text:
As North Central College looks back on its 150-year history during its yearlong Sesquicentennial celebration, February presents an opportunity to recall a devastating event that resulted in major transformations to the school and campus.
On Feb. 23, 1929, a fire of unknown origin destroyed Nichols Hall. When the building opened in 1902, it was just the second structure on campus—joining Old Main—and represented the growing importance of physical education and athletics in the lives of college students.
Nichols Hall was named after James L. Nichols (1851-1895), an 1880 alumnus who bequeathed funds to build the gymnasium and Naperville's public library. After graduating, Nichols returned to teach business courses at the College, authored several books about business practices and founded a successful publishing company.
While the fire totally destroyed Nichols Hall, the catastrophe did hasten plans to build improved athletic facilities. As reported in the Feb. 26, 1929 issue of the student-run newspaper, the Chronicle, "The fire, although an upset in the smooth running affairs of the college, will only serve as a goad to plans already under way. The need of better facilities has been felt for some time and has prompted preliminary action."
The action was spearheaded by Edward E. Rall, who served as the college's fifth president, from 1916 to 1946. The longest-serving of North Central's nine presidents, Rall's tenure spanned the crisis of World War I, the boom years of the Roaring Twenties, the Great Depression and World War II. Among Rall's many strengths was his skill in securing donations for facility improvements that endure to this day.
In 1923, alumnus Peter Kroehler—founder of Naperville's Kroehler Manufacturing Company—donated money that enabled the college to acquire land known as the Fort Hill Campus. Today, a historical plaque on the property describes how in 1832, the Fort Payne stockade was built on the site and soldiers protected settlers from roaming bands of native Americans during the Black Hawk War.
In the 1920s, the college acquired the land from the estate of Naperville's Judge John S. Goodwin. After the Nichols Hall fire, Rall's leadership and the generosity of the Pfeiffer family—G.A. Pfeiffer, Henry Pfeiffer and Annie Merner Pfeiffer—led to the construction of Merner Field House. Upon its dedication on Jan. 23, 1931, it was the second-largest college athletics facility in Illinois. Merner Field House is an example of the great vision of the College's leadership throughout its history.
Today, similar visionary leadership is evident with the new building next to Merner Field House. The Residence Hall/Recreation Center is an environmentally innovative, LEED-certified structure that is the first in the nation to combine a residence hall and recreation center on a college campus. In addition to being home to North Central's national champion indoor track & field program, the facility houses more than 300 students and features facilities that enable the instruction of athletic training, physical education, exercise science and other areas of study.
The Res/Rec Center is large enough to comfortably accommodate expositions, graduations and other big events. On May 20, the first concert will be held in the Res/Rec Center when the popular band Switchfoot performs.
North Central's celebration of its Sesquicentennial continues through Commencement on June 9. Visit northcentralcollege.edu/150 to learn more.01-31-2012


text:
Dear Members,
Keep in mind that Character Bashing is now prohibited. Making fun of certain characters/character pairings leads to a pointless thread filled with insults and general rule breaking.
Also, remember that Versus threads are allowed only in the Versus section.
Thank you, NarutoBase Staff
Rock lee stated that he wanted to fight neji to prove his strength, wondering who would have won if they fought then, also who would win in part 2 prior to nejis death
I wish we could have seen a match between them, it would be good but i'll say Neji, out of respect :p
if lee went 8 gates....neji would have lost that battle
Neji, in 128 plam mode!
I've never seen how the gentle fist could beat lee or guy. They can't block or their arm is broken, and without blocking they can't counter to close chakra points. I don't even see how Neji could win if Lee just took off his weights.
all hail to lord tapatio... i love you so much
i always felt he couldn't keep up with lee but after seeing neji's speed against kidomaru i was like maybe he is better, either way he died as lees superior rival and that's the way it's staying
Why thank you haha
NEJI beats the shit out of LEE
Without 8-Gates - Neji Wins
With 8-Gates - Lee Wins
Originally Posted by ALCH3MY
Without 8-Gates - Neji Wins
With 8-Gates - Lee Wins
Originally Posted by COLONELJJ81
if lee went 8 gates....neji would have lost that battle
if Lee used 8th gate, they both lose...
Originally Posted by eldiego68
if Lee used 8th gate, they both lose...
I never said the 8th Gate
I said Gates. As in the power of the 8 gates. Not the 8th gate itself...
(i doubt he'd even need to open more than 3-4 to take on Neji)
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Dental Health Info
Howard Lee - Stanley Lee
Howard Lee - Stanley Lee
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Stanley Markovitz - Parkville, MD
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March 2009 Archives
March 31, 2009
Radar Detector Tips: Keeping Suction Cups Fresh
Hi there, today I thought we would talk about something other than red light cameras. Crazy talk I know, but there are a lot of tips and tricks out there for radar detectors. Now some of these are, well, more subjective than others, but a few of these are just smart, simple, and useful.
Out first tip, or trick is one for those of you using windshield brackets. Have you noticed that after a while the suction cups used to hold the bracket to the windshield seem warped, all worn out, and may even not hold as well anymore. Well, try placing them for a short bit in some boiling water. That should have them return to their original springy state. At least they will be clean.
Now if they are still not as good as new, try this. Place a very small amount of either liquid dish soap or Vaseline on the suction cup (very, very, small amount). This will help them adhere better to the windshield and will not leave much of a mess later to clean up. Do not use anything else though, trust me, you may want to remove the radar detector someday.
If the two tricks above do not work we also sell replacement mounting brackets along with a large selection of accessories. Try boiling them first though, you may be surprised.
March 26, 2009
No More Red Light Cameras in One State
We have been talking a lot about red light cameras lately it seems. Well here is a short bit of information on the fight to remove red light cameras. Mississippi has passed a law that will remove red light cameras from the state.
Jackson Mississippi has stopped issuing tickets or collecting fines based on pictures taken by red light cameras already. The only remaining city with red light cameras, Columbus has until October 1st to remove them. The law also makes the installation of new red light cameras illegal, stopping their installation in other cities in the state.
This relates to red light cameras only, not to in-car police cameras or even speed cameras. From the article, the law passed "...the House 117-3 on Feb. 11. It passed the Senate 42-9 on March 4." That looks a bit one sided, and it would seem that people are being listened to at least in one state.
As long as sates view red lights as more of a revenue generator, than say a tool for traffic management, we hope to keep you informed. We offer a great selection of camera protection devices until the cameras are gone.
Way to go Mississippi!
March 19, 2009
I Need a New Radar Detector! Wait, No I Need a Red Light and Speed Camera Detector. Oh, You can Have Both!
Ok, after the last Veil Guy post, we started talking about how there are a lot of interesting red light and speed camera related products out now in the world of radar detectors. So we decided to create a list of the most popular products that function as both a radar detector and camera detector.
Even though some communities have been able to have red light and speed cameras removed, their use is still growing. Combine that with the fact that some cities are purposely shortening the length of yellow lights to generate revenue. (I had to retype that last part. Making a light shorter just to write more tickets is rude and annoys me. My first comment was more vehement .)
So here you go, our list of radar detectors that can also be used to warn you of Yellow Light Cash Generators. (See what I did there.) Oh, we would like to point out, this list is far from comprehensive. We also have some detectors with optional red light and speed camera components you can get separately. These however have everything you need in one box:
Beltronics Pro 500 Radar Detector Preloaded database of camera locations that can be updated.
Cobra SPX 7800BT Radar Detector Can be tethered to your iPhone or Android smartphone and connected to Cobra's AURA® database for community threat sharing.
Escort Passport 9500ix Radar Detector Preloaded database of camera locations that can be updated from their website or manually updated.
Escort Passport Max2 Radar Detector Preloaded database of camera locations that can be updated. It can also be tethered to your iPhone or Android smartphone and connected to Escort's online real-time ticket-protection network.
Whistler CR90 Radar Detector w/ GPS Alerts Preloaded database of camera locations that can be updated via USB to Whistler's Verilight database.
Blinder Replacement Lens Covers
Just letting all of you know, we now have Blinder replacement lens cover sets in stock. Works with all Blinder Xtreme models, including the current M25 and M45. Are your lens covers all chipped and cracked from road debris? Excessive wear to the lenses can impact the performance capabilities of your Blinder Laser Jammer.
Each set contains two replacement covers for $39.99. Note: These are covers only, not the modules.
March 17, 2009
The Veil Guy vs. Red Light Cameras (Well Sorta)
It would seem this is a good time of year for comparison test. We just had our License Plate Protection Comparison Test of 2009, and the Veil Guy has a great test of GPS red light/speed camera/radar detectors over at his blog.
As part of his review of the new Cobra XRS 9960G, he also compares the Beltronics Professional Series GX 65, the Escort Passport 9500ix, and the Cheetah C100 GPS camera/radar detectors. So watch the video for a real world product test.
Oh, and for that intersection (towards the end of the video) where the cameras were not detected, well some extra protection might be a good idea.
We hope this helps those in areas implementing red light/speed cameras, and answers some of your questions. As always, contact us with any questions concerning these products.
March 9, 2009
The Great License Plate Protection Comparison Test of 2009
Here at Buy Radar Detectors we found ourselves looking at the different anti-photo plate protection products we carry, and we thought a small, informal comparison test might be needed. Well, not needed. More like we thought it would be fun to get outside on a nice spring day. So after obtaining a test vehicle we decided to see how well each product would work, and how noticeable they were.
Plan A we had to cancel. It mostly involved duct tape, the four lane freeway outside, a cheap camera equipped cell phone, and a tall tree. Wishing to avoid upsetting area commuters and for a more controlled test environment, we instead decided on a more scientific approach to our comparison test. Hereafter known as Plan B.
In our test we will be reviewing the following products:
TollFree Protector Anti-Photo License Plate Cover
Super Protector Anti-Photo License Plate Cover
Photo Blur Anti-Photo License Plate Cover
Photo Stopper Anti-Flash License Plate Spray
For testing the plate covers we used a Canon EOS Rebel XTi tripod mounted camera with a Canon EF-S 17-85mm f/4-5.6 IS USM SLR lens and a Canon 430EX flash. We took three pictures of each product:
- Picture from above (camera height 7'10") - This position should provide an idea of how the plate cover would perform against a red light camera, which are typically mounted high in an intersection and angled down.
- Picture from behind (camera height 4'3") - This position should give you an indication of how the license plate cover will appear to other drivers or police officers that are looking at your vehicle from behind.
- Picture from the side (camera height 4'3") - This position should provide an idea of how the plate cover would perform against photo radar equipment, where the camera is typically positioned on the side of the road.
We also used the flash in every plate cover picture, as this is typical for photo enforcement equipment. For the Photo Stopper anti-flash spray, we used the same equipment (camera height 4'3") and show each angle, with and without a flash, to show the effect of the product.
For an anti-photo product to be effective it needs to achieve a delicate balance. At angles used by photo enforcement equipment, the license plate numbers should appear obscured. On the other hand, when viewed straight-on the numbers need to appear clear and legible to avoid attracting any unwanted attention.
Please Note: Actual conditions vary according to camera location, time of day, and weather conditions. This is an informal test, and subjective. Feel free to try this at home.
For Plan B we did try to have some controls in place with similar lighting, same test vehicle, same camera, and same camera location. We also used a ladder from the warehouse for the "above" test to get a better result.
TollFree Protector Anti-Photo License Plate Cover
The Toll Free Protector is advertised as offering the best protection against cameras at the cost of being more noticeable. At first glance, this appears to be the case. The shot from the side completely obscures the plate number, and when viewed straight-on it is fairly obvious there is a plate protector. The shot from the top did not turn out as well as we had hoped. The numbers seem to be obscured, but if you look very closely you can make out at least 5 of them. Is this enough to save you from a ticket?
Super Protector Anti-Photo License Plate Cover
Next, we have the Super Protector, which is typically advertised as being the best mix of effectiveness and noticeability. From above, well... you are getting a ticket. From the rear, it is far less obvious than the TollFree Protector. From the side it does partly obscure half of the numbers (which is what it is supposed to do).
Photo Blur Protector Anti-Photo License Plate Cover
The Photo Blur actually looks a lot like the standard "clear" bubble plate covers sold in most automotive supply stores. It is generally advertised as being the plate cover that is least likely to attract unwanted attention, as even at an angle the obscuring looks more like a glare from the sun or accidental distortion. One very important feature we liked, unlike the other two protectors it does not require a separate tag frame to hold the cover in place. With some states making plate frames a violation, this alone is interesting.
This one surprised us, from above it does partly obscure the tag numbers, enough to possibly keep from getting a ticket. It also does a good job from the side. From a straight-on view it performs as advertised, being the least noticeable of the covers we tested.
Bonus test!
Photo Stopper Anti-Flash License Plate Spray (With and without flash.)
Photo Stopper does a great job at making your plate look shiny! While it does slightly overexpose the picture when a flash is used, it was not enough to obscure the plate number in our setup. Perhaps the results would have been better with a stronger flash or with a license plate where the numbers are not black and raised? We're told that products like this tend to work against older equipment, but are fairly ineffective against newer technology.
With Flash
Without Flash
With Flash
Without Flash
So there you go. The one we thought would block the plate from every angle, the TollFree Protector, is not so great when the picture is taken from above (better from the side though!). And it may lead to interesting conversations with local law enforcement officers. The Super Protector worked from the side. If you want the best mix of possibly obscuring a picture of your plate while not being very obvious, the Photo Blur does a rather good job. Finally, all the PhotoStopper spray really does is make your plate look shiny and new.
In closing, one of the better ways we have seen to avoid the cameras:
March 3, 2009
More New Products from Whistler (Updated!)
We just got the scoop on two new upcoming products from Whistler that are expected to be available sometime in 2009. We don't have all of the details at this point, but thought we would share some basic specs and a few images.
Whistler RLC-100
Whistler RLC-100 Red Light Camera Detector
First is the new Whistler RLC-100 red light and speed camera detector. The RCL-100 compares your current GPS location with an on-board database of red light and speed camera locations and alerts you when you are near one.
- High Sensitivity GPS Antenna
- Updatable Camera Database
- Dual Alert Display
- Current Speed Reading with Max Hold Feature
- 100 Location Manual Entry
The RLC-100's database is updatable from the internet using the integrated USB port. You can also connect the RLC-100 to a Whistler radar detector if you use the optional interface cable (not included). You can specify MPH or KPH and a speed warning notification. The RLC-100 also has a digital clock and trip meter.
Dimensions and Weight:
- 3.13" long x 2.13" wide x .75" height
- 1.8 oz
Whistler BT Headset
Motorcycle Bluetooth® Headset
The second item from Whistler is a series of motorcycle Bluetooth® headsets. The BT2200 / 2300 / 3200 / 3300 headsets are designed to work with any full/flip-up/open style helmet and allow full duplex bike to bike or bike to passenger communications. Whistler has produced motorcycle-specific radar detectors in the past, but this product presents an exciting new direction. This series includes four products to cover all scenarios (bike to bike or bike to passenger, and open faced or closed faced helmets). The MSRP is $219.95 for the bike to passenger products, and $259.95 for the bike to bike products.
- Bluetooth® 2.0 High Quality Stereo Audio
- Noise Cancellation Microphone
- Easy Installation
- Full Duplex Wireless Intercom
- Weather Proof Case
The BT2200/2300 headsets provides two channel rider to passenger communications, and the BT3200/3300 headsets provide two channel bike to bike communications. In addition, the headsets can also be used for true stereo music. Battery duration is estimated at 7-14 hours of usage. You can adjust the volume and the BT2200/2300/3200/3300 headsets also have a large mute button for easy use.
Whistler Headset
Dimensions and Weight:
- 3.31" long x 1.75" wide x .81" height
- 1.8 oz


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Years ago someone carved an image in a block of wood by allowing the object to remain above the area that had been chiseled away. They covered the image with ink and placed it on another surface and made a copy of the image and some say that "printing was born." In A.D. 779 the …
Tag Archive: writing
Jun 19 2013
Announce the word!
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Apr 07 2011
7th Annual Pine Tree Intermediate Writing Contest results
Twelve students from Pine Tree Intermediate Campus were recently selected as winners for a campus-wide writing contest. The Annual Pine Tree Intermediate Writing Contest is celebrated every year at the Spring PTA meeting. This year students will be honored at the May meeting. The competition selects winners from the poetry and story writing submitted by …
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Intel moves to put chips in shoes, sunnies and snowboards
Intel is set to move into the increasingly lucrative sports and fitness markets through new partnerships with companies like ESPN, New Balance and Oakley.
Intel is set to move into the increasingly lucrative sports and fitness markets through new partnerships with companies like ESPN, New Balance and Oakley.
MSI says it has just what you need to keep your Skylake CPU from bending due to a monster cooling set-up: a metal frame.
Budget builders rejoice! Tech site Techspot confirms you can now overclock cheap Skylake chips with a BIOS update.
Hewlett Packard Enterprise is the latest partner to work with Intel on the Internet of Things, announcing it will develop products for computing at the edges of networks.
For a while it was hard to get a hand on an ARM, but that may not be the case soon.
Iris graphics give a gaming boost to Intel's 6th-generation Core i5 NUC kits.
A new battery from Prieto Battery could provide five times more energy capacity
While AMD gets burned by the shrinking PC market, Intel has insulated itself by developing another business that's going gangbusters.
Cisco is tying with a Chinese partner for joint development and better access to the local market, according to a newspaper report.
A forensic research firm has published a list of the industry's most hackable and least hackable vehicles based on how easy it is to wirelessly gain access their computerized systems.
Intel is creating the Automotive Security Review Board to help the automotive industry use its hardware in a secure way -- and to persuade security researchers to help it find bugs in its own automotive hardware.
Fully functional quantum computers are still a dozen years off, which is why Intel needs to invest in fundamental research now, according to CEO Brian Krzanich.
A wireless charging system that packs enough power to replenish a laptop battery should hit the market in 2016, helping realize the long-held dream of a cable-free desk, Intel said on Wednesday.
Intel has at last launched the chips it developed under the "Skylake" codename, now calling them sixth-generation Core processors. The launch is an important step for the company, which has had trouble keeping up in a marketplace that is increasing d...
The Toshiba Satellite Radius 12 packs Intel's new Skylake processor, a 4K display option, and support for Windows Hello biometric security.
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First impression on unpacking the Q702 test unit was the solid feel and clean, minimalist styling.
For work use, Microsoft Word and Excel programs pre-installed on the device are adequate for preparing short documents.
The Fujitsu LifeBook UH574 allowed for great mobility without being obnoxiously heavy or clunky. Its twelve hours of battery life did not disappoint.
The screen was particularly good. It is bright and visible from most angles, however heat is an issue, particularly around the Windows button on the front, and on the back where the battery housing is located.
My first impression after unboxing the Q702 is that it is a nice looking unit. Styling is somewhat minimalist but very effective. The tablet part, once detached, has a nice weight, and no buttons or switches are located in awkward or intrusive positions.


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Tree View
The Brewery's
Brews & Views Bulletin Board Service
Brews and Views Archive 2005
Archive through September 22, 2005
Price of Bulk Malt - ouch!
Last Poster
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Senior Member
Username: Chumley
Post Number: 3634
Registered: 02-2003
Posted From: 18.104.22.168
Posted on Tuesday, September 13, 2005 - 08:27 pm:
That is to say, the price of bulk malt shipping - ouch.
I've been doing a little comparison shopping on the internet on where to get the best deal on 4 sacks of base malt for the fall brewing season. A couple of years ago, I bought 4 sacks from North Country. Although they are in New York and I live in Montana, they are so cheap that they actually worked out to be the best deal. $20-$25 bucks per sack plus $25 per sack shipping came out still under a buck a pound.
Not anymore. I just priced shipping from North Country to Montana via UPS - $40 per sack! North Country's prices, by contrast are now more like $23-$27 per sack - still a good deal for those of you who live back east. Spending $40 per sack shipping UPS goes against my grain, especially after how those wangs broke my NHC entries this year.
I see B3's 4 sack shipping is around $50-$60 per sack, but they are still including free shipping (for now!) My alternative is to wait until I go to Portland the 1st weekend of October and hope to find some LHBSs with some cheap deals, but right now I am inclined to order from B3 as I am a malt snob and want to buy European.
Side question: Durst or Castle pils - which would be a better choice? They cost the same.
Steve Jones
Username: Stevej
Post Number: 102
Registered: 08-2001
Posted From: 188.8.131.52
Posted on Tuesday, September 13, 2005 - 10:51 pm:
I'm not familiar with their prices, but I know a place that will drop ship supplies. They get the wholesaler to ship directly to the consumer.
Their website is being rebuilt, so you'll have to call them. I do know a couple of folks who got bags of malt for under $50 including shipping.
Asheville Brewers Supply
Asheville, NC
(828) 285 0515
Chris Vejnovich
Intermediate Member
Username: Cjv85vmax
Post Number: 257
Registered: 06-2003
Posted From: 22.214.171.124
Posted on Wednesday, September 14, 2005 - 01:04 am:
Chumley, isn't there a brew pub with in a 100 miles of you or so? I don't recall where you live in Montana. Buy a couple of bags from them. The only reason that I don't do that is because we have a good LHBS here in Lincoln.
Patrick C.
Intermediate Member
Username: Patrickc
Post Number: 397
Registered: 01-2001
Posted From: 22.214.171.124
Posted on Wednesday, September 14, 2005 - 01:32 am:
You may just have to suck it up and buy domestic. Aren't there any maltsters nearby you could back a truck up to?
Senior Member
Username: Chumley
Post Number: 3635
Registered: 02-2003
Posted From: 220.127.116.11
Posted on Wednesday, September 14, 2005 - 03:14 am:
Hmmm...I like the buy it from a brewpub idea, especially since the brewpub I have in mind was once upon a time my LHBS, before they decided there was much more profit in being a microbrewery instead of a LHBS.
Knowing these guys use Crisp M.O. is another reason to pester them - dammit, they owe me!
Patrick, there are no maltsters in Montana at the present; however, construction has been going on for over a year at Great Falls (85 miles from me) on a new plant. Rest assured I will be pestering them when they come on line.
George Schmidt
Advanced Member
Username: Gschmidt
Post Number: 594
Registered: 08-2004
Posted From: 188.8.131.52
Posted on Wednesday, September 14, 2005 - 06:01 am:
Do you have a shipping dock where you work? On a whim, I asked if I could recieve a palletized shipment at work and they were fine with it. I got 6 bags shipped to Indy for $90. Obviously, Montanta won't be that cheap, but it surely won't be $240 either. Something to check out, anyway.
Be wary of strong drink. It can make you shoot at tax collectors -- and miss. ~~Robert A. Heinlein: The Notebooks of Lazarus Long
Vance Barnes
Senior Member
Username: Vancebarnes
Post Number: 1843
Registered: 03-2003
Posted From: 126.96.36.199
Posted on Wednesday, September 14, 2005 - 03:14 pm:
Yea, I don't remember what the minimum is but NCM will palletize an order and ship it common carrier if you have a dock they can unload at. Well actually my lhbs does that and they don't have a dock. Should be lots cheaper that way than UPS.
Denny Conn
Senior Member
Username: Denny
Post Number: 5063
Registered: 01-2001
Posted From: 22.214.171.124
Posted on Wednesday, September 14, 2005 - 05:41 pm:
Durst or Castle??? Tough choice..I've ben using 'em both lately and really like both of them. I don't think you could really go wrong with either, so you may want to let price decide for you. I DO really like the Durst TurboPils, though, since it's specifically malted for a single infusion. I've been using the Castle without a protein rest, but I think it might benefit from a short high temp protein rest.
LIfe begins at 60...1.060, that is.
Randy McCord
Intermediate Member
Username: Mccord
Post Number: 419
Registered: 02-2003
Posted From: 18.104.22.168
Posted on Wednesday, September 14, 2005 - 06:42 pm:
Do brewpubs regularly sell bags of grain if requested? I'll be going to Upland brewery this weekend and might try to score a bag or two. Sorry Chumley, not trying to highjack the thread.
Tom Burk
Junior Member
Username: Tomburk
Post Number: 97
Registered: 03-2003
Posted From: 184.108.40.206
Posted on Wednesday, September 14, 2005 - 08:36 pm:
Randy and Chumley, several of the brewers around me will order extra malt for me when they are ordering malt. They don't, except Michigan Brewing that has thingsbeeras as a hbs, sell from their stock. I usually buy at thingsbeer and pick it up at the shop, I don't know what their shipping charges are.
Bill Pierce
Username: Billpierce
Post Number: 3487
Registered: 01-2002
Posted From: 126.96.36.199
Posted on Wednesday, September 14, 2005 - 08:54 pm:
Some brewpubs and microbreweries are happy to sell malt to homebrewers. Others don't really have a procedure in place for selling ingredients or don't wish to be seen as competing with a local homebrew shop. So the answer is it depends. But of course it doesn't hurt to ask.
Intermediate Member
Username: Miker
Post Number: 278
Registered: 02-2003
Posted From: 220.127.116.11
Posted on Thursday, September 15, 2005 - 03:13 pm:
I don't understand why their UPS rates are so high. We ship 50 lb bags every day from work (fertilizer) and if I pick a couple of zip codes from New York to Montana from our files and plug them in for a UPS quote, I get a total rate (once you reach 200 lbs you are not charged per package but get into hundred weight shipping rates) of about $75. If not in a box they may get you for an additional fee but I think that's $5/piece which would bring you to about $95 total shipping. We do have UPS discounts in place, but so should North Country. You might ask them why they are wanting to charge $40 per bag shipping?
We rarely find it cheaper to go by truck on shipments of less than about 250 lbs. UPS is usually as cheap or cheaper and more convenient.
Vance Barnes
Senior Member
Username: Vancebarnes
Post Number: 1847
Registered: 03-2003
Posted From: 220.127.116.11
Posted on Thursday, September 15, 2005 - 06:32 pm:
Most companies quoted UPS shipping charges are actually higher than the real UPS charges, ie "handling charges". Same as if you went to a UPS store compared to shipping it yourself from work or an actual UPS facility.
Tom Fries
New Member
Username: Tfries
Post Number: 6
Registered: 12-2003
Posted From: 126.96.36.199
Posted on Thursday, September 15, 2005 - 07:00 pm:
Hey Denny,
I really like the Turbo Pils too. Our local supplier no longer carries it though and I have run out
Do you get yours locally?
Roger Herpst
Intermediate Member
Username: Roger456
Post Number: 271
Registered: 12-2004
Posted From: 22.214.171.124
Posted on Thursday, September 15, 2005 - 07:05 pm:
I've noticed that my UPS shipping costs for the last couple of month have been adjusted from the World Ship quoted price for fuel surcharges. Those surcharge adjustments haven't been cheap, either.
Denny Conn
Senior Member
Username: Denny
Post Number: 5067
Registered: 01-2001
Posted From: 184.108.40.206
Posted on Thursday, September 15, 2005 - 09:10 pm:
Yeah, I do, Tom, but it was locally through a club buy that Kaz arranged. ;) Guess you'll be in on the next one, huh?
LIfe begins at 60...1.060, that is.
Dave Witt
Advanced Member
Username: Davew
Post Number: 799
Registered: 03-2003
Posted From: 126.96.36.199
Posted on Friday, September 16, 2005 - 01:23 am:
I've been thinking lately about placing an order at NCM. I was at their website the other night and it appears as though they ship FedEx, at least looking at the homebrewers section.
I have a friend who has access to a loading dock. Last year, I ordered along with him and several other people, about 18 sacks total. The shipping charge per bag was only $6-7, IIRC, to Chicago. Of course MT is much farther and there's the high cost of fuel this year.
Do you have friends that brew AND have access to a loading dock?


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Kaelee E. Salacka a 7 year old,2nd grader at Norwood-Norfolk Elementary School is scheduled to have 11-12 inches of her hair cut Saturday April 24th to be donated to Locks of Love in Memory of her Godfather, Uncle Chuck who passed away one year ago this weekend due to complications from Leukemia. Kaelee has enjoyed having beautiful long hair for 7 year and is ready to make anothers child's dream of having the same beautiful hair a reality. She saw her Uncle Chuck lose his hair more than once as he underwent Chemotherapy and understands how the same thing happens to children who have medical illnesses that cause them to lose their hair. Kaelee's parents, Frank and Tina Salacka,Raymondville are very proud of Kaelee's contribution to such a great cause.
7 Year Old To Donate Hair For Good Cause
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So proud of Kaelee..Uncle Chuck would be proud of you...42144869
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Natural versus "natural" in CAMworld
"When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean — neither more nor less."
"The question is," said Alice, "whether you can make words mean so many different things."
"The question is," said Humpty Dumpty, "which is to be master— that's all."
From: Through the Looking Glass, and
What Alice Found There by Lewis Carroll
"How can I help seeing what is in front of my eyes? Two and two are four."
"Sometimes, Winston. Sometimes they are five. Sometimes they are three. Sometimes they are all of them at once. You must try harder. It is not easy to become sane."
From: Nineteen Eighty-Four by George Orwell
One of the most powerful weapons in the armamentarium of advocates of the unscientific and implausible medical practices that fall under the rubric of "complementary and alternative medicine" (CAM) or, even worse, "integrative medicine" (IM), both of which seek to seamlessly "integrate" pseudoscience with science to the point that people start to be unable to tell which is which in order to "complement" effective medicine with placebo-based medicine, is their skill manupulating language. Wally Sampson has harped on this time and time again on this blog, particularly in his masterful fictional (but all too true-sounding) response to the question, "Why would medical schools associate with quackery?" Kimball Atwood has even turned the–shall we say?–"plasticity" with which CAM/IM advocates manipulate language to their advantage into humorous and all-too-infrequently recurring Friday feature. All of us have complained about how CAM/IM advocates have coopted diet and exercise as being somehow "alternative" and are now using that as the "foot in the door" to introduce pseudoscientific quackery like reiki and homeopathy into not just medical schools but to try to persuade the incoming Obama Administration to fund quackery on equal terms with scientific medicine as part of a "reform" designed to "promote health."
Much of the success, both previous and current, of CAM/IM advocates depends upon language. Just like Humpty-Dumpty, to ideologues like Deepak Chopra, words mean just what they choose them to mean, and, just like the view forced on Winston Smith at the Ministry of Love, two plus two are sometimes five, no matter how much we know they are four. All it takes is viewing science as "just another narrative," as postmodernist supporters of CAM/IM would like. Once that happens, there is nothing to stop one from viewing CAM/IM as being a "narrative" just as valid as that of science-based medicine. It's the way "quackery" has been transformed into "unconventional," later into "alternative," and most recently "integrative" medicine. It's all designed to play on the natural American desire to be "fair" and the media's desire for "balance," even though it is not fair to give pseudoscience a patina of scientific respectability that it does not deserve or use "balance" to present quackery as though it has equal standing with scientific medicine.
If there is one word that has been corrupted by the CAM/IM movement more than any other, my vote would go the world "natural." Of course, it's not just the CAM/IM movement that has molded this word to mean whatever meaning is required for whatever purpose is desired. For decades, the advertising industry has done the same. However, the CAM/IM movement takes it to a new level, or "kicks it up a notch," as a certain TV chef likes to say.
I came across a perfect example of this in the form of a man named Tony Isaacs.
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Dilger, John A. MD*; Rho, Edwin H. MD*; Que, Florencia G. MD*†; Sprung, Juraj MD, PhD*
Departments of *Anesthesiology and
†Surgery, Mayo Clinic, Rochester, Minnesota
Accepted for publication September 9, 2003.
Address correspondence and reprint requests to Juraj Sprung, MD, PhD, Mayo Medical School, Department of Anesthesiology, Saint Mary's Hospital, MB 2-752, 200 First St. SW, Rochester, MN 55905. Address e-mail to email@example.com.
Octreotide may be a life-saving treatment in the case of an acute carcinoid crisis, but when given as an IV bolus in larger doses, it may cause significant effects on the cardiac conduction system. We describe cardiac conduction impairment observed during octreotide administration in a patient undergoing carcinoid tumor surgery. In this patient, IV boluses of 100 μg of octreotide resulted in symptomatic bradycardia, Mobitz type II atrioventricular block, and complete heart block. Perioperative physicians especially need to be aware of these potential effects because they may be more likely to occur during surgery because of the larger doses and boluses that are used to treat acute symptoms secondary to tumor manipulation.
Octreotide, a long-acting synthetic cyclic octapeptide, is a somatostatin analog used for treatment of carcinoid syndrome symptoms. Octreotide may be a life-saving treatment in the case of an acute carcinoid crisis but at the same time may have effects on cardiac conduction. We present a patient who received a bolus of octreotide during resection of metastatic carcinoid tumor and developed symptomatic bradycardia, Mobitz type II, and third degree atrioventricular block. Despite the well-known fact that somatostatin has physiologic importance in the neurohumoral control of cardiac impulse formation and conduction (1–5), its synthetic analog octreotide has never been associated with severe cardiac conduction defects, such as that seen in our patient. Moreover, a recent textbook of anesthesiology suggested that IV administration of large doses of octreotide is safe (6).
A 67-yr-old man, weighing 95 kg, underwent abdominal laparotomy for liver resection of metastatic carcinoid tumor. Relevant medical history consisted of long-standing hypertension, which was treated with felodipine 10 mg twice daily and enalapril 20 mg twice daily. His preoperative symptoms consisted of facial flushing, palpitations, and diarrhea consistent with carcinoid syndrome. These symptoms were preoperatively treated with octreotide 100 μg sc twice daily. He denied any allergies and had no anesthesia history.
Preoperative electrocardiogram (ECG) showed normal sinus rhythm of 78 bpm and was entirely normal. His preoperative transthoracic echocardiogram showed moderate diastolic dysfunction but was otherwise normal. All preoperative laboratory values were within normal limits. After all of the standard ASA anesthesia monitors were applied, a radial 20-gauge arterial catheter was inserted. Before the induction, his arterial blood pressure was 140/75 mm Hg, and his heart rate was 90 bpm. General anesthesia was induced with IV fentanyl 250 μg, propofol 150 mg, and succinylcholine 120 mg to facilitate endotracheal intubation. Anesthesia was maintained with isoflurane and muscle paralysis with cisatracurium 8 mg. Approximately 10 min after the induction of anesthesia and immediately after surgical incision, we gave a prophylactic bolus dose of octreotide 100 μg IV. Up until that time, the patient's intraoperative course had been uneventful, with his arterial blood pressure at 135/78 mm Hg, and his heart rate at 85 bpm. Immediately after the octreotide was given, the heart rate acutely decreased to 35 bpm, and arterial blood pressure decreased to 85/40 mm Hg. There was no increase in arterial blood pressure preceding the bradycardia. Ephedrine 20 mg IV was given, as well as a fluid bolus of 500 mL of lactated Ringer's solution, resulting in a heart rate increase to 82 bpm and arterial blood pressure increase to 155/90 mm Hg. During this event, we at first did not associate the administration of octreotide with the hemodynamic changes. After a 30-min period of intraoperative hemodynamic stability and while manipulating the liver, the patient's face became flushed without changes in hemodynamics. We administered an additional bolus of 100 μg of octreotide IV. Immediately after the injection, the heart rate decreased to 45 bpm, followed by a 3-s asystolic pause, then by a 1-min period of atrioventricular dissociation consistent with third degree atrioventricular block. This episode was followed by an approximately 20-s episode of second-degree (Mobitz type II) atrioventricular block. Arterial blood pressure at that time was 75/34 mm Hg. We immediately placed external cardiac pacing pads. Simultaneously, we administered ephedrine 20 mg and glycopyrrolate 0.2 mg IV, resulting in the heart rate and arterial blood pressure increasing to 100 bpm and 155/86 mm Hg, respectively. The patient remained hemodynamically stable throughout the remainder of surgery. No additional octreotide was administered. At the end of the surgery, the patient's trachea was extubated, and he was transferred to the recovery room. His postoperative 12-lead ECG, cardiac enzymes, electrolytes, and arterial blood gas values were all within normal limits.
The rest of this patient's hospitalization was uneventful. Because the patient had no cardiac history and the rhythm disturbances occurred with a close temporal association to the administration of the bolus doses of octreotide, the cardiologist determined that there was no need for further electrophysiologic evaluation of this patient's cardiac conduction system.
This is the first case in the anesthesia literature illustrating severe hemodynamic sequelae after administering octreotide in an anesthetized patient undergoing carcinoid tumor surgery. In this patient, an IV bolus of octreotide resulted in hemodynamically significant bradycardia, Mobitz type II atrioventricular block, and complete heart block. Mild bradycardia has been described after octreotide administration in other clinical settings, although infrequently (7–9). The manufacturer's product information suggests the possibility of bradycardia and dysrhythmias (9%) in acromegalic patients receiving octreotide, but these ECG changes are not uncommon in acromegalic patients, irrespective of octreotide treatment (9). Herrington et al. (7) described a patient who was receiving octreotide subcutaneously and who developed bradycardia (38 bpm) without heart block. In several other reports, octreotide administration did not consistently demonstrate a reduction of heart rate (10–12). In a small series of patients with acromegaly receiving octreotide subcutaneously, the mean heart rate decreased, and the mean systemic vascular resistance increased, both statistically significantly (13). However, in some of these studies (13,14), it is impossible to distinguish between indirect long-term beneficial effects of octreotide on heart function (improved congestive heart failure, which would result in decrease in heart rate) from its direct pharmacologic effects (4,5). Therefore, it is more meaningful to assess the effects of octreotide or somatostatin on heart rate in acute clinical situations (5,15,16). A significant bradycardia was recorded with octreotide (15), and termination of supraventricular tachyarrhythmias has been accomplished with somatostatin (3,5,16). In both reports, the drugs were administered IV. We believe that our patient experienced severe bradycardia primarily because of the rapidly administered large dose of octreotide IV. In another report, the modest reduction of heart rate was found when a smaller diluted bolus dose was given (25 μg in 10 mL of normal saline) (15). Indeed, it seems that bradycardia occurs less often in patients who are receiving octreotide subcutaneously (12,17), compared with those who are receiving it IV (10,11,15). Furthermore, slower IV infusions of octreotide, 100 μg/h during two hours (11) or 50 μg/h (10), have less negative chronotropic effects than faster IV infusion rates (250 μg/10 min) (5).
The mechanisms by which octreotide can cause bradycardia are numerous, and it is still not known if these effects are mediated indirectly through its effects on systemic circulation (18) or directly through ionic mechanisms at the level of heart (4). Octreotide increases systemic vascular resistance, and bradycardia may be a baroreceptor-induced reflexive response to increase in the systemic blood pressure (15,18). This mechanism, based on reflexive bradycardia, may be assumed only in patients who developed hypertension before bradycardia after octreotide was administered. This did not occur in our patient who simultaneously developed bradycardia and hypotension. Furthermore, the bradycardia in our patient was associated with atrioventricular block, suggesting that the pathogenesis was more likely via a direct action of octreotide on the heart. There is another possibility of an indirect mechanism of octreotide-induced bradycardia. Octreotide suppresses the secretion of vasoactive intestinal peptide (VIP) (19), which can increase the heart rate even more so than norepinephrine (20). Therefore, by blocking VIP, octreotide may cause bradycardia.
The most plausible explanation for bradycardia after octreotide is through its direct effects on the heart. Control of the cardiovascular system is provided not only by a regulatory influence of the classical neurotransmitters acetylcholine and norepinephrine, but also via some regulatory peptides, such as somatostatin. Somatostatin-like immunoreactivity was found in the heart of several mammals (4,21), including humans (4). It was detected in the human atrial and ventricular myocardium, conductive system of the heart, and cardiac postganglionic parasympathetic neurons (4). Somatostatin coexists with acetylcholine in presynaptic vagal endings and may be released by high-frequency stimulation of the vagus nerve (2). The main cardiac effects of somatostatin are heart rate deceleration, decrease of myocardial contractility, and slowing of the propagation velocity along the cardiac conduction system (21). IV infusions of somatostatin slow the sinus rate and depress atrioventricular conduction (4). Somatostatin also plays a role in cardiac rhythmogenesis. It modifies the electrophysiological properties of cardiac pacemakers, modulates the cardiac chronotropic action of the autonomic nervous system, and prevents supraventricular tachyarrhythmias. The cardiovascular effects of somatostatin may result from its modulatory action on presynaptic release of acetylcholine, norepinephrine, and other humoral substances. However, some effects of somatostatin result from its neurotransmitter action, which is provided by the interaction with specific somatostatin receptors. Somatostatin receptors belong to the family of G-protein coupled receptors, and activation of these receptors results in inhibition of adenylyl cyclase (resulting in a decrease in intracellular cyclic adenosine monophosphate concentration), which decreases conductance of voltage sensitive calcium channels (via an inhibition of inward calcium current) and activation of potassium membrane conductance (22,23). Because of its ability to slow the heart rate by prolonging atrioventricular conduction time and refractoriness (3,5), somatostatin has been successfully used to treat supraventricular tachycardia (5,16); these effects were comparable to the effects of verapamil (3). We believe that octreotide has caused bradycardia and atrioventricular conduction abnormality primarily by acting directly on the cardiac conduction system.
Octreotide may be a life-saving treatment in the case of an acute carcinoid crisis, but when given as an IV bolus and in larger doses (≥100 μg), it may cause significant effects on the arterial blood pressure, heart rate, and cardiac conduction system. Perioperative physicians especially need to be aware of these potential effects because they may be more likely to occur during surgery because of the larger doses and boluses that are used to treat acute symptoms secondary to tumor manipulation. As suggested by the evidence in the literature, it may be advisable to dilute octreotide and infuse it slowly with continuous monitoring of the ECG. In a case of carcinoid crisis, when octreotide is given as a bolus, the anesthesiologist should be prepared to treat significant bradycardia and cardiac conduction delays.
© 2004 International Anesthesia Research Society
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Describe each of the following properties of the graph of the Cosine Function, f() = cos() and relate the property to the unit circle definition of cosine.
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Garcia-Albea, Victoria
Victoria Garcia-Albea, CPNP, MSN, Lahey Clinic, Burlington, MA.
The author declares no conflict of interest.
Correspondence concerning this article should be addressed to Victoria Garcia-Albea, CPNP, MSN, Lahey Clinic, 41 Mall Road, Burlington, MA 01805. E-mail: firstname.lastname@example.com
ABSTRACT: Urticaria pigmentosa is one of a spectrum of diseases of the mast cell, termed mastocytosis. This is an uncommon disorder in which mast cells are overproduced and accumulate in various organs. In urticaria pigmentosa, mast cells accumulate in the skin, causing a rash. In this article, the diagnosis and management of urticaria pigmentosa will be reviewed by examining a case occurring in a 5-month-old boy. There is also a brief review of systemic mastocytosis and other mastocytosis variants.
A 5-month old boy was referred to the dermatology clinic for a 1-week history of an asymptomatic rash. The patient's mother initially thought he had bug bites; however, when he seemed to wake up with more lesions, she became concerned. The lesions did not seem to bother the patient; he was not scratching them. He had no history of systemic symptoms such as fever or weight loss, and there were no changes in sleep, bowel, or eating habits. His mother denied that he ever developed any blisters or facial flushing.
The patient's past medical history was unremarkable. He was a healthy 5-month-old boy, who was born to a healthy 32-year-old woman, with no complications during pregnancy or delivery (Figure 1). His 2-year-old sister was healthy. There was no recent travel and no new pet exposures in the weeks preceding the rash. His medications included only a vitamin D supplement, which was not new. He was breastfed exclusively. His immunizations were all up to date. No one else at home had a rash. The patient's mother reported no changes in soaps, detergents, lotions, or moisturizers.
On presentation, the patient was a healthy-appearing 5-month-old White boy, who was awake and alert during the examination. He was playful and smiling, well-nourished and well-hydrated, moving all extremities, and was in no apparent distress. His mucous membranes were moist, and the anterior fontanel was open and soft. Located on his face and trunk, but with the highest concentration on the extremities, were numerous pinkish-brown edematous 3-mm to 1-cm smooth, dermal papules and plaques. There was no epidermal change. When two discrete pinkish-brown 3-mm macules on the lower abdomen were stroked with a pencil eraser, they developed into erythematous urticarial wheals, displaying a positive Darier's sign (Paller & Mancini, 2006; Skrabs, 2002).
A complete blood count (CBC) was performed, which was normal. The patient did not have a skin biopsy. The Darier's test was performed as described above, and it was positive. The Darier's test or Darier's sign refers to a localized urticarial wheal that is produced at the site when a lesion is rubbed or scratched with a tongue blade or pencil eraser (Avshalumov, Pichardo, Jorizzo, Sangueza, & Goldenberg, 2008; Skrabs, 2002). This will be discussed in greater detail below.
On the basis of the patient's history of present illness, clinical presentation, and positive Darier's sign, the diagnosis of urticaria pigmentosa (UP) was made (Almahroos & Kurban, 2003; Longley et al., 1993). UP is one of several forms of mastocytosis (Avshalumov et al., 2008). Mastocytosis refers to a heterogeneous group of clinical disorders characterized by increased mast cell accumulation in the skin or other organs (Longley et al., 1993; Paller & Mancini, 2006). UP can occur at any time from birth to middle age but is most often seen in children; 55% of cases present before 2 years old (Almahroos & Kurban, 2003; Paller & Mancini, 2006).
The diagnosis of pediatric mastocytosis is based on characteristic skin findings and a positive Darier's sign (Paller & Mancini, 2006). This test is "notoriously positive" in 90% of patients with UP (Paller & Mancini, 2006, p. 226). The skin will develop localized erythema and urticarial wheals when rubbed with a tongue blade or pencil eraser (Avshalumov et al., 2008; Paller & Mancini, 2006). In children under 1 year old, rubbing can cause a blister to form (Avshalumov et al., 2008). A positive Darier's sign aids in diagnosing all forms of cutaneous mastocytosis, although it can be negative in patients with mastocytosis, especially when lesions are macular at baseline (Paller & Mancini, 2006). One should use caution when performing the Darier's test, because when positive, histamine is released and anaphylaxis has been reported.
When skin lesions are present, a skin biopsy can be performed to confirm the diagnosis. The biopsy should be performed on lesional skin and should be sent for hematoxylin and eosin staining; direct immunofluorescence is not needed. Local anesthetic without epinephrine should be used because epinephrine can cause mast cell degranulation, making them more difficult to identify (Alto & Clarcq, 1999). In UP, this would show accumulation of mast cells in the dermis. Special stains can help confirm the mast cell nature of the infiltrate. When systemic symptoms are present, such as nausea, abdominal pain, diarrhea, weight loss, headache, hypotension, bone pain, fatigue, syncope, tachycardia, or respiratory distress, a biopsy of the bone marrow or the gastrointestinal tract may be necessary (Paller & Mancini, 2006).
The etiology of UP is not well understood. Mast cell growth and regulation is dependent on stem cell factor, which is cytokine that binds to the c-kit gene (Paller & Mancini, 2006). Studies of adult patients with mastocytosis have shown c-kit mutations. However, these genetic mutations are not typically present in pediatric patients with UP. Mastocytosis is usually a sporadic disorder, but there have been reports of familial cases (Paller & Mancini, 2006).
Cutaneous mastocytosis includes mastocytomas, which can be single or multiple; UP; bullous mastocytosis; diffuse cutaneous mastocytosis; and telangiectasia macularis eruptiva perstans. Mastocytosis can be separated into a cutaneous form and a systemic form, with potential overlap. There are consistent differences between adult and pediatric mastocytosis. Adult disease is classified into indolent mastocytosis, mastocytosis with associated hematologic disorder, mast cell leukemia, and lymphadenopathic mastocytosis with eosinophilia. In pediatric patients, there tends to be an earlier onset, usually within the first year of life; more common spontaneous resolution, often before puberty; rare association with hematologic disorders; and rare extracutaneous involvement (Paller & Mancini, 2006).
The classification of mastocytosis can be confusing; however, categorization of pediatric disease can be simplified (Paller & Mancini, 2006). The most common pediatric presentations are mastocytomas (single or multiple), UP, and occasionally, diffuse cutaneous mastocytosis. Vesicular or bullous variants of each of these can occur.
In some patients, facial flushing is seen, along with blistering and itching (Almahroos & Kurban, 2003; Paller & Mancini, 2006). These symptoms are related to the release of histamine, prostaglandin, heparin, tryptase, leukotrienes, and other mast cell mediators (Paller & Mancini, 2006). Signs and symptoms of mast cell disease vary depending on where in the body the mast cells are located (Bains & Hsieh, 2010). The most common location for mast cell accumulation is in the skin; therefore, most patients with mastocytosis have cutaneous involvement (Bains & Hsieh, 2010). Other organs can be involved, most commonly the bones, bone marrow, gastrointestinal system, heart, lungs, and central nervous system (Avshalumov et al., 2008; Longley et al., 1993). Bone involvement can be lytic, sclerotic, or a mixed process (Barete et al., 2010). Diffuse involvement is more common, and in many adult patients with systemic mastocytosis, there is generalized osteoporosis (Barete et al., 2010). Sclerotic changes are seen in the axial skeleton and the ends of the long bones (Barete et al., 2010). When the disease is more severe, patients may experience systemic symptoms demonstrating accumulation of mast cells in other organs. Patient may experience nausea, abdominal pain, diarrhea, malabsorption with hypoalbuminemia, weight loss, headache, hypotension, bone pain, fatigue, syncope, tachycardia, and less commonly, pulmonary symptoms (Almahroos & Kurban, 2003; Avshalumov et al., 2008; Bains & Hsieh, 2010; Paller & Mancini, 2006). In adults, the extent of cutaneous disease can correlate with systemic symptoms (Paller & Mancini, 2006). In children, this correlation does not exist (Paller & Mancini, 2006).
Extensive laboratory or radiographic studies are generally not indicated in the pediatric population (Paller & Mancini, 2006). In diffuse cutaneous mastocytosis, a CBC, complete metabolic panel, and serum tryptase may be indicated (Paller & Mancini, 2006). Serum tryptase measures the level of mast cell activation (Sperr et al., 2002). A urine histamine level would be elevated (Paller & Mancini, 2006).
Mastocytomas, a common type of childhood mastocytosis, are skin-colored to yellow, orange, or tan papules or plaques. They can look like bruises or café au lait macules and can range in size from a few millimeters to several centimeters. Mastocytomas display a positive Darier's sign. They can appear anywhere on the skin, but the most common locations are the arms, neck, and trunk (Paller & Mancini, 2006).
UP, the most common type of pediatric mastocytosis, presents with multiple mastocytomas. Lesions may be purpuric or may have a yellowish hue. Darier's sign is positive, and dermatographism is present in 30%–50% of patients (Paller & Mancini, 2006).
Diffuse cutaneous mastocytosis is a more rare type of mastocytosis and is especially uncommon in children (Paller & Mancini, 2006). Skin appears thick and reddish-brown and may have a peau d'orange texture, which when translated from French means "orange peel-like texture" (Paller & Mancini, 2006, p. 227). These patients are more likely to have systemic disease and may experience pruritus, flushing, fever, vomiting, diarrhea, abdominal pain, gastric ulceration, or respiratory distress. Pediatric patients with diffuse cutaneous mastocytosis may be at risk for peptic ulcer disease (Paller & Mancini, 2006).
Telangiectasia macularis eruptiva perstans is a type of mastocytosis that occurs almost exclusively in adults. It has rarely been reported in children. These patients have minute, reddish-brown telangiectatic macules on the trunk and extremities (Paller & Mancini, 2006).
Mastocytosis with systemic involvement is significantly more common in adults than in children (Paller & Mancini, 2006). Organs most commonly involved are the gastrointestinal tract and skeletal system; however, lungs, kidneys, lymph nodes, myocardium, pericardium, liver, spleen, and bone marrow can be involved (Pardanani & Tefferi, 2010). In adults, there is an increased risk for hematologic malignancy. In pediatric patients with systemic mastocytosis, the hematologic system is rarely involved; therefore, their level of risk for hematologic malignancy is unclear (Paller & Mancini, 2006).
The course and prognosis of mastocytosis depends on the subtype, disease severity, and age of onset (Paller & Mancini, 2006). Usually, pediatric patients with mastocytosis have a favorable outcome, and at least 50% of patients have complete resolution by adolescence (Paller & Mancini, 2006). If mastocytosis persists into adulthood, patients have the same risk of systemic disease as patients with adult-onset mastocytosis (Paller & Mancini, 2006). However, adults with pediatric-onset mastocytosis generally have milder symptoms as adults (Jappe, Aumann, Mittler, & Gollnick, 2003). When adults develop UP, it is usually more severe, involvement in extracutaneous organs is more common, and the disease is termed systemic mastocytosis (Jappe et al., 2003).
Treatment is symptomatic as there is no cure for mastocytosis. There should be a focus on patient and parent education about the disease, its natural history, differences between adult and pediatric disease, and possible triggers. Antihistamines help reduce dermatographism, itch, facial flushing, and gastrointestinal symptoms. Oral nonsedating histamine type 1 receptor (H1) antagonists are the first-line treatment. These include cetirizine, loratadine, and fexofenadine. In more severe cases, oral sedating H1 antagonists may be useful. These include diphenhydramine and cyproheptadine. Adding an oral H2 antagonist may be helpful for persistent gastrointestinal symptoms. These include cimetidine, ranitidine, and famotidine (Paller & Mancini, 2006).
Another treatment of gastrointestinal symptoms is oral chromolyn sodium, although it has not been studied extensively in children. Psoralen plus UVA can be effective for UP, cutaneous mastocytosis, and systemic mastocytosis. Aspirin and nonsteroidal anti-inflammatory drugs can cause mast cell degranulation, but they also reduce flushing in some patients. Potent topical steroids applied with occlusion can ameliorate or clear mastocytomas. Short courses of oral prednisone can be used for temporary symptom relief. Cyclosporin and low-dose methotrexate have been used in adults with aggressive forms of systemic mastocytosis (Molderings, Brettner, Homann, & Afrin, 2011; Paller & Mancini, 2006). Finally, patients who experience intermittent hypotension should carry an epinephrine pen at all times for emergency use (Paller & Mancini, 2006).
One month after his initial presentation, the patient returned to the dermatology clinic for a follow-up examination. At that time, his mother stated that the rash was getting worse. She reported that the patient was developing a higher number of lesions, more frequently (Figures 2–6). He was still without itch, fever, diarrhea, weight loss, or pain and was otherwise healthy. The patient's mother denied any other signs or symptoms of UP and stated that she was unaware of any triggers, such as heat, hot baths, or stress. She was visibly nervous about her son's skin condition and was also concerned that his disease seemed to be worsening. After a lengthy discussion with the patient's mother about the benign nature of UP, she was reassured. The patient was started on oral cetirizine at bedtime.
Since the last visit, the patient has continued to have numerous mastocytomas. These lesions occasionally become inflamed and raised, primarily when the patient's temperature is elevated. The patient is monitored every 6 months in the dermatology clinic to screen for systemic involvement. This screening includes a thorough review of systems and a physical examination. His pediatrician is aware of his diagnosis, and she monitors him as well, including checking his CBC regularly. He is expected to outgrow this condition sometime during adolescence.
Cutaneous Mastocytosis; Mast Cell; Mastocytoma; Mastocytosis; Systemic Mastocytosis; Urticaria Pigmentosa
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Gennette promoted to prez at Macy's
March 31, 2014-- Home Textiles Today,
Cincinnati – Macy's chief merchandising officer Jeffrey Gennette has been promoted to president of Macy's Inc.
Gennette will continue to be based in New York and will report to company chairman and ceo Terry Lundgren. In addition to overseeing Macy's merchandising, Gennette will lead marketing and macys.com as well as Macy's Private Brands division.
He has held the chief merchant position for five years. He served as chairman and ceo of Macy's West in 2008, and was chairman and ceo of Macy's Northwest in Seattle from December 2005 to February 2008. Before that, Gennette was executive vp and director of stores for Macy's Central in Atlanta and svp/general merchandise manager at Macy's West. Gennette joined Macy's West in 1983 as an executive trainee and held various merchant and store management positions in that division. His career has also included positions as a store manager for FAO Schwarz and director of stores for Broadway Stores.
"Jeff Gennette is an outstanding merchant who has proven to be an insightful strategist and strong leader in our company," Lundgren said. "As our president, with the additional responsibility for Macy's private brands, Gennette will have a total view of Macy's merchandise assortment and marketing strategy – both in stores and online – consistent with our omnichannel vision. Our exclusive private brands, which have provided a powerful competitive advantage for Macy's, will continue to play a vitally important role in delivering fashion, quality and value to our customers."
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Accommodation In Belfast
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NSA Catalog Lists Vulnerabilities to Exploit Networking Gear: Report
The National Security Agency has a "mail-order" catalog of security vulnerabilities it uses to exploit networking equipment, according to a new published report.The U.S. National Security Agency (NSA) has its own catalog of vulnerabilities that it uses to exploit commercial networking gear in order to insert backdoors to conduct surveillance, according to a report published this weekend in German news magazine Der Spiegel. The report is based on materials leaked by NSA whistleblower Edward Snowden and details new revelations about an NSA unit known as the Tailored Operations Unit, or TAO, which conducts operations that enable it to gain access to user PCs and computer networks in a number of ways. One of the more elaborate ways the NSA is able to insert backdoors is by intercepting technology shipments from a vendor to a user, loading malware onto the device, then forwarding the technology to its original destination. According to the report, TAO is also able to gain information is by exploiting Microsoft Windows crash reports sent from user PCs. Microsoft has recently taken steps to boost its own encryption efforts in a bid to improve its security in light of previous NSA exploitation disclosures. Microsoft isn't the only U.S. tech vendor that the NSA's TAO has been able to exploit. According to the Der Spiegel report, there is a 50-page document that reads like a mail-order catalog of exploits that the agency can use to infiltrate myriad technologies from U.S.-based technology vendors.
Among the vendors named in the report as being exploitable is networking giant Cisco Systems. In a publicly released statement, Cisco Chief Security Officer John Stewart denied any knowledge of any NSA backdoor vulnerabilities in the company's equipment.
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Meet Monza, another mean machine straight from the future. Designed by Iman Maghsoudi, this one is a perfect portrayal of his belief that driving cars in the future will be like operating a PC while zooming at 200 km/h. Thanks to the unsurpassable technological advancement this otherwise impossible phenomenon will now be achieved thanks to the hyper-computerized Monza that is not just built for speed but also for auto driving.
At the low speed beginning of your journey on Monza, you'll be sitting inside the cockpit controlling it like a motorcycle but as soon as the speed exceeds a particular limit, the car gets into the auto mode and the computer takes over relieving you. At this stage, the vehicle transforms into something looking like an airfoil to provide maximum aerodynamics.
The design is such that it creates a lift to reduce friction while the strong ground effects keep you from taking off. Since the vehicle will be swimming in air, thanks to its speed, the 2 manta ray like fins continue their work of adjusting to channel air to keep the vehicle well balanced and swiftly floating…errr…running!
Via: Yankodesign