextrin, xylitol, tagatose, sucralose(<.0005g)
Consume one to four servings daily for optimum nitrogen balance. Take approximately one gram (1g) of protein for each pound of body weight per day. Add one scoop to approximately 8 oz of milk, water, juice or drink of your choice. IsoMorph 28 pure whey isolate will mix easily without a shaker cup.
Consult your physician before starting this, or any other supplement. Not recommended for individuals with preexisting medical conditions. DO NOT consume for more than 8 weeks consecutively without taking at least 8 weeks off.


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Rose Atoll NWR releases Management Plan for review
The U.S. Fish and Wildlife Service (Service) released its Draft Comprehensive Conservation Plan and Environmental Assessment (CCP/EA) for the Rose Atoll National Wildlife Refuge (NWR) on October 9th.
Public comments regarding the plan will be accepted until November 9, 2012. A CCP is a 15-year plan for managing a National Wildlife Refuge, and the Fish and Wildlife Service is required to develop a CCP for each Refuge.
Rose Atoll is one of 556 national wildlife refuges, which are found in every state and territory in the United States.
Rose Atoll National Wildlife Refuge was established in 1973 through an agreement between the American Samoa government and the Fish and Wildlife Service and covers 2.6 square miles. The Refuge was also included in the Rose Atoll Marine National Monument, which was established in 2009 and covers 13,450 square miles.
The CCP is for the Refuge portion of the Monument only.
Other planning is underway for resources outside of the Refuge's perimeter reef.
"This draft plan has been evolving since the Fish and Wildlife Service first went out to communities in 2009 and incorporates much of what we heard during those public scoping meetings," said Refuge/Monument Manager Frank Pendleton. "It is the first-ever management plan for this Refuge and it is essential we have the input of the people of American Samoa in its development."
Some examples of how community ideas were incorporated into the Draft CCP/EA include the plan's call for creating environmental education materials such as DVDs and posters for use with school groups, engaging local students with scientific research through partnering with schools and the college, and starting a Refuge internship program.
The Draft CCP is also an Environmental Assessment and provides two management alternatives to be considered for the final CCP. Alternative A continues existing management of the Refuge, while Alternative B is the preferred alternative and enhances habitat restoration, monitoring, outreach, and law enforcement.
Interested citizens, agencies, partners, and organizations are welcome to review and comment on this Draft CCP/EA. Copies of the CCP are available from the Refuge Manager located in the National Park Service office in Pago Pago.
There will be 3 public meetings in American Samoa where printed copies of the CCP will be available and refuge staff will answer any questions:
• October 16 at 2:00 pm Sadie's by the Sea;
• October 18 at 9:00 am Ofu Community Center
• October 18 at 2:00 pm Ta'ūHigh School
Comments can also be sent in the following ways;
• Comments can be emailed to firstname.lastname@example.com (make sure to identify in the subject line "Rose Atoll NWR Draft CCP/EA");
• Written comments can be mailed to the Refuge office at Rose Atoll NWR/MNM, c/o National Park Service, Pago Pago, AS 96799 or faxed to 684-699-3986; and
• Comments can be taken by phone at the Refuge/Monument office at 684-633-7082, ext. 15.
Comments are due by November 9, 2012.
"We appreciate everyone's involvement and invite your continued input to improve and complete this CCP," Pendleton said.
Persons with disabilities needing reasonable accommodations to participate in the public meetings are invited to contact Frank Pendleton at 684-633-7082 ext. 15 (voice) or email firstname.lastname@example.com.
The mission of the U.S. Fish and Wildlife Service is working with others to conserve, protect, and enhance fish, wildlife, plants, and their habitats for the continuing benefit of the American people. We are both a leader and trusted partner in fish and wildlife conservation, known for our scientific excellence, stewardship of lands and natural resources, dedicated professionals, and commitment to public service. For more information on our work and the people who make it happen, visit www.fws.gov. Connect with our Facebook page at www.facebook.com/usfwshttp://www.facebook.com/usfws, follow our tweets at www.twitter.com/usfwshq, watch our YouTube Channel at http://www.youtube.com/usfws and download photos from our Flickr page at http://www.flickr.com/photos/usfwshq


text:
I think you are asking for the index (or order) of 3 modulo 31?
Or are you asking for the order (or index) of 3^20=3486784401 modulo 31?
Consider the ring Z_{200}.find all units in Z/200Z
What are its units?
Answer, those are the numbers such that gcd(n,200)=1.
Meaning the numbers relatively prime to it.


text:
There's something about Latin women that drives us crazy. Those hips...that accent...that passion!
Luckily for us the sports world is teeming with sexy Latinas, whether they're athletes, WAGs, or even sportscasters.
For a quick history lesson (I know you click on slideshows like this for the historical content), the region is named Latin America because the languages spoken there (Spanish, Portuguese, French) are based on Latin.
The region known as Latin America encompasses Mexico, the Caribbean, Central America and South America.
Plenty of places from which to choose our 30 sexiest Latinas of the sports world. So sit back, relax, and do yourself a favor by putting this Playlist on in the background. Trust me, it will make it that much more enjoyable.


text:
Ad blocker interference detected!
Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers
Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected.
Yo man is it possible I get a rollback position.
I am very active and I specialise in the GTA IV's radios, especially Beat 102.7 and The Classics.Loading editor
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Hi Tom. That would be great, thanks. I've started working from today so will be offline for a lot of the day but I'll do my very best to be online as much as possible.Loading editor
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Hey dude,do remember me?the person who told me to calm down when I was fighting with Instulent.Hey but then I am a blocked user.Can you remember me?Loading editor
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Hey, Thomas. How many Affliates your wiki has? I thought of making this wiki affliate to GTA Liberty Wiki. Currently has 73 pages and it is going well. Huh? What do you say?Loading editor
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Hey there Tom. I'd like to ask for permission to be promoted to patroller on this wiki. I have been very active these last few weeks, and I have worked on making pages for the songs for Lowdown FM, as well as all of the songs of Liberty Rock Radio. My current project is to complete all the stations and songs from GTA V. If it matters at all, I'm very active on the GTA Wiki, and I'm an admin on your affiliate wiki, GTA Myths Wiki. I have over 100 edits on this wiki, and I am planning on being very active here. So, to sum it up, I'd like to be a patroller here. Thanks.Loading editor
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Hi Tommy, if you don't mind, I'll edit the theme. This one is too much blue and the links can't be seen clearly.Loading editor
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Hey Thomas, since I'm here, and I'm interested in every song I hear in Grand Theft Auto, can I be an Admin. Tomorrow is my latest exam and I'll be editing.Loading editor
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FollowHey Thomas. Check this background out!
But seriously, we need to get a background. I tried making one with loads of radio stations all over it but the file size is apparently too big.Loading editor
There are few sites around the internet where you can make your pic smaller, BTW, it would be cool having a background image with these three images together.Loading editor
Yeah. The thing was that it was too many kilobites bigger.Loading editor
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FollowHey there Thomas. The wiki's looking good so far. I was wondering, could you possibly make me an admin? It's just I'd be able to do a bit more and I want to try to see if I can add an image to the wiki's header.Loading editor
- View all 15 replies
Yes! I've been searching for websites around the internet to format textes but I didn't found nothing useful. Thanks for the header, I'll add it right now.
And about the administrator rights, like this is a subsidiary Wiki of the GTA Wiki, I'll give admin rights for the administrators from the GTA Wiki, but with one condition. They need to prove that they will be active enough to keep the position. So, do you accept?
In the meantime, I'll create a Staff page.Loading editor
Yeah, I'll be as active as I can. Just remember, I am active on a lot of wikis and at the moment I'm being very active on the Dead Island Wiki but I'll come on this one as much as I can.Loading editor
I'm having a problem with fixing the wordmark, I can't upload the image, a message shows up saying that the image exceed the dimensions' limits. I hope you can fix it.
Anyways, rights granted.Loading editor
Thanks. Could you tell me what size it needs to be?Loading editor
250x65. Like the one from the GTA Wiki.Loading editor
Oh wait, stupid question. How many px do you want it?Loading editor
I don't know if you can see it yet but...I DID IT!!! :DLoading editor
Thanks! It looks awesome. Sorry for the late replies because I'm not accustomed with message walls.Loading editor
It's ok.Loading editor
And remember that we also have an infobox for radio stations, (see in this page). Plus, to keep things organized, I think it's better to put the [[...]] only in the songs and not in the artists, to not confuse what we have here and what exists on Wikipedia only.Loading editor
We could make pages for the artists. And also, I was just having my dinner and I was going to return and do the infobox after (which would be now).Loading editor
Of course, but I prefer to make the pages for the artists after all the songs pages have been completed. Because it's too much stuff and stress for the beginning, organizing the categories and etc.. but we'll do it, of course.Loading editor
Alright.Loading editor
Loading editor
Hello, We're excited to have GTA Songs Wiki as part of the Wikia community!
There's still a lot to do; here are some helpful tips and links to get your wiki going:
- Check out Wiki Features to see which features you can enable on your wiki, including Chat, Achievements and many more.
- Customize your wiki's look by visiting the Theme Designer, where you can add color and style to your background and wordmark.
- Stop by Community Central to stay informed through our staff blog, ask questions on our community forum, participate in our webinar series, or chat live with fellow Wikians.
- Lastly, visit our help pages to learn the ins and outs of using Wikia, including how to add a new page to your wiki, how to attract contributors, and how to add other admins.
- You can also use all of these tools by visiting your Admin Dashboard, which can by found by clicking "Admin" on the bottom toolbar.
All of the above links are a great place to start exploring, and have fun!Loading editor
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text:
York, ME
Bittersweet Bed and Breakfasst is a refurbished 1910 farmhose with 7 comfortable rooms.
York, ME
York Harbor, ME (2 miles from York Beach)
Charming York Maine Bed and Breakfast by the sea between York Beach and York Harbor.
York Harbor, ME (2 miles from York Beach)
Overall rating:
The York Beach B&B review score is based on feedback from travelers from around the world. See property page for full, detailed reviews by real travelers.


text:
Cool Cats Fat Quarters - 6/pkg.
Cool kitties galore!
These bright and happy fat quarters feature colorful kitties with attitudes that are sure to jump right off the fabric and into any project! Also featuring colorful stripes, polka dots and paw prints, stitch up a quilt or even a handbag for your favorite cat-lover and you'll have a grateful and happy person on your hands! Includes 6 (18" x 22") fat quarters of 100% cotton fabric from Loralie Designs.


text:
Our modern and traditional toilet brush holders and toilet bowl brushes are made from brass and come with a hygienic polished chrome finish. The range comes with matching brush handles, and can be combined with a toilet roll stand for a neat, cost-saving solution.
A toilet brush and holder will not only make a useful addition to your bathroom or cloakroom suite but will help to complete the look too. To help create more floor space why not choose a wall-mounted toilet brush holder, this will provide a neater finish too.
Create a coodinating look with one of our towel rails, soap dishes and toothbrush holders.
A toilet brush holder as well as other accessories such as a toilet roll holder, towel rail and soap dish provide the best way to create a neat, organised look to your bathroom or en-suite. Toilet brush holders are available in a choice of designs to blend in with the style of your modern or traditional bathroom and they offer a practical way to clean inside the toilet too.
Toilet brush holders are available in chrome and antique gold finishes. Chrome plated toilet brush holders will help to enhance other chrome items in your bathroom such as the shower and taps. Toilet brush holders in a gold finish provide a different alternative to chrome and enhance a traditional bathroom.
Keep your toilet brush holder looking in great condition by cleaning it often simply by using warm soapy water and then dry with a soft cloth. Try to avoid harsh cleaning products as they can damage the surface.


text:
- Game Details
- News (5)
- Review
- Previews (1)
- Videos (2)
- Images
- Cheats & Walkthroughs
Atlus, Trine Developer Partnering On Unannounced New Game For 2011
Press releases teasing upcoming announcements are wastes of Internet space, but as a huge fan of last year's massively overlooked fantasy...
There Will Be More Trine, But Where And When Remains A Secret
Very soon, you'll be able to download Trine over PlayStation Network. It's been a long time coming, but with the game launched in Europe, a US...
Trine On PlayStation 3 Still Doesn't Have A Release Date
Frozenbyte's fantastic looking (and playing) platformer Trine was supposed to be released on PlayStation Network before the end of July, but a...
Trine Won't Arrive On PlayStation Network Tomorrow, Release Date Fuzzy
I don't wish to be the bearer of bad news, but Trine developer Frozenbyte has confirmed what I suspected last night. Trine will not hit...
Is Trine Being Released This Week On PlayStation Network?
The wonderful, beautiful platformer Trine was released on the PC a few weeks back to near unanimous critical acclaim and was pegged by publisher...
Trine Interview With Frozenbyte CEO Lauri Hyv?rinen
Frozenbyte has come out of nowhere with Trine, a beautiful physics-based 2D platformer that has players transforming between a wizard, a thief and a knight. Trine was released on the PC over the summer should be on the PlayStation Network soon enough. With the game's console debut almost here, I spoke with Frozenbyte CEO Lauri Hyv?rinen about Trine.
My X-Play 1000Th Episode PosterLatest Post: Mar 18, 2013 by Smashdrama
I Can't Believe It's Come To This.Latest Post: Mar 18, 2013 by Shadow_ben_jamin
Anime Corner Farewell Tour! March...Latest Post: Mar 18, 2013 by Squeakachu31


text:
Milestones of constructing
the central building
Topping-Off Ceremony January, 19, 2015
On January 19th the Leuphana University of Lüneburg celebrated the topping-off ceremony of its new Central Building. Numerous prominent representatives from business and politics were present at the ceremony, including the Lower Saxony Minister for Science and Culture, Dr. Gabriele Heinen-Kljajic. The architecture professor, Daniel Libeskind, also attended the ceremony in order to address the guests. The Board of Trustees and the Presidential Committee described the building as a milestone in the university's progress and a driving force for the entre region. More
03.02.2015 Susanne Leinss


text:
A year ago today the world was reminded of what it is like to feel terrified.
On April 15, 2013, the Boston Marathon finish line was bombed, leaving three dead and more than 250 injured.
It was a horrible moment that left a lasting impact on its victims and their families.
As the smoke cleared and it became apparent what had happened, many Bostonians and Marathon attendees were shipped to hospitals to receive medical assistance.
Twenty-seven hospitals treated victims of the blasts. The images that came out of the bombing were incredible. People were being escorted away in wheelchairs without limbs. Others were left wandering, covered in soot from the explosion, disoriented and confused. In some ways it is almost impossible to see past the experience, but in others, there is no other valid option.
People were marked — in some cases physically, and in others emotionally — and potentially for a lifetime in Boston on that spring day.
But the collective wisdom of the bombing victims, which has slowly been released in media reports marking the bombing's anniversary, has as a whole seemed to bring a better light to the narrative of what happened.
Even when they have every right to hate the men who cost them — in some cases — almost everything, many of the survivors have sounded the same note.
It isn't a note of sorrow or hatred.
It's one of positivity. One of hope and a dream of tomorrow.
The images of the Boston Marathon bombing are permanent and not open for interpretation, but their meaning is, and many of the bombing survivors have found that meaning.
They refuse to be defeated. They're Boston Strong. And the Times-Herald newsroom couldn't admire them more.
All Times-Herald editorials are written by the editorial staff.


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PAMPA - James Marvin "Jim" Dougless, 84, died Sunday, Dec. 19, 2004, in Hobbs, N.M.
Services will be at 10:30 a.m. Wednesday in Carmichael-Whatley Funeral Directors Colonial Chapel with Rodney Tedford officiating. Pallbearers will be Russell Sean Davis, Jimmy Dougless, Robert Dougless, Russell Dougless, Joshua Dougless and Dylan Dougless. There will be no graveside services.
Mr. Dougless, 84, of Pampa left this Earth to join his beloved wife, Tampa, in heaven on Dec. 19, 2004.
Jim was born March 20, 1920, to Marvin Eugene Dougless and Hettie Dougless in Wizard Wells.
He married Tampa Kenner Davis on Jan. 6, 1951, in Pampa. They lived in Pampa for 50 years. In 2002, he moved to Hobbs. He was a retired drilling and completion foreman for Diamond Shamrock and Maxxus Energy and was a member of the Plumbers and Pipefitters Union 654 of Abilene. Jim served honorably in the Army Air Corps during World War II with the 405th Fighter Squadron and the 34th Photo Reconnaissance Squadron and participated in campaigns in Northern France, Normandy, the Rhineland and the central European air offensive. He enlisted in 1941 and was discharged as a sergeant in 1946. He was a member of Pampa Masonic Lodge 966 and Mary Ellen at Harvester Church of Christ. He had served as a board member for the Freedom Museum USA and had been active with the Pampa Army Air Force Reunion.
He was preceded in death by his wife of 50 years; his parents; a brother, Pete Dougless; and a sister, Gladys Rockwell.
Survivors include three sons, Russell Davis and wife, Joyce, and James Kirk Dougless and wife, Bobbi, all of Amarillo, and Robert "Bobby" Dougless and wife, Polly, of Hobbs; 12 grandchildren, Russell Sean Davis, Shane Davis, Jennifer Wilkerson, Jill Wardlow, Jimmy Dougless, Robert Dougless, Russell Dougless, Kristi Summers, Nikki Summers, Amanda Summers, Joshua Dougless and Dylan Dougless, 11 great-grandchildren; and a sister, Cleatta Murtaugh of Fort Worth.
The family suggests memorials be to Cal Farley's Boys Ran ch, P.O. Box 1890, Amarillo, TX 79174.
Sign the online guest register at www.carmichael-whatley.com.
Visitation will be from 6 to 8 p.m. today at the funeral home.
Amarillo Globe-News, Dec. 21, 2004
© 2016. All Rights Reserved. | Contact Us


text:
Sausage Party
Penguins of Madagascar
Madagascar 3: Europe's Most Wanted
Puss in Boots
Shrek Forever After
Monsters vs. Aliens
Madagascar: Escape 2 Africa
Bee Movie
Shrek the Third
All Conrad Vernon photos
All Conrad Vernon films
Movies.com, the ultimate source for everything movies, is your destination for new movie trailers, reviews, photos, times, tickets + more! Stay in the know with the latest movie news and cast interviews at Movies.com.
Copyright © 2016 FANDANGO MOVIES.


text:
Tranzqual Improves User Experience for Mobile Workforce
Tranzqual is in the Industry Training Organisation responsible for setting world class training standards for the commercial road transport, passenger services, warehouse and logistics, fright forwarding, ports and stevedoring industries. The company works with a wide variety of companies with these industries including transport, bus. courier, taxi warehousing, logistics, ports and stevedoring companies to increase the skills and knowledge of their employees. Read more.
Maintaining control over cloud access, collaborative applications, and user mobility are three of the major challenges to protecting data and files that enterprise IT departments face. Alongside the task of maintaining appropriate enterprise network resource access, organizations need file protection products that offer appropriate levels of control for the internal users and the variety of external users requiring access to sensitive and/or regulated information. Satisfying these challenges is necessary to protect the intellectual property of the business and its market position, and to manage the reputation and liability risks associated with privacy and compliance. Download whitepaper »
File Insecurity: The Final Data Leakage Frontier Download whitepaper »
Australia is refining its focus on science, technology, engineering, and mathematics (STEM) subjects to produce the skills that today's students will need to be active members of tomorrows workforce. Choosing the right technology is essential - but do you know how to make that choice? Download whitepaper »


text:
ActiveStomp v. 0.0.1 released
I just released new gem ActiveStomp. It helps dealing with ActiveMQ message receiving by abstracting the most common Ruby Stomp gem methods into one. I'm planning to make it even more flexible, though I need to think more about it's future shape.
I appreciate any pull requests. :)


text:
PDF To Image Converter
PDF To Image Converter
( Version: 11.4.0 )
Mgosoft PDF To Image is a fast, affordable way to batch convert PDF files to image formats. It directly convert PDF files to dozens of image formats, such as TIFF, JPEG, PNG, BMP, PCX, GIF, WMF, EMF, TGA and so on, it retains the layout, images, text, line, ellipse, color, and formatting of the original PDF file.
Mgosoft PDF To Image does NOT require Adobe Acrobat, and original PDF formatting and interrelation of text and graphical elements on each page. Creating documents which can be viewed on any computer with a Image viewer. And you can set the image quality, image color, image resolution, etc.
More License to Buy
Unit Price
PDF To Image GUI
PDF To Image Command Line
Developer License
PDF To Image SDK/COM
Developer License
License Agreement
Developer License & SDK/COM: It is unlimited license, you can integrate the corresponding SOFTWARE into your developed software and redistribute it to all your customers with royalty-free. If the SOFTWARE contains source codes, you have the right to modify and reuse the codes.
Main interface of the software:
Display All Screenshots and Settings >>
Key Functions
Support dozens of image formats, include TIF, TIFF, JPG, GIF, PNG, BMP, PCX, WMF, EMF, TGA etc;
Produce multipage TIFF files;
Support Progressive JPEG, Baseline JPEG;
Support for PACKBITS, CCITT Fax4/Fax3, LZW, RunLength, JPEG, etc. compression of TIFF files;
Supports conversion into 1, 4, 4-bit grayscale, 8, 8-bit grayscale or 24-bit format;
Supports set the image format (bitonal, grayscale, color);
Options to control target compression algorithm and quality;
Choose to convert each page or a custom page range;
Change DPI settings depending on your needs;
Standalone software, Adobe Acrobat and Reader NOT required!
Support for Unicode and all PDF font formats;
Convert owner password protected PDF files to image files directly.
Support Password Protected PDF file conversion.
Use it on all Windows version including the latest builds of Windows 10.
Command Line
Usage: pdftoimage <-i PDF File> [options]
-i <string>
Specify input pdf file or folder.
-o <string>
Specify output folder
-w <string>
Set open pdf file password.
-t <string>
Set image type, default is 'jpg'.
-t tif: tif image file ( -b 24, 8, 7, 4, 3, 1 ).
-t bmp: bmp image file ( -b 24, 8, 7, 4, 3, 1 ).
-t png: png image file ( -b 24, 8, 7, 4, 3, 1 ).
-t pcx: pcx image file ( -b 24, 8, 7, 4, 3, 1 ).
-t gif: gif image file ( -b 8, 7, 4, 3, 1 ).
-t jpg: jpg image file ( -b 24, 7 ).
-t wmf: wmf image file.
-t emf: emf image file.
-t tga: tga image file ( -b 24, 8, 7 ).
-t jp2: jpeg2000 image file ( -b 24, 7 ).
-t jpc: jpeg2000 image file ( -b 24, 7 ).
-t ras: ras image file ( -b 24, 7 ).
-b <int>
Set color depth.
-b 24: True color ( 24 bits )
-b 8: 256 color ( 8 bits )
-b 7: 256 color grayscale ( 8 bits )
-b 4: 16 color ( 4 bits )
-b 3: 16 color grayscale ( 4 bits )
-b 1: black/white (1 bits )
-q <int>
Set quality for jpeg image,from 1 to 100,default is 75.
-z <int>
Set save jpeg image mode.
-z 1: Progressive JPEG (default)
-z 2: Baseline JPEG
-z 3: Optimized baseline JPEG
-c <string>
Set compression method fo tiff files, default is 'jpeg'
-c none: Create TIFF file without compression ( -b 24, 8, 7, 4, 3, 1 )
-c lzw: Compress TIFF using LZW arithmetic ( -b 24, 8, 7, 4, 3, 1 )
-c jpeg: Compress TIFF using JPEG arithmetic ( -b 24, 7 )
-c packbits: Compress TIFF using PACKBITS arithmetic ( -b 24, 8, 7, 4, 3 )
-c g4: Compress TIFF using CCITT G4 arithmetic ( -b 1 )
-c g3: Compress TIFF using CCITT G3 arithmetic ( -b 1 )
-c rle: Compress TIFF using RLE arithmetic ( -b 1 )
-x <int>
Set Horizontal resolution in generated image files,form 72 to 600, default is 72.
-y <int>
Set Vertical resolution in generated image files,form 72 to 600, default is 72.
-g <int>
Set rotate angle, 0,90,180,270
-s <string>
Set image size.
-s 1024x768: Set generated image width is 1024, height is 768.
-n <string>
Set page range to convert.
-n 2,5-15,20-: Extract page 2,page 5 through 15, page 20 through end.
-n even: Extract even pages.
-n odd: Extract odd pages.
Set output to multi-page TIFF file, default is output to single page TIFF files.
===Text stamping===
-at <string>
The content of the stamp.
-as <int>
Set the font size, default is 16 point.
-ac <int>
Set the text color,range from 0-16777215,default is 255(red).
-af <int>
Set the font name, default is Arial.
Set the font bold.
Set the font is italic.
Set the font is underlined.
-ap <int>
The Position of stamps.
1 = Stamps on the Top-Left of the page. (default)
2 = Stamps on the Top-Center of the page.
3 = Stamps on the Top-Right of the page.
4 = Stamps on the Right-Center of the page.
5 = Stamps on the Right-Bottom of the page.
6 = Stamps on the Bottom-Center of the page.
7 = Stamps on the Left-Bottom of the page.
8 = Stamps on the Left-Center of the page.
9 = Stamps on the Center of the page.
-ax <int>
Offset from current position.
e.g -ax 10 Move to right 10 point
e.g -ax -10 Move to left 10 point
-ay <int>
Offset from current position.
e.g -ay 10 Move to bottom 10 point
e.g -ay -10 Move to top 10 point
Supported Operating Systems
OS: Microsoft® Windows XP/Vista/7/8/10 of both 32-bit and 64-bit.


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Google's revenue last year was close to $29 Billion. If you look at how much of their revenue comes from search advertising (mainly Google Adwords), this equates to 28.4B. Now let's look at how much of that comes from Insurance
According to Wordstream, the number one money earner (in terms of Cost Per Click) are insurance related terms. This works out at a whopping 6.8 BILLION DOLLARS just for insurance related terms in one year.
Google made 6.8 Billion Dollars on Insurance Last Year
{ 6 comments }
- November 20, 2011 at 5:15 pm
That makes the one / two TLD coms's very valuable, very long term marketing tools: re Quinnstreet @ Bankrate verticals. They use white label comparison agreements (Kanetix) They have the options to become full service providers and build a new brand through the keywords, interesting how Unum used TV advertising 4 = http://www.backupplan.com/ and the generic website to advertise the brand "Unum"
- November 22, 2011 at 7:18 pm
Come on people where are the SEO experts replies, or are you waiting for SEOmoz / some other forum to help out. Truly there are very few SEO people worth the salt. IMO this is marketing in a nutshell =
http://knowledge.wharton.upenn.edu/articlepdf/2305.pdf?CFID=170154803&CFTOKEN=44156521&jsessionid=a830887a8a027a0e6172269506db7b421815 = become the brand via deep pockets or jump-start marketing through linguistics / keyword.
- December 30, 2011 at 10:05 pm
$6.8 Billion, I only want 0.001% of that
- January 2, 2012 at 12:31 pm
I was wondering how much you would charge to advertise on your INSURANCE related site. I am looking to place a small text based ad. If the price is affordable I may buy more than one over time. I usually ask for one line with just a few words. I prefer them at the top, middle, or bottom of the main content area of the site. However, I am sure we can work out placement.
Please let me know what you would charge me to place a link ad on your site. If you are interested let me know the price and if you prefer PayPal or a check?
Paul White
Inventory Manager
- February 15, 2012 at 5:00 pm
I prefer them at the top, middle, or bottom of the main content area of the site. However, I am sure we can work out placement.
- October 22, 2012 at 2:06 pm
Trust me to be in the biggest niche within the internet for CPC. Amazing amounts of profit their for Google. The ad words area on the search results is getting bigger all the time. I don't imagine the stats on clicks to natural results are as high as they used to be. Even being in position 3rd on page one puts my site below the fold on laptops. Not good. But unfortunately Google are the only search engine worth being on so we don't have much choice.
Comments on this entry are closed.


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Welcome to the Division of University Housing at UW-Madison! Whether you are an undergraduate student in our residence halls, a PhD candidate in our apartment communities, a hungry customer in our dining markets, a summer program attendee, an employee, or a proud parent, University Housing provides an experience that is built for your success. We are here to serve you and to support the mission of the University.
Nov. 24-27: Thanksgiving Recess
Dec. 15: Last Class Day
Dec. 17-23: Final Exam Period
Dec. 24: All Residence Halls Close
Jan. 9: 3rd Quarter Housing Bill Due
Jan. 14: All Residence Halls Reopen
Mar. 13: 4th Quarter Housing Bill Due
Mar. 18-26: Spring Recess
May 4: Last Class Day


text: BJBE offers dynamic, innovative programming for our members and guests. We provide an active community to those who wish to make a difference, a caring community to those less fortunate, and a nurturing community to those seeking connection. This includes BJBE's award-winning Sisterhood, the Men's Club and other programs and events.


text: Home > About Us > News & Events > Press Releases > Give a Gift that Makes a Difference for Patients & Families in your Community Press Releases Give a Gift that Makes a Difference for Patients & Families in your Community 2/2/2012 White Plains Hospital is pleased to be included as one of the charities listed on presentsforpurpose.com, an online gift boutique that lets shoppers pick their favorite charity to receive a portion of the proceeds for their purchase. Unique merchandise to benefit White Plains Hospital now available at PresentsforPurpose.com White Plains, NY (February 2, 2012) -With lots of gift-giving opportunities coming up around the corner, from Valentines Day to Mother's Day to graduation, why not buy something for that special loved one that also benefits your community hospital? White Plains Hospital (WPH) is pleased to be included as one of the charities listed on presentsfor purpose.com, an online gift boutique that lets shoppers pick their favorite charity to receive a portion of the proceeds for their purchase. Visitors who browse the site's eclectic collection of apparel, jewelry, accessories and gift collections, can now donate 10% of their purchase to WPH by selecting "White Plains Hospital" from the drop down menu of charity options on select product pages. All items are attractively packaged with an informative card about this special giving program. The proceeds that WPH receives from the website will be used towards a variety of funding needs such as expansion of state-of-the-art medical technologies and facilities, professional development for clinical teams, and enhancement of support programs and services for patients and their families. This is an exciting new outlet to benefit the hospital that makes giving back a little more personal and of course, fun. Visit www.presentsforpurpose.com for more information. ### White Plains Hospital (WPH) is a 292-bed voluntary, not-for-profit health care organization with the primary mission of offering high quality, acute health care and preventive medical care to all people who live in, work in or visit Westchester County and its surrounding areas. Centers of Excellence include the Dickstein Cancer Center, The William & Sylvia Silberstein Neonatal & Maternity Center, The Ruth and Jerome A. Siegel Stroke Center and The Westchester Orthopedic Institute. The Hospital has the busiest Emergency Department in Westchester County, with more than 55,000 visits a year. White Plains Hospital is the only community hospital in Westchester County licensed to perform emergency & elective angioplasty. The Hospital is a nine-time winner of the Consumer Choice Award, an honor given to the nation's top hospitals by the National Research Corporation, and received Magnet designation in 2012 from the American Nurses Credentialing Center. WPH is a member of the New York-Presbyterian Healthcare System and the Stellaris Health Network, Inc. For additional information, visit http://www.wphospital.org. News & Events Press Releases Physician News Annual Report HealthMatters Magazine Calendar of Events Photo Gallery White Plains Hospital Videos Meet Our Doctors YouTube Channel Community Outreach Featured Video As the leading regional cancer facility, the WPH Cancer Program provides patients with the best care available in an easily accessible setting. View All Videos Annual Report The 2014-2015 White Plains Hospital Annual Report is now available online. Please click here to see compelling patient testimonials and read about the remarkable growth of the Hospital and exciting plans on the horizon as we continue to modernize and expand. Read more


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Sioux City, IA (ABC 9 News) - Window treatments not only bring a stylish touch to any room, they can also provide a good source of shade.
In fact, experts say window blinds – either the vertical or horizontal type – can reduce solar heat gain, by roughly 45%. Insulated draperies can also improve your efficiency, but you need to pay attention to the fabric type and color.
Angie Hicks, with Angie's List, says, "When it comes to keeping cool in the summertime grandma's advice about pulling the drapes on windows that face the west and the south still holds true. Using a medium–colored drape with a white plastic backing can cut your solar heat gain by 33 percent."
Not only that, several types of window shades can also cut energy costs.
Pat Rebb, a window covering specialist, says, "One of the most efficient window coverings is cellular or honeycomb shades. They have a gap of air between the cells which helps as a barrier for that warm air and the heat coming in, that solar heat coming in."
Shutters are an option and so are awnings, for a more modern appearance.
These actually cut solar gain by roughly 77%, and the one's out there, now, are generally good for 12 to 15 years.Keep in mind: the key to reducing energy use in your home is ensuring window treatments are installed properly. The good news here? Angie's List found that most window treatment companies do offer free, in–home consultations.
Copyright 2016 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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Prostate cancer
From Free net encyclopedia
Template:DiseaseDisorder infobox |
ICD9 = Template:ICD9 | Image = Prostatelead.jpg | Caption = | ICDO = | OMIM = 176807 | DiseasesDB = 10780 | MedlinePlus = 000380 | eMedicineSubj = radio | eMedicineTopic = 574 |
}} Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. Cancer occurs when cells of the prostate mutate and begin to multiply out of control. These cells may spread (metastasize) from the prostate to other parts of the body, especially the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, erectile dysfunction and other symptoms.
Rates of prostate cancer vary widely across the world. It is least common in South and East Asia, more common in Europe - though the rates vary widely between countries - and most common in the United States [1]. According to the American Cancer Society, prostate cancer is least common among Asian men and most common amongst Black men. with figures for European men in between [2] [3]. However, these high rates may be affected by increasing rates of detection [4].
Prostate cancer only occurs in men and develops most frequently in those over fifty. It is the second most common type of cancer in men in the United States, where it is responsible for more male deaths than any other cancer except lung cancer. However, many men who develop prostate cancer never have symptoms, undergo no therapy, and eventually die of other causes. Many factors, including genetics and diet, have been implicated in the development of prostate cancer, but as of 2005, it is not a preventable disease.
Prostate cancer is most often discovered by physical examination or by screening blood tests, such as the PSA (prostate specific antigen) test. There is some current concern about the accuracy of the PSA test and its usefulness. Suspected prostate cancer is typically confirmed by removing a piece of the prostate (biopsy) and examining it under a microscope. Further tests, such as X-rays and bone scans, may be performed to determine whether prostate cancer has spread.
Prostate cancer can be treated with surgery, radiation therapy, hormone therapy, occasionally chemotherapy, or some combination of these. The age and underlying health of the man as well as the extent of spread, appearance under the microscope, and response of the cancer to initial treatment are important in determining the outcome of the disease. Since prostate cancer is a disease of older men, many will die of other causes before the prostate cancer can spread or cause symptoms. This makes treatment selection difficult.Template:Ref The decision whether or not to treat localized prostate cancer (a tumor that is contained within the prostate) with curative intent is a patient trade-off between the expected beneficial and harmful effects in terms of patient survival and quality of life.
The prostate
The prostate is a male reproductive organ which helps make and store seminal fluid. In adult men a typical prostate is about three centimeters long and weighs about twenty grams.Template:Ref It is located in the pelvis, under the urinary bladder and in front of the rectum. The prostate surrounds part of the urethra, the tube that carries urine from the bladder during urination and semen during ejaculation.Template:Ref Because of its location, prostate diseases often affect urination, ejaculation, or defecation. The prostate contains many small glands which make about twenty percent of the fluid comprising semen.Template:Ref In prostate cancer the cells of these prostate glands mutate into cancer cells. The prostate glands require male hormones, known as androgens, to work properly. Androgens include testosterone, which is made in the testes; dehydroepiandrosterone, made in the adrenal glands; and dihydrotestosterone, made in the prostate itself. Androgens are also responsible for secondary sex characteristics such as facial hair and increased muscle mass.
Early prostate cancer usually causes no symptoms. Often it is diagnosed during the workup for an elevated PSA noticed during a routine checkup. Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hypertrophy. These include frequent urination, increased urination at night, difficulty starting and maintaining a steady stream of urine, blood in the urine, and painful urination. Prostate cancer may also cause problems with sexual function, such as difficulty achieving erection or painful ejaculation.Template:Ref
Advanced prostate cancer may cause additional symptoms as the disease spreads to other parts of the body. The most common symptom is bone pain, often in the vertebrae (bones of the spine), pelvis or ribs, from cancer which has spread to these bones. Prostate cancer in the spine can also compress the spinal cord, causing leg weakness and urinary and fecal incontinence.Template:Ref
Image:Normal cancer cell division from NIH.png
Prostate cancer is classified as an adenocarcinoma, or glandular cancer, that begins when normal semen-secreting prostate gland cells mutate into cancer cells. The region of prostate gland where the adenocarcinoma is most common is the peripheral zone. Initially, small clumps of cancer cells remain confined to otherwise normal prostate glands, a condition known as carcinoma in situ or prostatic intraepithelial neoplasia (PIN). Although there is no proof that PIN is a cancer precursor, it is closely associated with cancer. Over time these cancer cells begin to multiply and spread to the surrounding prostate tissue (the stroma) forming a tumor. Eventually, the tumor may grow large enough to invade nearby organs such as the seminal vesicles or the rectum, or the tumor cells may develop the ability to travel in the bloodstream and lymphatic system. Prostate cancer is considered a malignant tumor because it is a mass of cells which can invade other parts of the body. This invasion of other organs is called metastasis. Prostate cancer most commonly metastasizes to the bones, lymph nodes, rectum, and bladder.
The specific causes of prostate cancer remain unknown.Template:Ref A man's risk of developing prostate cancer is related to his age, genetics, race, diet, lifestyle, medications, and other factors. The primary risk factor is age. Prostate cancer is uncommon in men less than 45, but becomes more common with advancing age. The average age at the time of diagnosis is 70.Template:Ref However, many men never know they have prostate cancer. Autopsy studies of Chinese, German, Israeli, Jamaican, Swedish, and Ugandan men who died of other causes have found prostate cancer in thirty percent of men in their 50s, and in eighty percent of men in their 70s.Template:Ref In the year 2005 in the United States, there were an estimated 230,000 new cases of prostate cancer and 30,000 deaths due to prostate cancer.Template:Ref
A man's genetic background contributes to his risk of developing prostate cancer. This is suggested by an increased incidence of prostate cancer found in certain racial groups, in identical twins of men with prostate cancer, and in men with certain genes. In the United States, prostate cancer more commonly affects black men than white or Hispanic men, and is also more deadly in black men.Template:Ref Men who have a brother or father with prostate cancer have twice the usual risk of developing prostate cancer.Template:Ref Studies of twins in Scandinavia suggest that forty percent of prostate cancer risk can be explained by inherited factors.Template:Ref However, no single gene is responsible for prostate cancer; many different genes have been implicated. Two genes (BRCA1 and BRCA2) that are important risk factors for ovarian cancer and breast cancer in women have also been implicated in prostate cancer.Template:Ref
Dietary amounts of certain foods, vitamins, and minerals can contribute to prostate cancer risk. Men with higher serum levels of the short-chain ω-3 fatty acid linolenic acid have higher rates of prostate cancer. However the same series of studies showed that men with elevated levels of long-chain ω-3 (EPA and DHA) had lowered incidence.Template:Ref Other dietary factors that may increase prostate cancer risk include low intake of vitamin E (Vitamin E is found in green, leafy vegetables), lycopene (found in tomatoes) omega-3 fatty acids (found in fatty fishes like salmon), and the mineral selenium. Lower blood levels of vitamin D also may increase the risk of developing prostate cancer. This may be linked to lower exposure to ultraviolet (UV) light, since UV light exposure can increase vitamin D in the body.Template:Ref
There are also some links between prostate cancer and medications, medical procedures, and medical conditions. Daily use of anti-inflammatory medicines such as aspirin, ibuprofen, or naproxen may decrease prostate cancer risk.Template:Ref Use of the cholesterol-lowering drugs known as the statins may also decrease prostate cancer risk.Template:Ref Sterilization by vasectomy may increase the risk of prostate cancer, though there are conflicting data.Template:Ref More frequent ejaculation also may decrease a man's risk of prostate cancer. One study showed that men who ejaculated five times a week in their 20s had a decreased rate of prostate cancer.Template:Ref Infection or inflammation of the prostate (prostatitis) may increase the chance for prostate cancer. In particular, infection with the sexually transmitted infections chlamydia, gonorrhea, and syphilis seem to increase risk.Template:Ref Finally, obesityTemplate:Ref and elevated blood levels of testosteroneTemplate:Ref may increase the risk for prostate cancer.
Prostate cancer screening is an attempt to find unsuspected cancers. Screening tests may lead to more specific follow-up tests such as a biopsy, where small pieces of the prostate are removed for closer study. As of 2005 prostate cancer screening options include the digital rectal exam and the prostate specific antigen (PSA) blood test. Screening for prostate cancer is controversial because it is not clear if the benefits of screening outweigh the risks of follow-up diagnostic tests and cancer treatments.
Prostate cancer is a slow-growing cancer, very common among older men. In fact, most prostate cancers never grow to the point where they cause symptoms, and most men with prostate cancer die of other causes before prostate cancer impacts their lives. The PSA screening test may detect these small cancers that would never become life threatening. Doing the PSA test in these men may lead to overdiagnosis, including additional testing and treatment. Follow-up tests, such as prostate biopsy, may cause pain, bleeding and infection. Prostate cancer treatments may cause urinary incontinence and erectile dysfunction. Therefore, it is essential that the risks and benefits of diagnostic procedures and treatment be carefully considered before PSA screening.
Prostate cancer screening generally begins after age fifty, but may be offered earlier in black men or men with a strong family history of prostate cancer.Template:Ref Although there is no officially recommended cutoff, many health care providers stop monitoring PSA in men who are older than 75 years old because of concern that prostate cancer therapy may do more harm than good as age progresses and life expectancy decreases.
Digital rectal examination
Digital rectal examination (DRE) is a procedure where the examiner inserts a gloved, lubricated finger into the rectum to check the size, shape, and texture of the prostate. Areas which are irregular, hard or lumpy need further evaluation, since they may contain cancer. The DRE only evaluates the back of the prostate, but fortunately, 85% of prostate cancers arise in this part of the prostate. Prostate cancer which can be felt on DRE is generally more advanced.Template:Ref The use of DRE has never been shown to prevent prostate cancer deaths when used as the only screening test.Template:Ref
Prostate specific antigen
The PSA test measures the blood level of prostate-specific antigen, an enzyme produced by the prostate. Specifically, PSA is a serine protease similar to kallikrein. Its normal function is to liquify gelatinous semen after ejaculation, allowing spermatazoa to more easily "swim" through the uterine cervix.
PSA levels under 4 ng/mL (nanograms per milliliter) are generally considered normal, while levels over 4 ng/mL are considered abnormal. PSA levels between 4 and 10 ng/mL indicate a risk of prostate cancer higher than normal, but the risk does not seem to rise within this six-point range. When the PSA level is above 10 ng/mL, the association with cancer becomes stronger. However, PSA is not a perfect test. Some men with prostate cancer do not have an elevated PSA, and most men with an elevated PSA do not have prostate cancer.
PSA levels can change for many reasons other than cancer. Two common causes of high PSA levels are enlargement of the prostate (benign prostatic hypertrophy (BPH)) and infection in the prostate (prostatitis). PSA levels are lowered in men who use medications used to treat BPH or baldness. These medications, finasteride (marketed as Proscar or Propecia) and dutasteride (marketed as Avodart), may decrease the PSA levels by 50% or more.
Several other ways of evaluating the PSA have been developed to avoid the shortcomings of simple PSA screening. The use of age-specific reference ranges improves the sensitivity and specificity of the test. The rate of rise of the PSA over time, called the PSA velocity, has been used to evaluate men with PSA levels between 4 and 10 ng/ml, but as of 2005, it has not proven to be an effective screening test.Template:Ref Comparing the PSA level with the size of the prostate, as measured by ultrasound or magnetic resonance imaging, has also been studied. This comparison, called PSA density, is both costly and, as of 2005, has not proven to be an effective screening test.Template:Ref PSA in the blood may either be free or bound to other proteins. Measuring the amount of PSA which is free or bound may provide additional screening information, but as of 2005, questions regarding the usefulness of these measurements limit their widespread use.Template:RefTemplate:Ref
Confirming the diagnosis
Image:Prostatehistopath.jpg When a man has symptoms of prostate cancer, or a screening test indicates an increased risk for cancer, more invasive evaluation is offered. The only test which can fully confirm the diagnosis of prostate cancer is a biopsy, the removal of small pieces of the prostate for microscopic examination. However, prior to a biopsy, several other tools may be used to gather more information about the prostate and the urinary tract. Cystoscopy shows the urinary tract from inside the bladder, using a thin, flexible camera tube inserted down the urethra. Transrectal ultrasonography creates a picture of the prostate using sound waves from a probe in the rectum.
If cancer is suspected, a biopsy is offered. During a biopsy a urologist obtains tissue samples from the prostate via the rectum. A biopsy gun inserts and removes special hollow-core needles (usually three to six on each side of the prostate) in less than a second. The tissue samples are then examined under a microscope to determine whether cancer cells are present, and to evaluate the microscopic features (or Gleason score) of any cancer found. Prostate biopsies are routinely done on an outpatient basis and rarely require hospitalization. Fifty-five percent of men report discomfort during prostate biopsy.Template:Ref
Template:Main An important part of evaluating prostate cancer is determining the stage, or how far the cancer has spread. Knowing the stage helps define prognosis and is useful when selecting therapies. The most common system is the four-stage TNM system (abbreviated from Tumor/Nodes/Metastases). Its components include the size of the tumor, the number of involved lymph nodes, and the presence of any other metastases.
The most important distinction made by any staging system is whether or not the cancer is still confined to the prostate. In the TNM system, clinical T1 and T2 cancers are found only in the prostate, while T3 and T4 cancers have spread elsewhere. Several tests can be used to look for evidence of spread. These include computed tomography to evaluate spread within the pelvis, bone scans to look for spread to the bones, and endorectal coil magnetic resonance imaging to closely evaluate the prostatic capsule and the seminal vesicles.
After a prostate biopsy, a pathologist looks at the samples under a microscope. If cancer is present, the pathologist reports the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue and suggests how fast the tumor is likely to grow. The Gleason system is used to grade prostate tumors from 2 to 10, where a Gleason score of 10 indicates the most abnormalities. The pathologist assigns a number from 1 to 5 for the most common pattern observed under the microscope, then does the same for the second most common pattern. The sum of these two numbers is the Gleason score. The Whitmore-Jewett stage is another method sometimes used. Proper grading of the tumor is critical, since the grade of the tumor is one of the major factors used to determine the treatment recommendation.
Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, High Intensity Focused Ultrasound (HIFU), chemotherapy, cryosurgery, hormonal therapy, or some combination. Which option is best depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors are the man's age, his general health, and his feelings about potential treatments and their possible side effects. Because all treatments can have significant side effects, such as erectile dysfunction and urinary incontinence, treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations.
If the cancer has spread beyond the prostate, treatment options significantly change, so most doctors who treat prostate cancer use a variety of nomograms to predict the probability of spread. Treatment by watchful waiting, HIFU, radiation therapy, cryosurgery, and surgery are generally offered to men whose cancer remains within the prostate. Hormonal therapy and chemotherapy are often reserved for disease which has spread beyond the prostate. However, there are exceptions: radiation therapy may be used for some advanced tumors, and hormonal therapy is used for some early stage tumors. Cryotherapy, hormonal therapy, and chemotherapy may also be offered if initial treatment fails and the cancer progresses.
Watchful waiting
Watchful waiting, also called "active surveillance," refers to observation and regular monitoring without invasive treatment. Watchful waiting is often used when an early stage, slow-growing prostate cancer is found in an older man. Watchful waiting may also be suggested when the risks of surgery, radiation therapy, or hormonal therapy outweigh the possible benefits. Other treatments can be started if symptoms develop, or if there are signs that the cancer growth is accelerating. Most men who choose watchful waiting for early stage tumors eventually have signs of tumor progression, and they may need to begin treatment within three years.Template:Ref Although men who choose watchful waiting avoid the risks of surgery and radiation, the risk of metastasis (spread of the cancer) may be increased. Additional health problems that develop with advancing age during the observation period can also make it harder to undergo surgery and radiation therapy.
Surgical removal of the prostate, or prostatectomy, is a common treatment either for early stage prostate cancer, or for cancer which has failed to respond to radiation therapy. The most common type is radical retropubic prostatectomy, when the surgeon removes the prostate through an abdominal incision. Another type is radical perineal prostatectomy, when the surgeon removes the prostate through an incision in the perineum, the skin between the scrotum and anus. Prostatectomy can cure about seventy percent of cases of prostate cancer.
Radical prostatectomy is highly effective for tumors which have not spread beyond the prostate. However, it may cause nerve damage that significantly alters the quality of life of the prostate cancer survivor. The most common serious complications are loss of urinary control and impotence. As many as forty percent of men will be left with some urinary incontinence, usually in the form of leakage when they sneeze, cough or laugh. Impotence is also a common problem. Although penile sensation and the ability to achieve orgasm usually remain intact, erection and ejaculation are often impaired. Medications such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) may restore some degree of potency. In some men with smaller cancers, a more limited "nerve-sparing" technique may help avoid urinary incontinence and impotence.Template:Ref
Radical prostatectomy has traditionally been used alone when the cancer is small. However, courses of hormone therapy prior to surgery may increase cure rates and are currently being studied.Template:Ref Surgery may also be offered when a cancer is not responding to radiation therapy. However, because radiation therapy causes tissue changes, prostatectomy after radiation has a higher risk of complications.
Transurethral resection of the prostate, commonly called a "TURP," is a surgical procedure performed when the tube from the bladder to the penis (urethra) is blocked by prostate enlargement. TURP is generally for benign disease and is not meant as definitive treatment for prostate cancer. During a TURP, a small tube (cystoscope) is placed into the penis and the blocking prostate is cut away.
In metastatic disease, where cancer has spread beyond the prostate, removal of the testicles (called orchiectomy) may be done to decrease testosterone levels and control cancer growth. (See hormonal therapy, below).
Radiation therapy
Image:Brachytherapy.jpgRadiation therapy, also known as radiotherapy, uses X-rays to kill prostate cancer cells. X-rays are a type of ionizing radiation that can damage or destroy the DNA crucial to cancer cell growth. Two different kinds of radiation therapy are used in prostate cancer treatment: external beam radiation therapy and brachytherapy.
External beam radiation therapy uses a linear accelerator to produce high-energy X-rays which are directed in a beam towards the prostate. A technique called Intensity Modulated Radiation Therapy (IMRT) may be used to adjust the radiation beam to conform with the shape of the tumor, allowing higher doses to be given to the prostate and seminal vesicles with less damage to the bladder and rectum. External beam radiation therapy is generally given over several weeks, with daily visits to a radiation therapy center.
Image:Linacprostate.jpg Brachytherapy involves the placement of about 100 small "seeds" containing radioactive material (such as iodine-125 or palladium-103) with a needle through the skin of the perineum directly into the tumor. These seeds emit lower-energy X-rays which are only able to travel a short distance. Brachytherapy seeds will stay in the prostate permanently, but men with implanted seeds are not at risk of exposing others to radiation.Template:Ref
Radiation therapy is commonly used in prostate cancer treatment. It may be used instead of surgery for early cancers, and it may also be used in advanced stages of prostate cancer to treat painful bone metastases. Radiation treatments also can be combined with hormonal therapy for intermediate risk disease, when radiation therapy alone is less likely to cure the cancer. Some radiation oncologists combine external beam radiation and brachytherapy for intermediate to high risk situations. One study found that the combination of six months of androgen suppresive therapy combined with external beam radiation had improved survival compared to radiation alone in patients with localized prostate cancer.Template:Ref Others use a "triple modality" combination of external beam radiation therapy, brachytherapy, and hormonal therapy.
Less common applications for radiotherapy are when cancer is compressing the spinal cord, or sometimes after surgery, such as when cancer is found in the seminal vesicles, in the lymph nodes, outside the prostate capsule, or at the margins of the biopsy.
Radiation therapy is often offered to men whose medical problems make surgery more risky. Radiation therapy appears to cure small tumors that are confined to the prostate just about as well as surgery. However, as of 2005 some issues remain unresolved, such as whether radiation should be given to the rest of the pelvis, how much the absorbed dose should be, and whether hormonal therapy should be given at the same time.
Side effects of radiation therapy might occur after a few weeks into treatment. Both types of radiation therapy may cause diarrhea and rectal bleeding due to radiation proctitis, as well as urinary incontinence and impotence. Symptoms tend to improve over time.Template:Ref Men who have undergone external beam radiation therapy will have a higher risk of later developing colon cancer and bladder cancer.Template:Ref
Cryosurgery is another method of treating prostate cancer. It is less invasive than radical prostatectomy, and general anesthesia is less commonly used. Under ultrasound guidance, metal rods are inserted through the skin of the perineum into the prostate. Liquid nitrogen is used to cool the rods, freezing the surrounding tissue at −196 °C (−320 °F). As the water within the prostate cells freezes, the cells die. The urethra is protected from freezing by a catheter filled with warm liquid. Cryosurgery generally causes fewer problems with urinary control than other treatments, but impotence occurs up to ninety percent of the time. When used as the initial treatment for prostate cancer, cryosurgery is not as effective as surgery or radiation.Template:Ref However, cryosurgery is potentially better than radical prostatectomy for recurrent cancer following radiation therapy.
Hormonal therapy
Image:Prostatehormone.jpg Hormonal therapy uses medications or surgery to block prostate cancer cells from getting dihydrotestosterone (DHT), a hormone produced in the prostate and required for the growth and spread of most prostate cancer cells. Blocking DHT often causes prostate cancer to stop growing and even shrink. However, hormonal therapy rarely cures prostate cancer because cancers which initially respond to hormonal therapy typically become resistant after one to two years. Hormonal therapy is therefore usually used when cancer has spread from the prostate. It may also be given to certain men undergoing radiation therapy or surgery to help prevent return of their cancer.Template:Ref
Hormonal therapy for prostate cancer targets the pathways the body uses to produce DHT. A feedback loop involving the testicles, the hypothalamus, and the pituitary, adrenal, and prostate glands controls the blood levels of DHT. First, low blood levels of DHT stimulate the hypothalamus to produce gonadotropin releasing hormone (GnRH). GnRH then stimulates the pituitary gland to produce luteinizing hormone (LH), and LH stimulates the testicles to produce testosterone. Finally, testosterone from the testicles and dehydroepiandrosterone from the adrenal glands stimulate the prostate to produce more DHT. Hormonal therapy can decrease levels of DHT by interrupting this pathway at any point.
There are several forms of hormonal therapy:
- Orchiectomy is surgery to remove the testicles. Because the testicles make most of the body's testosterone, after orchiectomy testosterone levels drop. Now the prostate not only lacks the testosterone stimulus to produce DHT, but also it does not have enough testosterone to transform into DHT.
- Antiandrogens are medications such as flutamide, bicalutamide, nilutamide, and cyproterone acetate which directly block the actions of testosterone and DHT within prostate cancer cells.
- Medications which block the production of adrenal androgens such as DHEA include ketoconazole and aminoglutethimide. Because the adrenal glands only make about 5% of the body's androgens, these medications are generally used only in combination with other methods that can block the 95% of androgens made by the testicles. These combined methods are called total androgen blockade (TAB). TAB can also be achieved using antiandrogens.
- GnRH action can be interrupted in one of two ways. GnRH antagonists suppress the production of GnRH directly, while GnRH agonists suppress GnRH through the process of downregulation after an initial stimulation effect. Abarelix is an example of a GnRH antagonist, while the GnRH agonists include leuprolide, goserelin, triptorelin, and buserelin. Initially, these medications increase the production of LH. However, because the constant supply of the medication does not match the body's natural production rhythm, production of both LH and GnRH decreases after a few weeks.Template:Ref
As of 2005 the most successful hormonal treatments are orchiectomy and GnRH agonists. Despite their higher cost, GnRH agonists are often chosen over orchiectomy for cosmetic and emotional reasons. Eventually, total androgen blockade may prove to be better than orchiectomy or GnRH agonists used alone.
Each treatment has disadvantages which limit its use in certain circumstances. Although orchiectomy is a low-risk surgery, the psychological impact of removing the testicles can be significant. The loss of testosterone also causes hot flashes, weight gain, loss of libido, enlargement of the breasts (gynecomastia), impotence and osteoporosis. GnRH agonists eventually cause the same side effects as orchiectomy but may cause worse symptoms at the beginning of treatment. When GnRH agonists are first used, testosterone surges can lead to increased bone pain from metastatic cancer, so antiandrogens or abarelix are often added to blunt these side effects. Estrogens are not commonly used because they increase the risk for cardiovascular disease and blood clots. The antiandrogens do not generally cause impotence and usually cause less loss of bone and muscle mass. Ketoconazole can cause liver damage with prolonged use, and aminoglutethimide can cause skin rashes.
Palliative care
Palliative care for advanced stage prostate cancer focuses on extending life and relieving the symptoms of metastatic disease. Chemotherapy may be offered to slow disease progression and postpone symptoms. The most commonly used regimen combines the chemotherapeutic drug docetaxel with a corticosteroid such as prednisone.Template:Ref Bisphosphonates such as zoledronic acid have been shown to delay skeletal complications such as fractures or the need for radiation therapy in patients with hormone-refractory metastatic prostate cancer.Template:Ref
Bone pain due to metastatic disease is treated with opioid pain relievers such as morphine and oxycodone. External beam radiation therapy directed at bone metastases may provide pain relief. Injections of certain radioisotopes, such as strontium-89, phosphorus-32, or samarium-153, also target bone metastases and may help relieve pain.
Prostate cancer rates are higher and prognosis poorer in Western societies than the rest of the world. Many of the risk factors for prostate cancer are more prevalent in the Western world, including longer life expectancy and diets high in animal fats. Also, where there is more access to screening programs, there is a higher detection rate. Prostate cancer is the ninth most common cancer in the world, but is the number one non-skin cancer in United States men. Prostate cancer affected eighteen percent of American men and caused death in three percent in 2005.Template:Ref In Japan, death from prostate cancer was one-fifth to one-half the rates in the United States and Europe in the 1990s.Template:Ref In India in the 1990s, half of the people with prostate cancer confined to the prostate died within ten years.Template:Ref African-American men have 50-60 times more prostate cancer and prostate cancer deaths than men in Shanghai, China.Template:Ref In Nigeria, two percent of men develop prostate cancer and 64% of them are dead after two years.Template:Ref
In patients who undergo treatment, the most important clinical prognostic indicators of disease outcome are stage, pre-therapy PSA level and Gleason score. In general, the higher the grade and the stage, the poorer the prognosis. Nomograms can be used to calculate the estimated risk of the individual patient. The predictions are based on the experience of large groups of patients suffering from cancers at various stages.Template:Ref
Prostate cancer risk can be decreased by modifying known risk factors for prostate cancer, such as decreasing intake of animal fat.Template:Ref Several medications and vitamins may also help prevent prostate cancer. Two dietary supplements, vitamin E and selenium, may help prevent prostate cancer when taken daily. Estrogens from soybeans and other plant sources (called phytoestrogens) may also help prevent prostate cancer.Template:Ref The selective estrogen receptor modulator drug toremifene has shown promise in early trials.Template:RefTemplate:Ref Two medications which block the conversion of testosterone to dihydrotestosterone, finasterideTemplate:Ref and dutasterideTemplate:Ref, have also shown some promise. As of 2005 the use of these medications for primary prevention is still in the testing phase, and they are not widely used for this purpose.
A 2003 study [5] indicated that regular ejaculations may help prevent prostate cancer.
Image:Hugginsprostate.jpg Although the prostate was first described by Venetian anatomist Niccolò Massa in 1536, and illustrated by Flemish anatomist Andreas Vesalius in 1538, prostate cancer was not identified until 1853.Template:Ref Prostate cancer was initially considered a rare disease, probably because of shorter life expectancies and poorer detection methods in the 19th century. The first treatments of prostate cancer were surgeries to relieve urinary obstruction.Template:Ref Removal of the entire gland (radical perineal prostatectomy) was first performed in 1904 by Hugh Young at Johns Hopkins Hospital.Template:Ref Surgical removal of the testes (orchiectomy) to treat prostate cancer was first performed in the 1890s, but with limited success. Transurethral resection of the prostate (TURP) replaced radical prostatectomy for symptomatic relief of obstruction in the middle of the 20th century because it could better preserve penile erectile function. Radical retropubic prostatectomy was developed in 1983 by Patrick Walsh.Template:RefImage:Schally portrait.jpg This surgical approach allowed for removal of the prostate and lymph nodes with maintenance of penile function.
In 1941 Charles B. Huggins published studies in which he used estrogen to oppose testosterone production in men with metastatic prostate cancer. This discovery of "chemical castration" won Huggins the 1966 Nobel Prize in Physiology or Medicine.Template:Ref The role of the hormone GnRH in reproduction was determined by Andrzej W. Schally and Roger Guillemin, who both won the 1977 Nobel Prize in Physiology or Medicine for this work. Receptor agonists, such as leuprolide and goserelin, were subsequently developed and used to treat prostate cancer.Template:RefTemplate:Ref
Radiation therapy for prostate cancer was first developed in the early 20th century and initially consisted of intraprostatic radium implants. External beam radiation became more popular as stronger radiation sources became available in the middle of the 20th century. Brachytherapy with implanted seeds was first described in 1983.Template:Ref Systemic chemotherapy for prostate cancer was first studied in the 1970s. The initial regimen of cyclophosphamide and 5-fluorouracil was quickly joined by multiple regimens using a host of other systemic chemotherapy drugs.Template:Ref
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- Template:Note Brenner DJ, Curtis RE, Hall EJ, Ron E. Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer. 2000 Jan 15;88(2):398-406. PMID 10640974
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- Template:Note Robson M, Dawson N.How is androgen-dependent metastatic prostate cancer best treated? Hematol Oncol Clin North Am. 1996 Jun;10(3):727-47. Review. PMID 8773508
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- Template:Note Walsh, P. C., Lepor, H. & Eggleston, J. C. Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate 4, 473-485 (1983). PMID 6889192
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- Template:Note Denmeade SR, Isaacs JT. A History of Prostate Cancer Treatment. Nature Reviews Cancer 2, 389-396 (2002). PMID 12044015
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See also
External links
- Prostate Cancer - from Symptoms to Medical and Natural Treatment Options on urologychannel.com
- Prostate Cancer Foundation
- American Cancer Society
- Information about prostate cancer on prostate.com
- IGF1R gene may increase prostate cancer treatment
- National Institute on Aging Information Center
- National Kidney and Urologic Diseases Information Clearinghouse
- Prostate Cancer Survivor One survivor's story
- Many NCI publications may be viewed or ordered on the Internet at http://cancer.gov/publications
- National Prostate Cancer Coalition (NPCC)
- The Prostate Cancer Charity (UK)
- Studies of capsaicin by AACR
Patient support sources:
- news://alt.support.cancer.prostate, a newsgroup for men dealing with the disease.
- Non-profit prostate cancer website updated weekly
- A website for all aspects of prostate cancer
Template:Tumors Template:Featured articlebg:Рак на простатата ca:Càncer de pròstata de:Prostatakrebs es:Cáncer de próstata fr:Cancer de la prostate hr:Rak prostate it:Carcinoma della prostata he:סרטן הערמונית la:Cancer prostatae nl:Prostaatkanker ja:前立腺癌 fi:Eturauhassyöpä sv:Prostatacancer tl:Kanser sa prostate zh:前列腺癌


text: I posted a question in infant forum the other day and got only 2 responses and just kinda thought it maybe get a few other feed backs since you have all done this longer here So heres my question. I have a 9mo old going on 10 months and he has taken the liking to nipple twiddling, or pinching as it is, because sometimes it can hurt. I never used a nursing necklace because unfortunaly didn't hear about any such thing till a few months ago and he wasn't doing this. I just was wondering if it's too late to try it now and if anyone has been able to introduce it succesfully at such at late age. I wanna make it to a year plus but with the biting and now twiddling it seems hard, the only thing that keeps me going is that he won't take a bottle(fortunate for him) haha. I really want to go over a year and it's been so hard and he's my last!


text:
News from Dave Lawley, G4BUO...
To all UK contesters
The IARU Radiosport contest is less than five days away now, and theGB5HQ team has been working very hard to be ready to compete against themajor HQ stations. We need the help of as many contesters as possible tocome on and work us, phone on CW, on all six bands topband to 10m. Thecontest period is 1200z Saturday to 1200z Sunday and full rules are athttp://www.arrl.org/contests/rules/2006/iaru.html
WRTC-2006 takes place at the same time in Brazil so there will also belots of 4-letter PR and PQ calls active. See www.wrtc2006.com
Contrary to what was suggested on here a while ago we are not saying"come on a work us but no-one else". We want you to come on and enjoy the contest, and make as many QSOs as possible but if you work our maincompetitors (DA0HQ, SN0HQ, R9HQ, TM0HQ) on more bands than you work GB5HQ, then you'll be helping them more than you'll be helping us.Because of skip, there will be times when other HQ stations are louder than ours, at least on the HF bands, but our 80m station should be a 'beacon' around most of the country so if you call them, they'll be able to give your our working frequencies on the other band/mode slots. All
the stations will be interconnected over the Internet using Starlogsoftware by G3WGV.
For info, here are the main locations of our stations around the country though we do have the ability to swap roles to some extent, and we have a backup station located in Anglesey who may take over if any of themain stations has a problem.
10m SSB Suffolk
10m CW Yorkshire
15m SSB Somerset
15m CW Kent
20m SSB Suffolk
20m CW Devon
40m SSB Stirling
40m CW Cornwall
80m SSB Buckinghamshire
80m CW Yorkshire
160m SSB Stirling
160m CW Guernsey
DA0HQ get a phenomenal level of support from German hams, and this is a large factor in their success in this contest. We have a chance ofwinning this contest for the UK, but to do it we need your support, so please work GB5HQ on as many band/mode combinations as possible, andencourage all your club members to do the same. Awards are available for working us on three or more slots, see www.gb5hq.com for moredetails and for pictures of the stations which comprise the RSGB HQ entry in the IARU contest.
Many thanks,Dave Lawley G4BUO
On behalf of the RSGB HQ station GB5HQ


text:
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|Viewing Single Post From: Thursday, January 31st Daily Discussion
|Feb 1 2013, 09:12 AM
Yesterday's show were just there...nothing particularly wonderful about anything and a lot of WTFery to last me a life time. My thoughts:
Kristen and Brady have fizzled for me. They were so good in the beginning, with so much potential and now they just seem to be doing the same thing over and over again, week in and week out. Brady is still an idiot and he needs a shave....so go get that done baby....oh and take off your shirt so Lysie and I can at least watch and be....rewarded... ya know.
I see this blonde woman coming out of the coffee shop and she looks like Sami...yep...she's Sami...okay...she's calling Everett....there he is...he's happy and giddy...like a high school teen guy when he's about to score big! Oh brother....The Rafe/Ej exchange was expected and 2 points for Rafe for calling Ejevett a MORON.....it's kind of funny that Ej claims to know Sami so well, but somehow but couldn't read her at all.... and to the rest of the Ej/Sami exchange....that blonde woman, I thought was Sami...she's fucking insane....all the crap coming out of her mouth makes no sense...I'm finally done with this chick....Ej can have her, she can fuck him every way she wants to...I want so much better for Lucas... and Sami is no longer that person I want for him....and she'll never be that person unless we find out that she really is not Sami. So that being said, I think my days of shipping Lumi for now are officially over, as I don't want Lucas anywhere near this person that looks like Sami but has clearly lost her damn mind. For years Sami did shit to spite her family and the only part that I could actually think that would make sense with the exchange of wanting to please her family is that at times she has wanted to behave in a way that would make Will proud of her, that he wouldn't be ashamed of the stuff she'd done...but that was way back in 2005, post Stan...so I don't get this....Caroline and Sami spoke and Caroline actually said some shit that makes no sense at the time, but she pretty much said she understood how Sami felt about both men....then she was happy and told Hope and Hope was happy for her...even compared Safe to Bope and all.....then she even said, 'do you really think Rafe and I are like you and uncle Bo?'...whatever..it's a mess...
I don't get Nick's reaction to finding the news either....I think that was a writing error...what they should have done is made sure that the point came across that Nick KNEW that Lucas went to prison for shooting EJ....maybe at the point of reading the article on the computer he could have said, 'He confessed, he wasn't convicted? Hmmm' and then have him mention what he overheard at the square....and then he has an "AHA" moment....."maybe he confessed to cover for Will? I need to get to the bottom of this, did Will try to kill EJ and his father tried to cover it up?" It just played wrong, IMHO. I am starting to feel real bad for Will...he's getting his hopes up so high that Nick wants to make this all work for all three of them...they are all going to be one big happy family....NOT.....Will is going to be hit and hard and he's going to unravel pretty quickly...I just need him to really tap into his gray side a bit to go up against crazy eyes.
Oh touching on Sami's behavior toward Gabi....I would just love to know if Sami even paid attention to what Will told her the other day. Why does she think that Gabi has this covert plan to fuck Will over from being part of his child's life....if anything she should be targeting her anger at NIck...but I guess Nick is not being obvious about his dislike yet....so Sami goes and alienates the one person that she shouldn't for now....this is going to blow up in her face and Will is going to put the blame squarely on Sami's shoulder's.....
Chad and Ej were meh....dude...you've been fourth choice for Sami at one point...wtf.....you've moved up a bit...be happy.
|Thursday, January 31st Daily Discussion · DAYS: News, Spoilers & Discussion