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August 12, 2003
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New Braunfels Herald Zeitung (Newspaper) - August 12, 2003, New Braunfels, Texas Contact Sports Editor, Bryan Adams at 625-9144 ext.223 Sports Tuesday, August 12, 2003 IBCowboys Extra Points: OL Larry Allen missed practice because of a swollen right ankle. The 6-foot-3, 335-pound lineman did stretch exercises and rode a stationary back on the side. Parcells said he's concerned about the stamina of the seventime Pro Bowler, who played just five games last year after surgery on his left ankle.... Free agent DE Eric Ogbogu, drafted by Parcells for the New York Jets in 1998, signed with the Cowboys and practiced.... OL Marques McFadden, WR DeVeren Johnson and DE Derrius Monroe were released.... Rookie C Al Johnson, the team's second-round pick and projected starter, will miss the season. Parcells said he will be placed on injured reserve when the team trims its roster to 65 players in two weeks. Cowboys starting QB still up for grabs By Stephen Hawkins AP Sports Writer SAN ANTONIO — Bill Parcells hasn't given up on picking the Dallas Cowboys' starting quarterback after the next game. But even the coach knows that may be wishful thinking. Quincy Carter or Chad Hutchinson? The answer to that still escapes Parcells, whose plan has been to use the final two preseason games — after Friday's game against Houston — to prepare-the starter and adjust the gameplan to that quarterback's strengths for the Sep. 7 season opener against Atlanta. "FII do my best, but I'm not sure I can," Parcells said Monday. "I'm not going to really go into how I think they played." ITiat's because while Carter and Hutchinson missed chances to impress and both had turnovers, they didn't get much help from the rest of the offense in the 13-0 loss at Arizona on Saturday night. Nothing in the game PARCELLS helped in the evaluation of the quarterbacks. By Parcells' count, the Cowboys had only two legitimate scoring chances in 13 possessions against Arizona. There were three turnovers, a dropped third-down pass and two drive-killing offensive penalties. The team also faced 2-and-12 or worse four times. "It was a difficult game to play quarterback," Parcells said. "Overall, there was no chance to maneuver offensively. That would have to be my most disappointing thing." Hutchinson went 5-for-10 for 43 yards as the starter, and fumbled the ball away when he was sacked. Carter hit 8-of-l3 passes for 81 yards, but threw an interception in the end zone. Parcells remains committed to choosing between those two quarterbacks, and said there is no one available that could do a better job. "Just because the boat rocks a little bit, you can't jump in the water yet," he said. Cowboys owner Jerry Jones insisted Monday that he had no second-thoughts about not bringing another quarterback into camp. And, he added, he's not looking for another one. Miller outduels Wood in 3-1 win By Rick Gano AP Sports Writer CHICAGO — Wade Miller outpitched Kerry Wood and Jeff Kent hit a two-run double Monday night as the Houston Astros beat the Chicago Cubs 3-1. Craig Biggie homered for the Astros, who maintained their two-game lead over St. Louis in the NL CentralNext Four MILLER after the Cardinals beat the Pirates 6-4. The third-place Cubs fell 3 1/2 back. Miller (9-10) gave up five hits and a run in six innings, striking out nine. Octavio Dotel pitched two scoreless innings, and Billy Wagner worked the ninth for his 34th save in 37 chances. Wood (11-9) allowed seven hits and three runs in seven innings. He also struck out nine and reached 1,000 career strikeouts faster than any major league pitcher, achieving the milestone in his 134th game. HOUSTON ASTROS SCHEDULE Tuesday, Aug. 12 Astros at Chicago Cubs, 7:05 p.m. on FXSN. Wednesday, Aug. 13 Astros at Chicago Cubs, 1:20 p.m. on FXSN. Thursday, Aug. 14 Astros at Chicago Cubs, 1:20 p.m. on WCN. Friday, Aug. 15 Astros at Cincinnati Reds. 6:10 p.m. on ASTRO. TICKETS 1-877-927-8767 Kent, 10-for-19 (,526) against Wood entering the game, broke a scoreless tie in the fifth. After singles by Geoff Blum and Jeff Bagwell, he drove a ball over Doug Glanville's head in center. Sammy Sosa doubled in the sixth, moved to third on a single by Aramis Ramirez and scored on an RBI single by Erie Karros. Biggio's 10th homer made it 3-1 in the ninth. Brad Ausmus had three hits for the Astros and Lance Berkman, a Canyon High School graduate, was 0-for-4 in the game. Former Olympic coach dead at 66 Williams wins Tournament of Champions From staff reports Nick Williams of New Braunfels posted a 36-hole score of 1-under-par 143 (68-75) to win the Boys 16-18 Division of the 2003 Southern Texas PGA Junior Tour Tournament of Champions at Meadowbrook Farms Golf Club in Katy. Williams, 16, said after the final round, "I played really well the first day. I played pretty solid (Monday), too, but the wind came up at the end and I had a couple of bad holes." Williams said runner-up Mathieu Leclair of San Antonio, playing with him in the last group, had closed to within three shots, "but then I eagled 18 (Williams' ninth hole of the round)." Williams had laid up just short of the green on the par 5 and then holed a pitch-and-run for the eagle. "It feels great. I finished second last year, so it's good to know I improved," Williams said. Leclair finished in second place at 147, with Beaumont's Mark Odenthal taking third place with a total of 149. Austin's Erin Wilson, 18, closed out her junior career by winning the Girls 16-18 Division of the STPGA Junior Tbur Tournament of Champions. By Dave Campbell AP Sports Writer MINNEAPOLIS — Herb Brooks, who coached the U.S. hockey team to the "Miracle on Ice* victory over the Soviet Union at the 1980 Lake Placid Olympics, died Monday in a car accident. He was 66. The Hall of Famer lost control of his minivan, veering onto a grassy area at a highway intersection north of the Twin Cities and rolling over. Brooks apparently was not wearing a seat belt, and his body was found about 40 yards from the vehicle. Brooks attended a Hall of Fame celebrity golf event and was on his way to the Minneapolis airport to catch a flight to (Chicago, USA Hockey spokesman Chuck Menke said. "It seems like all the great innovators die young," said Ken Morrow, a defenseman on the 1980 team and now a scout for the New York Islanders. "Coach may have been the greatest innovator the sport has ever had* Brooks was behind the bench when the Americans pulled off one of the biggest upsets ever, beating the mighty Soviets with a squad of mostly college players. That shocking victory, plus beating Finland for the gold medal, assured the team a place in sports immortality and gave the nation a reason to celebrate. The hostage-taking in Iran, the Soviet invasion of Afghanistan and the energy crisis had cast a pall over the United States. On Feb. 22, 1980, the U.S. team scored with IO minutes to play to take a 4-3 lead against the Soviets and held on. As the final seconds ticked away, announcer Al Michaels exclaimed, "Do you believe in miracles? Yes!"Texans' linebacker 'Peeks' coach's interest in camp Texans HOUSTON (AP) — Antwan Peek got Texans coach Dom Capers' attention quickly as training camp began, and not in a good way. The linebacker, a third-round draft choice out of Cincinnati, had hit fellow rookie Tony Hollings twice in a row during drills after the defense was specifically told not to pop the running back, who underwent major knee surgery last fall. Peek's overaggressiveness earned a tongue-lashing from Capers. Secretly, it may have also earned a smidgen of respect. "That's instinctive in some of the guys. That's normally a good problem to have," Capers said Monday as he recalled the incident. "You don't want to discourage that, but at the same time you don't want to lose a player." Hollings was OK, and Peek has played under more control as Capers and defensive coordinator Vie Fangio convert him from a defensive end to an outside linebacker in the Texans' 3-4 system. Everyone, including Peek, agree he's raw and it might take a full season or more for him to make the transition from lineman to linebacker, where hell be asked to stop the run and defend passes as well as attack quarterbacks. "I've gotten better and better as time has gone on," Peek said. "I think I'm turning into a well-groomed linebacker, and coach Vie is doing a great job of showing me what to do." There's little doubt the 6-foot-1, 230-pound Peek knows how to seek and destroy. In four years at Cincinnati he had 27 1/2 sacks, forced 14 fumbles and recovered IO loose balls and blocked six kicks, all school records. Extra Points: Several players put a new video game, "NFL GameDay 2004" by 989 Sports, to the test. Two TV sets in the players lounge were set up, with OL Steve McKinney and Zach Wiegert squaring off on one and Hollings and WR Jabar Gaffney on the other Wiegerfs Steele rs beat McKinney's Texans 33-14 while Gaffney's Texans came from far behind to beat Hotings' Falcons 43-28 When informed he had scored two touchdowns in Gaffney's win, tight end Billy Miller remarked, "Just like real life."No time to waste DAVID INGRAM/Heratd-Zeitung Canyon High School assistant football coach John O'Dell barks instructions at a Canyon player during tbaJirst day of two-a-day fall practices Monday at the high school. The Cougars open the season Sep. 5 against Somerset. Cougars, Rangers begin practice as season openers grow near By Bryan Adams Sports Editor Canyon and Smithson Valley began fall football practices Monday as they get ready for their season openers right around the comer. The Cougars and Rangers both practiced once a day during the spring for four weeks, so both coaching staffs rely on a lot of retention for fall workouts. "We just stepped right in where we left off in the spring. The guys came back in pretty good shape. I was very happy with the way things went," Canyon head coach Brad Wright said. Smithson Valley head coach Larry Hill has a little less time to prepare his team for their season opener Aug. 29 against Port Arthur Memorial at Bryan High School. "The kids impressed us with how much they retained from spring training," Hill said. "We're certainly not as good as we need to be, our kids by and large knew what to do the first day." The Cougars, who were 7-2 this past season and finished fourth in District 25-4A, begin the season Sep. 5 against Somerset at home. "It's good that we're all familiar with what we're doing," Wright said. "We're starting our fourth season and everybody is on the same page. That definitely makes things a lot easier. 'Hie kids came in with a great attitude and we're ready to go." Both teams will put on the pads Friday and classes will start Monday. Canyon's first scrimmage is Aug. 23 at Bandera. Smithson Valley's first and only scrimmage is Aug. 23 against San Antonio MacArthur. "The first four days you just have to teach a lot," said Hill, who led the Rangers to the state finals for the season year in a row this past season. "We hope to install our entire offense, defense and kicking game in the next four days. We're not practicing anything filii speed, so we like to use this time as mainly as a teaching period. Hopefully we're just re-teaching." DAVID INGRAM/HerakJ-Zeitung Smithson Valley quarterback Matt Wright throws to a receiver downfield during the first day of two-a-day practices on Monday at SVHS. ;
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- Tarryn Schuldiner-Harpaz, Moshe Coll
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Global warming may affect species abundance and distribution, as well as temperature-dependent morphometric traits. In this study, we first used historical data to document changes in Orius (Heteroptera: Anthocoridae) species assemblage and individual morphometric traits over the past seven decades in Israel. We then tested whether these changes could have… (More)
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Let us know when your receive great advice so we can thank our lawyers and point others with similar questions in the right direction.Got it!
My girlfriend has been living with me since our daughters birth 3 months ago which ive been the primary caretaker of them both. She ups & leaves without probable cause & gets a order of protection against me for no reason which hasent been served. I filed a DIR for custodial interference. I have a court order to come to for custody next month but in the mean while I havent seen my daughter or been able to contact mother. Girlfriends mother whos always drunk thinks im her son when I call her tells me my daughter almost was kicked off of a bed and is sleeping on a airbed at a relatives house. Im concerned of her safety. I also have my daughters medication that she takes daily which her pharmacy call me for every refill. This is neglectful to me. Should I call asc.
While you should be careful in involving ACS, this may be what is required here. At the very least, your child's medication is not being taken by your child and that needs to be happening. If the mother is not doing what is required medically for the child, that is medical neglect.
It also sounds like you need an attorney to represent you here.Ask a similar question
The medicine is a vitamin suppliment she suppose to take daily since shes being breastfed and another for her reflux .
Welcome to our circle. Your DIR will go nowhere. Her TOP will become effective upon service (or she can fabricate proof that you were served when in fact you were not). Your assertions that the child was kicked off a bed have been used in prior cases so you have to come up with new allegations none of which will matter.
You were not the primary caretaker of both mother and child. Mother will counter your assertion with the domestic violence allegation. Your petition for custody comes at the wrong time.
So the mother outmaneuvered you by striking first with a family offense petition. You are taking actions that cone intuitively but are all wrong. You cannot face family court because you don't know what you are doing.
You need a family attorney who can navigate through family court. Otherwise, you may find yourself in some hot water.
Good luck.Ask a similar question
All these facts are coming from recent recorded phone calls. She has no stable housing at the time. I filed the DIR the day she left. Went to the court the next day to file my petition. She was in court doing the same thing the same morning. So it cant be labeled as outmaneuvering, its just my daughter is being puppeted.
David is correct about dealing with ACS. If the medication is for a serious condition, then you might have no choice but to call. Be aware that once ACS gets involved, you will be examined as well. You should consult with an attorney to go over everything before you act.Ask a similar question
i have no problem being examined as far as my lifestyle im a straight road. Shes not ill. Any meds are serious to me though. My daughters well being is what im concerned with considering the pathological behavior of her mother just up and leaving with no probable cause. I just felt the need of ACS getting involved for the fact that the court is going to most likely bring up an investigation on this when we appear.
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celebrity facts 71 Famous Scientologists f p @
Almost everyone is curious about Scientology and its followers. Which famous people are Scientologists? Why do so many celebrities join the Co$? Click through the list below to find out.
Tom Cruise is an American actor, filmmaker and scientologist. Cruise has been nominated for three Academy Awards and has won three Golden Globe Awards. He started his career at age 19 in the 1981 film Endless Love. After portraying supporting roles in Taps and The Outsiders, his first leading role ...more
More About
Age: 54
Birthplace: Syracuse, New York, United States of America
Profession: Television director, Film Producer, Screenwriter, Actor
Children: Suri Cruise, Connor Cruise, Isabella Jane Cruise
Medical Conditions: Dyslexia
Credits: Top Gun, Mission: Impossible, Jerry Maguire, A Few Good Men
Also Ranked
#70 on The Best American Actors Working Today
#54 on The Best Living American Actors
#47 on The Greatest Actors Who Have Never Won an Oscar (for Acting)
#97 on The Best Actors in Film Historysee more on Tom Cruise
Elisabeth Singleton Moss is an American actor, known for her roles as Peggy Olson, secretary-turned-copywriter on the AMC series, Mad Men, which earned her five Emmy Awards nominations and one Golden Globe nomination; Zoey Bartlet, the youngest daughter of President Josiah Bartlet, on the NBC ...more
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Age: 34
Birthplace: Los Angeles, California, United States of America
Profession: Actor, Voice acting
Credits: Mad Men, Girl, Interrupted Girl, The One I Love Get Him to the Greek
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#25 on The Best Actresses Who've Never Won an Emmy (for Acting)
#34 on Which Actress Do You Think Will Be The Next Meryl Streep?see more on Elisabeth Moss
Kirstie Louise Alley is an American actress and comedian known for her role in the TV series Cheers, in which she played Rebecca Howe from 1987 to 1993, winning an Emmy Award and a Golden Globe Award as the Outstanding Lead Actress in a Comedy Series in 1991. She is also known for her role in the ...more
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Age: 66
Birthplace: Wichita, Kansas, United States of America
Profession: Comedian, Television producer, Screenwriter, Actor
Children: William True Stevenson, Lillie Price Stevenson
Credits: Cheers, Look Who's Talking, Veronica's Closet, Star Trek II: The Wrath of Khan
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#43 on Celebrities Who Just Seem Crazy to Yousee more on Kirstie Alley
John Joseph Travolta is an American actor, dancer, and singer. Travolta first became known in the 1970s, after appearing on the television series Welcome Back, Kotter and starring in the box office successes Saturday Night Fever and Grease. His acting career declined through the 1980s, but enjoyed a ...more
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Age: 63
Birthplace: Englewood, New Jersey, United States of America
Profession: Film Producer, Actor, Voice acting, Singer Dancer
Children: Jett Travolta, Ella Bleu Travolta, Benjamin Travolta
Credits: Pulp Fiction, Grease, Face/Off, Bolt
Also Ranked
#98 on The Best American Actors Working Today
#76 on The Best Living American Actors
#57 on The Greatest Actors Who Have Never Won an Oscar (for Acting)
#61 on Celebrities Who Just Seem Crazy to Yousee more on John Travolta
Laura Prepon is an American actress, known for her role as Donna Pinciotti in all eight seasons of the Fox sitcom That '70s Show. She is also known for the role of Hannah Daniels on the ABC drama October Road and her role as Alex Vause in the Netflix original series Orange Is the New Black. She has ...more
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Age: 37
Birthplace: Watchung, New Jersey, United States of America
Profession: Ballet Dancer, Film Producer, Model, Actor Voice acting
Credits: That '70s Show, Orange Is the New Black, Karla, The Kitchensee more on Laura Prepon
Jason Michael Lee is an American actor, producer, and skateboarder. Lee is known for his role as Earl Hickey in the television series My Name Is Earl, the role of Dave Seville in the Alvin and the Chipmunks film franchise, and the voice of Syndrome in The Incredibles. A skateboard enthusiast, Lee is ...more
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Age: 46
Birthplace: Huntington Beach, California, United States of America
Profession: Businessperson, Comedian, Television producer, Entrepreneur Skateboarder, + more
Children: Pilot Inspektor Lee, Sonny Lee, Casper Lee
Credits: My Name Is Earl, The Incredibles, Almost Famous, Vanilla Sky
Also Ranked
#8 on The Best Former Athletes Turned Actorssee more on Jason Lee
Kelly Preston is an American actress and former model. She has appeared in more than 60 television and film productions, most notably including Mischief, Twins and Jerry Maguire. She is married to John Travolta. ...more
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Age: 54
Birthplace: Honolulu, Hawaii, United States of America
Profession: Model, Actor
Children: Jett Travolta, Ella Bleu Travolta, Benjamin Travolta
Credits: Jerry Maguire, Twins, Death Sentence, For Love of the Gamesee more on Kelly Preston
Beck Hansen, known by the stage name Beck, is an American singer-songwriter, producer, and multi-instrumentalist. He rose to fame in the early 1990s with his lo-fi, sonically experimental style, and he became well known for creating musical collages of a wide range of styles. His later recordings ...more
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Age: 45
Birthplace: Los Angeles, USA, California
Profession: Film Score Composer, Record producer, Songwriter, Musician Singer-songwriter, + more
Children: Cosimo Henri Hansen, Tuesday Hansen
Credits: Eternal Sunshine of the Spotless Mind^! Moulin Rouge!^! Scott Pilgrim vs. the World^! Knocked Up
Also Ranked
#23 on The Greatest Musical Artists of the '90s
#99 on The Greatest Rock Songwriters of All Time
#52 on The Most Iconic Celebrity First Names
#47 on The Best Opening Act You've Ever Seensee more on Beck Hansen


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|Absolut vodka
|Tuesday, 14 November 2000 00:00
Between November 2 and November 14, preciselyat 15.00 every other day we could watch the new, tangerine tasting Absolut Vodka gradually enter the Czech market. At this time, the image of an Absolut Vodka bottle, depicted on a 126 m2 large megascreen installed on the Maxx Planet building, on the Prague Národní trída, was gradually revealed.
Eclipse got a chance to take part in the manufacturing of this unique job, made particularly attractive by the peeling off of the top part of the graphics, showing the zest of the fruit, gradually revealing the hidden motif of the bottle. This lower motif had been printed using Vutek technology on 600 g/m2 PVC fabric. The segments were joined by invisible seams, the canvas fitted with eyelets and pockets for fastening, with the use of a high frequency welding machine.
The upper motif was printed on the Vutek, on nonpermanent foil consisting of 50 x 150 cm bands. To achieve the effect of a realistic looking tangerine zest, an irregular cutting of the edges of this upper foil was necessary, requiring very precise and careful work - a careless move could easily cut the underlaying canvas.


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Is that a vibrator in your panties or are you just glad to see me? From Jezebel.
New Undies With Bluetooth-Connected Vibrating Pantyliner Will Make Your Day A Lot More Interesting
Like a diminutive, pantyliner-shaped version of the obelisk from 2001: A Space Odyssey, the latest in wearable tech has appeared upon our horizon, leaving us shrieking and jumping in place confusedly. It's called the OhMiBod Remote App, and it's a vibrator that connects, via Bluetooth, to your smartphone.
Sex toy company OhMiBod unveiled the product — which will retail for a mere $135 — at this year's CES show in Las Vegas.
It's due out in March, so gird your loins, ladies.
According to the company's website, the vibrator is meant to sit in the front of a matching blue "panty," and it contains a Bluetooth chip, which reacts to input from one's — or one's partner's — smartphone. Users can then use the phone's built-in touch sensors and volume controls to control the vibrator.
(Read more)


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B.E. is short for Before the Exodus.
The Exodus of the Gods is an event that marks the center point of the Mouvelian Calendar. (For more information read the Manual)
The present time in the game (Chapter 1) is the year 1072 AE.


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- Despite a highly touted announcement last November, Mitsubishi and Nissan-Renault have not yet finalized a plan to develop a midsize car that would replace the Mitsubishi Galant.
- A Galant replacement would target the Ford Fusion, Honda Accord and Toyota Camry, among others.
- The Galant was discontinued in 2012.
CHICAGO — Despite several months of discussions, Mitsubishi and Nissan-Renault have not yet finalized a plan to develop a midsize car for the Japanese automaker to sell in the United States. The car would replace the Mitsubishi Galant, a Japanese offering that lagged the pack in the midsize sedan segment.
Mitsubishi announced last November that an agreement had been reached between the two automakers to develop a midsize sedan that would be based on a Renault model.
Mitsubishi has not offered a midsize sedan in the U.S. market since the 2012 model, the last year for its Galant.
"We have had multiple meetings with them, but no final decisions yet on what direction," Don Swearingen, executive vice president, Mitsubishi Motors North America, Inc., told Edmunds. "We have to have the right product at the right price."
Asked if there is a target date for U.S. sales, Swearingen said, "We don't really have the timing in place. The direction to our management is move as quickly as possible."
In that November announcement, Mitsubishi also said Nissan-Renault would develop a global compact sedan for the Japanese automaker and an electric vehicle. Swearingen did not reveal the status of those discussions.
"Our interest here in the U.S. is more focused on the D segment (midsize sedan)," he said. "We have a lot of Galant customers coming out of their vehicles, and we are getting them into a lot of other Mitsubishis."
Swearingen was interviewed at the 2014 Chicago Auto Show.
"But if (car shoppers) are still looking for that sedan in that D segment, we just don't have it," he said. "We know that is a huge gap we need to fill."
The midsize sedan segment is made up of such vehicles as the Chevrolet Malibu, Ford Fusion, Honda Accord, Nissan Altima and Toyota Camry.
"That is a huge segment. We have sold many cars in that segment, and we know it is something that consumers still want," he said. "We are looking at this partnership as an opportunity to better utilize a production facility. We want to make sure that we can not only deliver a competitive product, but we can make it at a competitive price, and make it efficient for ourselves and our partners."
Although the Galant was assembled at Mitsubishi's plant in Normal, Illinois, Swearingen said it is more likely that the new sedan would be imported. Renault has capacity outside the United States.
Among the issues to be determined is whether the midsize sedan would have its own styling or be a rebadged Renault model.
"We are discussing both of those topics," he said.
Edmunds says: The midsize sedan segment is one of the most competitive vehicle segments in the United States. A stylish Renault-designed model might be the right direction to draw buyers to Mitsubishi.


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Time to make your move? Know what to consider before relocating
While many aspects of your business are within your control, you are generally at the mercy of the market environment. Factors such as demography, economy, technology, natural forces, and culture can all affect your business. If the market research you've gathered suggests that your current business location is not ideal, could relocating help?
There are different approaches you can take:
- You can stay where you are, and make adjustments to the business to try and improve your potential for success. You might consider:
- Expanding online with e-commerce, or exporting
- Adding or altering product lines, offering new services, or changing your promotional strategy
- Partnering with a complementary business
- You could relocate the business to an area with more potential, including:
- Access to new markets, land, buildings, and quality talent
- Better infrastructure for business
- Improved business climate (e.g. strong lending industry)
Things to consider if you're thinking about relocating
- Have you signed a lease or other contracts? Would it be possible to undo them if needed?
- What are the financial and logistical challenges of relocating (finding new space, hiring new employees, shipping inventory, arranging for new suppliers and/or distributors, etc.)? You might have to close your business temporarily during this time.
- What effects would moving the business have on you personally? How far is the commute to the new location? Are you prepared to find a new place to live, or manage operations remotely?
If you need help making your decision, seek advice from professionals. A lawyer with experience in business relocation can advise you on things like due diligence, regulatory compliance, contracts and more.
Remember, even if you move to a new location, you will still be in a constantly changing environment, and you will have to manage the risks that come with it. In the end, you'll need to weigh the pros and cons of relocating versus staying where you are. Look at the big picture, and give yourself lots of time to plan before making your move.


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Home defence ant stop ant killer granules are easy to use leaving no dust and kills ants and their nests. The formula of ant stop granules contains natural active ingredients and can be used inside and outside all the year round.
More information about Ant Stop Ant Killer Granules:
300 gram pack
Contains spinosad
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We offer two different delivery options for all of our products (delivery rates and services offered by marketplace sellers may vary):
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Saturday's severe weather did more than just shut down the Washington Town and Country Fair.
About 5,000 Ameren Missouri customers in Franklin County were without power following the storms.
More than half of those customers had power restored by 9:30 a.m. Sunday, according to an official with the company's communications department.
Nearly 2,000 of the 5,000 impacted were in Washington.
Only about 800 were without power by noon and only about 160 by 2 p.m. All customers had power restored by 5 p.m. Sunday.
Another front moved through the area earlier in the day on Aug. 4. That storm knocked out power to about 300 Ameren customers in southern Warren County and 200 in Franklin County.
The Warren County outages were reportedly fixed by 8:30 a.m. with those in Franklin County resolved by 2 p.m.


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Frank's Country Rustic GetawaySend to a friend
From $295 / night
Reserve for only
balance of due
12 travelers
viewed this property in the past week
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Description from the owner
Description from the owner
Bedrooms: 3/
Bathrooms: 2/
Sleeps: 7/
Type: House
Book this 3 bedroom, 2 bathroom house in Los Angeles today! A total of 7 people can sleep here comfortably.
Guests can enjoy a pool, outdoor grill, and air conditioning among other amenities offered by this rental.
Travelers are sharing their opinions on this property. It has an overall rating of 5/5 thanks to an average of 53 reviews.
Costs vary, with the average weekly rate as low as $2,065.00, depending on travel dates.
The owner responds to 95% of inquiries.
Frank's Country Rustic Getaway Los Angeles, California
Additional Location Information
Conveniently located in the quieter valley of Los Angeles. All major attractions are just moments away. Ten minutes from Universal Studios, twenty minutes to beautiful beaches, fifteen minutes from Hollywood, twenty minutes from downtown and only one hour to Disneyland
Proximity to TripAdvisor's Top Los Angeles Attractions
Proximity to TripAdvisor's Top Los Angeles Attractions
Rates shown in $ USD
|Minimum Stay
Please note: these rates exclude taxes and fees and may vary depending on the length of your stay. Rates are also subject to change at the owner's discretion.
Additional notes from the owner
Please contact owner for discounts
- A/C or climate control
- Local Guides/Maps
- Central heating
- Towels Provided
- Cleaning Service
- Safe
- Clothes Dryer
- Washing Machine
- Soap/Shampoo Provided
- Ceiling Fans
- Linens Provided
Phone / Internet
- Telephone
- Internet Access
Pool / Spa
- Shared outdoor pool (unheated)
Property Features
- Parking
- Wheelchair accessible
- Freezer
- Dishwasher
- Stove or Oven
- Blender
- Grill
- Microwave
- Refrigerator
- Satellite or cable TV
- Stereo or CD player
- Books
- DVD Player
- Television
- Garden
- Balcony or terrace
- Outdoor Dining Area
- Patio
- Garage
- Pet
- Smoking
- children
Living space
- 2300 square feet
Reviews (45)
based on 45 reviews
of guests would stay again
Very good
A FlipKey verified reviewer
"Home away from home."
My family had a wonderful vacation at Frank's. He is super friendly and extremely accommodating. After our arrival, he checked in on us and he gave us his number. The couple of times we called with some questions, he was immediately responsive. The house is lovely; everything is exactly as described in the write up, except better! We were visiting family in LA for a series of events and the location is ideal. This is a very centrally located home we got everywhere we needed to go quite easily (including the YMCA where my sister is a member and 24 Hour Fitness, where I'm a member). Trader Joe's, Whole Foods and Starbucks along with CVS and a couple of shopping malls are all easily accessible. And the car stayed cool in the garage! Frank even furnished us with the automatic garage door opener. The house itself is lovely; a homey rustic feel, but modern appliances, including excellent stove and coffee maker. We had an easy time with meal preparation and the living / dining area is light and airy. The outdoor seating by the pool is cool and comfortable. The inside and out are clean and well maintained The house is quite safe, with a great keypad entry system - no keys to forget or have to share! The layout of two bedrooms and a bathroom on one side of the kitchen/living/dining area and another bedroom and bathroom on the other side is perfect when one part of the group wants to go to bed earlier. The beds are comfortable, with extra mattresses available if needed. There is plenty of storage for clothes etc, with dressers and plenty of closet space available and lots of hangers. There's lots of bedding, sheets and blankets etc. Frank is a wonderful host and my whole family wants to return. We are very much looking forward to returning to Frank's house, where we felt so at home. Frank invited us to just have a great time, which we did! We had the experience of being as comfortable as at home, with the relaxation of being on vacation. Frank is easy to work with and really wanted to do everything he could to ensure we had a great time. Myself and everyone in my family highly recommend Frank's home for any length of time (although you'll be sorry if you leave too soon - our 11 days went way too fast!!!!) Thanks again Frank - we look forward to our next trip!
Response from the owner, Frank Schultz - 07/07/2016
I can't tell you how much I enjoyed you and your family.It was a real joy just to come to the house and engage in conversation with you and your husband and family. It is the little things in life that make one happy. Every once in awhile I have guests who I can now call friends. Please come back and visit soon. Take good care Frank
A FlipKey verified reviewer
"Great location, great house and lovely owner !"
We stayed here for 10 days recently, and had a lovely time. Frank was extremely easy to work with, quick to respond to emails and booking process was very easy and didn't feel at all worried about booking something over the internet ! The house is huge, loads of space for our family of four, the kids had their own room and double bed each and bathroom between them. Kitchen had everything you needed, my husband would have liked to have seen some real glasses as we could only find plastic ones but that's not really an issue to be honest ! The a/c and heating worked well, we seemed to catch LA when it was extremely hot one day and really cold the next ! Pool was nice, kids had fun, and I enjoyed sitting outside in the morning eating breakfast. It is a very quiet area, the odd fire engine or dog bark in the distance but considering you're in LA, I thought it was really peaceful. We're not disturbed at all by anything ..Easy to find, location is fantastic, local services were great. Oh and the internet was very good, WIFI worked extremely well we had no issues with it at all. Supermarket Fresh and Easy just a couple of blocks drive away, mobile phone shop 5 min walk away sorted out a sim card for me in about 10 minutes and were extremely friendly. While we were there, a commercial was being filmed on location at the house, there were people, actors, make-up catering and crew everywhere!! My kids had the best day ever. In fact it's the first thing they tell anyone when asked about our trip, never mind Disney or Universal !! My son especially got involved and was allowed to direct a little and was treated really well by all the crew, he asked a lot of questions ! We also ate with everyone that evening and all were extremely considerate about the fact they had invaded our living space for the day. It was an experience and a half and a little dip into the world of Hollywood !! I should also mention the garden was so beautifully made up with lights for the shoot, it was amazing to see in the evening.. Overall we had a wonderful stay, Frank is very easy going lovely person and fun to chat to.. When we come over again, then we know just where to stay.. Thanks Frank !
Response from the owner, Frank Schultz - 06/06/2015
Hi Emma I so much enjoyed your family. I am so glad you all had a great time and loved the house. I am also very happy that your son Ben had an opportunity to play director for the day. It makes me happy that is a memory he will always cherish. Please come back and visit anytime. Take good care Frank
A FlipKey verified reviewer
"Great Vacation"
Our little family had such a great time staying at Frank's place. He was EXTREMELY accommodating! The location was perfect and made for just a short drive to so many adventurous locations. We truly enjoyed our vacation and are so grateful to Frank for opening up his place to our family. We felt right at home.
Response from the owner, Frank Schultz - 06/06/2015
I am happy that you at a wonderful vacation at the house. Please come back and visit soon. Take good care Frank
A FlipKey verified reviewer
"Great Location!!"
We really enjoyed our stay at Frank's house. We were in LA for our son's wedding and were there for a full week. There were 8 (sometimes 9) of us visiting LA and we wanted a place where we could all be together. There was plenty of room and it was nice to be able to relax and enjoy our time together. The location was great -- close to Universal City Walk, several parks, restaurants and not a far drive to the beach. As an added bonus, they were filming a TV show (Workaholics - which is on the comedy channel) at a house down the street and we were able to walk down to the house and watch all the action!! Frank did come by to say hello and was very nice and very pleasant to work with. The whole rental process, from start to finish, was very easy.
Response from the owner, Frank Schultz - 11/18/2014
Hi Amy I am so glad the house and location worked out for you. I really enjoyed your stay and talking with all your family members. Such a fun group. Please come back and visit anytime. Take good care Frank.
A FlipKey verified reviewer
"Fantastic holiday great place to stay"
We stayed for 11 nights, the house was far better than expected with a decent sized pool that the children loved, the room are a really good size we slept 3 girls easily in one room. Plenty on amenities around and a great base the Tavel from. Frank the owner is great, he popped to see us, a really decent guy
Response from the owner, Frank Schultz - 09/15/2014
Hi Jon I enjoyed meeting you and your lovely family. Please come back and visit anytime. Kind Regards Frank
A FlipKey verified reviewer
"Rustic charm in a great location."
My husband and I along with our two teenage children stayed here and my sister and her husband stayed in Frank's other property in the same grounds. We all had the most lovely stay. The house is fully equipped and comfortable and provided everything we needed. The air-con works well but seems to be colder down one end of the house but an extra bed blanket sorts that out :) The location is in a residential street and it seems to be a good area and the road is very quiet but everything you need is only a short drive away. It is close to restaurants and all major roads and is only 12-15 miles form the beach. The pool is lovely, we ate lunch outside on several occasions followed by a dip in the pool. There is plenty of shade in the garden too when it gets hot, the layout is well thought out. Frank is very helpful, we couldn't find the hair-dyer so he bought a new one and popped it over along with some washing liquid for the washing machine! It proved to be a great base for getting around Los Angeles but I would say that the LA traffic is very busy to allow plenty of time for driving. Frank ensures that you have everything you need for a wonderful stay, he wants to know you are happy and clearly loves his properties, I would recommend staying here!
Response from the owner, Frank Schultz - 12/19/2014
Thanks so much for your stay. Please come back and visit anytime. Kind Regards Frank
A FlipKey verified reviewer
"We keep coming back to this great vacation rental!"
Frank's place is a spacious, comfortable, nicely-kept, home-away-from-home. It has several nice amenities, including a lovely private backyard area with a gated-pool, washer/dryer, central A/C, off-the- street parking, and cable TV. This year was our seventh year staying at this property. We come from CT to visit our family every year, and return to this house not only because it works so well for our extended family, but also because of the wonderful owner. Frank is easy to work with, is attentive, friendly, and always available for any questions. He makes sure to stop by at some point to make sure everything is going well. Upon arriving to the house, I couldn't figure out how to turn on the ceiling fans, so I texted Frank. Within three minutes, I received a response with the solution. My friends are in awe at the way he treats his clients like family. In addition to being centrally-located to all the attractions one would want to visit, the house has easy access to highways, food stores, restaurants, malls, medical centers, etc. It's a great place to wind down in between sight-seeing, or even to spend the afternoon or evening relaxing, or entertaining guests. I highly recommend this rental...you will, too, after you stay here.
Response from the owner, Frank Schultz - 08/19/2014
It is indeed a great pleasure for me to have you and Randy as a returning client for the last seven years. You are now like family. I especially enjoyed hanging out and laughing over coffee on your last visit. Here's to another seven good years. Take Care Frank
A FlipKey verified reviewer
"Awesome family getaway near almost everything in LA"
What an awesome oasis in the heart of the LA suburbs! It's right off the highway and close to most tourist things in LA. Tall palm trees line the quiet street. The property is shaded and the landscaping is well kept. Open the front door and you're greeted by the most inviting great room, with leather furniture, a huge brick fireplace, and a cathedral ceiling. Then around the corner is a great big kitchen with all the things you'll ever need in a kitchen. Everyone could be in there at the same time, fixing breakfast or snacks, yet not bumping into each other. We immediately felt at home! There are three large bedrooms which are very comfortable - with very comfortable beds. The cool part about the bedrooms is that there is a master bedroom and separate bathroom, with a monstrous walk-in closet and really great glass-doored shower, on one side of the house (I called it the West Wing), and two additional bedrooms, sharing another full bath/shower, on the other side of the house (the East Wing). And any of the three bedrooms is big enough to take an additional mattress (which is available if needed) for another person. This setup was perfect for our multi-generational family - us in the West Wing and the kids/grandkids in the East Wing. And, let's not forget the pool. The grandkids had a ball. We were so sorry that Frank was out of town and we were unable to meet him. Nevertheless, Frank was readily available via cell and text for all of our questions, and couldn't have been more cordial and accommodating. In summary, look no further for your LA vacation family getaway lodging. And, by the way, Frank's place is only a couple miles from Dr. Hogly Wogly's Tyler Texas BBQ - for the best ribs (pork and beef) and brisket in the world! 'nuf said!
Response from the owner, Frank Schultz - 08/05/2014
Hi Norm I am so glad the house worked for you. Hopefully next time we will be able to meet in person. Thanks for letting me know where the best ribs are in the area. I will have to check it out. Please come back and visit anytime. Take good care
A FlipKey verified reviewer
"Great Place to Stay!!!!"
We had a very pleasant stay and a wonderful experience at this location. The house was very clean, spacious and very well furnished. We had everything we needed for our eight night stay. We felt very comfortable and "at home" while vacationing there. Frank is very friendly and easy to work with. The booking process was painless and went very smoothly. The location of the house is perfect. It is located in a quiet neighborhood but still close to all of the LA sites. I would definitely recommend this house for anyone wanting to stay in the suburbs of Los Angeles. We will definitely stay here again if we ever make it back to LA.
Response from the owner, Frank Schultz - 12/19/2014
Thanks so much for your stay. Please come back and visit anytime. Kind Regards Frank
A FlipKey verified reviewer
San Francisco
"Great Place"
Was a wonderful house to stay in with family. Everything was very clean and furnished. We all felt very comfortable staying there. It was a beautiful weekend and the garden is lovely to sit in and have lunch. Would definitely recommend this place for families.
Response from the owner, Frank Schultz - 04/27/2014
I am so glad the house worked perfectly for you. Please come back and stay anytime. Kind Regards Frank
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Use the tools below to refine your search by only displaying reviews with a certain number of star ratings or to only show reviews from a certain time period. Eg click on '1 star' to just display the reviews we have which received a 1 star rating click or 'Within the last month' to display just reviews posted over the last month.
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Jenna Marie Clancy MBACP (Registered)
07856 061390
About me
Hello and thank you for visiting my page! My name is Jenna and I wish you a warm welcome. I hope you will find all the information you need here or on my website. If you would like to speak to me before making an appointment or ask any further questions, please get in touch.
About Me
I offer confidential counselling to adults on a one to one basis both in person and over the phone. Most people find that telephone counselling is just as effective as face-to-face, and in many cases find its easier because you are in the comfort of your own home.
Regardless of how you wish to receive counselling, my role is the same; I am here to listen and help you find your own answers to the problems that you face. Reaching out for help can be daunting and for this reason I am committed to providing you with a safe space to talk about your concerns, where you will be listened to with respect, empathy, warmth and acceptance.
My Background
My experience as a counsellor began over 10 years ago in a voluntary organisation where I counselled people for general life problems around the issues of home, work, relationships and family. I gained valuable experience in a number of areas to do with:
- abuse
- self-esteem
- loneliness
- bereavement
- shyness
- suicide
- unwanted sexual experiences
- OCD and panic disorder.
I later progressed to working with a national sight loss charity where I now manage a dedicated counselling service for people living with a sight impairment. Far from only dealing with sight loss, this experience has opened me up to working with a variety of common concerns such as:
- stress
- anxiety
- depression
- grief and loss
- disability
- mental health
Together with my experience as a private counsellor, I feel I have encountered many problems that people are likely to bring to counselling a number of times.
How I work
The model of counselling I work from is known as 'relational' and this simply means that I tend to focus on our connectedness to others and how early relationships impact our psychological development. I often describe the counselling process as a journey in which You decide where we will begin. On that journey we may revisit events in your life that have been significant in shaping the person you are today. Together we will unpick your past to get a better understanding of what thoughts, feelings and patterns of behaviour have brought you to this present moment. Then we will look at where you want to be and what steps you need to take to get there.
I work with clients of all ages (18+) on a wide range of issues, so do please get in touch if I haven't mentioned your particular concern above. The length of time I work with people differs according to individual need and includes both longer term as well as short term therapeutic work.
What should I expect from our sessions?
Unless you're looking for telephone counselling, all sessions take place at my home, which is close to local bus routes and 5 minutes drive from Southport town centre. There is plenty of free on-street parking.
Your first session will be about why you are looking for therapy and what you want to gain as well as agreeing how we are going to work together. This will involve me asking you a number of questions and checking that I can offer you the most appropriate support. If, at the end of this session you feel happy about working with me and want to continue, we will make a regular counselling arrangement.
If you think I might be the right counsellor for you please get in touch by email, phone or text and I will be pleased to hear from you.
Training, qualifications & experience
- BSc in Psychology, University of York (2005)
- Diploma in Counselling COMPASS (2009)
- Certificate in Introduction to Transactional Analysis 101
Professional Membership Status
It is important for you to know that I am a Registered Member of the BACP and adhere to their ethical codes and standards of practice. This means that you have somewhere to go if you are not happy about any aspect of our work together. I am also committed to life-long personal and professional development and as such I undertake regular training to update my skills and also attend monthly clinical supervision.
Areas of counselling I deal with
- Depression
- Disabilities
- Domestic violence
- Low self-confidence
- Low self-esteem
- Obsessive compulsive disorder (OCD)
- Redundancy
Other areas of counselling I deal with
- sight loss
- disability
Therapies offered
Photos & videos
My fee is £40 per 1 hour session, payable after each session for face-to-face counselling or before the session for telephone counselling.
Sessions usually occur on a weekly basis, but other patterns can be accommodated.
I require 24 hours notice for the cancellation of a session, otherwise the cost of the session will be charged.
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My website contains more information about me and what to expect from counselling. You can also read more testimonials from previous clients for an insight into what they gained from the service that I offer.
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I'm evaluating tools for screencasting on Linux (Gentoo ~x86 and Ubuntu 8.10/9.04, specifically).
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Tue 30 Jun 15
MORECAMBE suffered their first defeat in five games as a fluke goal from Jack Payne gave Orient victory in the first ever meeting between the two sides.
Payne scored on 29 minutes with a freak ricochet when his block from Ryan Edwards's attempted clearance rebounded goalwards and flew past the helpless Barry Roche from the edge of the area.
It proved to be the decisive moment of a game that saw few clear cut chances.
The Shrimps, who were without the injured Shaun Miller started well and Ryan Edwards headed an early corner wide.
Jamie Devitt then headed a decent opportunity wide after an excellent cross from Tom Barkhuizen
John Marquis picked up a booking in the 24th minute when his enthusiasm got the better of him and he caught Shaun Beeley late.
Five minutes later and Orient had their best shot on target and it would give them the lead, but in fortuitous circumstances.
Payne beat his marker and tried to pass to his team mate, but the ball got intercepted and Edwards attempted clearance was charged down by the Orient midfielder and flew past Barry Roche in the Morecambe goal and into the net.
It was his first goal for the club and a minute later and Payne tried his luck from range, but it was easily saved.
Kevin Ellison had an effort at the other end – Cisak comfortably gathered, however, and it remained 1-0 to the away side.
The O's pushed to extend their lead and broke smartly seven minutes before the interval after Palmer won the ball off the home defence.
He passed out to Bradley Pritchard and his cross looped over Roche, but hit the crossbar and bounced over.
The Shrimps got the second period underway and should have equalised immediately as Paul Mullin cut inside Connor Essam but he curled a poor effort wide of the left hand post.
Orient might have doubled their lead in the 49th minute, though, when Palmer won Pritchard's centre, but Simpson, at full stretch, toe poked wide at the far post.
It was inches anyway from giving the east Londoners a two goal lead and Morecambe appeared to use that to their advantage.
They once again put the away goal under pressure, but couldn't fashion a decent opener and it was Hendon's men that had the next chance.
Pritchard fed Simpson, he rolled his marker well, but curled his shot wide from just outside the area.
Once again Morecambe hit back and a Devitt corner was won by Alan Goddall, his header went over and it remained 1-0 to the O's with an hour played.
With 25 minutes left the Shrimps began to bombard the Orient goal.
Devitt drilled an effort wide from the edge of the box and Aaron Wildig, a second half substitute, tested Cisak for one of the first times in the game when he let fly from range.
Wildig was starting to become influential and his cross was narrowly missed by Barkhuizen.
The pressure was mounting now and Cisak made a stunning low save from Barkhuizen before O's captain Mathieu Baudry appeared to handle the ball, but Morecambe's penalty appears were waved away and the visitors held on for their first away win since beating Newport County on August 22.
Morecambe: Roche, Beeley, McGowan, Kenyon (Kelleher 81), Edwards, Devitt, Barkhuizen, Ellison, Mullin (Molyneux 68), Goodall (Wildig 59), Parrish.
Unused substitutes: Thompson, Bondswell, Bailey.
Leyton Orient: Cisak, Clohessy, Baudry, Essam, Chicksen, Payne, Pritchard, Moore, Marquis (James 63), Simpson (Turgott 87), Palmer.
Unused substitutes: Grainger, Shaw, Dunne, Kashket, Moncur.
Attendance: 2,105 (398 Away)
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text: CA S E R EP O RT Successful surgical rescue of delayed onset diaphragmatic hernia following radiofrequency ablation for hepatocellular carcinoma Tsukasa Nakamura, M.D.,1,2 Koji Masuda, M.D.,2 Rajveer Singh Thethi, M.D.,3 Hirotaka Sako, M.D.,2 Takaharu Yoh, M.D.,4 Toshimasa Nakao, M.D.,1 Norio Yoshimura, M.D.1 1 Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2 Department of Surgery, 4Gastroenterology and Hepatology, Omihachiman Community Medical Center, Shiga, Japan; 3 Department of Hepatobiliary and Pancreatic Surgery, St. James's University Hospital, Leeds, United Kingdom ABSTRACT Radiofrequency ablation (RFA) has been established as the mainstay therapy for hepatocellular carcinoma (HCC) in patients deemed unsuitable for surgical resection. However, delayed diaphragmatic hernia can occur as a result of this procedure. There have been only seven other cases reported on this complication in the literature. Considering the recent growth in the popularity of the procedure, it is predictable that the incidence of the diaphragmatic hernia, due to RFA, will definitely increase. This case report is therefore vitally important as it increases clinical awareness of this currently rare complication, which could lead to improved survival rates in these patients. This case concerns an 81-year-old Asian man with a past medical history of cirrhosis and HCC (segment IV and VIII) who presented with a delayed, right diaphragmatic hernia and strangulated ileus 18 months after his original RFA procedure. It is important to implement extra measures to limit the risk of diaphragmatic, thermal injuries when RFA is performed. In particular, gastroenterologists, surgeons and accident and emergency staff should all be aware of this complication proceed with rapid diagnosis and management when patients, who previously underwent RFA, present with acute abdominal pain. Key words: Delayed onset; diaphragmatic hernia; hepatocellular carcinoma; radiofrequency ablation. Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) has gained significant popularity and interest among clinicians since its original introduction in 1995. Although the utilization of RFA for HCC has been shown to carry a poorer prognosis when compared to hepatectomy, RFA is now classified as the mainstay therapy for HCC in patients unsuitable for surgery. tions; and systemic complications. Intrahepatic complications include injury to the hepatic duct, portal vein, hepatic artery, and hepatic vein. Extrahepatic complications include pleural effusion, ascites, and injury of the abdominal wall. Reported systemic complications include hepatic failure, acute respiratory failure, etc. Among these complications, delayed diaphragmatic hernia following RFA is quite rare. In this article, we report the case of a delayed diaphragmatic hernia, which subsequently caused strangulated ileus due to RFA for HCC. Common complication of RFA can be divided into three categories: intrahepatic complications; extrahepatic complica- CASE REPORT INTRODUCTION Address for correspondence: Tsukasa Nakamura, M.D. Kajii-cho 465, Kamigyo-ku Kyoto, Japan Tel: 81752515532 E-mail: [email protected] Qucik Response Code Ulus Travma Acil Cerrahi Derg 2014;20(4):295-299 doi: 10.5505/tjtes.2014.03295 Copyright 2014 TJTES Ulus Travma Acil Cerrahi Derg, July 2014, Vol. 20, No. 4 An 81-year-old man with a medical history of cirrhosis, HCC (segment [S] IV and VIII) due to hepatitis C complained of severe right upper quadrant (RUQ), abdominal pain and dyspnea. He had undergone RFA 18 months ago for S IV and VIII HCC measuring 19 and 24 mm, respectively, following transcatheter arterial embolization which had been performed 20 months earlier. Ultrasonographic guided RFA had been performed by means of a cool-tip radiofrequency probe (3 cm electrode, 15 cm length). The ablation for S VIII was approached from the epigastric fossa and involved three ses295 Nakamura et al. Successful surgical rescue of delayed onset diaphragmatic hernia following RF ablation for hepatocellular carcinoma sions. Similarly, the S IV lesion was ablated twice. Each procedure did not cause any immediate, major complications. Magnetic resonance imaging and computed tomography (CT) was performed 3 months later in order to confirm the effectiveness of the RFA treatment and rule out any other lesions. These diagnostic imaging techniques did not reveal diaphragmatic injuries (DI). He was admitted to our hospital with acute onset, severe, RUQ pain that started 8 hours previously and that remained constant in nature. He had no history of acute or traumatic injury. Arterial blood gas results revealed a reduced partial oxygen pressure (pO2): 75.6 mmHg. A chest US detected distended bowel loops in the right thoracic cavity. Furthermore, following a CT scan, it was confirmed that there was a right diaphragmatic hernia containing strangulated small intestine (Fig. 1). Subsequently, the patient underwent an emergency diaphragmatic hernia repair and small bowel resection. There was a diaphragmatic hernia located in close, anatomical proximity to the S VIII HCC (Fig. 2a). Surgical visualization of the right hepatic lobe indicated significant atrophy as a result of chronic cirrhosis. Approximately 1 m of small bowel was found to have been incarcerated through a 5 cm defect of the right diaphragm (Fig. 2b and c). Via an incision of the hernial orifice, the incarcerated bowel was released, and the ischemic bowel was resected; after which the right diaphragm was repaired by using 3-0 prolene sutures in an interrupted manner (Fig. 2d). As his clinical course was stable and uncomplicated, he was discharged after 15 days of hospitalization. Currently, the patient is systemically well and with no signs of hernia. DISCUSSION RFA has gained popularity and has now become the mainstay procedure for HCC. Therefore, it can be argued that, although presently small, the incidence of complications such as diaphragmatic hernias as a result of RFA will inevitably increase. Diaphragmatic hernia following RFA procedure can be categorized as DI. Delayed diagnosis of DI possibly lead to poor prognosis compared to early diagnosis: namely 30% (delayed) and 7.1% (early), respectively.[1] Interestingly, right-sided and left-sided DI might show a different outcome: right-sided DI face higher risk for strangulation than left-sided.[2] According to these discussions, it is a vital point to confirm early (a) (b) (c) (d) Figure 1. Computed tomography (CT) scan demonstrating the right diaphragmatic hernia. The hernial orifice was located in close proximity to the site of the segment (S) VIII hepatocellular carcinoma (HCC). (a) Chest radiograph, (b) horizontal enhanced CT scan, (c and d) sagittal enhanced CT scan. Figure 1b Yellow arrow head: strangulated small intestine in the right thoracic cavity, Figure 1c Yellow arrow head: diaphragmatic hernial orifice, white arrow: S VIII HCC. 296 Ulus Travma Acil Cerrahi Derg, July 2014, Vol. 20, No. 4 Nakamura et al. Successful surgical rescue of delayed onset diaphragmatic hernia following RF ablation for hepatocellular carcinoma (a) (b) (c) (d) Figure 2. (a) Diaphragmatic hernia: small intestine was strangulated by the defect of the right diaphragm. (b) Strangulated small intestine demonstrated an irreversible, ischemic injury. (c) The defect size was roughly 5 cm. (d) The defect was closed with 3-0 prolene, interrupted sutures. diagnosis of diaphragmatic hernia due to RFA where most of the reported lesions are located at right-sided as discussed in detail later, given difficulties of early diagnosis and leathal outcomes, Pekmezci et al.[3] had reported that thoracoscopy was an effective tool for the diagnosis, including subsequent surgical repair of DI. Furthermore, it is also capable of eliminating pleural collections which might cause pyothorax. Therefore, when the diagnosis is uncertain, thoracoscopy should be recommended. It is also noteworthy that this patient developed a diaphragmatic hernia 18 months after the initial RFA procedure. All eight cases of delayed onset diaphragmatic hernia following RFA in the international literatures[4-9] have patients presenting with severe, abdominal pain between 9 and 20 months after their RFA procedure (Table 1). Furthermore, all eight cases describe RFA for HCC in S V-VIII which are in close proximity to the right diaphragm. Therefore, there seems to be a correlation between the increased incidence of diaphragmatic hernias, the anatomical location of the HCC lesions and their distance from the diaphragm. The onset of the diaphragmatic hernia with strangulated ileus seems to have a possible risk factor: Chilaiditi syndrome is defined as the transposition of colon between the diaphragm and liver. The condition generally involves the transverse colon, but Ulus Travma Acil Cerrahi Derg, July 2014, Vol. 20, No. 4 can also refer to the small intestine. Chilaiditi syndrome usually remains as an asymptomatic, anatomical variant and is normally identified as an incidental radiological finding, when it is referred to as the Chilaiditi sign. It can occur as a direct result of abnormalities of the falciform or suspensory ligaments of the transverse colon or congenital transposition.[10] Furthermore, in the case of cirrhotic patients, the incidence of Chilaiditi syndrome inevitably increases, because the right lobe has a propensity to atrophy due to the cirrhosis and the subsequent generation of the space between the diaphragm and liver.[11] In our case, his standard liver volume was 1061 ml according to the Urata formula,[12] and his actual liver volume based on CT scan was 1009 ml. However, his right liver volume occupied just 50% of total due to cirrhotic atrophy, which was significantly smaller size compared to the standard size. Thus, it can be argued that when diaphragmatic hernia happens on cirrhotic patients, the incidence of subsequent strangulated ileus should be higher than on patients presenting without cirrhosis. In fact, Shibuya et al.[5] had indicated the patients demonstrated Chilaiditi syndrome before the onset of diaphragmatic hernia with strangulated ileus. Although there was no evidence of Chilaiditi syndrome in our case, it is important to be aware of its existence, whether the cirrhotic patients who underwent RFA demonstrate Chilaiditi syndrome or not. 297 Nakamura et al. Successful surgical rescue of delayed onset diaphragmatic hernia following RF ablation for hepatocellular carcinoma Table 1. Summary of previous reported delayed diaphragmatic hernia following RFA for HCC Reference Age Segment affected CP score score Onset of RFA Strangulated by HCC and and MELD defect needle ileus/prognosis medical history (months) Thoracic cavity or intraperitoneal saline infusion/intraabdominal carbon dioxide Koda et al., 2003[4] No information 61 IV, VI, VII, VIII CP 9 (Class B) HBV related MELD unknown 13 Le veen Existed/recovered well, but 1 month later died of hemorrhage due to rupture of HCC Shibuya et al., 2006[5] Existed/patient 72 IV, VIII Alcoholic CP unknown liver cirrhosis MELD unknown di Francesco et al., 2008[6] 49 VII Nawa et al., 2010[7] 50 VIII Yamagami et al., 2011[8] 71 Singh et al., 2011[9] 15 RITA Cool-tip No/patient recovered well CP 6 (Class A) Existed/patient 20 RITA MELD 9 VII HCV related CP 7-9 (Class B) liver cirrhosis MELD - unknown 9 II-III and V-VIII CP 5-6 (Class A) MELD 2 related liver cirrhosis 81 19 IV, VIII HCV related CP 6 (Class A) MELD 2 18 No/No No information recovered well Cool-tip No/patient liver cirrhosis No/No recovered well Cool-tip No/patient alcoholic and HBV No information recovered well MELD unknown Nakamura et al., 2014 46 CP unknown 18 No information recovered well Cool-tip Existed/patient No/No recovered well HCC: Hepatocellular carcinoma; HCV: Hepatitis C virus; CP: Child–Pugh; MELD: Model for end-stage liver disease; RFA: Radiofrequency ablation; RTIA: Radiofrequency interstitial tissue ablation. When RFA is utilized for HCC in close proximity to the diaphragmatic surface of the liver: S IV, VII, and VIII, it is necessary to protect the diaphragm in order to avoid the potentially lethal complications of a diaphragmatic hernia. Therefore, it is advised that before RFA is initiated, the use of either intraabdominal carbon dioxide, thoracic cavity or intraperitoneal carbon dioxide is warranted. In general, it can be argued that intraperitoneal saline infusion is more effective than intrathoracic cavity saline infusion in terms of the risk of developing diaphragmatic injury.[13] It is of vital importance to make a rapid and accurate assessment of any patient, who having had previous RFA, complains of acute abdominal pain. Thoracoscopy should be performed as the occasion demands. As a result of this report, we would like to make clinicians more aware of the increasing incidence diaphragmatic hernias as possible complications of RFA for HCC. This can lead to improved patient survival rates from RFA. Ethical Approval Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request. Conflict of interest: None declared. 298 REFERENCES 1. Demetriades D, Kakoyiannis S, Parekh D, Hatzitheofilou C. Penetrating injuries of the diaphragm. Br J Surg 1988;75:824-6. CrossRef 2. Zierold D, Perlstein J, Weidman ER, Wiedeman JE. Penetrating trauma to the diaphragm: natural history and ultrasonographic characteristics of untreated injury in a pig model. Arch Surg 2001;136:32-7. CrossRef 3. Pekmezci S, Kaynak K, Saribeyoğlu K, Memişoğlu K, Kurdal T, Kol E, et al. Thoracoscopy in the diagnosis and treatment of thoracoabdominal stab injuries. Ulus Travma Acil Cerrahi Derg 2007;13:36-42. 4. Koda M, Ueki M, Maeda N, Murawaki Y. Diaphragmatic perforation and hernia after hepatic radiofrequency ablation. AJR Am J Roentgenol 2003;180:1561-2. CrossRef 5. Shibuya A, Nakazawa T, Saigenji K, Furuta K, Matsunaga K. Diaphragmatic hernia after radiofrequency ablation therapy for hepatocellular carcinoma. AJR Am J Roentgenol 2006;186(5 Suppl):S241-3. CrossRef 6. di Francesco F, di Sandro S, Doria C, Ramirez C, Iaria M, Navarro V, et al. Diaphragmatic hernia occurring 15 months after percutaneous radiofrequency ablation of a hepatocellular cancer. Am Surg 2008;74:129-32. 7. Nawa T, Mochizuki K, Yakushijin T, Hamano M, Itose I, Egawa S, et al. A patient who developed diaphragmatic hernia 20 months after percutaneous radiofrequency ablation for hepatocellular carcinoma. [Article in Japanese] Nihon Shokakibyo Gakkai Zasshi 2010;107:1167-74. [Abstract] 8. Yamagami T, Yoshimatsu R, Matsushima S, Tanaka O, Miura H, Nishimura T. Diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma. Cardiovasc Intervent Radiol 2011;34 Suppl 2:S175-7. CrossRef 9. Singh M, Singh G, Pandey A, Cha CH, Kulkarni S. Laparoscopic repair of iatrogenic diaphragmatic hernia following radiofrequency ablation for hepatocellular carcinoma. Hepatol Res 2011;41:1132-6. CrossRef 10. Saber AA, Boros MJ. Chilaiditi's syndrome: what should every surgeon Ulus Travma Acil Cerrahi Derg, July 2014, Vol. 20, No. 4 Nakamura et al. Successful surgical rescue of delayed onset diaphragmatic hernia following RF ablation for hepatocellular carcinoma know? Am Surg 2005;71:261-3. 11. Moaven O, Hodin RA. Chilaiditi syndrome: a rare entity with important differential diagnoses. Gastroenterol Hepatol (N Y) 2012;8:276-8. 12. Urata K, Hashikura Y, Ikegami T, Terada M, Kawasaki S. Standard liver volume in adults. Transplant Proc 2000;32:2093-4. CrossRef 13. Kapoor BS, Hunter DW. Injection of subphrenic saline during radiofrequency ablation to minimize diaphragmatic injury. Cardiovasc Intervent Radiol 2003;26:302-4. CrossRef OLGU SUNUMU - ÖZET Hepatoselüler karsinom için uygulanan radyofrekans ablasyon sonrası oluşan geç başlangıçlı diyafragma hernisinin başarılı cerrahi onarımı Dr. Tsukasa Nakamura,1 Dr. Koji Masuda,2 Dr. Rajveer Singh Thethi,3 Dr. Hirotaka Sako,2 Dr. Takaharu Yoh,4 Dr. Toshimasa Nakao,1 Dr. Norio Yoshimura1 Kyoto İdari Üniversitesi Tıp Fakültesi, Transplantasyon ve Rejeneratif Cerrahi Anabilim Dalı, Kyoto, Japonya; Omihachiman Toplum Sağlığı Merkezi, 2Cerrahi Kliniği, 4Gastroenteroloji ve Hepatoloji Kliniği, Shiga, Japonya; 3 St. James Üniversitesi Hastanesi, Safra Yolları ve Pankreas Cerrahisi Kliniği, Leeds, Birleşik Krallık 1 Cerrahi rezeksiyon için uygun olmadıkları düşünülen hepatoselüler karsinom (HSK) hastalarında temel tedavi olarak radyofrekans ablasyonun (RFA) rolü kanıtlanmıştır. Ancak bu işlem sonucunda geç dönemde diyafragma hernisi oluşabilmektedir. Literatürde bu komplikasyonu olan bu olgu dışında yalnızca yedi olgu bildirilmiştir. Bu işlemin popülaritesinde son zamanlarda oluşan artış göz önüne alınarak RFA'ya bağlı diyafragma hernisi insidansının kesinlikle artacağı öngörülebilir. Hastalarda bu halen nadir görülen komplikasyonla ilişkili sağkalım oranlarının iyileşmesine yol açabilen klinik farklındalığı artırdığı için bu olgu raporu yaşamsal önem taşımaktadır. Bu olgu, RFA prosedüründen 18 ay sonra geç başlangıçlı diyafragma hernisi ve boğulmuş fıtık belirtileriyle gelen, geçmişinde siroz ve HSK (IV. ve VIII. segmentler) öyküsü olan 81 yaşındaki Asyalı bir erkeğe ilişkindir. RFA uygulandığında diyafragmatik ve termal hasar riskini azaltmak için ekstra önlemler uygulamak önem taşır. Özellikle gastroenterologlar, cerrahlar, kaza cerrahisi ve acil cerrahi personeli tümüyle bu komplikasyonun farkında olmalı, daha önce RFA geçirmiş hastalar akut karın ağrısıyla geldiklerinde hızla tanı ve tedavi cihetine gitmelidir. Anahtar sözcükler: Diyafragma hernisi; geç başlangıçlı; hepatoselüler karsinom; radyofrekans ablasyon. Ulus Travma Acil Cerrahi Derg 2014;20(4):295-299 doi: 10.5505/tjtes.2014.03295 Ulus Travma Acil Cerrahi Derg, July 2014, Vol. 20, No. 4 299


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Lloyd Ziff, Photographer
Theater District
The Theater District has good bones but its a bit shabby and uneven--our euphemism for "dont go it alone after dark". The famous old theaters are gorgeous from the inside, and some from the outside as well, and they share their sidewalks with neon and glittering storefronts. Many fine restaurants wedge themselves behind small entries to offer theater-goers quickly delivered meals pre-theater, and a relaxed evening for post-theater diners. Recently the area has welcomed big business with grand shiny new buildings, most notably Reuters and The New York Times. Consequently, we suspect, the area will soon be posh: even the Port Authority, which in the 1980s was home to a large number of the citys homeless men and women, now has a restaurant with linen service.