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For the third consecutive time this 2009 season, the nationally-ranked Ferris State University softball team is listed first in the latest NCAA Division II Softball Regional Rankings for the Midwest Region. The regional rankings were released by the NCAA-II Softball Committee on Wednesday (April 8).
The top 10 teams in each eight regions were listed in rank order with season records as of April 6.
Ferris State, led by 12th-year head coach Keri Becker, had registered a 19-3 overall record and a 14-3 in-region record. Comprising the top five in the 10-team Midwest Region rankings besides Ferris State were Wayne State (second), Ashland (third), Missouri-St. Louis (fourth), and Lewis (fifth). Fellow Great Lakes Intercollegiate Athletic Conference (GLIAC) members Saginaw Valley State and Grand Valley State ranked seventh and eighth place, respectively.
Nationally, the Bulldogs are ranked eighth with 285 points the latest (April 8) National Fastpitch Coaches Association (NFCA) Division II Top 25 Poll.
Ferris State, which is currently 26-4 overall and 12-2 in the GLIAC this season, returns to the diamond Tuesday (April 14) for a two-game conference series against West Michigan archrival Grand Valley State in Allendale, Mich. Game one of the league twinbill will start at 3:30 p.m. (EDT) with game two to follow around 5:30 p.m. (EDT). The two outings represent the first of six consecutive conference road encounters for the Bulldogs, who have won nine of their last 10 encounters to date.

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Ganga Memorial College of Polytechnic
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Ganga Memorial College of Polytechnic is situated at Ganga Memorial College of Polytechnic At- NH-31, Harnaut, Nalanda Bihar- 803110 in Nalanda.
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Ganga Memorial College of Polytechnic - GMCP
Ganga Memorial College of Polytechnic aims at providing industry relevant education and training to its students with well crafted practical training Programme for the students in different semester of the courses. The students moving to the second year are provided within house training facilities in the fields like 'software development, computer networking, computer applications, internet technology, electronic hardware design, simulation and analysis etc. Also the students moving to the final year are being trained in the real workplace, i.e. factories, industrial installation and R&D centers etc. The mission of the organization is to set up a quality Technical College to provide education to the enspiring students with support and guidance from highly qualified experienced professors of the college. They will be groomed into competent technical professional. Such well groomed technical professionals with work and social ethics coming out of the College will, in their respective field of excellence, serve the industry, plan their roles in industrial and commercial growth of the state and will lead the nation to a path of industrial growth and prosperity. The mission of the college is to provide for excellence in technical education, to develop strong communication skills in the students, to create awareness for Social, Historical, Ethical, Cultural and Human values, to create a culture for self and lifelong learning and to create an intellectual spirit and capability for critical judgment.
Why join Ganga Memorial College of Polytechnic
Th college spread over in wide area.
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The institute is known for its hospitality, and we strive hard to keep up the tradition. In case wehave inadvertently slipped somewhere, I offer my sincere apologies. Our academic programme is amongst the best in the country. It provides an optimum level of practical knowledge, with strong bias on industrial applications. While the depth of training in engineering subjects is unquestioned, the span of our curriculum is often overlooked. The GMCP student learns subjects across departmental boundaries and excels in extracurricular activities. The mix of technology and management skills that a GMCPan possesses makes him an invaluable asset to any company he works for. With FIVE departments awarding degrees in diploma level engineering, we are one of the most diversified institutions. Whether you are young or old as a company, whether your business is in coal mining or in data mining, whether the job you are offering is in the shop floor or in R&D, have the right engineer and scientist for you. We give you freedom and extend to you all physical facilities to carry out your own recruitment process on our campus. In case you have a time constraints or other inconvenience, we shall only be too glad to meet your selection team in another city.
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I might have a slight infection. What do you think? Do I need antibiotics orally? (photos)
Doctor Answers 9
Slow healing behind the ear after Facelift
You certainly should not be alarmed. You appear to have a little loss (slough) of skin accompanied by light scabbing. This is very common behind the ear after facelift because the blood supply is limited in this area. The increased redness of the surrounding skin does not necessarily indication infection, however, the small white bumps toward the bottom of the photo are sometimes associated with certain bacterial infections such as Staph. In my practice, I would recommend soaking the entire area behind your ear (including the occipital hairline incision) with a low strength acetic acid solution made from water and white vinegar. I would recommend that you soak it several times a day for about 5-10 minutes at a time. The acetic acid solution can help break down the crusty scab and has a well known anti-bacterial effect. After soaking or bathing, I would apply a generous amount of antibiotic ointment. I would not do any of this, however, without first consulting with your surgeon. He/she will want to keep a close eye on the situation and may prescribe antibiotics if you worsen or fail to show definite signs of improvement.
Web reference: http://ridenourplasticsurgery.com/Procedures/Facial-Cosmetic-Surgical-Procedures/Face-and-Neck-Lift
Open wound after surgery behind the ear
My answer depends on the cause of the problem and the procedure.
If the ear cartilage was involved in your surgery, e.g. an ear setback, I would prescribe antibiotics to protect the cartilage. If it was skin surgery, I would only treat it locally unless the redness was spreading or you had pain, fever or increasing odor, drainage or fatigue.
Your surgeon, not the nurse, should see you.
This is a surgical complication which s/he needs to personally direct.
Always see a Board Certified Plastic Surgeon.
Hope this information is helpful. Best wishes!
Infection after surgery
You aren't sure its getting any better but is it getting any worse? Its essential to continue following the advice of your plastic surgeon over the next two days and then an assessment can be made by your surgeon about oral antibiotics at your post operative appointment. If you begin to feel unwell or the wound appears to get worse then you should advise your surgeon.
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Postoperative healing after facelift
Because an infection is a risk that is very, very important to avoid, most surgeons would want to err on the side of safety when it comes to treating. Because there is a small open area, however, at least any potential infection could drain.
The wound care instructions you received are helpful. I would put safety first and see your surgeon in person, so they can make the diagnosis firmly and treat as appropriate.
Wound crusting and reddness
Do I have an infection?
One of the key guideleines I give is that I want to know if you think there is a problem. The surgeon who performed the procedure is the one to offer advice, and would rather know of your concerns sooner than later.
I suggest give them a call and ask their advice.
Jeremy Hunt
Web reference: http://www.drjeremyhunt.com.au
Healing after surgery
Minor wound healing issues after facelift are not necessarily infections.
Web reference: http://www.zubowicz.com/procedures/facelift/
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


text: Anyone have any instruction on the wiring I need to lead into my amp from the head unit? http://www.amazon.com/Rockford-Fosgate-R2S-1X10-10-Inch-Enclosure/dp/B0068XYNH4 http://www.amazon.com/PAC-SNI35-Adj...ywords=line+out+converter+with+remote+turn+on http://www.amazon.com/KIT-2-Complete-Gauge-Amplifier-Installation/dp/B000FKP7TY/ref=pd_bxgy_e_text_y Already have a 1000 watt amp, going for the under floor above the tire setup. What's the easiest location to hook the converter up too? And is there anything I'm over looking?


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RPT-UPDATE 2-Toronto stocks buoyed by strong resource issues
(Refiles to fix typo in headline) (Updates stock prices, adds details, quotes)
TORONTO Feb 25 (Reuters) - The Toronto Stock Exchange's main index surged higher on Monday, led by gains in the energy and materials sectors.
The oil and gas sector gained 2.4 percent, as crude prices pushed above $99 a barrel, buoyed by rising heating fuel futures.
Canadian Natural Resources CNQ.TO was up C$3.08, or 4.5 percent, at C$71.70, while Suncor Energy SU.TO rose C$2.17, or 2.2 percent, to C$99.68.
The materials sector, home to resource shares, gained 0.7 percent. Inmet Mining IMN.TO rose C$2.57, or 3 percent, to C$89.07, while Potash Corp of Saskatchewan POT.TO was up C$4.69, or 3 percent, at C$163.21.
"People are looking for areas where they can see longer term value and I think, looking through this year, people are beginning to focus in on (materials and energies)," said Michael Sprung, president of Sprung & Co. Investment Counsel.
The S&P/TSX composite index .GSPTSE was up 96.87 points, or 0.71 percent, at 13,682.80 with six of its 10 main sectors in the negative.
The benchmark rose alongside stocks south of the border after Standard & Poor's said it had removed U.S. bond insurer MBIA Inc MBI.N from credit watch. Concerns that bond insurers could be downgraded have contributed to market jitters over the credit crunch.
The ratings agency also affirmed Ambac Financial Group Inc's ABX.N credit grade, while talk of a rescue plan for Ambac added to the optimism. Continued...


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2 weeks post tummy tuck fleur de lis, is this a good healing scar? (Photo)
I am 16 days post tummy tuck fleur de lis, and my doctor says my scar is healing well i get a bit paranoid, is this a good sign that my scar is healing well and what can i do about the black spots.
Doctor Answers 7
Excellent Result
Hi - for 2 weeks post op your result looks excellent. I believe your surgeon has done a great job. Continue to follow their advice regarding your care. All the best
Abdominal scar healing
looks like your surgeon did a great job and you appear to be doing well. Use sunblock, wear a firm but not tight garment and massage your scar in its direction highly with a lubricant. All will help to mature your scar quickly and do keep your regular cisits.
Good healing?
Thank you for your question. Sounds like you may need a little reassurance. The Fleur de lis procedure is a bit more involved than a standard tummy tuck. Your incisions look to be healing very nicely at two weks. Follow your surgeons instructions diligently. Scars can take up to a year or more to fully mature. So be patient. You look to have a very nice result!Best Wishes,
Dr. Morrissey
Dr. Morrissey
You might also like...
Scar healing after tummy tuck takes time
Thank you for posting your photograph. Of course, your surgeon is the best source of information about the course of healing, I do not see anything in this photograph that would make me concerned about a wound healing problem. There is some crusting along the incision lines, which is certainly normal, and a little redness along the incisions, but limited to a short distance from the incision, which is also normal.Things to watch for would include redness spreading beyond the area of the incisions, and especially increased pain, which could indicate infection.Patients are often anxious about the course of healing, which is certainly understandable, and it can be hard to be patient, but there is nothing anyone can do to make it heal faster. I recommend you speak with your surgeon whenever you have a concern, and remember that when you have surgery, it will take a while to completely heal.
2 weeks post op, some advices:
Thank you very much for sharing your concerns with us.At this point (2 weeks post-po) the swelling is normal.
To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts.
Kind regards,
Dr. Emmanuel Mallol Cotes.-
To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts.
Kind regards,
Dr. Emmanuel Mallol Cotes.-
Post TT scar concerns
Thank you for your question. You are healing good and wound healing well as expected. Scar maturation usually takes about 6-9 months. Please follow instructions from your PS
Post-Op Scar Healing
Well, I can tell you what I tell my patients and that is healing after the #tummytuck will take time. I have my patients out of bed and walking the night of surgery and every hour while awake. I allow my patients to return to work at one to two weeks with 14 days preferred. No lifting or straining. At three weeks increased level of activity and full, no restrictions, at 6 weeks.Swelling can persist for several months and will gradually improve and will look better at three months, six months, and even one year. Frequently the pubic area can become very swollen and discolored during the first two weeks due to gravity as this is the lowest area for swelling to accumulate. I can tell you that you appear to have minimal swelling which looks good, just be sure to care for the incisions well.
Web reference: http://www.horowitzmd.com/plastic-surgery-procedures-newport-beach/abdominoplasty/
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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New Braunfels Herald Zeitung (Newspaper) - January 18, 1987, New Braunfels, Texas Lawyers in like Appraisal Notes am Reappraisal frequency not static The Comal County Bar Assoc, has elected new officers for 1987. Mark Clark is now the president, Ron Friesenhahn is vice president, and Carter Casteel is secretary Texas may open prisons HUNTSVILLE, Texas (AF*) The Texas prison system may start admitting inmates as usual on Monday after making weekend releases, officials said Saturday "It looks Uke we'll be below the 95 percent capacity by Monday We have atiout 80 we can release today and we will release some more tomorrow,'' Brown said The nation's second largest pnson system closed its doors Fit day after the population exceeded a court-ordered 95 percent capacity with 38,414 inmates incarcerated at midnight Thursday At 95 percent, the 26 prison units can legally confine 38.376 inmates. Texas Department of Corrections spokesman Charles Brown said Castro family seeks help in paying for relative's transfer treasurer. Pictured above, Clark (left) presents a plaque to 1986 president Mike Smithers (right) in appreciation for his ser vices. Offices close to honor MLK City, county, state and federal of flees will be closed Monday in memory of Dr Martin Luther King Although King s birthday anniver sary was Jan 15. the official celebre lion is the third Monday of the month This is the second year the ob ser Vance has been a national holiday The U.S. Postal Service will not deliver mail on Monday and most banks and savings and loans will be closed How often must my property be reappraised? Until 1982, the frequency of reappraisals in Texas really depended upon each individual taxing jurisdiction. Some jurisdictions reappraised every year or two, some every four of five years, and others might have appraised improvement only when they were first built. There are many individual taxing units across the state, and there were different opinions as to how often property should be reappraised, and at what levels those appraisals should be. There were different levels of funding, and the level of appraisal and frequency of reappraisal sometimes depended to a great extent upon how well each individual tax office was staffed. With passage of Senate Bill 621, or the "Peveto Bill," the Legislature specifically mandated that reappraisals be conducted at least every four years This seemed at first to be a comfortable timetable, since appraisal districts would only need to review existing values every four years From a property owner's viewpoint, however, this meant the possibility of a sizeable increase every time his property was reap-preaised There is another serious problem with a four year reappraisal cycle The State Property Tax Board con ducts a ratio study each year, to determine how close the values in each appraisal district are to market value These ratio study results eventually become part of the calculation used in determining the amount of state aid each school district will receive If assesed values are below what the state feels is current market, the school districts are penalized by a decrease in the amount of money they would have received had the values been at IOO percent When appraisal districts first began, values in many cases were well below actual market value, and the increase in assessed value in 1982 was drastic formost people According to State Property Tax Board studies, overall values within the jurisdiction of the Comal Appraisal By DAV ID MAY Staff Writer New Braunfels relatives of a woman who died last month of mysterious circumstances have raised half the monies needed to bring her body home to be laid to rest alongside her mother Family members of Rosa Castro, a New Braunfels native who was found dead in her Seguin residence last Dec. 12, said Friday that are still some $500 short of having enough money to cover costs having her body transferred from her Seguin burial site to Comal County. Sandra Martinez, sister of the deceased, said relatives are still searching for help from groups and persons in the community interested in assisting the family in their wishes "We still need some help and we're looking and asking all around," Martinez said. A local church group is expected to make a donation to the family on Sunday to help defray costs. Seguin authorities discovered the 45-year-old woman dead in her living room after tieing summoned to the residence by her brother, Richard Castro, who lived there with his wife Seguin District Attorney WG Kirkendall confirmed that the woman had sustained numerous injuries including several broken ribs and bruises over much of her body According to the Travis County Medical Examiner's office, who per formed an autopsy at the request of authorities, determined the woman died of a stroke that resulted from a blood clot Their report showed that the woman received a severe blow to the back of the head that may have lead to the stroke. Prosecutors have been unable to determine the exact nature of the woman's injuries, due largely to the lack of cooperation of the brother, who arranged (or her burial in Seguin The case went before the Guadalupe County grand jury Jan. 8,though the jury passed on making any determinations "The people involved are not being very cooperative," Seguin Assistant District Attorney Sean Proctor commented Thursday adding that investigators hope to return to the grand jury Feb 5 with more findings. Richard Castro had been subpoenaed to fortify before the grand jury though he refused No charges have hp*>n filed in connection with the woman's mysterious death. Caus to the offices of defense attorneys for the brother went unreturned last week. Kirkendall refused early in the investigations to speculate on the causes of the woman's injuries, saying ''We don't know if they were the result of an attack or an accidental tau." He committed to no theory or motive In the Incident. An officer with the Cornel County office of the Department of Human Resources confirmed Thursday visiting the woman at her home on several occasions but was unable to report the reasons or findings of those visits Martinez said in an earlier article that she believed her brother was responsible for the sister's death Though the woman died Dec 12. family members here were not aware of it until an uncle saw a story in a San Antonio newspaper Martinez said that, after talking to the funeral home with whom burial arrangements were made, the woman had been placed in a very inexpensive casket, one prone to leaking and decay. She noted that the family needs to raise about $600 for a sealed casket and some $250 to open her grave and have her brought here and laid back to rest alongside her mother who passed away in 1983 Relatives lack the monies needed to make the transfer OIL CHANGE & LUBRICATION TRANSMISSION SERVICE 1466 So Seguin FRANCES BRIDGES ie there for you with Scrapbook every Thursday in the Herald-Zritung Mi 9omumij Sate at Clriiui-K-Tluiup Sane 20-50% oh Sick RrtoE fkviMQMuih Fine Onptaf.Stfue* & Sfautfieao Btatft & Vomoim 9tem Him & Kitchen Accmotto Lange Setectw oft faun* & (Muck HW!! Bui Huwtj, Sate Hub Week Orig 9mI9fk - 24(k China-n-Things Bridal Ragistry Unda Plaza Shopping Center District after the 1982 reappraisal were still only at 78 percent of actual market value. There was no reappraisal in 1983 or 1984, and the 1984 ratio study showed that assessed values in the district had dropped to 67 percent of market value. A major reappraisal was begun in 1985. and the ratio study for that year indicated that overall values were at 87 percent Ratio study figures for 1986 have not yet been released, but should show an improvement over 1985 figures Reappraisals have been very painful for most of us the last few years, to say the very least, because they have been so drastic The purpose of the Peveto Bill was to create equality and uniformity, and the guideline used was market value Once this level has been reached, appraisal districts will no longer need to play catch up, and increases inassessed value should follow the market A reader of Appraisal Notes has written the following Question: Gentlemen. I wasn't sure to whom I should write concerning this question but am a faithful reader and hope that you can either answer or refer me to the proper party We live on and own the lots adjacent to a cemetery lot her at Canyon Lake, which has two tombstones dated in the 1800's We would like to purchase that lot as it is not kept up and impacts negatively on our property. Can I buy it and. if so to whom do I direct my inquiry^ If I cannot buy it, can I still run my fence around it? Sincerely, D L. Answer: A check of appraisal records shows this lot to be specifically noted onthe plat as a cemetery lot, and no trasfer of ownership from the original developer has been found Title may lie with the developer, but descendents of the persons buried there could also have some claim to the property You may contact either the county clerk's office or the abstract department of the appraisal district if you wish further deed information You should consult an attorney before placing a fence around this property (APPRAISAL NOTES is a public service of Comal County Central Appraisal District. Questions and comments regarding property appraisal functions can be sent to the district in care of the Herald-Zeitung. 196 S. Caste!!. New Braunfels, Texas. 78131-1328 I BEST FOR LESS TRAVEL CLUB TOURS LOWEST PRICES FROM THE AREA EARLY RESERVATION DISCOUNTS WITH (T^AKA BRADI N Of AUSTIN I X( HINO TRIPS CARIBBEAN CHI ISH TOI R ESPECIALLY FOR SINGLE ADULTS MARCH 14 21-8 WON DER FVL DAYS IN SUN KISSED AREAS AT THE RIGHT TIME OF THE YEAR CAP HAITIEN. HAITI. SAN JUAN. ST THOMAS & PUERTA PLATA. DOMINICAN REPUBLIC-11,079-1M M E DI ATE RESERVATIONS NECESSARY FINLAND fi^jA fc QftfcAT NORTHERN CAPITOLS- JULY » JO 22 GRAND DAYS DENMARK SWEDEN FINLAND THE SOVIET UNION. POLAND. BERLIN & MUCH MORE- 49 MEALS INCLUDED ACT NOW TO GET DISCOUNT NEW YEAR CRUISE TOUR ABOARD THE CUNARD PRINCESS dec 26-J an 2 "st MA Aft TEN ANTI 611 A Gl'AftALfllTF. ST THOMAS-*, nm. ON THIS FESTIVE HOLIDAY CRUISE FLY-IN ft NOTORCOACH- Wf MALADY HA VT Rf SLRVATIONN GREAT PACIFIC NORTHWEST A CANADIAN ROCKIES WONDERLAND SI 179 IF kESERVATIONS MADE NOW JU NC 24 JULY 7 JULY IS a SEPT I—SAIT LAKE CITY. GRAND TETON S. YELLOWSTONE FABULOUS RIXTCIES. VANCOUVER. 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Alton Telegraph (Newspaper) - February 1, 1999, Alton, Illinois SERVING THE RIVER BEND SINCE 1836 f|l|| Region Updated ginde touts River Bend Page IM Bucket Brigade Seeking homes rn need of paint Page B-l The outlook Qoudy with a chance for rain; high near 47, low near 37 Page IM ; Stampede ! Broncos I trample i Falcons i 34-19 PageC-lVol. 164, No. 17 —50 cents Monday, February 1,1999 www.thetelegraph.com Area activist Area/Illinois.......A-3 Bulletin Board B-2 Comics........ .D-2 Editorial .....A-4 Nation/World ----B-3,4 Obituaries........A*5 Bruce, Lievers, Simpson, Stewart, Stites, Summers, Turner Television ....... D-3 Scoreboard.......C-2 Weather..........D-4 EDITOR'S NOTE: This is the final installment of a two-part series about the fight to control and cure multiple sclerosis, By BETHANY BEHRHORST Telegraph staff writer Fund-raisers are a vital part in trying to stomp out multiple sclerosis in the U.S. A concert held at Joshua's Convention Center in East Alton in January raised $1,000 for the cause. An annual walk-a-thon scheduled to take place April ll at Gordon Moore Park should raise more funds "It's a five-mile round-trip (walk) and lunch is provided when the walkers get back,** said Julie Full Lopez of Godfrey. "It's a nice, family thing to do." Full Lopez became a strong health care activist after being diagnosed Keeping clean without court Program to offer 'Supervision by Grafton group's park project finally blooming By SUE HURLEY For The Telegraph GRAFTON - A group of seven residents is finally seeing its efforts pay off in its struggle to create a focal point in Grafton. The Grafton Parks Committee has been working for almost five years to gain financial and other support to complete construction of the Grove Memorial ..................— Park on the corner of Illinois Routes 3 and KH) Plans include the _ installation of a round gazebo that will be surrounded by brick and stone walkways, stone benches, trees, landscaping and playground equipment. The one-square-block park is now decorated with a -Welcome to Grafton" sign, a park bench and a scattering of trees. In the summer, weekend farmers markets are held there "A lot of people didn't think this would ever be a reality, Telegraph Towns but it's going to happen," said committee member Joyce Harmon, who has sold engraved bricks and paving stones that will be laid in place on park grounds soon "We've worked very hard on this since 1994 to get it all together." The city was recently awarded a Federal Highway Administration grant , of $106,500 for parking areas and —— restrooms. The Illinois Department of Natural Resources has also pitched in with $191,000 in matching funds. AmerenUE donated $5,000 for the installation of lights. City officials have also been holding fund-raisers to help pay for the park's many amenities. About $6,000 annually has been raised for several years at the city's Indian Summer Days festivities, where volunteers have fried thousands of pounds of fish in a grass-roots ......................... > v # ■ See PARK, Page A-7 By DENNIS GRUBAUGH Telegraph staff writer EDWARDSVILLE - County officials will soon let more traffic offenders pay for their misdeeds by mail. Traffic ticket forms have been distributed to area police departments for a new program called "Supervision by Mail." The program is aimed at giving traffic offenders u chance to keep their driving records clean without the hassle of coming to court to do it. "Prior to this (drivers) had two choices; mail in their guilty plea, which would give them a conviction on their driving record, or they could appear in court, where they could request supervision (and avoid a mark on their record)," said Assistant State's Attorney Thomas Gibbons. "This way we're bypassing their need to come to court. This gives them the opportunity to keep their driving record clean." Offenses will be kept off their driving record as long as motorists don't commit subsequent offenses during the period of their supervision, which generally runs 60 to 180 days, he said. Those who qualify are people who haven't had court supervision for the last year on traffic offenses where they were not required to appear in court, Gibbons said. Only minor infractions will be considered for the program, such as some speeding tickets and moving violations like failure to use turn signals and improper lane usage. The Telegraph/M ARG IE M BARNES Pastor Dave Runyan, of Grace Community Church in Bethalto hands out door prizes to children Sunday during the Super Bowl Blast at East Alton Recreation Center. Super Bowl Blast a touchdown with teens By REBECCA HOPKINS Telegraph staff writer EAST ALTON - The Keasler Complex was Super Bowl central oh Sunday when nearly IOO teens from the area gathered to watch the game, eat junk food and generally share in fun with others of the same age group Sponsored by the Rev. Dave ("Pastor Dave") Runyan and the Grace Community Church in Bethalto, the fourth annual Super Bowl Blast was a safe gathering for teens. Even the adults were having fun no matter how much effort it cost them. Organizers Scott Campbell and Clifton Champlin just wanted to give teen-agers a place to gather and have fun. Campbell is a 17-year employee of the East Alton Recreation Dept, and a member of the church. Champlin works with the church's youth group. ■ See BLAST, Page A-7 People with DUIS, multiple-violation offenses and tickets from accidents can still count on coming to court, Gibbons said. The program has been in the works since fall, when Chief Judge Andy Matoesian suggested it as a means of convenience to the public. Response to the idea shows broad approval. "The state's attorney wants it, the judges want it and the circuit clerk wants it," Matoesian said. The chief judge handed the task of organizing the program to Chief Associate Judge Randall Bono. Bono said the public will have plenty of reasons to support the concept. "Right now, people have to take off ■ See MAIL, Page A-7 The Telegraph/STEVE WHITWORTH A crowd begins to gather for the weekly traffic docket at the Madison County Courthouse in Edwardsville. The "Supervision by Mail" program may soon help cut down on these crowds.helps fund fight against multiple sclerosis with MS 19 years ago. She has a 16-year-old son and works as a writing instructor for the department of instructional services at Southern Illinois University Edwardsville and a general education instructor at Sanford Brown Business College. It takes all the energy she cad muster in her spare time to volunteer for the Gateway Area Chapter of the National Multiple Sclerosis Society. She and Jeanette Hazen are chairwomen of this year's walk-a-thon. Full Lopez said the walk should generate more than $350,000 in the Metro East, The Illinois Department of Transportation, the City of Alton, the Alton Police Department and the' city's Public Works Department all are cooperating to make the event possible. The money generated locally from various events is given to the Gateway Area Chapter of the National MS Society, the money is used for research projects aimed at find a cure for the illness, as well as to expand on existing advocacy programs, support groups for individuals and their caregivers and educational classes. Full Lopez said she believes in the society and its work She went without treatment for 14 years after being diagnosed. Then she said the development of new drugs made her future brighter. Full Lopez said ifs important for those newly diagnosed with the illness to seek out advice from doctors regarding medications and other treatments "You go on treatment so you don't get that bad," she said Avonex, Betaseron and Copaxone are the three drugs used to prevent exacerbations, which are flare-ups of ■ See ACTIVIST, Page A-7 The Telegraph/RUSS SMITH Julie Full Lopez has been a strong voice for legislation on multiple sclerosis. TIO H. Adams Parkway Alton, IL 62002 466.5301 HUGE SAVINGS ON ALL SPAS Nordic Hot Tubs ;
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The Rockies' Troy Tulowitzki left today's game vs. the Nationals after he felt discomfort fielding a groundball. He has had rib issues in the past and it was initially believed to be sore muscles. However, according to the Denver Post, Tulo has a broken rib and will be on the DL for a while, as I'm sure he probably can't even swing a bat.
An MRI Thursday night of Troy Tulowitzki's right side revealed a broken rib, according to two major league sources. Tulowitzki is likely facing a lengthy absence.
Tulowitzki was having difficulty breathing after his injury, pointing to a possible rib or intercostal muscle issue. The two-time all-star shortstop has been dealing with soreness in the rib area for a few days, but it wasn't serious enough to prevent him from playing.
Because of the torque involved to swing a bat, a serious rib injury could take several weeks to heal before the player is able to play again. Tulowitzki was clearly worried before heading to the hospital, leaving teammates bracing for the worst.
This, of course, comes after Dexter Fowler and Carlos Gonzalez were both involved in an ugly collision. The Rockies are currently 2.5 games back of the Diamondbacks in the NL West.


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Urinary System. Radiographic examinations of the urinary system are among the most common contrast media procedures performed in radiology departments. The urinary system consists of two kidneys, two ureters , one urinary bladder , and one urethra.
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Radiographic examinations of the urinary system are among the most common contrast media procedures performed in radiology departments. The urinary system consists of two kidneys, two ureters, one urinary bladder, and one urethra
The two kidneys and the ureters are organs that lie in the retroperitoneal space. These two bean-shaped organs lie on either side of the vertebral column in the most posterior part of the abdominal cavity. The right kidney generally is slightly lower or more inferior than the left because of the presence of the liver. Near the upper medial part of each kidney is a suprarenal (adrenal) gland. These important glands of the endocrine system are located in the fatty capsule that surrounds each kidney.
Each kidney is connected to the single urinary bladder by its own ureter. Waste material, in the form of urine, travels from the kidneys to the bladder via these two narrow tubes, termed ureters. The saclike urinary bladder serves as a reservoir that stores urine until it can be eliminated from the body via the urethra.
The Latin designation for kidney is ren, and renal is an adjective that is commonly used to refer to the kidney.
Anterior view
Posterior view
Kidneys the posteriorly placed kidneys lie on either side of the vertebral column in the upper posterior abdomen. They lie posterior to the lower portion of the liver on the right and posterior to the lower spleen on the left . The lower ribcage thus forms a protective enclosure for the kidneys.
Ureters most of each ureter lies anterior to its respective kidney. The ureters follow the natural curve of the vertebral column. Each ureter initially curves forward, following the lumbar lordotic curvature, and then curves backward on entering the pelvis. After passing into the pelvis, each ureter follows the sacrococcygeal curve before entering the posterolateral aspect of the bladder
The urethra connects the bladder to the exterior. The urethra exits from the body inferior to the symphysis pubis.
The entire urinary system is either posterior to or below the peritoneum. The kidneys and ureters are retroperitoneal structures, whereas the bladder and urethra are infraperitoneal structures.
The usual orientation of the kidneys in the supine individual is shown below. The large muscles on either side of the vertebral column cause the longitudinal plane of the kidneys to form a vertical angle of about 20° with the midsagittal plane. These large muscles include the two psoasmajor muscles. These muscle masses grow larger as they progress inferiorly from the upper lumbar vertebrae. This gradual enlargement produces the 20° angle, wherein the upper pole of each kidney is closer to the midline than its lower pole
These large posterior abdominal muscles also cause the kidneys to rotate backward within the retroperitoneal space. As a result, the medial border of each kidney is more anterior than the lateral border.
Transverse cross-sectional views through the level of L2 illustrate the usual amount of backward rotation of the kidneys.The normal kidney rotation of about 30° is due to the midline location of the vertebral column and the large psoas major muscles on either side. The quadratus lumborum muscles also are shown on each side just posterior to the kidneys. The deep muscles of the back include the group of erector spinae muscles on each side of the spine.
When posterior oblique projections are used during radiographic studies of the urinary system, each kidney in turn is placed parallel to the plane of the image receptor. The body is rotated about 30° in each direction to place one kidney, and then the other, parallel to the IR plane. A 30° LPO positions the right kidney parallel to the IR, and a 30° RPO positions the left kidney parallel.
Most abdominal radiographs are performed on expiration with the patient supine. The combined effect of expiration and a supine position allows the kidneys to lie fairly high in the abdominal cavity. Under these conditions, the kidneys normally lie about halfway between the xiphoid process and the iliac crest. The left kidney normally lies about 1 centimeter more superior than does the right one. The top of the left kidney is usually at the level of the T11-T12 interspace. The bottom of the right kidney most often is level with the upper part of L3
Because the kidneys are only loosely attached within their fatty capsule, they tend to move up and down with movements of the diaphragm and position changes. When one inhales deeply, the kidneys normally drop about 1 inch (2.5 cm) or one lumbar vertebra. When one stands upright, the kidneys normally drop about one lumbar vertebrae, or 5 centimeters (2 inches). If the kidneys drop farther than this, a condition termed nephroptosis is said to exist. With some very thin and older patients in particular, the kidneys may drop dramatically and end up within the pelvis, which may create problems caused by "kinking" or twisting of the ureters.
The primary function of the urinary system is the production of urine and its elimination from the body. During urine production, the kidneys perform the following functions:
1.Remove nitrogenous wastes
2.Regulate water levels in the body
3.Regulate acid-base balance and electrolyte levels of the blood
Nitrogenous waste products such as urea and creatinine are formed during the normal metabolism of proteins. Buildup of these nitrogenous wastes in the blood results in the clinical condition termed uremia and may indicate renal dysfunction.
The average water intake for humans during each 24-hour period is about 2.5 L (2500 ml). This water comes from ingested liquids and foods and from the end products of metabolism. This 2.5 L of water eventually ends up in the bloodstream. Vast quantities of blood are filtered every 24 hours. At rest, more than 1 L of blood flows through the kidneys every minute of the day, which results in removal of about 180 L of filtrate from the blood every 24 hours. More than 99% of this filtrate volume is reabsorbed by the kidneys and returned to the bloodstream. During the reabsorption process, blood pH and quantities of various electrolytes, such as sodium, potassium, and chloride, are regulated.
The macroscopic internal structure of the kidney.The outer covering of the kidney is termed the renal (fibrous) capsule. Directly under the renal capsule surrounding each kidney is the cortex, which forms the peripheral, or outer, portion of the kidney. Under the cortex is the internal structure termed the medulla, which is composed of from 8 to 18 conical masses termed renal pyramids. The cortex periodically dips between the pyramids to form the renal columns, which extend to the renal sinus.
The renal pyramids are primarily a collection of tubules that converge at an opening at the renal papilla (apex) and drain into the minor calyx. Calyces appear as hollowed, flattened tubes. From 4 to 13 minor calyces unite to form two to three major calyces. The major calyces unite to form the renal pelvis, which appears in the shape of a larger flattened funnel. Each expanded renal pelvis narrows to continue as the ureter. Thus urine formed in the microscopic or nephron portion of the kidney finally reaches the ureter by passing through the various collecting tubules, to a minor calyx, to a major calyx, and then to the renal pelvis.
The general term renal parenchyma is used to describe the total functional portions of the kidneys, such as those visualized during an early phase of an intravenous urogram procedure.
The structural and functional unit of the kidney is the microscopic nephron. Approximately one million nephrons exist within each kidney.. Small arteries in the kidney cortex form tiny capillary tufts, termed glomeruli(glo-mer′-u-li). Blood initially is filtered through the many glomeruli.
The ureters transport urine from the kidneys to the urinary bladder. Slow peristaltic waves and gravity force urine down the ureters into the bladder. This is an image taken 10 minutes after injection of contrast media into the bloodstream performed as part of an intravenous urogram procedure.
The renal pelvis leaves each kidney at the hilum to become the ureter. The ureters vary in length from 28 to 34 centimeters, with the right one being slightly shorter than the left.
As the ureters pass inferiorly, they lie on the anterior surface of each psoas major muscle. Continuing to follow the curvature of the vertebral column, the ureters eventually enter the posterolateral portion of each side of the urinary bladder.
The ureters vary in diameter from 1 millimeter to almost 1 centimeter. Normally, three constricted points exist along the course of each ureter. If a kidney stone attempts to pass from kidney to bladder, it may have trouble passing through these three regions.
The first point is the ureteropelvic(u-re′-ter-o-pel′-vic)(UP) junction, where the renal pelvis funnels down into the small ureter. This section is best seen on the radiograph in.
The second is near the brim of the pelvis, where the iliac blood vessels cross over the ureters.
The third is where the ureter joins the bladder, termed the ureterovesicaljunction, or UV junction. Most kidney stones that pass down the ureter tend to hang up at the third site, the UV junction, and once the stone passes this point and moves into the bladder, it generally has little trouble passing from the bladder and through the urethra to the exterior.
The urinary bladder is a musculomembranous sac that serves as a reservoir for urine. The empty bladder is somewhat flattened and assumes the more oval shape only when partially or fully distended.
The triangular portion of the bladder along the inner, posterior surface is termed the trigone . The trigone is the muscular area formed by the entrance of the two ureters from behind and the exit site of the urethra. The trigone is firmly attached to the floor of the pelvis. The mucosa of the trigone is smooth, whereas the remaining aspect of the inner mucosa of the bladder has numerous folds termed rugae. As the bladder fills, the top of the bladder expands upward and forward toward the abdominal cavity.
The bladder functions as a reservoir for urine and, aided by the urethra, expels urine from the body. Normally, some urine is in the bladder at all times, but as the amount reaches 250 ml, the desire to void arises. The act of voiding (urination) is normally under voluntary control, and the desire to void may pass if the bladder cannot be emptied right away. The total capacity of the bladder varies from 350 to 500 ml. As the bladder becomes more and more full, the desire to void becomes more and more urgent. If the internal bladder pressure rises too high, involuntary urination occurs.
Venipuncture is defined as the percutaneous puncture of a vein for withdrawal of blood or injection of a solution such as contrast media for urographic procedures. In the past, venipuncture for urography was performed by physicians and laboratory or nursing personnel. However, in recent years, venipuncture has become part of the scope of practice for the diagnostic imaging professional.
Before contrast media is withdrawn from any vial or bottle, confirmation of the correct contents of the container, route of administration, amount to be administered, and expiration date is imperative.
Water-soluble, iodinated contrast media is used for radiographic examinations of the urinary system. This type of contrast medium can be administered by either bolus injection or drip infusion.
A bolus injection is one in which the entire dose of contrast media is injected into the venous system at one time. This method of administration is used typically for maximum contrast enhancement.
Bolus injection
Drip infusion is a method whereby contrast media is introduced into the venous system via connective tubing attached to the IV site. A specified amount of contrast media is introduced over a specified period. This method is used most frequently when the drip infusion catheter is already in place for repeated or continuous infusions.
The contrast media is contained in an IV solution bag or bottle that is inverted and connected to the tubing. The rate of infusion, which may be gradual or rapid, depending on the needs of the study, is controlled by a clamp device located below the drip chamber on the IV tubing.
The following is a list of supplies needed for performance of venipuncture:
•Sharps container
•70% isopropyl alcohol
•Various sizes of butterfly and over-the-needle catheters
•Disposable or prefilled syringes
•IV infusion tubing
•Arm board
•Cotton balls or 2 × 2–inch (5 × 5 cm) gauze
•Tape or securing device like Tegaderm
•Gloves (latex-free recommended)
•Contrast media
During introductions, proper identification of the patient, and the explanation of the procedure, the mental and emotional status of the patient must be assessed. This assessment may confirm that the patient is more comfortable lying down, especially if syncope (temporary loss of consciousness) is a concern.
Venipuncture is an invasive procedure that carries risks for complications, especially when contrast media is injected. Before beginning the procedure, the technologist must ensure that the patient is fully aware of these potential risks and has signed an informed consent form. If a child is undergoing venipuncture, the procedure should be explained to both the child and the guardian, and the guardian should sign the informed consent form.
The two major types of iodinated contrast media used in urology are ionic and nonionic.
For many years, patients received a type of organic, iodinated contrast medium referred to as ionic. This contrast agent contains iodine as the opacifying element and other chemical components that create a complex molecule. The parent compound of the molecule is a carboxyl group in the form of benzoic acid, to which other chemical components (side chains) are attached. Ionic, iodinated contrast media contain a positively charged side chain element called the cation. The cation is a salt, usually consisting of sodium or meglumine, or a combination of both. These salts increase the solubility of the contrast media.
Once injected, the cation dissociates from the parent compound or anion, thus creating two separate ions in the blood. This action creates a hypertonic condition, or an increase in the blood plasma osmolality. This increase in osmolality can cause vein spasm, pain at the injection site, and fluid retention. More important, ionic contrast agents may increase the probability that a patient will experience a contrast media reaction. Any disruption to the delicate balance of the body's physiologic functions may result in a reaction. This concept is the basis of the chemotoxic theory, which states that any disruption to the physiologic balance, called homeostasis, may lead to an adverse reaction. Increasing the number of ions in the plasma can disrupt homeostasis and create a reaction. Patients most likely to experience adverse contrast reactions to ionic contrast media are those with a history of previous contrast media reaction, asthma, known hematologic disorders, kidney, heart, or liver disease and/or diabetes.
Common commercial names of ionic contrast media include Hypaque, Conray, and Renografin. These various compounds all adhere to the three iodine atoms per two ion relationship. It is the combination of anion, cation, sodium content, iodine concentration, and viscosity levels that differs among the name brands.
In 1984, a new generation of contrast media was introduced into the United States, which also contains iodine needed for opacity but contains no positively charged cations. The ionizing carboxyl group is replaced with a nondisassociated group, such as amide or glucose. When dissolved in water, a nonionic compound forms with each molecule, also containing three iodine atoms. Therefore, when injected into the blood or other body cavities, the contrast medium remains intact. The term nonionic was coined to describe this type of contrast medium, based on its nonionizing characteristic.
Lower Osmolality and Less Chance of Reaction.
Because of their nonionizing nature, these contrast agents are of low osmolality and therefore do not increase the osmolality of blood plasma. Nonionic contrast media thus are near isotonic and are better tolerated by the body. Research indicates that patients are less likely to have contrast media reactions or more likely to have less severe reactions or side effects when nonionic contrast agents are used. The cost for nonionic contrast media, however, is greater than for ionic. Therefore, although many radiology departments use nonionic contrast media exclusively, others base their decisions to use nonionic contrast media on patient history and the potential for a reaction.
Common commercial names of nonionic contrast media include Omnipaque, Isovue, Amipaque, and Optiray. These compounds each contain the same three iodine atoms per ion composition. It is the iodine concentration and viscosity levels that differ among these name brands
Side effects occur in many patients as an expected outcome of injected iodinated contrast media. They are brief and self-limiting.
Two common side effects that may occur after an intravenous injection of iodinated contrast media are a temporary hot flash and a metallic taste in the mouth. Both the hot flash, particularly in the face, and the metallic taste in the mouth usually pass quickly. Discussion of these possible effects and careful explanation of the examination help to reduce patient anxiety and to prepare the patient psychologically.
Patient History
A careful patient history may serve to alert the medical team to a possible reaction. Patients with a history of allergy are more likely to experience adverse reactions to contrast media than are those who have no allergies. Questions to ask the patient include the following:
1.Are you allergic to anything?
2.Have you ever had hay fever, asthma, or hives?
3.Are you allergic to any drugs or medications?
4.Are you allergic to iodine?
5.Are you allergic to any foods?
6.Are you currently taking metformin, Glucophage, Glucovance, Avandamet, Diofen, Fortamet, Riomet, Actosplus Met, Diabex, or Metaglip?
7.Have you ever had an x-ray examination that required an injection into an artery or vein?
A positive response to any of these questions alerts the injection team to an increased probability of reaction.
The technologist must check the patient's chart to determine the creatinine and BUN (blood urea nitrogen) levels. These laboratory tests should have been conducted and reported in the patient's chart before the urinary study is undertaken. Creatinine and BUN levels are diagnostic indicators of kidney function. Elevated creatinine or BUN levels may indicate acute or chronic renal failure, tumor, or other conditions of the urinary system. Patients with elevated blood levels have a greater chance of experiencing an adverse contrast media reaction. Normal creatinine levels for the adult are 0.6 to 1.5 mg/dl. BUN levels should range between 8 and 25 mg/100 ml.
Metformin hydrochloride is a drug that is given for the management of non–insulin-dependent diabetes mellitus. Patients who are currently taking metformin can be given iodinated contrast media only if their kidney function levels are within normal limits. Because the combination of iodinated contrast media and metformin may increase the risk for contrast media–induced acute renal failure and/or lactic acidosis, the American College of Radiology recommends that metformin be withheld for at least 48 hours after the procedureand resumed only if kidney function is again determined to be within normal limits
Selection and preparation of the correct contrast media are important steps before injection. Because labels on various media containers are similar, one should always read the label very carefully several times. In addition, the empty container should be shown to the radiologist or the person who is making the actual injection. The empty contrast container should be kept in the exam room until the procedure is complete and the patient is dismissed, in the event of a contrast reaction
Because contrast media reaction is possible and unpredictable, a fully stocked emergency response cart must be readily available whenever an intravenous injection is made. In addition to emergency drugs, the cart should contain cardiopulmonary resuscitation equipment, portable oxygen, suction and blood pressure apparatus, and possibly a defibrillator and monitor.
The technologist is responsible for ensuring that the emergency drug cart is stocked and available in the room. Masks and cannula for oxygen support, suction tips, needles, and syringes must be readily available in the room. The status of this equipment and emergency drug cart should be verified before any contrast media procedure is undertaken.
A common emergency drug is epinephrine, which should be available along with a syringe and needle ready for use.
Premedication Procedure
To reduce the severity of contrast media reactions, some patients may be premedicated before an iodinated contrast media procedure is performed. The patient can be given a number of medications at different stages to reduce the risk of an allergic reaction to the contrast media. One of the common premedication protocols includes a combination of Benadryl and prednisone given over a period of 12 or more hours before the procedure. Patients who have a history of hay fever, asthma, or food allergy may be candidates for the premedication procedure. The technologist should ask patients whether they have received any premedication prior to the procedure and should note their response in the appropriate chart.
Categories of Contrast Media Reactions:
Four general categories of contrast media reactions have been identified:
(1) mild, (2) moderate, (3) severe, and (4) organ specific. These four reaction types are classified according to the degree of symptoms associated with the reaction
Mild:This nonallergic reaction typically does not require drug intervention or medical assistance. Two of these symptoms are also considered as side effects. This type of reaction may be based on anxiety and/or fear. Although this may not be a life-threatening situation, the technologist must be attentive to all needs of the patient. Symptoms of a mild reaction include the following:
•Metallic taste (common side effect)
•Mild erythema
•Warm, flush sensation during injection (common side effect)
•Mild, scattered hives
Possible treatment for a mild reaction might include having the patient breathe slowly, providing a cool wash cloth, and reassuring the patient. Continue to observe the patient to ensure that these symptoms do not advance into a more serious reaction.
Moderate:This second type of reaction is a true allergic reaction (anaphylactic reaction) that results from the introduction of iodinated contrast media. Symptoms of a moderate reaction include the following:
•Urticaria (moderate to severe hives)
•Possible laryngeal swelling
•Tachycardia (>100 beats per minute) or bradycardia (<60 beats per minute)Because moderate reactions may lead to a life-threatening condition, medical assistance must be provided without delay. Treatment often involves drug intervention to counter the effects of the reaction.
Severe:This third type of reaction, also known as a vasovagal reaction, is a life-threatening condition. The introduction of iodinated contrast agents stimulates the vagus nerve, which may cause the heart rate to drop and the blood pressure to fall dangerously low. Fast and prompt response from the medical team is required.Symptoms of a vasovagal reaction include the following
• Hypotension (systolic blood pressure <80 mm Hg)
• Bradycardia (<50 beats/minute)
• Cardiac arrhythmias
• Laryngeal swelling
• Possible convulsions
• Loss of consciousness
• Cardiac arrest
• Respiratory arrest
• No detectable pulse
A medical emergency must be declared immediately. Ensure that the emergency drug cart is nearby with oxygen and suction equipment available. Hospitalization for this patient is eminent.
Organ specific: This is the fourth and final type of contrast media reaction, in which specific organs are affected by the contrast media injection. These include the following:
•Cardiac system—pulseless electrical activity
•Respiratory system—pulmonary edema
•Vascular system—venous thrombosis
•Nervous system—seizure induction
•Renal system—temporary failure or complete shutdown.
•Extravasation—Leakage of iodinated contrast media outside of the vessel and into surrounding soft tissues
Extravasation—Suggested Treatment Protocol
Extravasated contrast media, particularly high-osmolity contrast agents, are toxic to surrounding tissues. Acute, local inflammatory response to the skin peaks 24 to 48 hours following extravasation of contrast media. Ulceration and tissue necrosis may result within 6 hours following the event.
Although consensus regarding treatment has not been reached, a common protocol for extravasation includes the following:
•Notify department nurse and/or physician so treatment can be administered quickly.
•Elevate affected extremity above the heart to decrease capillary pressure and promote reabsorption of extravasated contrast media.
•Use a cold compress followed by warm compresses to first relieve pain and then improve resorption of contrast media.
•Document the incident.
Following are common pathologic terms related to the urinary system that may be used to describe possible reactions to contrast media. These terms may be encountered in the patient's chart, the examination requisition, or the exam results report:
(an′-je-o-e-de′-ma) Regions or areas of subcutaneous swelling caused by an allergic reaction to food or drugs (i.e., lips, other parts of the mouth, eyelids, hands and feet)
(an-ur′-e-a) Complete cessation of urinary secretion by the kidneys; also called anuresis.
(bak-ter′-e-u′-re-a) Presence of bacteria in the urine.
(brad′-e-kar′-de-a) Slowness of heartbeat, usually <50 beats per minute.
(brong′-ko-spazm) Contraction of the bronchi and bronchiolar muscles, producing restriction of air passages.
(di′-u-ret′-ik) An agent that increases excretion of urine.
(fe′-kal-u′-re-a) Fecal matter in the urine.
(gloo′-ko-su′-re-a) Glucose in the urine.
(he′-ma-tu′-re-a) Blood in the urine.
(hi′-po-ten′-shun) Below normal arterial blood pressure.
(la-ring′-go-spazm) Closure of the glottic aperture within the glottic opening of the larynx.
(la′-siks) Brand name for a diuretic.
(lith′-o-trip′-se) A therapeutic technique that uses acoustic (sound) waves to shatter large kidney stones into small particles that can be passed.
(mik′-tu-ri′-shan) The act of voiding or urination.
(nef′-rop-to′-sis) Excessive downward movement of the kidney when erect.
(ol′-i-gu′-re-a) Excretion of a diminished amount of urine in relation to fluid intake, usually defined as less than 400 ml per 24 hours; also called hypouresis and oligouresis.
(noo′-mo-u′-re-a) Presence of gas in the urine, usually as the result of a fistula between the bladder and the intestine.
(pol′-e-u′-re-a) Passage of a large volume of urine in relation to fluid intake during a given period; a common symptom of diabetes.
(pro′-te-nu′-re-a) The presence of excessive serum proteins in the urine; also termed albuminuria.
Renal agenesis
(re′-nal a-jen′-a-sis) Absence of formation of a kidney.
Renal failure (acute or chronic)
The inability of a kidney to excrete metabolites at normal plasma levels, or the inability to retain electrolytes under conditions of normal intake.
The inability to void, which may be due to obstruction in the urethra or lack of sensation to urinate.
(sin′-ko-pe) Loss of consciousness caused by reduced cerebral blood flow; also called "fainting."
(tak-i-kar′-de-a) Rapid heartbeat, usually >100 beats per minute.
(u-re′-me-a) An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acid metabolism; often present with chronic renal failure; also may be called azotemia.
Urinary incontinence
Involuntary passage of urine through the urethra; commonly caused by failure of voluntary control of the vesical and urethral sphincters.
Urinary reflux
Backward or return flow of urine from bladder into ureter and kidney; also termed vesicoureteral reflux; a common cause of pyelonephritis, in which the backflow of urine may carry bacteria that can produce infection in the kidney.
Urinary tract infection (UTI)
Infection that frequently occurs in both adults and children and that is caused by bacteria, viruses, fungi, or certain parasites; commonly caused by vesicoureteral reflux.
(er′-ti-kar′-i-a) An eruption of wheals (hives) often caused by hypersensitivity to food or drugs.
Bladder calculi are stones that form in the urinary bladder. These stones are not as common as renal calculi, but they can grow quite large in the and may be radiolucent or radiopaque. The radiolucent stones are most often uric acid stones. The presence of bladder stones can make urination difficult. These stones may be demonstrated during an IVU or retrograde cystogram. They are seen clearly during a CT scan of the pelvis as well.
Congenital anomalies are structural or chemical imperfections or alterations present at birth.
•Duplication of ureter and renal pelvis involves two ureters and/or the renal pelvis originating from the same kidney. It is the most common type of congenital anomaly of the urinary system.* This anomaly usually does not cause a health concern for the patient. The IVU confirms this condition.
•Ectopic kidney describes a normal kidney that fails to ascend into the abdomen but rather remains in the pelvis. This type of kidney has a shorter than normal ureter. Although this condition does not pose a health concern for the patient, it may interfere with the birth process in females. Although an IVU will confirm the location of the ectopic kidney, sonography and CT of the pelvis also will demonstrate this anomaly.
•Horseshoe kidney occurs as a fusion of the kidneys during development of the fetus. Nearly 95% of cases involve fusion of the lower poles of the kidneys.* This fusion usually does not affect the function of the kidney. Because of fusion of the lower poles, the kidneys do not ascend to their normal position in the abdomen and typically are situated in the lower abdomen/upper pelvis. CT and sonography of the abdomen demonstrate this congenital condition, as does the IVU.
•Malrotation is an abnormal rotation of the kidney that is evident when the renal pelvis is turned from a medial to an anterior or posterior direction. The ureteropelvic junction (UPJ) may be seen lateral to the kidney. Usually, malrotation does not produce major complications for the patient.
Cystitis(sis-ti′-tis) describes an inflammation of the urinary bladder caused by a bacterial or fungal infection. It is seen most often in females because of the shorter urethra that more readily permits retrograde passage of bacteria into the bladder.
Polycystic kidney disease is a disorder marked by cysts scattered throughout one or both kidneys. This disease is the most common cause of enlarged kidneys. Its cause may be genetic or congenital, depending on the type of polycystic disease. These cysts alter the appearance of the kidney and may alter renal function. In some cases, the liver may have cysts as well.
Vesicorectal (vesicocolonic) fistula is a fistula (artificial opening) that forms between the urinary bladder and rectum or aspects of the colon. This condition may be due to trauma or tumor, or it may be a congenital defect.
Approximately 60% of fistulas result from diverticulosis (outpouching or herniation of an organ wall, usually in the small or large intestine). Another 20% are caused by an invading carcinoma, colitis, and trauma.* Pneumaturia and fecaluria are symptoms of a fistula.


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Renee's Rescue Round - Up! Adopt, FIND & SHARE!
Please help spread the word to adopt from a shelter first!!! Take a look at all the urgent animals here and see the Lost and Found Pound below too!!!
Artesia AKA#29 https://www.youtube.com/watch?v=y4oX7mXD7qo Female pit mix Approx 8 months old Approx 45 lbs This scared, sweet girl will steal your heart She is absolutely petrified at the shelter She would not walk at first, and had to be carried But with some gentle love and reassurance, she quickly showed that she is willing to trust and love right back! Tail wags came out when dogs were around https://www.youtube.com/watch?v=75kC_t5cP1s And here she is after five minutes, seeking out more love and giving kisses! https://www.youtube.com/watch?v=algFY08hqb4 She is an amazingly sweet girl that we are confident will thrive once she is in the loving home she deserves!! LEGAL DAY OF ADOPTION IS 7/22 IF INTERESTED IN ADOPTING PLEASE EMAIL firstname.lastname@example.com PLEASE TAKE ADOPTION SERIOUSLY, DOGS CANNOT BE RETURNED TO THE SHELTER. THANK YOU
URGENT DATE IS TUES 7/22 >>> TOMORROW <<< Poncho AKA #31 Male pit/lab mix Approx 2 years old Approx 55 lbs This boy is SOOOO Sweet! *** He did AWESOME with a child! *** https://www.youtube.com/watch?v=9mlwU_wQMlw This sweet boy is missing someone look at those pleading eyes.... He is very mellow He has sad eyes but will wag his tail to see you He was disinterested in dogs he met, had no reaction to them He needs to find someone to love again https://www.youtube.com/watch?v=DrpQSJllUk4 LEGAL DAY OF ADOPTION IS 7/22 IF INTERESTED IN ADOPTING PLEASE EMAIL email@example.com PLEASE TAKE ADOPTION SERIOUSLY, DOGS CANNOT BE RETURNED TO THE SHELTER. THANK YOU
CLICK here for all the pups in Waterbury!!! Including this Senior Chi!!!!
Click here for all Kenway's Cause pets!
Clara is looking for her furever home. She's a happy go lucky girl who is devoted to her humans! She is spayed, UTD on shots and micro chipped. She would do well in a home with people who can spend time with her. She knows her basic commands and is eager to learn. If interested in this of love please email firstname.lastname@example.com And please share this precocious girl!
CLICK here or below for all pets available through The Sadie Mae Foundation!
Click here to see the Lost and Found!


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Swim-Bike-Run Speeds - Track and log workouts
By Walsh iTechnology LLC
Open iTunes to buy and download apps.
The perfect app for the athletes wanting to know the distance, time, pace and speed quickly and log your workout details. A perfect calculator to determine your workouts distance, time, pace and speed quickly and easily. Also, log your workouts with calorie/kJ location, weather, elevation, Heart Rate, Activity, and Notes.
What's New in Version 3.6.0
• Graphing
• Data sync
• Feedback reporting (shake your device)
- Free
- Category: Health & Fitness
- Updated: 28 November 2016
- Version: 3.6.0
- Size: 35.8 MB
- Languages: English, French, Italian, Simplified Chinese, Spanish
- Developer: Walsh iTechnology
- © 2016 Walsh iTechnology LLC
Compatibility: Requires iOS 9.0 or later. Compatible with iPhone, iPad and iPod touch.


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The capital, which is home to 7.4 million people, is also home to 23 of the world's richest people.
With this tally, London was named yesterday as the 'unchallenged magnet' for the world's billionaires.
No other city holds such a captivating power over people who have enough money to live in a palace anywhere that they choose.
They could live in New York, Geneva, Sydney or Bombay, but they prefer London, according to research by Forbes magazine.
New York has 34, but most of the people with 10-figure fortunes are American.
London, by contrast, has the most international rich set.
In the capital, there are a few home-grown billionaires, such as Sir Richard Branson, 56, the serial entrepreneur, but most of them were born hundreds of miles away.
Paul Maidment, the author of the Forbes report, said: 'Many cities vie for the title of the world's capital.
'But London still attracts the elite of the world's rich and successful. And it can lay claim unchallenged to one title: it is the magnet for the world's billionaires.'
The richest person - whose wealth completely overshadows the Queen's fortune - is the Indian steel tycoon Lakshmi Mittal, 55, worth £13 billion.
This is a man who can afford to buy a £70 million mansion in a street in London nicknamed Billionaire's Row, and not even live it in full-time.
A few years ago, 1,200 people were invited to his daughter Vanisha's £30 million wedding, held at the finest chateau and garden in France, the 17th-century Vaux le Vicomte.
His wealth is so vast that it is bigger than the entire economic output of many African countries.
His rival for the crown of London's richest is Roman Abramovich who has only just turned 40 but still has a fortune worth £10 billion.
It is an extraordinary achievement for a man who was orphaned at the age of four and then dropped out of college.
He owns not just Chelsea football club, but also a large chunk of west London's most expensive homes.
Mr Abramovich is thought to have spent nearly £50 million on property in the most exclusive boroughs, mostly a short walk from Harrods.
And why has the capital become such a magnet for the super-rich?
Mr Maidment said: 'London is not only discreet. It is also safe and politically stable.
'Politicians and bureaucrats are not corrupt. The courts work. Property rights are protected. There are elegant shops, luxurious private clubs and good schools for the children.
'All expensive enough to keep the riff-raff at bay.'
One of the biggest influences has been on the capital's soaring property market.
It is thanks to the foreign billionaires, and their less successful alternatives, the millionaires, that the average price of a home in the exclusive borough of Kensington & Chelsea is now over £1 million.
Every day, nearly 20 homes are sold in England and Wales for £1 million or more, according to the Land Registry. Many are sold to foreign buyers.
Linda Beaney, who runs the Chelsea estate agents Beaney Pearce, said she regularly deals with international clients who want to buy in London.
She said: 'They have a minimum of three houses around the world, but possibly up to seven or eight.'
Recent sales include a 'quite modest' £7 million home in Kensington which has seven bedrooms but only 'a titchy patch of garden.'
Even flats sell for £5 million or £6 million, and they are 'not even penthouses.'
Liam Bailey, head of residential research at the estate agents Knight Frank, said foreign buyers have pushed up prices for 'top end' country houses too.
He said: 'Over the last year, prices for top end country houses have gone up 12 to 15 per cent, largely due to competition from foreign buyers.'
Knight Frank's figures show the price of a manor house has gone up an extraordinary £26,671 every month for the last 12 months.
For many, the attractions of London are simple - they do not pay much tax.
In fact, they pay less tax than many workers who earn a fraction of their multi-billion pound fortunes.
Mike Warburton, senior tax partner at the accountants Grant Thornton, said: 'The UK is a tax haven - and long may that remain.
'It has helped to attract in such a great deal of wealth and enterprise.'Reuse content


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"ALLURO" Shaving Soap by Tcheon Fung Sing
"ALLURO" Shaving Soap by Tcheon Fung Sing
A wonderful description written by Alessandro Pistoia:
The first stop on a long journey: ALLURO. The project to create this shaving soap was inspired by PASSION shared with true friends that put everyone on the same road. ALessandro Pistoia, LUca Dinaro and ROberto Santini, share a long common goal, put a bit of ourselves into something that many friends, we hope, will use with the same satisfaction with which it was created. A soap that was realized with skill, handcrafted by TFS that has helped us in achieving it. We wanted a new soap, able to bring its user in a different sensory plan: together we have created the scent with a decided predominance of sambuca, notes of jasmine, prickly pear, coffee flowers and drops of whiskey. But we wanted to go beyond its fragrance: we thought of a strong exfoliation effect, able to return to its user a soap able to oxygenate tissues, promoting a regeneration and helping in the prevention of ingrown hairs. The process for creating this soap which lasted about six months brought us to a shave soap that enjoys a perfect balance of the following ingredients:
- Macadamia oil (Macadamia Ternifolia Seed Oil) which is non greasy and that gives smoothness and touch which serves as a balancing of the lipid secretion of the skin;
- Linseed oil (Linum Usitatissumum Oil) obtained by pressing previously toasted seeds, soothing for dry, scaly skin;
- Refined coconut oil (Cocos Nucifera Oil) extracted from the pulp of the coconut, with softening and protective properties;
- Calamine (Calamine) powder with soothing and protective effect, in the case of highly dehydrated and flaky skin.
The fragrance, reminds us of Italy and more specifically of the traditional coffee 'chaser' which follows the morning espresso in a traditional Italian bar and we are hoping to bring this scent everywhere in the world of wet shaving. Finally, the label: hand drawn by my life long love, who I continue to thank for her patience and for standing by me every day... (Enza, I love you!). Nothing was left to chance, a journey that lasted six months, brings the satisfaction of a vision, wanted and realized together. Thanks Roberto, Luca, Enza, Stefano Santasilia(for moral and psychological support) and TFS.
Size: 150ml (5.0 oz)
Scent: Sambuca, notes of jasmine, prickly pear, coffee flowers and drops of whiskey
Artisan Made by Tcheon Fung Sing in Torino, Italy


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Each book you read, please add the url to that post in the Linky below. I may choose your review as a surprise winner!
The year is almost done, how are you doing in the challenge? Do you think you will complete it, or have you already? I know some of you have. I am not sure if I will complete it, to be honest, but am going to do my best.
There was no surprise awarded for this month. I loved reading all your reviews, I just couldn't do it again this month.
Now onto the Linky for November. Happy reading!
**No compensation was received for posting. This post is part of a book challenge originated on this site. Opinions are owned by this site.


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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!
The court date for the car repossession is next month. My house has been in foreclosure for about 3 months. I wanted to wait until the last possible moment to file bankruptcy, but the car repo is the wild card because my understanding is that the bank can dip into my bank account. I'm barely scraping by as it is due to child support. Should I file chapter 7 now? And if I do, how much time will I have in my home, best and worst case scenarios?? Thanks so much.
So as I understand your question, the car has already been repoed and you are being sued for money, correct?
The sooner you file bankruptcy, the sooner you will have protection from the federal court to protect you. In my state, you gain no advantage by waiting until the last minute to file, because the foreclosure will pick up where it left off once the creditor obtains the right to resume foreclosure by obtaining a "lift stay."
I am not able to make best & worst case predictions for you, as, alas, my crystal ball has gone dark! Sorry.
You will need to meet with an experienced bankrutpcy attorney in your community who is familiar with local practices for an estimate of the amount of time you might have before you have to move.
Hope this helps & good luck!Ask a similar question
The bankruptcy will delay the foreclosure but how much time you have depends on the actions of the bank and what stage the foreclosure is at. if you wait too long the bankruptcy will not delay anything. you should talk to aomeone right away.
Good Luck!
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Disclaimer: This answer does not constitute legal advice. I am admitted in the States of New York, New Jersey and Massachusetts only and make no attempt to opine on matters of law that are not relevant to those three States. This advice is based on general principles of law that may or may not relate to your specific situation. Facts and laws change and these possible changes will affect the advice provided here. Consult an attorney in your locale before you act on any of this advice. You should not rely on this advice alone and nothing in these communications creates an attorney client relationship. The opinions expressed herein are those of the author only and the fact that he has worked as an Assistant District Attorney; State Supreme Court Clerk; Special Assistant United States Attorney (Hawaii); Assistant Cornell University Counsel or Judge Advocate, United States Marine Corps should not be relied upon to assume that these statements reflect the policy of these organizations.Ask a similar question
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text: Synthesis of novel organosilicon compounds possessing highly substituted imidazole core catalyzed by antimony trioxideKazem D. Safa, Maryam Allahvirdinesbat, Hassan NamaziMolecular Diversity2014A general synthetic route for the exclusive preparation of tetrasubstituted imidazoles, possessing benzylic methyl groups has been developed using $$\hbox {Sb}_{2}\hbox {O}_{3}$$ Sb 2 O 3 via solvent-free, one-pot reaction conditions. Detailed results from our investigation on the bromination of the benzylic methyl groups of imidazoles are described. The… (More)


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Puppet on the Podium
Her voice rose and fell with the wind and the times. It quivered with emotion, pain and joy, sorrow and exhilaration. It bloomed out, casting a rainbow-coloured spell over the whole world, and the whole world seemed to shrink to her voice in the rusty stadium, and the whole world prospered and blossomed and grew.
Spectators drowsed in a trance, transfixed, listening, at the same time unseeing, unhearing, unfeeling. The golden voice brought home destiny, and the spectators saw and heard and felt destiny in the voice.
The voice reached out, a tangible force, pleading and begging the hearts of the people of the world for freedom and life and liberty.
The girl's voice held the note at the top of the scale, perfect, pure and pristine in its unblemished loveliness.
Then it came crashing down with a great ring that echoed everywhere. The girl's voice faltered, and a slender ashen body crumpled on the podium as if folding in half like an abandoned puppet.
Used by the power of the voice, an instrument of supreme might, the girl was merely a slight puppet, a sack of bone and skin, when deserted by the virtue that kept her jealously and used her as it pleased.
But at least she did not have to die. She had sung. If the cruel unfeeling power of the voice did not kill her first, she did not have to die. No; she would be bought instead, and some master would keep her for amusement, unaware of the hypnotic qualities of that great and wonderful voice. Freedom was far off.
Liberty was a dream; a form like an abandoned puppet on the podium in a foul rotting stadium. That was her.


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Sept. 29, 2007
SALT LAKE CITY - Despite not only scoring first but scoring in the opening quarter for the first time all season, Utah State lost to Utah, 34-18, at a cold and snowy Rice-Eccles Stadium Saturday. USU has now lost 10 in a row to Utah and now trail the all-time series, 28-75-4, including 17-51-4 at Salt Lake City.
The Aggies dropped to 0-5 with the loss, marking the second year in a row and the third time in the last seven seasons as the other time was 2001.
After a 64-yard interception return by sophomore S James Brindley gave the Aggies a first-and-goal at the Utah 1, USU got on the board first, with a 1-yard plunge from senior QB Leon Jackson III. Freshman K Peter Caldwell followed with an upright split to gave the Aggies their first points in the opening quarter all season.
Utah then scored the next 14 points, a 22-yard pass from Brian Johnson to Jereme Brooks and later a 75-yard punt return for a TD by Derrek Richards and USU never saw the lead again.
Caldwell hit a 24-yard field goal, capping a 12-play, 66-yard drive to pull USU within 14-10 midway through the second quarter.
Johnson had a 38-yard scoring pass to Marquis Wilson and Louie Sakoda hit a 31-yard field goal as time expired to send USU into halftime on the short side of the 24-10 score.
The Utes expanded the lead to 34-10 on a 3-yard run by Darrell Mack and a 39-yard Sakoda field goal.
The Aggies countered with a 10-yard pass from Jackson to junior WR Otis Nelson, then freshman RB Derrvin Speight tacked on the two-point conversion to pull USU within 34-18.
Utah State recovered the onside kick and after a lengthy review on the play, senior WR Kevin Robinson was ruled to have successfully covered the ball. The Aggies drove to the Utah 13 before getting stopped on fourth down. The Utes took two knees to run out the clock and end the game.
USU ended with 275 yards of total offense, led by Jackson's 17-of-24 passing with the one TD pass. Jackson's 17 completions give him 298 for his career and move him into seventh on USU's career passing completions list.
Jackson also now has 3,711 yards of total offense, moving to No. 9 on the Aggies' career total offense.
Speight matched last week's debut with 22 carries for the second game in a row, but only had 67 yards.
Robinson had seven catches for 71 yards, giving him 149 for his career and moving him to tied for No. 5 on USU's career receptions list with Kevin Alexander (1992-95).
Defensively, the Aggies were led by linebackers, junior De'von Hall and sophomore Paul Igboeli with 11 tackles each. Fellow linebacker, junior Jake Hutton also nabbed his first career interception to go with eight tackles.
Utah had 325 yards of total offense, led by Johnson with 18-of-29 passing for 181 yards and two TD's.
After making its shortest trip to Salt Lake City Saturday, Utah State makes its longest road trip of the year, traveling to Honolulu to take on 19th-ranked Hawai'i on Saturday, Oct. 6. Kickoff is set for 10:05 p.m. (MT). Fans can follow the action on the radio on KVNU (610 AM) in Logan, 1320 AM in Salt Lake City and 105.3 FM in Montpelier, Idaho, as well as streamed on the Internet through Yahoo! Sports on www.UtahStateAggies.com.
Utah State Football Post-Game Notes
Utah State at Utah - Sept. 29, 2007
Rice-Eccles Stadium - Salt Lake City, UT
--Utah State has lost to Utah 10 games in a row and now trail the all-time series 28-75-4, including 17-51-4 at Salt Lake City... The Utes have won 18 of the last 20, 21 of the last 24 and 24 of the last 27 meetings.
--The Aggies lost their 10th consecutive game overall and their ninth straight non conference road game, as well as their last 10 games in the month of September.
--USU has lost seven straight games against the Mountain West Conference.
--With 18 points, USU topped its combined point total in the last three years (losing 48-6 in 2004, 31-7 in 2005 and 48-0 in 2006).
--Freshman RB Derrvin Speight made his first career start in only his second career game.
--Senior OG Pace Jorgensen made his team-leading 32nd career start... Junior OC Ryan Tonnemacher, senior OG Shawn Murphy and junior S Caleb Taylor all made their team-leading 17th consecutive starts.
--Utah State went three-and-out in its first possession for the fourth game in a row... USU's only first down on its first possession was in game one vs. UNLV when the Aggies had a 27-yard pass play on the first play from scrimmage.
--USU's first quarter TD was the Aggies' first points of the opening quarter this season... Last time USU scored in first stanza was vs. Hawai'i last season (Nov. 4) and last time they had first quarter TD was vs. San Jose State a year ago (Oct. 14).
--This was the first time USU had scored first in a game since the San Jose State game last year (Oct. 14), a span of nine games...
--USU has now been outscored 37-7 in the first quarter this season, the largest quarter deficit for the Aggies.
--Was USU's first lead vs. Utah since a 7-0 lead in 2005 before Utah scored 31 unanswered and won, 31-7.
--Sophomore S James Brindley nabbed his first career interception and returned it 64 yards in the first quarter... Brindley's 64-yard return was USU's longest INT return this season and longest since Robert Watts had a 90-yard INT return vs. UNLV on Sept. 25, 2004.
--The interception was the fourth game in a row for the Aggie defense to record a pick and the sixth of the season, tying last year's season total... The four straight games with an INT matches the longest streak since a four-game stretch from Sept. 11-Oct. 2, 2004.
--Freshmen RB/WR Diondre Borel and CB Chris Randle made their Aggie debuts.
--Utah's Derrick Richards' 75-yard punt return for a touchdown was the first punt return for a TD against Utah State since Darren Toney of Arkansas State on Nov. 11, 2004.
--Utah's field goal at the end of the first half marked the third time this season a FG was made as time expired (by USU vs UNLV, by Oklahoma vs USU and Saturday by Utah vs Utah State).
--Junior LB Jake Hutton logged his first career interception in the third quarter.
--It was the third time this season that USU has had two INT's in a game (at Wyoming on Sept. 6, vs San Jose State Sept. 22 and Saturday vs Utah)... The last time that USU had three games with two or more INT's was 2004... The Aggies now have seven INT's, topping last season's total and matching the 2005 season total.
--Utah's 16-play, 80-yard, 7:02 scoring drive was the most plays and longest time for a scoring drive allowed by Utah State's defense this season.
--USU went scoreless in the third quarter for the fourth time this season - the only game the Aggies scored in the third stanza was the Wyoming game... USU has now been outscored 39-15 in the third quarter.
--Utah State's offense failed to reach 300 yards for the fifth time this season.
--USU opened the season 0-5 for the second year in a row and the third time in the last seven seasons (2007, 2006, 2001).
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