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1490 Meier Drive, Traverse City 49686
See more homes for sale in Traverse City, MI
Beautiful Mission Peninsula Haven. An almost 3000 s.f. Custom Home built in 2000 with 2X6 walls and authentic Michigan white cedar log siding, anderson windows/doors, granite kitchen counters with exquisite copper/ore back-splash from Michigan's U.P., maple cabinets, laminate wood and ceramic floors on top of 3/4" PINE over sub-floor, wood burning fireplace, security system, natural gas forced air with heat-pumpt, heated 3-car garage, several auxiliary buildings with heat & water, irrigation, TOTAL SECLUSION within minutes of Bowers' Harbor. New roof in 2016, new water heater, new 1200 s.f. pole building in 2015, much much more. Neighbors are conservancy property and a 20-acre parcel. You must see this property. Call for more information and a tour.
Property Information
- Status
- Active
- Address
- 1490 Meier Drive
- City
- Traverse City
- Zip
- 49686
- County
- Grand Traverse
- Township
- Peninsula
- Possession
- Negotiable
- Zoning
- Outbuildings Allowed, Residential
- Listing Date
- 07/03/2016
- Total Finished SqFt
- 2,970
- Above Grade SqFt
- 2,970
- Garage
- 3.0
- Garage Desc.
- Attached, Concrete Floors, Door Opener, Heated, Other, Paved Driveway, Plumbing
- Waterfront Desc
- None
- Water
- Private Well
- Sewer
- Private Septic
- Year Built
- 2000
- Home Style
- 1.5 Story, Lodge, Log Home
Rooms and Land
- MasterBedroom
- 24X17 2nd Floor
- Bedroom2
- 24.6X13 2nd Floor
- Bedroom3
- 11X11 1st Floor
- Bedroom4
- 11X10.6 1st Floor
- Dining
- 19X12 1st Floor
- Kitchen
- 14X13 1st Floor
- Laundry
- 1st Floor
- Living
- 24X20 1st Floor
- Basement
- Crawl Space, Other, Poured Concrete
- Cooling
- Forced Air, Heat Pump, Humidifier, Natural Gas
- Heating
- Forced Air, Heat Pump, Humidifier, Natural Gas
- Acreage
- 2.4
- Lot Dimensions
- 540x482x196x423x230x50
- Appliances
- Dishwasher, Disposal, Exhaust Fan, Microwave, Natural Gas Water Heater, Oven/Range, Refrigerator, Satellite Dish, Security System, Smoke Alarms(s), Water Softener Owned
- Fireplace Desc.
- Fireplace(s), Masonry, Wood
- Interior Features
- Built-In Bookcase, Cathedral Ceilings, Den/Study, Drywall, Exercise Room, Foyer Entrance, Game Room, Granite Kitchen Tops, Great Room, Island Kitchen, Jetted Tub, Loft, Mud Room, Paneling, Pantry, Solid Surface Counters, Walk-In Closet(s), Workshop
- Exterior Materials
- Log Siding
- Exterior Features
- Covered Porch, Deck, Landscaped, Porch, Screened Porch, Sprinkler System
Listing Video for 1490 Meier Drive, Traverse City MI 49686
Mortgage Calculator
Listing Broker
Listing Courtesy of Exit Realty Paramount
Office Address 13919 S West Bayshore Drive Suite 104
Listings last updated: . Some properties that appear for sale on this web site may subsequently have been sold and may no longer be available.
Our Michigan real estate agents can answer all of your questions about 1490 Meier Drive, Traverse City MI 49686. Real Estate One, Max Broock Realtors, and J&J Realtors are part of the Real Estate One Family of Companies and dominate the Traverse City, Michigan real estate market. To sell or buy a home in Traverse City, Michigan, contact our real estate agents as we know the Traverse City, Michigan real estate market better than anyone with over 100 years of experience in Traverse City, Michigan real estate for sale.
The data relating to real estate for sale on this web site appears in part from the IDX programs of our Multiple Listing Services. Real Estate listings held by brokerage firms other than Real Estate One includes the name and address of the listing broker where available.
IDX information is provided exclusively for consumers personal, non-commercial use and may not be used for any purpose other than to identify prospective properties consumers may be interested in purchasing.
Nothern Great Lakes REALTORS® MLS. All rights reserved.


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Twisted Metal (2012) is a vehicle combat video game developed by Eat Sleep Play and published by Sony Computer Entertainment for the PlayStation 3. It is a reboot of the Twisted Metal franchise.
I'm a fan of the Shin Megami Tensei and Persona series, Pokémon, PlayStation and gaming in general. Also, a fan of anime and heavy metal.
Recoinnasance is my thing. Stealth, not so much.
Casado, gosto de uns joguinhos e jogar haxball.

subset: commoncrawl


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Big Dee's Equine Dewormer Rotation Pack Basic
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- This basic package includes one year's worth of paste dewormers for one horse up to 1200 lb
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JAN/FEB - 1 tube PYRANTEL PAMOATE
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Item #97901
Product Description
The rustic details of our Wallace Coffee Table recall an old-world aesthetic. This unique round coffee table is hand-crafted of iron and given an antique copper finish. You'll notice subtle impressions left behind from the hammering process and other slight variations on the surface of this accent table that make it a unique and interesting conversation piece.
Product Details
Corbit Coffee Table
Lords Area Rug
Was: $89.00 - $1,599.00
Sale: $71.00 - $1,279.00
Langston Trunk Coffee Table
Cowan Coffee Table
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Is this restaurant appropriate for Kids?
Is this restaurant good for business meetings?
Is this restaurant good for dining on a budget?
Is this restaurant good for brunch?
Is this restaurant family-friendly?
Is this primarily a coffee shop?
Is this a cafe?
Does this restaurant offer takeout or food to go?
Are the prices at this restaurant low or inexpensive?
Can a vegetarian person get a good meal at this restaurant?
Thanks for helping!
Nice place to hang out if you prefer. Coffee was above average and service just fine and pleasant. Food is not so great - pre packaged baked goods and fake (need to be nuked in microwave) eggs - not so appealing.
Their coffee is fantastic. We didn't have anything worthwhile except an over crowded Starbucks, in our hotel so we walked down there- had great breakfast treats and wonderful soul warming coffees!
Went in because of the high rating, but honestly don't know why it deserves it. The breakfast sandwiches were overheated (microwave), and not much selection for breakfast, unless breakfast for you is a microwaved muffin. Cozy atmosphere.
Great coffee and a cool eclectic seating area to go along with friendly and courteous staff. Their coffee (americano) tasted smooth with with complex notes and sis not have any bitter after taste.
The interior space has a very welcoming feel and nice vibe. An easy place to relax or take the lap top and get some work accomplished.
Very friendly atmosphere and people that are here. The latte was the best I've had in a long time! Will definitely come back when I'm in Spokane again!
I really liked the coffee at Brews Brothers. While in town for the week I tried a new coffee place each day to see which one I liked the best. By far Brews Brothers had the best flavor and quality!
Regularly have breakfast here when in Spokane. Great range from healthy to less so and very friendly staff
Great coffee and friendly service, nice pick-me-up on a Sunday morning. Lots of different choices and also some snacks available.
I stayed at the Hotel Lusso across the street and i'm an early riser. I don't like to brew coffee in my hotel room, so I found Brews Brothers to be a great alternative.
In town for business had some extra time, so we stopped in. Wow what great coffee. When we ever get back here I will stop in again.
Own or manage this property? Claim your listing for free to respond to reviews, update your profile and much more.


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New Scar Symmetry single
Cheesy, 80-ish and upbeat, but pretty fun to listen to. The production is better than on their last two albums as well
Well, I'm looking forward to this more than I was for their last two albums, so that's gotta mean something.
Digging: Immolation - Atonement
"The Singularity, Phase I: Neohumanity"
That chorus is painfully cheesy, even by Scar Symmetry standards. Will still check out the album though, all the ingredient are there for them to make something great again, just not getting hopes up
All their albums sound the same but I really like it so I'll probably look into this.
It's cheesy alright, but not quite as cheesy as The Iconoclast or The Anomaly. Those were right cheesy, in a bad way too. this is cheesy in a good way
is this band good
Digging: Analepsy - Atrocities from Beyond
They're okay
First three albums are fantastic, subsequent two are meh
Definitely fun, but just way way too cheesy for me. Will pass.
"The production is better than on their last two albums as well" [2]
I'm so glad for that.
sounds like ass
First three albums are fantastic, subsequent two are meh [2]
The cleans need to die but the riffs are fine.
Lars seems to squeeze his throat terribly when singing the "ee" sound, that's one mannerism of his that he needs to learn to drop
It's alright. My problem with the guy who does the cleans is that I always imagine how much better it would sound if Christian still did them.
Styx metal
Oh yeah, Def Leppard is back :]
My favorite from them is Holographic Universe. If you want to know if you'll like them, it's a great album to start with.
Symmetric in Design is still their best though
I like this a surprising amount
so cheesy it made me constipated just from listening to it.
Digging: Bing and Ruth - Tomorrow Was The Golden Age
After the past couple albums, this is good to hear. Definitely cheesey, but the production is solid and the riffs are catchy. I'm interested.
Liking the riffs tbh
Digging: Madonna - Ray of Light
Those screams are really incredible! Digging the 80's sound too!
I don't know why, but the chorus makes me uncharacteristically happy. They lay the swede cheese on this pretty well.
This band never fucking disappoints me. Song is great. Unique and awesome lyrics as always. In my opinion, Scar Symmetry is one of the best overall metal bands out there. I love every album they have put out and I know this one will just as good.
It's just not the same without Christian, but Solution .45 is in the studio making a double album!
It's an okay song, but it just doesn't have that power. They are getting closer to a formula that they can stick with. I feel like the dual vocalists is too much. Either go with one or the other, in my opinion. Still gotta hand it to Per Neillson for delivering some great guitar work!
That was actually pretty cool.
solution .45 was never quite as good as scar symmetry's first three albums, it's just fap fodder for those who think scar symmetry was all about Christian.
Song is decent, still not better than the shit of the holographic universe which was legit as hell
I really like this actually, might check out the new album when it arrives
Digging: Oak Pantheon - In Pieces
The song previews at Amazon.com are very promising. Per Nilsson does a lot of singing on the album too, and he sounds way better than Lars
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Lia has been crushing on one guy most of her schooling even with other crushes he always remained her #1 only to be rejected many times by him. They'd spend hours texting over summers,her aiding him when he dealt with a heart ache, only to realize their relationship had no future. He seemed to have toyed with her emotions until he found a new girlfriend. 12 years later since they've talked; Now as a doctor Lia has been rethinking her past failed love attempts only to strangely bump into her only friend. She's moved on, but he's just now chasing after her, will Lia take a detour and give him one more chance, the chance he never gave her, or does she not need to be taught a lesson more than once.
Fate is but a word formed by human intelligence but a guidance and divine intervention from God - Ivana Kpessou
shadey37 Dec 19, 2016
Literally sounds like every white women who has complimented me ever
xXToxicAngelXxD Mar 22, 2016
Ugh. Just readin the dang on description p*ssed me off. I know I ain't even start yet, but I hope she ain't the type 2 take a guy back easily, or give in easily, But I can tell this gon be good. <3 She better reject him like he did her & like there's no damn tomorrow..... I swear....
idkhowtoread Jul 11, 2016
Isn't it " affection " "effection " is like when a woud is untreated and gets worse when it gets effected
Mini_Cee May 24, 2016
Oh nooooo.... See this shït happening to her because it's Karma. Treating him like he is God tf.


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Dyersburg Tractor Supply
About Search Results
YP - The Real Yellow PagesSM - helps you find the right local businesses to meet your specific needs. Search results are sorted by a combination of factors to give you a set of choices in response to your search criteria. These factors are similar to those you might use to determine which business to select from a local Yellow Pages directory, including proximity to where you are searching, expertise in the specific services or products you need, and comprehensive business information to help evaluate a business's suitability for you. "Preferred" listings, or those with featured website buttons, indicate YP advertisers who directly provide information about their businesses to help consumers make more informed buying decisions. YP advertisers receive higher placement in the default ordering of search results and may appear in sponsored listings on the top, side, or bottom of the search results page.
1. Tractor Supply Co
2705 Lake RdDyersburg, TN 38024
2. First Choice Farm & Lawn Inc
305 Highway 51 BypDyersburg, TN 38024
3. M & L Engine
Serving the Dyersburg Area.
From Business: We offer industrial engines such as: Isuzu Industrial, Isuzu Marine, General Motors, John Deere and Kohler Diesel, We also Natural Gas Engines. a wide variety of …
4. Tri County Farmers Equip Inc
209 Parks StNewbern, TN 38059
5. Rice Jim Equipment
7422 Highway 412Friendship, TN 38034
6. Puckett Auto And Tractor Supply
227 N Church StHalls, TN 38040
7. Jim Rice Equipment
8040 Highway 412Friendship, TN 38034
8. Don Medlin Co
1197 State Highway DCaruthersville, MO 63830
9. Tennessee Tractor
1571 Highway 54 NAlamo, TN 38001
10. Tennessee Tractor
595 Highway 51 NRipley, TN 38063
From Business: STIHL - The Number one Selling Brand of Chain Saws Worldwide STIHL is the trusted name for professionals and homeowners who demand power, dependability and longev…
11. B&R Head & Block Repair
Serving the Dyersburg Area.
From Business: Custom machining, sleeving and boring. We do surface grinding up to 134 and line boring up to 100 and cylinder boring up to 20 X 30 . We also re-condition Aerial,…
Showing1-11 of 11results


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Christian Louboutin, famous for its spike-laden footwear, releases the Ponyhair Harvanana. Louboutin's take on the varsity jacket, in shoe form of course, this iteration of the Harvanana is certainly not for the shy. The shoes are unabashed in showing off a zebra pattern ponyhair upper sharply contrasted by a hot pink spiked toecap. Accenting the shoe is a bright yellow trim and the Christian Louboutin crest emblazoned on the front. The $1,395 USD shoes can be found over at the brand's website.


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Edited by Jennifer Reiling, Editorial Assistant.
Some years ago one of the health officers of New York City stirred up
self-appointed representatives of the "new woman" by his remarks on the production
of nervous prostration in husbands by the nagging of wives. The novelists
devote much attention to the self-sacrifice of the wife to the hypochondriac
husband, but the reverse of the picture is too well known to physicians. The
hysteric nagging wife of the insane or neurasthenic husband is a familiar
acquaintance. . . . The puritan matron, like her descendants, however, was
often a hysteric. The eighteenth century statutes anent the use of the ducking-stool—which
still survive in Delaware—demonstrate the recognition of nagging as
an antisocial vice by the fathers of the republic. In the late sixteenth and
early seventeenth century, hysterics were far more frequent than is usually
supposed, and that minor form of hysteria which takes the direction of motor
restlessness was peculiarly apt to voice itself in nagging. Indeed, in the
"Comedy of Errors," which appeared in 1593, Shakespeare indicates that, according
to popular opinion of that time, husband nagging produced not only nervous
prostration but even insanity. In Act V, Scene 1, the Abbess endeavors to
ascertain the cause of the alleged insanity of Dromio of Syracuse, in the
dialogue with Adriana.
NAGGING WIVES AND NERVOUS HUSBANDS.. JAMA. 1999;282(10):924H. doi:10.1001/jama.282.10.924
© 2017


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Casablanca Maxi Dress by AMELIUS*
Specials Casablanca Maxi Dress by AMELIUS* online stockist. It is half lined, non stretch and opaque. Casablanca Maxi Dress by AMELIUS Featuring a high neckline with spaghetti draw String straps and tie at front This women's dress has a small v split at neckline and a drawstring waist tie. Skirt is split at both sides with knee length lining. Dress hem finishes at approximately ankle length and is a miax style. Available in White peach grey green Print. Perfect summer dress. Wear for a summer event, to the beach, to the bar or an engagement or wedding. Wear coral tone lips and nude heels or for a more dresssed down look, pop on a pair of sparkly flat sandals. Sale price from Clothing Factories Australia online store along with other sale Amelius Apparel & Accessories > Clothing > Dresses.
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Avaiilable now in . Located in our Apparel & Accessories > Clothing > Dresses department online. au$ 79.95. Available from online store AlibiOnline. This is a new, never used item. It is in stock now so take advantage of this price offer.


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Is Teddington Adventure Farm incorrect or missing key business information? Update your Hotfrog listing today.
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Hotfrog SouthAfrica provides information regarding Teddington Adventure Farm in Drakensberg KwaZulu-Natal. Teddington Adventure Farm is located at Swartberg, Mount Currie District, Drakensberg KwaZulu-Natal and provides Sports And Recreation services. Contact them on 039 747 4422.
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Here is my papercraft collection of all sorts of stuff but mainly includes game consoles
This is the happy papercraft keyboard cat assembly instruction video. please watch the happy video for
Help me fund my Kickstarter Project: Kirigami Papercraft Book!
Optimus Prime!!! The PaperCraft!!!
I finally came up with an idea for a video! Came up with this.
Craft ROBO cuts 3-D models from card stock. Ideal for Art & Science ... students about 3-D
This paper toy is eay to make and will surprise!
My son (dutchpaperson) has made a paper whale from
Assembly papercraft model of Super Mario. Part 2.
This SugarVeil Birthday Cake seems to magically decorate itself! Papercraft tools from Fiskars are
Difficulty ...
Length 1-4 hours
In this video I show you how to build a paper craft
Blog link: ...
A video review of how my Optimus Prime papercraft turned out when I


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StarTech 1 Port Pci Express 10 100 Ethernet Network Interface Adapter Card Network Adapter Pcie Low Profile 10 100 Ethernet
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1 Port PCIe Ethernet Network Card
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|1 Port PCIe Ethernet Network Card
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Add a 10/100Mbps Ethernet port to a desktop computer through a PCI Express slot. This PCI Express based 10/100 Ethernet Card provides a simple way to connect a PCIe enabled server or workstation to a 10/100 Ethernet network and offers a broad range of features and functions, including support for both Full and Half Duplex operation as well as Wake On LAN (WOL) Power Management.
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* Instant support only available during normal business hours.
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Greetings Guest!!Dismiss Notice
In order to combat SPAM on the forums, all users are required to have a minimum of 2 posts before they can submit links in any post or thread.
where can i learn Poisoning and how can i GM it?
Discussion in 'UO Spellcaster' started by zerathul, Mar 24, 2008.


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Chicago Blues
The City and the Music
By (author) Mike Rowe Ronald M. Radano
Format: Paperback
Normal Price: $31.40
Your Price: $28.26 AUD, inc. GST
Shipping: $7.95 per order
You Save: $3.14! (10% off normal price)
Plus...earn $1.41 in Boomerang Bucks
Availability: Available, ships in 8-11 days
Chicago Blues by Mike Rowe
Book DescriptionChicago has always had a reputation as a "wide open town" with a high tolerance for gangsters, illegal liquor, and crooked politicians. It has also been the home for countless black musicians and the birthplace of a distinctly urban blues--more sophisticated, cynical, and street-smart than the anguished songs of the Mississippi delta--a music called the Chicago blues. This is the history of that music and the dozens of black artists who congregated on the South and Near West Sides. Muddy Waters, Big Bill Broonzy, Howlin' Wolf, Elmore James, Tampa Red, Little Walter, Jimmy Reed, Otis Rush, Sonny Boy Williamson, Junior Wells, Eddie Taylor--all of these giants played throughout the city and created a musical style that had imitators and influence all over the world.
Buy Chicago Blues book by Mike Rowe from Australia's Online Bookstore, Boomerang Books.
Book DetailsISBN: 9780306801457
(210mm x 140mm x 16mm)
Pages: 226
Imprint: Da Capo Press Inc
Publisher: The Perseus Books Group
Publish Date: 1-Aug-1981
Country of Publication: United States
Books By Author Mike Rowe
Policing Beyond Macpherson, Paperback (February 2007)
Explores the impact of the Lawrence Report since it was published in 1999. This work assesses the extent to which, in retrospect, the Macpherson Inquiry has led to significant changes to policing, and highlights areas where efforts ought to be concentrated.
Policing, Race and Racism, Paperback (May 2004)» View all books by Mike Rowe
An investigation into why race has become a significant issue facing the British police. The author argues that the police response to race has led to a consideration of fundamental issues about the relation of the police to society as a whole and not just minority groups who might be most directly affected.
» Have you read this book? We'd like to know what you think about it - write a review about Chicago Blues book by Mike Rowe and you'll earn 50c in Boomerang Bucks loyalty dollars (you must be a member - it's free to sign up!)
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Liana Healthcare 26x26 inch Carrom Board
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Overview: Liana Healthcare 26x26 Inch Carrom Board
Liana carrom boards are one the leading carrom boards. This brand is known for its qualitative products recommended for professionals. It is manufactured by Liana Healthcare.
Product Description
An Indoor Game for the entire family
Carrom is the most popular indoor game that not only gives you enjoyment, but also gets the family together. With the Liana Healthcare professional tournament carrom board, you can enjoy some quality fun time with your friends and family. Measuring 26 x 26 inches, this carrom board has a large play area. It can be used to play professional tournaments as well as to play in leisure time. The board features a 3-inch thick frame border that provides proper hand support and maintains a gap between the board and the hand.
Highly durable and easy to store
Liana Carrom Boards are made of the original BOSS PLY and KIKKAR WOOD to rebound the coins in a better way. This board features a 4mm thick surface ply. The high-quality polished wood is durable as well as smooth, making it ideal for a professional carom game. Professional players recommend Liana Carrom Boards, because of deep hand woven woollen pockets that can hold many coins in it without causing discomfort to the players during the game. These boards can give up to of 4-5 rebounds at a time without affecting the smooth flow of the game. It is quite easy to maintain. This carom board can be placed horizontally under the bed or can be made to stand vertically behind a door.
Buy this Liana Healthcare carrom board today, and make it an integral part of your family time recreation.
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Is 94 STUDENT HOSTEL incorrect or missing key business information? Update your Hotfrog listing today.
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94 Student Hostel @ Aljunied Hall Located at 102 Upper Aljunied Road Our Room Rates starts from $380!!!There are Quad/ Triple /Twin / Single room types ranging from $380-$900 to accommodate each student's budget. 94Student Hostel cater specially for overseas students studying in Singapore, Creating "A Home far away from Your Home" CALL Candy at 9684 9494 or email now to book your room!!! Or visit our website.Our Facilities include: Study /© discussion area Students Lounge with TV, Pool Table, Board Games,© Newspaper and Magazine Corner Café serving simple snacks© & tidbits and beverages Vending Machines supplying snacks and drinks© Services include: Air-Conditioned Rooms, fully furnished© with Beds, Study Table, Wardrobe, etc Toilets and Bathrooms on each level© Free Wireless Internet access© Tight security surveillance with© 24-hour security guards, CCTV, Door Access Security System Free Laundry© Service Free Weekly Room Cleaning (Floor will be mopped and bedsheets will© be changed and laundered weekly) Printing and photocopying services© © Extra curricula activities such as Excursions / In-house Activities, Movie Nights, BBQ, etc Amenities 6 bus stops away from Aljunied© MRT Station (Approximately 6-8mins by bus) 15 – 20 mins away from© Bugis/City Hall MRT Stations Within walking distance to Prime Super© Market, 7 Eleven and nearby food outlets Near to Geylang Community Library© Near to Geylang East Swimming Complex© For enquiry please ring (65) 96849494 or email me.
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Rockford has 150,115 residents. It is located in Winnebago county.
Science schools in Rockford charged students an average tuition of $13,905.00 if they were Illinois residents, and $16,173.00 if they were non-residents, during the 2009 - 2010 school year.
The cost, on average, for books and supplies needed for science schools in Rockford is $840.00. Students living on campus at science schools in Rockford paid an average of $6,750.00 for room and board during the 2009 - 2010 school year. Students living at home incurred costs of $3,433.00. There is one science college in Rockford. In the 2008 - 2009 school year, reportedly 1 students completed science programs in Rockford.
|Average Salary
|Number Employed in City
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|Environmental Scientists and Specialists, Including Health
|Not available


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Panic spread in Sector 28 here as an amputated human arm was found near a drain on Saturday.
A worker who was cleaning the drain found it and informed the police, who tried hard to trace the body nearby, but found nothing.
"The DNA test will be conducted on Sunday," said inspector Arvind Kumar, station house officer (SHO) of Chandimandir police station.
Kumar said, "We searched the area and the hospital nearby to figure out that if any amputation had been undertaken by doctors. The sewerage of the area is also being searched for other body parts. But in vain."
In a separate incident, a man named Kapil, resident of SAS Nagar, was admitted to Alchemist hospital with a bullet injury and a fractured leg.
Kumar said, "We received information from Alchemist Hospital about Kapil. However, he is not in a condition to record his statement."
He added that the firing took place near the Morni T-point, but they did not find any empty shells there.
"We are investigating the case and further action will be taken after recording the victim's statement," inspector Kumar said.


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Hello fellow TTC'ers!!!
This is my first time posting (so I will give a bit of back-story, it will be LONG ). I live in Brisbane, and my husband and I have been TTC for 16 months. Originally thought it was male-factor, but menevit + carnitine seems to fix that up for the second test (amazingly!!!).
After a year of trying, we were referred to the free Mater fertility services (only had to wait a month to get in, despite my doctor telling me it was 18months in the public system).
The fertility service teaches you to do BBT charting and mucus classification, and if you pay a small amount ($100, not covered by medicare I guess) you get three bloodtests and 6 months support for BBT charting.
I only recently found out that my P-series (well I think that is what the midwife called it) showed a premature drop in progesterone 9 days after peak (P+9). Peak I think is ovulation day... They also test P+5 and P+7, and both of mine were about normal/mid-range (the P+5 was a tiny bit below average). From recollection, my P+7 was 50 something units (I'm sure someone more knowledgable will know exactly what those units are).
Even though my temperatures were highish on P+9, the progesterone was low (29.5) relative to my P+7 reading. I had suspected that I have a luteal phase defect, because my cycles are between 21 and 26 days, and from charting the last four months, my luteal is between 10 and 12 days. I've read of people getting pregnant with 12 day luteal, but maybe that is provided that the progesterone is still highish from P+9 to P+11?
According to the classifications of luteal defects, my results *almost* qualify as a type #3 defect, which is 'late luteal defect' - P+9 progesterone 50% or less than P+7 (mid-luteal progesterone).
The nurse said to me that we would qualify to participate in a clinical trial of progesterone pessaries, only issue is (1) 50% chance of getting the 'good' stuff, and (2) the trial runs for 8 MONTHS! While the trial gives you the pessaries for free (if you are unfortunate to be in the placebo group, you get 6 months of the progesterone pessaries after the trial), I am impatient and would rather just buy the stuff (despite it's expense).
I was wondering if anyone else here had a luteal phase defect, and whether they had tried progesterone pessaries (and could recommend any cheap pharmacies in Brisbane) and/or clomid (I've heard that helps too, but risk of twins etc.).
I also thought I'd mention that while waiting to get into the Mater scheme, I had also made an appointment with a private gyno/FS, and they only performed 1 blood test and had not specified which day of the cycle to get it. Furthermore, the private FS keeps pushing laparoscopy (even though I have very few of the endo symptoms), at a cost of $2k.


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"drive down to ST TROPEZ, the..." Nice Favorite Tip by Krystynn
Nice General: 179 reviews and 194 photos
Favorite thing: drive down to ST TROPEZ, the glitzy resort town along the French Riviera (just south of Nice) and home to the great Brigitte Bardot. St Tropez was never the same again ever since the sexy BB headed this way and called this place - home - decades ago (hey, I DO know about her OK!).
Fondest memory: What I truly enjoyed doing most was taking a loooong morning stroll along the quiet medieval streets (when the rest of the world is still sleeping from the previous night's heavy partying) and admiring its many quaint pastel-colored houses.
You must also check out its yacht-filled harbor (see photo below) and visit its many trendy boutiques.... then, finish off your day by taking a short (but much-needed) respite at a local outdoor cafe.
Surely life can't get any better than this?
Note: For more pics of St Tropez, please surf straight to my 'ST TROPEZ' travelogue located at the top right hand side of this page. Thanks!
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Located at District 7, it's take 8 minutes to move to district 1, opposite of Lotte Mart. With 3 bedrooms, it's wide enough for friends or colleagues to share rooms for living together and convenient for family.
With full modern furniture, nice decor, beautiful view, clean, airy space on the high floor, it's perfect for you!
Contact Name: Linh-Nice Apartment
Contact Number: 0902718345


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- VERY HOTTTTTOff the "Matt Allenn EP" Out Now Listen to Break It Down (Prod. By KyPiffa), a new offering from Matt Allenn, which was released on Wednesday, January 4th, 2012.8,762 Views 5 Comments Jan 4, 2012 at 12:00am
- HOTTTTTListen to Go Up (Prod by Ky Piffa), the new track by Matt Allenn featuring Dominic & Kid Ink which was dropped on Friday, December 2nd, 2011.8,439 Views 9 Comments Dec 2, 2011 at 12:00am
- HOTTTTTListen to Put My City On (Prod. by Anthem), the new track by Matt Allenn featuring Champ & Tommy Vonjo which was dropped on Monday, June 6th, 2011.4,611 Views 4 Comments Jun 6, 2011 at 12:00am
- HOTTTTTNew club joint from Anaheim's Matt Allen2,082 Views 2 Comments Jul 3, 2013 at 12:10pm
- HOTTTTTBy Trevor SmithAnother smoker's anthem comes through to celebrate 4/20, this time from none other than Matt Allenn, with "I Can Fly".103 Views 1 Comment Apr 20, 2013 at 12:49pm
- HOTTTTTListen to 9 to 5 (Prod by Ruwanga Samath), a new offering from Matt Allenn, which was released on Sunday, December 4th, 2011.27 Views 3 Comments Dec 4, 2011 at 12:00am
- HOTTTTTBy Rose Lilah*Just Added*Have you heard Matt Allenn's new track We Own The Night? It dropped on Sunday, October 17th, 2010.24 Views 0 Comments Oct 17, 2010 at 12:00am
- 4 QuartersMatt Allenn Feat. Kevin ParxHOTTTTTBump 4 Quarters (Prod. by Ky Piffa), the latest cut from Matt Allenn featuring Kevin Parx on the assist. It was released on Monday, December 19th, 2011.19 Views 1 Comment Dec 19, 2011 at 12:00am
- HOTTTTTBy Rose LilahBump Soldier, the latest cut from Matt Allenn featuring Topic & Hot Dollar on the assist. It was released on Saturday, January 8th, 2011.13 Views 3 Comments Jan 8, 2011 at 12:00am
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Pell City Public Library offers programming for all all ages — which is both entertaining and informative. Save the dates and join us!
Tuesday, February 14th at 4:30 p.m. —Anti-Valentine's Day Party (for Teens & Tweens)– Food . . . fun . . . activities! Free event!
Wednesday, February 15th at Noon — Wild and Wonderful Wednesday with World-Class Vocalist, B.J. Reed and Award-Winning Jazz Guitarist Keith Cashmere Williams! Enjoy the best in Jazz, R&B, Blues, and Gospel from these spectacular musicians! Free concert . Light refreshments served!
Saturday, February 18th at 10 a.m.-12 p.m. — Genealogy Workshop–Sponsored by the Broken Arrow Chapter of the DAR. Free to the public. Bring a friend and a thirst for research! Location: Pell City Municipal Building
Friday, February 24 at 6:00 p.m. —Mid-Winter Writers Conference "Meet and Greet!" Join us for an informal gathering of presenters and attendees of the Mid-winter Writers Conference. Mix and mingle and enjoy light refreshments. Free and open to the public.
Saturday, February 25, 2017– Writers Anonymous and the Pell City Public Library are proud to sponsor the fourth annual 2017 Mid-Winter Writers Conference. The conference will be from 8:00 a.m. to 5:00 p.m. at the Pell City Municipal Building with check-in starting at 7:30 a.m. Come early and enjoy a free Continental breakfast. Please Note: Registration is required to attend. For details contact the library or go to the 2017 Midwinter Writers Conference website: http://mwwconference.com
Story Time with Miss Jordan
Tuesdays at 10:30 a.m. and Thursdays at 5:00 p.m. during the school year! (Due to the Summer Reading Program, Story Time does not take place during June, July, and August.)
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The truth and CHATBOTS
A chatbot is a digital language processing service, powered by rules and artificial intelligence that simulates human-like conversation.
Announcing the 2009 "KMWorld Promise and Reality Award Nominations"
Throughout each year, KMWorld is introduced to the best and the brightest of the suppliers and the practitioners in the trade. We conduct dozens of interviews, hundreds of briefings and review probably thousands of press releases and e-mails.
Then ... we pick the best.
The nomination form for the 2009 "KM Promise and Reality" awards is now posted here.
You can learn more about the awards program, and determine whether your product/service or your deployment reaches the qualifications to be considered for this prestigious award.
Go here to review the qualifications.
SDL Tridion has launched Safeguard, a quality and compliance monitoring tool to help brand managers and content editors achieve a high-quality Web presence. Safeguard automatically scans companies' Web sites...
Continue Here: http://www.kmworld.com/Articles/News/News/Banking-on-brand-protection-56048.aspx
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Kofax has acquired 170 Systems, a provider of financial process automation software, for consideration of $32.9 million, net of cash held by the company. 170 Systems is...
Continue Here: http://www.kmworld.com/Articles/News/News/Kofax-acquires-170-Systems-56047.aspx
Kalido reports it has licensed and will directly sell a custom-built Netezza TwinFin data warehouse appliance engineered and optimized for the Kalido Information Engine and its new...
Continue Here: http://www.kmworld.com/Articles/News/News/Kalido-unveils-appliance-56046.aspx
A software-as-a-service (SaaS) solution is helping a large law firm reduce its e-mail costs by 33 percent. Fish & Richardson is using Mimecast's SaaS-based, unified e-mail management...
Continue Here: http://www.kmworld.com/Articles/News/KM-In-Practice/SaaS-cuts-e-mail-archiving-costs-56045.aspx
The world of knowledge management (KM) is changing. Successful organizations no longer use intranets or shared folders to communicate between departments and with clients. The new age of knowledge management integrates silos of information and provides employees with the tools necessary to provide customers with relevant, timely information, thereby improving customer satisfaction and increasing the productivity of each employee…
To read more of this Best Practices in Knowledge Management White Paper article, Click Here.
***Coming in April 2017***Best Practices in Customer Experience
Customer Experience. We think one of the vast challenges for businesses seeking a competitive edge is how they treat their customers. And it is as much a "philosophy" as a business issue. So learning from the leaders in customer experience should be revealing and guiding. Are you a leader in this critical aspect of business ?
What will be the next "have-to" trend? Share your strategies and go-to-market approaches.
You can participate in this White Paper opportunity by contacting:
Kathy email@example.com
***Coming in April 2017***Best Practices in Knowledge Management for Financial Services
In Financial Services Information is Imperative. There are special challenges facing the financial and banking community:
* Changing terms and regulations* Providing support for customers and staff* Implementing the highest level of security to keep customers safe
Solutions for customer relationship management, business process management, reporting and knowledge management must communicate with each other.
The next KMWorld White Paper: "Best Practices in Knowledge Management for Financial Services " will address this complex landscape. If you have a way to address it, please contact:
E-Discovery [January 2017]
BPM and Case Management [January 2017]
Knowledge Management [November/December 2016]
Cognitive Computing [October 2016]
Information Governance [September 2016]
The only comprehensive sourcebook, in print and on the Web, to solutions in:
Click here to view the current edition and to participate: http://www.kmworld.com/BuyersGuide/Default.aspx


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Nurse Home Care Salary
Most Home Care Nurses in the United States are women. The workforce as a whole earns a median of approximately $25.88 per hour. The majority of workers are highly satisfied with their job. Unfortunately, some people in this line of work are without benefits — about one-half lack coverage. On the flip side, approximately one-half have medical insurance and more than two-fifths receive dental plans. Figures cited in this summary are based on replies to PayScale's salary questionnaire.
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Job Description for Nurse Home Care
Home care nurses provide a variety of health services to patients inside their homes; this position is typically associated with senior citizens and chronically-ill patients with complex medical needs. These nurses work primarily within their patients' homes in all sorts of shifts, which may include overnight or weekend shifts depending on patients and their individual needs. Although they typically work independently inside homes, small teams of health care professionals may assist in the care of patients.Read More...
Home care nurses must be licensed and certified in their states of employment; this process can be accomplished via a diploma program or earning an associate's or bachelor's degree, and may also include certification from the American Nurses Credentialing Center. Ongoing education and training are typically required, as well.
Home care nurses may have a variety of responsibilities, including: administering medication; monitoring vital signs; educating patients and families; observing and assessing the health of each patient; tending to basic personal care; assisting with mobility; preparing meals and feeding; escorting to appointments; and providing additional specialized treatment as necessary. These nurses serve as primary companions for their patients and must have kind, compassionate, and helpful attitudes to succeed in their positions.
Nurse Home Care Tasks
- Visit patients in the home to perform technical procedures, infusion, patient assessment, patient education and other nursing duties.
- Supervise and coordinate home health care staff.
- Coordinate and perform patient care activities with pharmacy, physician, home health agencies and referral source.
- Assist+C233 with diagnostic, therapeutic and routine nursing procedures.
Nurse Home Care Job Listings
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Pay by Experience Level for Nurse Home Care
Median of all compensation (including tips, bonus, and overtime) by years of experience.
Relatively untried employees who have less than five years' experience make $56K, but folks with five to 10 years under their belts enjoy an appreciably larger median of $62K. Home Care Nurses claiming one to two decades of experience make an estimated median of $59K. Home Care Nurses who have spent more than 20 years on the job report earning a significantly higher median of $57K.
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Key Stats for Nurse Home Care
96 %
4 %
Job Satisfaction
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Rated 4 out of 5
based on 17 votes.


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Knowledge Base » DiscoverSim - System Requirements
System Requirements
on April 01, 2016
Minimum System Requirements:
Computer and Processor: 500 megahertz (MHz) processor or higher.
Memory: 512 megabytes (MB) of RAM or greater. 8 GB of RAM is recommended for large simulation runs (i.e., 1 million replications)
Hard Disk: 160 MB of available hard-disk space.
Drive: CD-ROM or DVD drive.
Display: 1024x768 or higher resolution monitor.
Operating System: Microsoft Windows 7, or later operating system.*
Microsoft Excel Version: Excel 2007, Excel 2010, Excel 2013 and Excel 2016 with the latest service packs installed. DiscoverSim supports the 64-bit versions of Excel 2010, 2013 and 2016.
Administrative rights are required to install DiscoverSim.
* DiscoverSim is not available for Mac OS X.
Important Information for Existing SigmaXL Customers:
DiscoverSim comes bundled with SigmaXL. Please do not load your existing copy of SigmaXL alongside DiscoverSim, as this could cause unwanted issues with the software.
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A virtual gift card is a great last minute gift.You can send it directly to the recipient's inbox, alternatively send it to yourself to print.
The recipient will receive a gift card code which is valid at Acne Studios online shop within one year and in the currency specified.
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text: Hello again, Here are two random notes: * at some point I'll seriously start to rewrite Psyco to be much, much clearer and much, much flexible. This probably involves rewriting it in Python. I'm currently designing a simple C parser that can turn selected portions of the C core of the regular Python interpreter into a high-level Python version. Yes, that's a kind of C-to-Python translator ! ...which is a good thing to do, believe me :-) * I might be considering alternate back-end architectures to port Psyco on other platforms. One of these is Java. Indeed, dynamically emitting code is easy in Java, and most Java run-times have a JIT (just-in-time compiler) that can run it quite fast. Actually, I wonder how much Jython (the Python interpreter written in Python) could benefit from Psyco. We may obtain a performance similar to what I currently get for the regular CPython interpreter, with the additional benefits of working on all Java-supported platforms... Jython out-performing CPython might be fun to see :-) Thanks, Armin.


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Season 2 of the Overtime podcast is here! Listen to the first episode with Meg Robichaud now.
Following up from the wireframes I posted up earlier I started to add the aesthetics and design elements. I wanted to keep things clutter free, I'm not a fan of over complicating things. This allowed me to put more emphasis on the chat area and the relevant key features available to the user on each screen.
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Kebebew E, Duh Q, Clark OH. Tertiary HyperparathyroidismHistologic Patterns of Disease and Results of Parathyroidectomy. Arch Surg. 2004;139(9):974-977. doi:10.1001/archsurg.139.9.974
© 2017
Patients with tertiary hyperparathyroidism (THPT) commonly have parathyroid hyperplasia and should have a bilateral neck exploration with subtotal or total parathyroidectomy with autotransplantation to obtain long-term cure.
A retrospective cohort study.
Tertiary referral medical center.
Thirty-four consecutive patients (21 women and 13 men; mean age, 48 years) who underwent neck exploration for THPT.
Main Outcome Measures
Sites and histologic pattern of parathyroid disease, and postoperative normalization of serum calcium and parathyroid hormone levels.
Twenty-seven patients underwent initial bilateral neck exploration and 7 patients underwent repeat neck exploration for persistent or recurrent THPT. The mean serum total calcium level was 11.2 mg/dL (2.8 mmol/L) (range, 10.3-13.5 mg/dL [2.6-3.4 mmol/L]) and the mean intact parathyroid hormone level was 355 ng/L (range, 95-1236 ng/L). The THPT was due to 4-gland hyperplasia in 33 patients and a single adenoma in only 1 patient. The parathyroid glands were in the normal position in 23 patients and in ectopic locations in 11 patients (8 intrathymic, 1 carotid sheath, 1 tracheoesophageal groove, and 1 intramuscular). Preoperative localizing studies did not identify ectopic or supernumerary glands in any of the patients (ultrasonography, 14 patients; technetium Tc 99m sestamibi, 15; and magnetic resonance imaging, 7). Persistent (n = 5) and recurrent (n = 2) THPT was more common in patients who had an initial 1- or 2-gland excision instead of subtotal or total parathyroidectomy with autotransplantation (P<.001). Four patients had transient hypocalcemia (<8.0 mg/dL [<2.0 mmol/L]), and no other permanent complications or deaths occurred. Biochemical cure was achieved in 94% of patients with a mean follow-up of 4.8 years.
Tertiary hyperparathyroidism is usually due to multiple hyperplastic parathyroid glands, and patients who have initial limited parathyroidectomy have a higher risk of persistent or recurrent THPT.
Tertiary hyperparathyroidism (THPT) is uncommon and occurs in less than 8% of patients with secondary hyperparathyroidism after a successful kidney transplantation.1- 3 In patients with secondary hyperparathyroidism due to chronic renal failure, THPT results from autonomous proliferation of the parathyroid glands and hypersecretion of parathyroid hormone (PTH) after a successful kidney transplantation.4,5 The THPT results in significant metabolic complications and symptoms, especially in patients who have had kidney transplants and are taking immunosuppressive therapy, which can be treated only by successful parathyroidectomy.6- 8
Tertiary hyperparathyroidism is commonly due to parathyroid hyperplasia involving 4 or more glands. Some investigators have reported that 2.6% to 32% of THPT may be due to a single adenoma or double adenomas.1,2,5,6,9- 15 These variable findings of single- or double-gland disease have important implications for the surgical approach used to treat patients with THPT. There is a consensus that patients with secondary or tertiary hyperparathyroidism should have a bilateral neck exploration with subtotal or total parathyroidectomy and autotransplantation. Many surgeons are now using a focused surgical approach (eg, minimally invasive parathyroidectomy, videoscopic parathyroidectomy, unilateral neck exploration) in patients with sporadic primary hyperparathyroidism, who usually (85%) have single adenomas, based on preoperative localizing studies and intraoperative PTH (IOPTH) measurement.16 Some may, therefore, consider that up to one third of patients with THPT may also be candidates for a focused parathyroidectomy approach.9,14,15,17
The main objectives of this retrospective study were to determine the frequency of "true" single or double adenomas as a cause of THPT and to determine the accuracy of localizing studies in patients with THPT. Furthermore, long-term follow-up results of parathyroidectomy in patients with THPT were used to determine risk factors associated with recurrent or persistent THPT.
Between September 1, 1982, and April 30, 2002, 34 patients underwent parathyroidectomy for THPT at the University of California, San Francisco, hospitals. Tertiary hyperparathyroidism was defined as the presence of hypercalcemia and elevated PTH level in a patient with successful kidney transplant who previously had secondary hyperparathyroidism due to chronic renal failure.
Pathology reports, operative notes, clinical medical records, laboratory data, and clinic follow-up notes were reviewed. In patients undergoing initial parathyroidectomy, a bilateral neck exploration was used with a subtotal parathyroidectomy leaving a 40- to 80-mg remnant and cryopreservation of the most normal parathyroid gland. In patients with persistent or recurrent THPT, a unilateral or focused approach based on preoperative localizing studies was used. As part of routine care, before and after parathyroidectomy, serum calcium and PTH levels were collected prospectively. Intraoperative PTH measurement was used in some patients with THPT. Baseline IOPTH levels were checked twice before resection of any enlarged glands (once before dissection and once right before parathyroid gland excision), and postoperative PTH levels were measured, 10 minutes or longer after resection of an enlarged parathyroid gland. A decrease of more than 50% in the PTH level was used to define a successful neck exploration and parathyroidectomy.16 Tertiary hyperparathyroidism due to parathyroid hyperplasia was defined as hypercellular parathyroid tissue present on permanent histologic examination of all resected glands, operative findings of enlarged glands, and normalization of postoperative calcium and PTH levels after subtotal parathyroidectomy. Tertiary hyperparathyroidism due to parathyroid adenoma was defined as hypercellular parathyroid tissue present on permanent histologic examination of a resected gland, operative findings of 1 enlarged gland in conjunction with at least 1 normal-appearing gland, and normalization of postoperative calcium and PTH levels after gland excision.
The accuracy of preoperative localizing studies was determined by comparing the results of the imaging studies with the operative finding, pathology report, and normalization of the postoperative serum calcium and PTH levels. Persistent THPT was defined as elevated calcium and PTH levels within 6 months after parathyroidectomy. Recurrent THPT was defined as elevated calcium and PTH levels more than 6 months after initial parathyroidectomy. A true-positive result of the localizing studies was based on the imaging study correctly identifying all abnormal parathyroid glands. The χ2 test and unpaired, 2-tailed t test were used for comparison of categorical data and continuous data, respectively. A difference was defined as statistically significant if the P value was less than .05. Unless stated, numerical values in the text and table represent mean ± SD.
Thirty-four patients had THPT, and their clinical, biochemical, and pathological characteristics are summarized in the Table. The mean age was 47.8 ± 14.1 years. The mean duration of THPT after successful kidney transplantation was 3.6 years, ranging from 4 months to 15 years. The mean total calcium level was 11.2 ± 1.2 mg/dL (2.8 ± 0.3 mmol/L), and the mean intact PTH level was 355 ± 590 ng/L.
Twenty-seven patients underwent initial bilateral neck exploration, and 7 patients underwent repeat neck exploration for persistent (n = 5; 3 patients after 1-gland excision, 2 patients after 2-gland excision) or recurrent (n = 2; after 3½-gland excision in the remnant gland) THPT. Only 2 of the 7 patients with persistent or recurrent THPT were initially treated at our institution. In these 2 patients, recurrent disease was from a remnant parathyroid gland after subtotal parathyroidectomy in one patient, and in the other patient, persistent disease occurred after an initial unilateral neck exploration and 2-gland resection. This patient had his initial operation performed by another surgical service and was thought to have only 2-gland disease on the basis of preoperative neck ultrasonograpic findings.
Tertiary hyperparathyroidism was due to 4-gland hyperplasia in 33 patients and a single adenoma in only 1 patient. Twenty-eight of the patients had a bilateral neck exploration with subtotal parathyroidectomy and 6 had a unilateral neck exploration (5 patients who had persistent or recurrent THPT and 1 patient with initial THPT who had a single adenoma). In 23 patients with THPT, the parathyroid glands were located in the normal anatomic distribution. Eleven patients had 1 ectopically located parathyroid gland: 8 intrathymic, 1 carotid sheath, 1 tracheoesophageal groove, and 1 intramuscular (strap muscle).
Four patients, all with 4-gland hyperplasia, had IOPTH measurements during their neck explorations. In 2 patients, the IOPTH level fell appropriately after 3½-gland resection by 74.5% and 68.6%. The IOPTH level was a false-negative finding in 1 patient; it decreased by only 27% after a 3½-gland resection. One patient had a false-positive PTH result with a decrease of 76.4% after excision of only 1 gland and a total decrease of 83.5% after a 3½-gland resection. All 4 patients had postoperative calcium and PTH levels within the reference ranges at follow-up.
Preoperative localizing studies in patients with persistent or recurrent THPT were true positive in 5 of 5 neck ultrasonography scans, 6 of 6 technetium Tc 99m (99mTc) sestamibi scans, and 6 of 6 neck and mediastinal magnetic resonance images. In patients with initial THPT, localizing studies suggested multiple-gland disease in 6 of 9 neck ultrasonography scans, 5 of 9 99mTc sestamibi scans, and 1 of 1 neck and mediastinal magnetic resonance images. None of the localizing studies identified ectopically located glands, and there were no patients with supernumerary parathyroid glands.
The total complication rate was 11.8% and consisted of transient hypocalcemia (calcium level, <8.0 mg/dL [<2.0 mmol/L]) in 4 patients who had subtotal parathyroidectomy. There were no transient or permanent recurrent laryngeal nerve injuries, no permanent hypoparathyroidism, and no deaths. The mean duration of hospitalization was 1.1 days (range, 1-6 days). The 1 patient who was hospitalized for 6 days developed severe hypocalcemia due to bone hunger and required intravenous calcium replacement. The mean follow-up time was 4.8 years (range, 1-13.25 years); 94% of patients were cured on the basis of total serum calcium levels within the reference range, and 70.6% were cured on the basis of PTH levels within the reference range. Of the 10 patients with elevated PTH levels after parathyroidectomy, 5 had developed chronic renal failure due to kidney graft function failure. Patient age, race, sex, PTH level, and kidney transplant graft failure were not associated with persistent or recurrent THPT as defined by hypercalcemia during normal renal function. Persistent or recurrent THPT, however, was more common in patients who had 1- or 2-gland excision instead of subtotal parathyroidectomy (P<.001).
Patients with THPT commonly have significant symptoms and metabolic complications that improve after parathyroidectomy.5- 8 In THPT, the autonomous growth and hypersecretion of PTH from the parathyroid glands is thought to subside after successful kidney transplantation. Indeed, less than 8% of patients who have secondary hyperparathyroidism due to chronic renal failure have parathyroidectomy for THPT.1,3,4 Generally, operative intervention is recommended in patients with THPT who have asymptomatic disease with total calcium level greater than 12.0 mg/dL (3.0 mmol/L) for more than 1 year, acute hypercalcemia, and symptomatic hypercalcemia.12 No clinical factors such as duration of dialysis requirement, cause of chronic renal failure, or immunosuppressive regimens have been found to predict which patients will require a parathyroidectomy.18 Biochemical factors such as PTH, creatinine, phosphorus, and alkaline phosphatase levels do not reliably distinguish which patients will require a parathyroidectomy.18 Only the posttransplant serum total calcium level predicts the need for parathyroidectomy, but this is used as an indication for operative intervention. In our cohort, all patients with THPT had symptoms associated with THPT (79.4%), metabolic complications (32.3%), or serum total calcium level greater than 12.0 mg/dL (3.0 mmol/L) (20.6%) for 1 or more years.
Although up to one third of patients with THPT have been reported to have single or double adenomas, we found only 1 patient (3%) who had a single adenoma, which is consistent with most studies.1,2,4- 6,9- 15 Many of these patients, however, have marked variation in the size of their abnormal parathyroid glands. It is unclear why most patients with THPT have parathyroid hyperplasia of 4 or more glands, especially a long time after successful kidney transplantation, as the stimuli for compensatory parathyroid hyperplasia from hypocalcemia, hyperphosphatemia, and decreased level of 1α,25-dihydroxyvitamin D are reversed after successful kidney transplantation. Although one would expect autonomous growth of the parathyroid glands to be monoclonal, this has not always been observed in the parathyroid glands of patients with THPT.11,19,20 Nodular hyperplasia is associated with autonomous growth of the parathyroid glands, but both diffuse and nodular patterns of parathyroid hyperplasia have been reported in THPT.11 It is, therefore, unclear whether single or double adenomas in THPT represent (1) an autonomous monoclonal parathyroid gland growth, (2) a primary hyperparathyroidism that was present before a patient developed secondary and then tertiary hyperparathyroidism, or (3) an asymmetric regression of hyperplastic parathyroid glands after successful kidney transplantation.
In addition to the rarity of single or double adenomas, localizing studies were not accurate in identifying all abnormal parathyroid glands in the patients who had initial bilateral neck exploration. The combined sensitivity of all the imaging studies (ultrasonography, 99mTc sestamibi scans, and magnetic resonance imaging) in this group was 63.2%. Although some experts recommend localizing studies to identify ectopic and supernumerary parathyroid glands in patients with secondary and tertiary hyperparathyroidism, none of these imaging studies identified ectopically located parathyroid glands and no patient in our cohort had a supernumerary parathyroid gland. The localizing studies were, however, accurate in the patients with persistent or recurrent THPT and allowed a unilateral neck exploration to be performed in these patients. The main factor associated with persistent and recurrent THPT was an incomplete parathyroidectomy due to an initial unilateral neck exploration or an enlarged parathyroid gland not correctly identified at the time of an initial bilateral neck exploration.
Intraoperative PTH measurement was used in 4 patients in the latter part of the series. Although our finding is drawn from a small number of patients, it documents that IOPTH measurement cannot be used reliably in patients with multiglandular disease, as we have similarly reported in patients with primary hyperparathyroidism caused by double adenomas.21
Our study documents that most patients with THPT have multiple hyperplastic parathyroid glands, so that a bilateral neck exploration should be done. Furthermore, localizing studies and IOPTH measurement do not appear to be accurate enough to select patients who would be candidates for a focused neck exploration without the confirmation of other normal parathyroid gland(s) being present on bilateral neck exploration. The main cause of persistent or recurrent THPT was an incomplete exploration at the initial operation.
Correspondence: Electron Kebebew, MD, Department of Surgery, University of California, San Francisco/Mount Zion Medical Center, San Francisco, CA 94143-1674 (email@example.com).
Accepted for publication April 22, 2004.
This study was supported by generous grants from the Harold Amos Medical Faculty Development Program of The Robert Wood Johnson Foundation (Princeton, NJ) and Hellman Family Award for Early Career Faculty (San Francisco, Calif) (Dr Kebebew), and in part by the Sanford and Helen Diller Foundation, the Albert Clark Family Foundation, and Mount Zion Health Systems (San Francisco).
This scientific poster was presented at the 75th Annual Meeting of the Pacific Coast Surgical Association; February 16, 2004; Maui, Hawaii; and is published after peer review and revision.


text:
back to selection
when 27 June 2016 -
1 July 2016
1 July 2016
language English
duration 1 week
fee EUR 1000
Spain, Barcelona
Competition Economics
when 27 June 2016 - 1 July 2016
language English
duration 1 week
fee EUR 1000
The Barcelona Competition Economics Summer School will be offered by the Barcelona Graduate School of Economics. The school consists of three separate blocks all of which have both teaching and research experience in their respective fields. These are Economic Theory Tools for Competition Policy, Mergers and Abuse of Dominance and Applied Methods for the Economic Analysis of Competition Policy.
Course leader
It is directed by Juan -Jose Ganuza (UPF and Barcelona GSE)
Fee info
EUR 1000: Reduced fee
EUR 1800: Regular fee


text:
Sacramento has 407,018 residents. It is located in Sacramento county.
The average in-state tuition for full time undergraduate students in crime scene investigator schools in Sacramento during the 2009 - 2010 school year was $7,117.00. The average tuition was $10,222.00 for non-residents studying in California.
The cost, on average, for books and supplies needed for crime scene investigator schools in Sacramento is $1,517.00. Students who live on campus while attending a crime scene investigator school in Sacramento, can expect to pay an average of $11,332.00 for room and board. Students who live at home can expect average costs to be $5,099.00. There are two crime scene investigator colleges in Sacramento for students to choose from. In the 2008 - 2009 school year, reportedly 485 students completed crime scene investigator programs in Sacramento.
|Average Salary
|Number Employed in City
|Detectives and Criminal Investigators


text:
Posts tagged kids games
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Jan 30th
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3 charming bugs, each with its own unique bonuses
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Find gifts, safes and treasure chests and use the loot you collect to customize your character and empower them with special ability upgrades.
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Bring out your inner cartoon character as you use an umbrella to protect yourself from falling anvils, wield a mallet that shoots out a boxing glove and more.
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Thanks to: POSTMORTEM
Unrar, run setup.exe, play DOWNLOAD
Planet Horse
Dec 17th
Saddle up for adventure in Planet Horse! Ride your mighty steed through different riding competitions and challenges! Immerse yourself in an enchanted universe and ride through luscious forests and exotic deserts. Gain unique items on your fantastic rides, and unlock different horses for you to ride in this fun game. Grab your cowboy hat and set off on a fantastic journey!
Happily Ever After
Dec 16th
Explore the lavish visuals travelling through the magical Kingdom of Unbelievaville, help instantly recognisable modern fairy-tale characters solve problems, take on challenging hidden objects puzzles, logic games, mazes, spot the differences, riddles and much more.
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Dec 16th
Baby Luv will have you falling in love with the cutest baby you'll ever see! Play hide and seek, feed and take care of her. Experience the joys of her first steps, her first words, first laugh and all of the fun of baby's first year.
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Dec 16th
SpongeBob SquarePants Typing offers boatloads of fun and interesting undersea facts all while you learn to type. Through arcade-style games and keyboarding drills, SpongeBob and his friends will make typing instruction fun! Dive right into a step-by-step typing tutorial that's awash with SpongeBob SquarePants' helpful hints, games, and friends! Now kids of all ages can learn to type the SpongeBob way!
Download: Mirror 1: Part 1 Part 2
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Dec 11th
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Second place has never been so rewarding, at least for those in senior jobs in multinational companies. The prospect that a few directors might get million-euro bonuses just to keep their bums on their seats, aroused unusual protest at the annual meetings of BP, Reed Elsevier, GlaxoSmithKline and Shell.
It's not really payment for failure, the usual cry in protests over executive excess, except that it is a sort of failure at a very personal level. GSK wanted to pay a bonus of £2.5 million to Chris Vierbacher because he lost out in the competition to succeed Jean-Pierre Garnier as


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Wattam's Garage Inc
Review for Wattam's Garage Inc
BERNIE A. on 02/17/2014
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Vehicle: Ford Pickup
Service Date: 01/21/2014
Review Created: 02/17/2014 02:08 PM


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China adhesive producer , Fenglei hot sale gasket shellac used for automobile
US $0.39-0.42 / Piece
6000 Pieces (Min. Order)
hot series of pvc rubber adhesive for sale
100 Sets (Min. Order)
Hot sale 1g or 3g nail super glue for shoes,3g super glue,white glue
US $0.063-0.083 / Piece
200 Pieces (Min. Order)
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US $0.1-0.3 / Piece
150 Pieces (Min. Order)
Hot sale resin repair metal glues and adhesives 789 silicone
US $2.5-3 / Piece
10 Pieces (Min. Order)
Hot Sales High Quality one component direct glazing polyurethane adhesive Factory Supplier/Manufacturer PU8730
US $1.43-2.44 / Unit
500 Units (Min. Order)
hot sale and low price industrial glue,acetoxy mastic puncture repair liquid tyre sealant
US $0.5-1 / Piece
10000 Pieces (Min. Order)
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glass adhesive hot sales
US $1.35-2.25 / Piece
5000 Pieces (Min. Order)
Hot Sale!! YC3195LV uv loca for LCD Digitizer Separating for Sumsung, for iPhone Mobile LCD Screen Repair
US $1.5-2 / Piece
1 Kilogram (Min. Order)
2014 Hot Sale Fix Flat Tire Sealant Spray (REACH, RoHS, SGS)
US $0.9-1.0 / Piece
7500 Pieces (Min. Order)
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US $0.00-3.00 / Unit
500 Units (Min. Order)
hot on sale best selling chemical 20KG package woodflooring concrete flooring sealant
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2000 Pieces (Min. Order)
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500 Barrels (Min. Order)
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20 Kilograms (Min. Order)
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20000 Packs (Min. Order)
JY923 Hot Selling custom design auto glass repair silicone sealant manufacturer sale
US $0.6-1.07 / Piece
7000 Pieces (Min. Order)
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