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To determine the prevalence of isolated tumour cells (ITC) in lymph nodes of patients with pathological node‐negative (pN0) tumours and to assess their impact on disease‐free and overall survival.
Paraffin embedded lymph nodes from oesophagogastrectomy specimens were examined immunohistochemically using monoclonal anti‐cytokeratin antibody (MNF118). Clinical and pathological features were summarised and overall and relapse‐free survival were estimated.
Isolated tumour cells were detected in 12 of 146 patients (8%), and 24 of 1694 (1%) lymph nodes. With a median follow‐up time of 28 months (range 0–160 months), both relapse‐free and overall survival were significantly (p<0.05) associated with the presence of ITC in pN0 lymph nodes. There was no significant difference in the prevalence of ITC between patients who underwent multimodal therapy and those treated with surgery alone.
ITC in pN0 lymph nodes may be less frequent than previously considered, but their presence is associated with poorer outcomes compared with true node negative disease.
Despite improvements in surgical outcomes and the advent of multimodality regimens, the overall outlook in oesophagogastric cancer remains bleak, with only 8–20% of patients alive at 5 years.1 The presence or absence of metastases to regional lymph nodes is the single most important standard risk factor for patients with oesophagogastric cancers, and even in patients with pT1 tumours the presence of lymph node metastasis has been reported to decrease overall 5‐year survival by up to 100%.2 A large sub‐group of lymph node negative (pN0) patients recur, either locally or systemically, and usually within two years of surgery. It has been hypothesised that early recurrence following complete resection of an apparently localised primary lesion is attributable to disseminated tumour cells which were not detected by routine staging methods at the time of surgery.3 Better methods for detecting and characterising subclinical metastatic deposits in various compartments of the body could enable us to both refine our estimates of the risk of recurrence for individual patients and perhaps tailor therapy more effectively.4 This study evaluates isolated tumour cells in lymph nodes of a large cohort of patients pathologically staged as node negative disease (pN0) and sets out to establish the prevalence and prognostic significance of such cells.
All patients with pN0 tumours who underwent curative therapy for oesophagogastric cancer between January 1990 and September 2002 were identified from the prospectively compiled upper gastrointestinal cancer database at this institution. All patients with overt metastatic (M1) disease were excluded and only adenocarcinomas or squamous cell carcinomas were included. The study group consisted of 146 patients: 76 (52%) underwent surgery alone and 70 (48%) underwent a multimodality regimen as previously described.5 This consisted of concurrent chemotherapy (cisplatin and 5‐fluorouracil) and radiotherapy (40 Gy/2 Gy per fraction) followed by oesophagogastrectomy at a median of 4 (range 3–6) weeks following neo‐adjuvant therapy.
This study was approved by the local hospital ethics committee (St James's Hospital and Federated Dublin Voluntary Hospital joint research ethics committee). Routine pathological staging at this institution is as follows. H&E slides are reviewed in all cases by a consultant pathologist. Resected specimens are fixed in 10% buffered formalin. Where no obvious macroscopic tumour remains, the site of tumour seen at endoscopy is entirely submitted for histological examination. Full thickness transverse sections of the wall are taken.
The mean number of blocks taken for each case was 10 (range 4–17) and the mean number of tumour/ulcer blocks taken for each case was 4 (range 3–10). Perioesophageal and greater and lesser curve lymph nodes were dissected where present and submitted separately for histology. For the purpose of the study an additional (4 μm) section of each resected node was taken off the surface of paraffin embedded lymph node tissue.
Immunostaining was performed as follows: each section was baked at 60°C overnight, deparaffinised and rehydrated through xylenes and graded alcohol series. Endogenous peroxidase activity was blocked by incubating the slides in 3% hydrogen peroxide (Sigma‐Aldrich Ireland Ltd) in water for 10 min. The slides were washed in deionised water for 5 min and digested for 5 min at room temperature with 0.05% proteinase (Sigma‐Aldrich Ireland Ltd) made in 0.005 M Tris‐buffered saline (pH 7.6) (TBS). The slides were then washed in TBS for 5 min. The tissue sections were blocked with 5% bovine serum albumin (Sigma‐Aldrich Ireland Ltd) for 10 min, blotted dry and then incubated with mouse anti‐human cytokeratin (Clone MNF 116, DakoCytomation Ltd, UK) (1:300 in 5% bovine serum albumin) in a humid chamber for 1 hour at room temperature. The slides were washed in TBS for 5 min and incubated with a biotinylated secondary antibody (1:300 in TBS) (rabbit anti‐mouse immunoglobulin, DakoCytomation Ltd, UK) for 30 min and then avidin‐horseradish peroxidase (Vectastain Elite ABC Kit; Vector Laboratories Ltd, UK) for 30 min. The slides were washed with TBS for 5 min after each incubation. The stain was developed by covering each specimen with a 3′3′‐diaminobenzidine solution (DakoCytomation Ltd, UK) for 5 min or until desired stain intensity was achieved. Finally each slide was counterstained with haematoxylin, cleared and mounted.
The immunostained slides were evaluated by an experienced pathologist, who was blinded to patient information, and were scored as positive for isolated tumour cells (ITC) if they contained single or small clusters of strongly immunoreactive epithelial cells in the subcapsular sinus or in the cortex of the lymph node. Patients were pathologically staged as per the 6th AJCC Cancer Staging Manual6 with the addition of TNM shorthand notation for isolated tumour cells first proposed by Hermanek and colleagues.7 Positive cases were designated as pN0(i+) and negative as pN0(i−). With each run, sections of primary tumours were used as positive controls and a negative control (primary antibody omitted) was always included.
Statistical calculations were performed using JMP software V.5.1.2 for Macintosh (SAS Institute, Cary, NC, USA). The Kaplan–Meier survival model was used to estimate survival. The log rank and Wilcoxon tests were used to determine statistical differences between groups. Analysis of the predictive value of clinicopathological variables for ITC was performed using the Kruskal–Wallis test for continuous variables and χ2 with Pearson test for categorical data. Cox's proportional hazard model was fitted to multivariate analysis. The following variables were controlled for in the model: gender, age, tumour site, tumour morphology, degree of differentiation, treatment modality and presence or absence of isolated tumour cells. All tests were two sided; results were considered significant at p<0.05.
Table 11 shows demographic and clinical details of the study group. The median age of the patients was 63 (range 29–84) years. There were 101 (69%) men and 45 (41%) women. A total of 1694 lymph nodes were dissected from the 146 oesophagogastrectomy specimens with a mean of 11 nodes per patient. Follow‐up data were obtained for all 146 patients. The median follow‐up time was 28 months (range 0–160 months) and the median actuarial overall survival time was 21 months (95% quartiles: 34–64 months) for the entire study group.
Positive MNF116 staining with malignant morphology was found in 24 of 1694 lymph nodes (1%) and in 12 of 146 patients (8%) studied. ITC was predominantly identified in the subcapsular sinuses either as a single cell (fig 11)) or as small clusters of tumour cells.
At a median follow‐up of 28 months (range 0–160 months), 59 patients were alive (four with evidence of relapse) and 87 patients had died. The overall and relapse‐free actuarial survival rates were significantly worse among patients who were pN0(i+). The actuarial median overall survival in the pN0(i−) patients was 53 months (95% quartiles: 27–69 months) versus 21 months (9–28) for the pN0(i+) patients (p<0.05) (fig 22).). The relapse‐free actuarial survival rate was 40 (27–56) months for the pN0 (i–) patients versus 21 (9–28) months for the pN0 (i+) patients (p<0.05) (fig 33).
No significant correlation was found between isolated tumour cells and a number of clinicopathological parameters including age, gender, tumour location, treatment modality, tumour stage, tumour grade, tumour length or mean number of lymph nodes examined. Although not significant, higher TNM staging tended to increase the probability of ITC (table 22).). Multivariate analysis revealed that degree of differentiation, tumour morphology and the presence of isolated tumour cells were independent prognostic factors for both relapse‐free and overall survival (table 33).
A variety of techniques have been developed to demonstrate occult tumour cells at sites such as the bone marrow, blood and lymph nodes of patients with breast cancer, colon cancer, non‐small‐cell lung cancer, prostate cancer, melanoma and oesophagogastric cancers.8,9,10,11,12 Both in vivo and in vitro studies have suggested that these cells not only have the phenotype of malignant cells, but also possess malignant molecular characteristics.13,14,15,16 Nevertheless the prognostic significance of these cells remains controversial, and a number of studies and a meta‐analysis have failed to verify the presence of occult metastases as an independent prognostic factor in solid tumours.17
One confounding variable in the interpretation of the literature to date has been the inconsistency in nomenclature for "metastases" detected by these methods. They have been inconsistently classified inter alia as micrometastases, subclinical metastases, occult metastases, and tumour cell micro‐involvement. The International Union Against Cancer has tried to clarify the terminology by making a distinction between "micrometastases" and "isolated tumour cells".7 Micrometastases are defined as being 2 mm in greatest dimension, in contact with a vessel wall, extravasated, proliferating and usually associated with a stromal reaction. Isolated tumour cells (ITC) in contrast are defined as clusters (<0.2 mm) or single tumour cells without any of the above characteristics whose presence can only be determined by immunohistochemistry, immunocytochemistry or molecular methods such as flow cytometry or PCR.
This study to our knowledge is the largest evaluation of the prevalence and prognostic significance of isolated tumour cells in patients reported as pN0 after curative treatment for localised cancer of the oesophagus or oesophagogastric junction. The study reports a low prevalence of isolated tumour cells in pN0 lymph nodes but a significant impact on overall and relapse‐free survival.
We have identified 12 previous studies examining the prevalence and prognostic impact of occult lymph node metastases in oesophagogastric cancer.2,18,19,20,21,22,23,24,25,26,27,28 Seven of these studies reported a significant impact on survival,20,21,22,23,26,27,28 four did not show significance,2,19,24,25 and one paper did not specify prognostic impact with respect to pN0 cases.18 This study differs from these earlier studies in a number of respects. We report on a larger series of pN0 patients than previous studies. Patients with pathologically involved nodes (pN1) were excluded, in contrast to other series.2,18,20,21,22,23,26 With the exception of a study by Vazquez‐Sequeiros et al,25 which reported a prevalence rate of 9%, the rate of 8% in this series was considerably lower than those quoted in previous studies which ranged from 26% to 62%.
There are a number of potential explanations for this low prevalence rate. Many pathologists report as relatively common a finding of single epithelial cells identified by immunohistochemistry for cytokeratin that on careful analysis was found to be hyalinised cytokeratin particles or artefact of overlay of cells from the staining solutions, water bath, or keratinocytes from the skin of the hands of the technician.29 These were also encountered during the course of this study, but only positively staining material with both cellular and malignant morphology as determined by an experienced histopathologist was classified as positive, consistent with current consensus.4
A significant proportion of pN0 patients will be reclassified as pN1 when additional lymph nodes are sampled in a systematic manner,30,31 and it is not unreasonable to infer that the likelihood of finding isolated tumour cells directly correlates with the number of sampled nodes. It is notable that studies such as this from the western world report much smaller nodal yield compared with Japanese series in particular.19,23,24,26,27 Notwithstanding this possibility, we did not find a significant difference in the average numbers of nodes sampled per case between the positive and negative groups in this study.
There is some experimental evidence that the greater the number of sections sampled per lymph node, the higher is the probability of identifying isolated tumour cells or micrometastases.18,32 It is also clear that to serially section and immunostain every resected node after an en bloc oesophagogastrectomy is not a practical proposition for routine pathology laboratories. Accordingly investigators make an empiric decision to sample somewhere between 1 and 5 sections per lymph node. We elected to sample one 4 μm section per lymph node because this was standard practice at this institution and would therefore be a procedure that we could expect to be practicable should this investigation suggest itself to be of clinical relevance.
In summary, this study shows that the prevalence of isolated tumour cells in pN0 lymph nodes of oesophagogastric cancer may be lower than previously reported, and that the presence of isolated tumour cells has prognostic significance when analysed in a sufficiently large cohort using stringent detection criteria. The integration of ITC detection into the routine staging of oesophagogastric cancers could improve our ability to determine prognosis and bring the realisation of the goal of patient‐tailored cancer therapy closer.
ITC - isolated tumour cells
pN0 - pathological node‐negative
Competing interests: None declared.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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ASNT NDT Level III RT/PT, NDT Inspection, Calibration, Expert Consultant Resume
This expert specializes in procedure development, revision and review, review and approval of contractor NDE inspection, and nondestructive lab design. Further expertise includes fluorescent penetrant inspection, x-ray inspection, and metallurgical labs.
Other areas of related specialization include radiation safety, NDT auditing, computed radiography, magnetic particle and liquid penetrant, and NDT engineering.
Consultant, Kevin Kennedy Associates Inc.
Nuclear Technical Specialist III, Dominion Resources, Waterford, CT
NDT Level III Examiner / Metallurgical Lab Supervisor, Unison Engine Components, Manchester, CT
Level II NDT Technician RT/PT, Magnaflux Quality Services, Hartford, CT
Level II MT, PT, VT Technician, NDT Engineering, Essex, CT
Hull Maintenance Technician, United States Navy
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subset: commoncrawl


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2015 65 VOLKSWAGEN SHARAN 2.0 SE NAV TDI BLUEMOTION TECHNOLOGY 5d 148 BHP£1500 Deposit and only £259 per month PCP (49 Months
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Every effort has been made to ensure the accuracy of the above information but errors may occur. Please check with a salesperson.
For more info on this vehicle call our showroom on 0141 778 1692
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KARACHI: Two robbers were shot dead by a citizen here on Khalid Bin Waleed Road on Sunday night, according to SSP Jamshed Town Tahir Noorani.
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One of the robbers was identified as Agha Gul, an Afghan national said SSP Noorani.
He further said that the Police was investigating the incident.
Courtesy : TheNews


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WP Engine and Backup Points
I had an issue pop up with WP Document Revisions and WP Engine. We were not able to run the automated backup points provided by WP Engine due to a conflict. Here's what their support team found:
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I made this using Stella 4d: Polyhedron Navigator, which you may try for free right here.
Tags » Icosahedron
Technote: Icosahedron Edge Calc
Technote: Icosahedron Edge Calculation:
Geodesic geometry is rather interesting and occasionally quite challenging. I have recently been involved in a project to explore construction options for a structure based on an Icosahedron form. 221 more words
Staining Die Numbers
I got a custom request through etsy to make an icosahedron and stain the numbers on it for a young couple. That whole process was quite a bit of work, but I think it came out nicely. 17 more words
Harmonia map updates for World Building Wednesday
No world building blog post this week just some updates to the Harmonia map for #worldbuildingwednesday
Next up for the world building guide will be kingdoms and sociology.
Geometry of Virus
This semester I am taking a course about protein structures. Here is a quick intro to proteins:
Though I have taken some other biology courses in past years, I found this course very much relatable to mathematics. 197 more words
Foldable Dymaxion Globe
Some time back, we posted about 's laser-cut/3D printed Dymaxion Globe — if you haven't read about it yet, you should check it out. loved the idea, and like a true hacker, built and shared an… 181 more words
Icosahedrons for Etsy
I recently sold some solid wood d20 widgets (icosahedrons) through my Etsy store, so I thought I'd post a picture. If anyone else is interested in some, or dodecahedrons, please leave a comment here or at my store.


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Child Safeguarding at Teach First
The aim of this policy is to ensure that:
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Copyright © 1998-2017
Frontware International Co., Ltd.


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text:
"My parents told me to 'go where your heart is,'" says Stephen Spicer recalling his college years, struggling with a marine biology major he thought would be practical. "I loved working with gems, but thought you couldn't make a living creating jewelry."
"I started collecting rocks when I was ten. I was mesmerized by my first purchase, a quartz and pyrite mineral specimen - its beautiful crystalline structure. My parents spoke to a local Chattanooga lapidarist when I was 12 and they accepted me as an apprentice. I learned how to cut cabochons and cast jewelry and gained knowledge of gems. I made my first ring that year. My dad still wears it."


text:
There are total 12 letters in Exactingness, Starting with E and ending with S.
Total 690 words created by multiple letters combination of Exactingness in English Dictionary.
Exactingness is a scrabble word? Yes (22 Points)
Exactingness has worth 22 Scrabble points. Each letter point as below.
Words that starting with Exactingness
Words that containing Exactingness
Words that ending with Exactingness


text:
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Songkran in Phibun Mangsahan
Many people celebrate the Songkran Festival in Phibun Mangsahn
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Chocolate Coulant
Be the first to review
READY IN: 36mins
Recipe by Yarelicar
Also called Chocolate Molten Cake or in French is Coulant au Chocolat. Is a mini cake with a melted inside. When you cut the cake, the melted chocolate will fall to the plate. Easy and delicious! Please note that the recipe is in grams (weight).
See Discussion:
Ingredients Nutrition
- 300 g butter
- 380 g dark chocolate (60%)
- 150 g sugar
- 130 g flour (sifted)
- 7 eggs
- 1 egg yolk
Directions See How It's Made
- Preheat oven at 425 °F (225 °C).
- Grease individual molds with butter.
- Melt chocolate in microwave.
- Mix ingredients: flour, sugar, butter room temperature, eggs, melted chocolate. Bring all together with a whisk.
- Fill in all 12 individual molds, each should weight about 110 grams.
- Put inside oven about 6 minutes, until the top is just done. Be carefull not to overcook.
- Take out of oven and put in a plate, unmold.
- Serve with whipped cream or ice cream.


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Mehndi has an essential fundamental spot in every type of cultural & traditional Pakistani, Indian and also all the Asian Events & festivals. Whether it is the shade of yellow look of the Mehndi ceremonies or the amazing carousing of the religious event Eid, henna mehndi patterns & designs are every time would like the modern young girls and women's of its countries like Pakistani, Indian and Asian. The fashion trend has grown to be so widespread and varied in their shape that it has increased with the help of lots of margins; the paint of mehndi is currently prevalent for the most special in the world part of the western ingredient. As the most recent we have talked the different fashion designs of henna mehndi designs used in Pakistani Mehndi Designs & Trends such as Arabic Mehndi Designs, Rajasthan Mehndi Designs, Turkish, Indian mehndi Designs and so on.
Pakistani Mehndi Designs & Trends
As you know that today we are a purpose of our post about the different mehndi trends & designs of Pakistani mehndi designs for Pakistani girls, Indian girls even Asian and western girls. This post has present totally latest and new aspect of henna mehndi patterns of 2017. The most stylish, beautiful, exciting and fancy mehndi designs will be showcased at this place and we will be explaining in this collection in niceties. Therefore, if you were still staying for stylish and ideal mehndi designs collection for approaching Bridal Wedding Season, for Eid after that you are only in destiny. At the same time as this post completely of assorted beautiful designs which are decorated with attractive shadings and further modified of colourful prints worn in this latest Pakistani mehndi designs collection of 2017.
Imagine does not classify the make use of sparkles and shimmer but it also explains each and every important and mehndi done henna designs collection 2017 for modern young girls and women's.
With the start of colourful fancy mehndi designs, these patterns are predictable for its stylish and beautiful demand of the ladies. There are two types of increasing fashion trends in this consider, the first is the dissimilar coloured mehndi to make use of whole designs of mehndi such as the use of gold brown, white, pink and lime green are contained in this category. While on the other hand, the second is utilize of patches of dried up shades & prints among the henna mehndi designs. They appear the same appealing like they showcased a wonderful & beautiful well-known contrast. The majority extensively applied shades are crimson red, dark green and so on these prints can end of the time of period. Therefore, there is expediency to use them for any type of function like wedding, a party even Eid day.
Latest Pakistani Mehndi Designs & Trends Collection 2017
Next, we continue our discussion with the showy dazzling with the help of the important designs of henna mehndi designs for beautiful girls & women's for all types of functions. These designs including many patterns collective with the make use of Tikki in the mid of the hand and apply to floral designs, peacock designs surrounded by it. These henna designs are looking much stylish and beautiful when you draw on your hands and feet. With the help of palms and wrist casing, enlarge to the guidelines of the fingers these patterns fulfilled with internal patterns is mainly used while the make use of important & heavy fillings of mehndi under the designs is as well as so famous and popular.
Further beats and shine in excess of the layer of mehndi used are also giving famous in these days. Therefore, whether you are in receipt of your hands & feet drawing with light and bright mehndi colours by hand having perfected beautiful patterns in your brain is compulsory. We are sure you have a perfect thought, we have brought out you all variety of appealing heavy Henna Designs which may best to any event or occasion you want to design it.
Hope you will love this collection of 2017 latest Pakistani Mehndi Designs & Trends collection. You can also see and more about the same topic you must keep in touch if our website and get much beautiful and stylish latest Bridal Mehndi Designs, Wedding Mehndi Designs, Party Mehndi Designs, Eid Mehndi Designs and much more.


text:
We all need rest to really feel our best Our cats are no diverse – rest is essential to your cat's health, even it seems like they sleep all day. For some cats a human hissing at them, staring at them, scowling at them, squirting them with water, or speaking sternly to them is strong enough to persuade the cat to keep away from where the human does not want the cat to be. So if you are fortunate adequate to have a trainable cat you might be in a position to train it to keep out of the bed if that is what you and your partner want.
Hi Angela, I wish I had known about Feliway numerous years ago when I got my initial kitten – the first issue he did was wee on the bed, then on my feet (my husband had bought him for me as I was ill in bed and he wanted to cheer me up) – nevertheless, I guess my kitten who spent two pennies straight away would not have been referred to as Tuppence for the rest of his really long life otherwise!
Typically around 16 hours every day, kitties get a lot more sleep than nearly any other pets around hence acquiring a higher-quality cat furnishings is a great idea to work on. Presented this basic data, it is vital that if you personal a cat, you need to prepare a web site for them to live along with keep them on their web site.
You leave it because cat poop will eed the bugs necessary in dirt to airate the life going on under the earth and the poop is very good for all plant life after the pine and bugs break smooth out the pile and move on. Or if the poopdrives u crazy when u see it piled up get a bag and bag them smooth out the pile and move on. Excellent news is the pine halts the use for them urinenating in it. Grass and dirt it exactly where they go. Again a battle you selection to take 1 win one particular smaller loss.
Due to the fact it really is something new and she's in no way noticed one particular ahead of, to get her to use it, I put her on the leading level and pet her and praise her so that she knows that it's safe for her and introduce the different platforms that she can jump on. If you have a cat like mine, let them take their time and they will commence utilizing it in a couple of days or so. Once you see them marking it by brushing up against it, you will know that they have accepted it and are generating it theirs.


text:
DENVER—In a further shifting of its executive ranks, Smashburger announced on Monday that it is bringing back its co-founder, Tom Ryan, into a more active role in the company. Ryan has been named to be the better burger chain's new chief brand officer.
DENVER—In an email on Friday to employees and franchisees, Smashburger announced that its CEO, Scott Crane, was immediately leaving the company. Three working days later, yesterday, the franchisor of better burger restaurants announced it had appointed a replacement – industry veteran Michael Nolan.
CINCINNATI—After a seven-month search, Frisch's Big Boy has found its new CEO, 25-year restaurant veteran Jason Vaughn. The new CEO started yesterday.
Toshifumi Suzuki, 83, chairman of the 7-Eleven parent company Seven & i Holdings, resigned abruptly yesterday after a disagreement that culminated with the board ruling against him.
OAK BROOK, IL--Andrew J. McKenna, 86, McDonald's [NYSE:MCD] chairman of the board, announced today that he has advised the board that he will not be standing for re-election as a member of the board at the company's annual shareholders' meeting on May 26.
LOUISVILLE, Ky.—Yum Brands, Inc. (NYSE: YUM) announced yesterday that it has appointed Robert D. Walter, age 70, to replace 63 year-old David Novak. Walter will serve as non-executive chairman of the company's board of directors, following the firm's May 20, 2016 annual meeting of shareholders.
Ron Garriques, the CEO of troubled RadioShack has called it quits after just nine months on the job. The firm's chief financial officer Gordon Briscoe has been named interim CEO as its board of directors searches for a permanent one.
EMERYVILLE, Calif.— Jamba Juice (NASDAQ:JMBA) announced this morning that it has named David A. Pace as the company's new chief executive officer. He will begin on March 14. Jamba has also appointed existing director Richard L. Federico to chairman of the board. He will remain an independent director on the board.
On January 5 the private equity holding company of Gold's Gym International let franchisees and employees know that their president and executive vice president of operations are no longer with the firm. Gold Gym's chairman has been appointed CEO
CARROLLTON, Texas— Casual dining chain TGI Fridays announced Tuesday that Mr. Robert Palleschi has been appointed as the firm's president and chief executive officer, effective February 8. The firm used global executive firm Egon Zehnder. Palleschi replaces Nick Shepherd, who stepped down in October 2015.
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text:
Mt. Bruno
15 comments:
- Carys :
These pictures are amazing, lovely clothes too!
From Carys of La Ville Inconnue
- February 24, 2011 at 6:34 AM
- Steffy's Pro's and Con's :
lovely pictures, wherever you are looks so beautiful i love the flowers and your dog, and your dress!
<3 steffy
please make sure you enter my giveaway: http://steffysprosandcons.blogspot.com/2011/02/steffys-pros-and-cons-first-giveaway.html
- February 24, 2011 at 6:53 AM
- Annebeth :
the pictures do look awesome, I'm checking out the site right now! and I loooooooove the backdrop and your outfit, those small yellow flowers are stunning and I want to be running there with you guys!
- February 24, 2011 at 7:08 AM
- gee :
such beautiful pictures.
i want to be where you are..the weather looks amazing.
- February 24, 2011 at 8:46 AM
- Rachel :
Beautiful! I love the print on your dress!
- February 24, 2011 at 8:55 AM
- alexandra grecco :
so gorgeous! you have such a lovely blog.
- February 24, 2011 at 8:57 AM
- Em :
Super cute and I love the way you did the pictures. Your dog is awesome!
- February 24, 2011 at 8:57 AM
- Maria Ramona :
I adore the picture of your black boots in the field of yellow flowers. I'm going to have to check out Picknik too! I've been using Picasa which is also free & easy but sounds like Piknick has moe to offer. thnx for the tip!
- February 24, 2011 at 11:39 AM
- elanor, :
your dress is beautiful! i've never been to mr. bruno, maybe i'll have to now - it looks lovely!
really cute dog, too. :)
- February 24, 2011 at 12:41 PM
- Meghan :
looks like fun, what a cute doggy!
- February 24, 2011 at 5:18 PM
- Meghan :
also, pixlr.com is a cool editing site, I find it faster than picnik
- February 24, 2011 at 5:19 PM
- Cole :
I love your dress & shoes!
And I also love picnik! Use it all the time.
- February 24, 2011 at 6:50 PM
- Green Tea and Cupcakes :
Beautiful pictures and Oozora is so cute.
- February 25, 2011 at 4:07 AM
- Michal :
I love these pictures!! They make me wanna run around outside & I can't wait until all of this snow is gone. I love the effects you used on the last photo. Picnik is great! I use it all the time, normally just to straighten and crop though. I should play around with it more.
- February 25, 2011 at 10:24 AM
- Sophi :
You look so beautiful in that portrait with the rock! Pretty (and intelligent and stylish and awesome) lady!
I use picnik all the time myself. It's actually really a pretty powerful tool! Who woulda thunk it?
- February 25, 2011 at 8:31 PM


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APD Interiors turns 10 years old
Today we are celebrating APD Interiors turning 10 years old. From humble beginnings back in 2004 we have grown over the last 10 years to become a successful design and build company who operates internationally. It's been a rocky road at times, especially through the recent economic crisis when no-one was spending money on their interiors – so we are pleased to be celebrating 10 years in business today. To celebrate I wanted to take a look back over the past 10 years at some of my favourite projects and explain how the business started.
In 2001 I had just purchased by first home with my partner in Islington and I was working in the City in private equity. In the evening I studied at The Interior Design School to learn more about the design process to help plan the major renovation work on the wreck of a house we had purchased. Then just as we'd started our project I was made redundant! I immediately saw this as an opportunity to escape the City, follow my dreams and finally work in interiors.
6 months later our new home was finished and was everything we wanted it to be. I'd spent my time learning about sourcing products, building contacts and also visiting the site to learn from our build team. Nothing prepares you for working in the Interiors industry like good experience onsite. Under the gentle supervision of our architect I ran our project day to day and when it was finished I knew interior design was my future.
After a brief stint working as an intern for another designer I quickly decided I'd only be happy running my own practice so on 11 June 2004 APD Interiors was born and I started my business from an office at home. I quickly picked up small projects through recommendations from our architect, worked on his projects and was also featured in the Evening Standard. One of my first large projects was the complete renovation of a mansion block apartment in Maida Vale. Designed for 'a country lad who lived in town' the style reflected his personal taste with painted kitchen cabinets and granite worktops.
Over the next few years my business steadily grew. My partner was still working as a senior Director in the corporate world but then in 2010 following his own redundancy we decided it was time to work together and grow the brand I'd been nurturing. Our clients increasingly wanted a company that dealt with everything for them – they are busy people and want one company to provide a turnkey service from start to finish. We therefore launched our Design and Build service, providing the one stop shop our clients asked for.
One of the first projects of our new enlarged business was the extension of a Grade II listed property in Islington. This was our first experience of working on a listed building, understanding not only the complexities of a building dating back to 1860 – but also the needs of the Conservation departments. From start to finish the project took nearly two years but the new glass infill brought light and openness to the property. Islington Council now feature this project on their Planning Documentation as the perfect example of a lightweight glass extension.
Since completing this project we have had a further two glass extensions approved by Islington Council which are both about to enter the build stage. We also have one in planning with Camden Council which is 4 floors up on an ex diamond warehouse in Hatton Garden. With the technical advances in glass manufacturing the possibilities are endless. The glass on the extension shown is so strong you could apparently sit a mini car on the top of it!
Over the years our skill set has increased to allow our clients to carry on their lives while we build the home for them to live in and enjoy. The majority of our work is now completed within Conservation areas of London and we have also worked on more Listed buildings. Understanding the processes and workings of the regulatory bodies is an essential part of a successful building project and is a skill set we have in abundance.
In the last few years we have also worked on a number of full house renovations in London. An example is shown below. This project involved the complete design and specification, project management and build for the whole property, which included three bedroom, two bathrooms and opening up the lower ground floor to create a new open plan entertaining room. As the 'before and after' images show an outdated small extension was removed to allow for a much larger extension with new bifold doors to open onto the garden.
Recent projects we have completed include a number of bespoke handleless kitchens for clients. The lack of handles allow the kitchen to blend seamlessly into a large open plan space. We now use solid surface worktops as standard to ensure our clients have a good quality surface that will provide years of service in their home.
A recent bathroom we did called on all our skills of sourcing to design and build a bathroom that was 3m x 4m for a very tight budget. Large bathrooms usually require large budgets due to the size of the room. With the design scheme agreed we sourced all the tiles for the room from Topps Tiles and they gave the perfect style the client wanted. The contemporary mosaics used in the shower were a very reasonable £50 m2., a great price for mosaic tiles!
Having reached our tenth birthday we are now looking forward to the future and exploring new markets and new ways to connect with our clients. We intend to grow our commercial arm over the next year, working with established professions in this field. We are also intending to fine tune our Facebook page and our Twitter page to connect with new clients. Our Houzz page features all of latest projects and later this year our website will be relaunched to reflect our new business services and feature more recent projects.
Thank you to everyone who has helped us to grow our business, whether you are a client, a supplier or someone who has just helped us along the ways – here's to another 10 years!
June 12, 2014 7:41 am
Happy Birthday and well done you. It was interesting to hear why you decided to have a change of career and how it came about. My reasons for studying Interior Design and consequently starting up my business are exactly the same as yours, snap!! I just hope that I too can be as successful as APD one day 🙂
June 12, 2014 9:09 am
Congratulations to team APD Interiors – 10 years old, wow! Great post, great blog, thanks Andrew!
July 17, 2014 1:06 pm
Congratulation you and your all team.Your are doing such a great job.Best of wishes of your next 10 year.


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- Dear Sharon,
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This article was written by 'CadmiumX99'. Please do not edit this fiction without the writer's permission.
Known as The Owl to Special Agent Boudica "Bee" Taylor, this Predator was drawn to the heat and conflict of events in Twin Peaks surrounding the death of Laura Palmer. The Owl makes a fateful decision regarding the supernatural force known as "Killer BOB".
- Twin Peaks/ Predator: The Owl (First)


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I have a confession to make! 6 months ago I knew almost nothing about Veeam. I knew they were a very popular VMware partner who did backup and recovery software. That was where my knowledge stopped. When Veeam announced that they would provide support for Hyper-V in version 6 of Backup & Replication I started More >
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This supplemental volume is divided into parts covering the broad view of international human resources management, HRM issues and practices in Europe and in other important regions, and international HRM and expatriates.
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About Betterment
Betterment is the largest independent online financial advisor with more than $9 billion in assets under management. The service is designed to help increase customers' long-term returns and lower taxes for retirement planning, building wealth, and other financial goals. Betterment takes advanced investment strategies and uses technology to deliver them to more than 250,000 customers across its three business lines: direct-to-consumer, Betterment for Advisors, and Betterment for Business. Learn more.Comments are closed for this post.
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Home heating, like an earthquake, dramatically changes what it feels like to sit in one's living room. Keep home heating apparatuses healthy through the winter with today's Groupon.
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- A $25 voucher good toward the cost of future carpet, furniture, or area-rug cleaning services<p>
Though Alberta Furnace Cleaning sometimes features a discounted price online, this Groupon still offers the best deal available.<p>


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Riedel Vinum Tumbler 6 1/4in
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Enjoy a cool cocktail on the rocks in a gorgeous highball glass from Riedel. Pair of tumblers. Made with 24% lead crystal. Hand washing recommended. Capacity: 11 oz. Diameter: 3 Height: 6.25 Weight: 15 oz. Made in Germany. Attention California residents. Proposition 65 WARNING: Consuming foods or beverages that have been kept or served in leaded crystal products or handling products made of leaded crystal will expose you to lead, a chemical known to the State of California to cause birth defects or other reproductive harm.


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Hatfield, PAUSA
October 19, 2013
I've been playing RPGs for 34 years now. I run numerous games via pbp online at Giants in the Playground, play a couple, and I run a Sunday table game that meets haphazardly. Want to play; willing to GM.
It took a while for me to find a mechanism to meet gamers in the area (I moved here in July), but I'm glad I finally got onto Meetup.
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By Morris Fenris
What occurs while a California lady meets a Montana man in the course of a quandary?
Sara needed for a husband for Christmas this 12 months after which married her boss. Now she is operating for her lifestyles from him with a warrant out for her arrest, doesn't are looking to be married anymore, and very wishes a miracle to avoid wasting her. To fill up her week - she unearths herself in the midst of a Montana storm from snow and sicker than she's ever been.
Trent give up the FBI to come back domestic and have become a sheriff. because the such a lot eligible bachelor in citadel Peaks, he's had his percentage of ladies chase him, yet has been disinterested; beforehand. He has a sworn accountability to guard the town's electorate and support different enterprises in doing a similar. while confronted with a suspect in a felony case, will he make the arrest or lead along with his center?
Join Sara Brownell as she runs for her lifestyles, immediately into the ready fingers of neighborhood sheriff Trent Harding. Throw in a life-size nativity and many snow and watch the magic of Christmas come to existence.
See how "Sara in Montana" perpetually adjustments the lives of Sara and Trent in addition to these round them.
Download E-books Love on the Slopes PDF
By Elizabeth Goddard
SHANNON DE CROIX HAD significant PLANS
But a significant damage ended her desires of creating the nation's most sensible ski group. Now, along with her good-looking trainer, Hudson Landers, at her aspect, Shannon hopes to compete back. yet although she trusts Hudson's judgment, she desires to educate tougher.
Hudson cares an excessive amount of approximately Shannon to enable her probability her lifestyles only for the sake of pageant. He fears that yet one more fall may possibly wreck her destiny and holiday her center. Can Shannon and the disabled children he coaches express him that falling down and getting again up back is what religion and love are all approximately?
Download E-books The Ex Games (The Romantic Comedies) PDF
By Jennifer Echols
Brace your self for the conflict of the exes. . . . Hayden and Nick was a scorching merchandise, yet their short affair ended with a hugely publicized breakup. Now the 2 are "just pals" apart from the occasional flirtation. whilst Hayden wins the women' department of a neighborhood skiing pageant, Nick is unimpressed, claiming that Hayden do not have an opportunity opposed to a man. Hayden calls Nick's bluff and demanding situations him to a head-to-head boarding contest. Their mutual buddies quick take aspects, the ladies on Hayden's and the lads on Nick's, making for an all-out conflict of the sexes. This pleasant pageant is sure to get heated - and they'd turn out igniting a few outdated flames.
Download E-books Muscling Through PDF
By J.L. Merrow
The higher they arrive, the tougher they fall... in love.
Cambridge artwork professor Larry Morton takes one, alcohol-glazed examine the massive, tattooed guy looming in a dismal alley, and assumes he's performed for. Moments later he reveals himself disarmed—literally and figuratively. And, the following morning, he can't leisure till he bargains an apology to the fellow who became out to be extra mild than vast.
Larry's intrigued to discover there is extra to Al Fletcher than meets the attention; he possesses a usual inventive expertise that shines via untutored method. regrettably, nobody else turns out to determine the delicate soul underneath Al's enforcing, scarred, undeniably attractive external. Least of all Larry's class-conscious kinfolk, who would favor not anything larger than to separate up this mismatched pair.
Is it actual? Oh, convinced, it's deliciously actual, and a lot more—which makes Larry's subsequent activity so daunting. not only convincing his colleagues, family and friends that their dating is greater than pores and skin deep. It's convincing Al.
Contains comedian misunderstandings, misuse of paintings fabrics, and unforeseen poignancy.
Download E-books Only Mine (Fool's Gold, Book 4) PDF
By Susan Mallery
You cannot win should you do not play…
Her town's loss of males might make headlines, however it is not information to Dakota Hendrix. the gorgeous blonde has greater difficulties to house, reminiscent of overseeing the romance fact festival filming in Fool's Gold. Screening eligible bachelors is a tricky adequate activity, yet Dakota hits an unforeseen snag whilst an attractive stranger involves town.
Finn Andersson will do whatever to maintain his dual brothers the right contestants off the express. regardless of Dakota's larger judgment, she unearths herself attracted to the mysterious outsider. Like her, Finn is aware approximately heartbreak and the way a family members can disintegrate, so she does not dare to wish for something greater than a fling. in the end, even within the Land of satisfied Endings, discovering real love is rarely as effortless because it seems on TV.
Download E-books The Cottage on Juniper Ridge (Life in Icicle Falls) PDF
By Sheila Roberts
How to alter Your Life…
Can a book switch your lifestyles? certain, whilst it is Simplicity, Muriel Sterling's advisor to straightforward residing. in truth, it conjures up Jen Heath to go away her demanding, overcommitted existence in Seattle and circulate to Icicle Falls, the place she rents a beautiful little cottage on Juniper Ridge. And the place she will get pleasure from easy pleasures—like becoming a member of the neighborhood ebook club—and complicated ones, like falling in love along with her horny landlord, Garrett Armstrong.
Her sister Toni is prepared for a metamorphosis, too. She has a teenage daughter who is continuously texting her associates, a husband who is extra concerned together with his machine than he's together with her, and a son who is fed on by way of games. Toni wishes her kin to develop closer—to go back to an easier means of life.
Other girls on the town, like Stacy Thomas, also are encouraged to sell off their extra stuff and the various additional obligations they have taken on.
But as all of them detect, occasionally lifestyles easily occurs. It does not regularly ensue simply!
Download E-books Christmas Seduction PDF
By Samantha Holt
In a time whilst marriage had little to do with love and every thing to do with cash, Alexander Fenhurst, Duke of Wyndbourne, by no means anticipated a love fit. yet he additionally didn't anticipate his spouse to run into the hands of one other guy just a month after their nuptials. Having came upon her within the include of one other man—and good conscious of her dislike of him—he did what any self-respecting guy might do. He left his Scottish property and spent virtually a 12 months mountaineering the Alps and indulging his ardour for adventure.
But no volume of experience will switch the actual fact he wishes an inheritor. Resigned to the information he one way or the other must win over his spouse adequate to permit him in her mattress, Alex returns to Scotland for Christmas to celebrate...and seduce.
Emma Fenhurst, Duchess of Wyndbourne, has spent virtually a yr on my own and depressing. She hadn't anticipated a lot from her marriage, yet she had no less than anticipated a toddler or , and Alexander had by no means appeared a merciless guy. yet after their fleeting first month of marriage, he bored with her and fled to France. Lonely and determined for a kid, the scoop of her estranged husband's go back summons her braveness and resolution. through the tip of the Christmas celebrations, she's going to be with baby and intends to do all she will to attract her husband into her mattress. despite the fact that, whereas she skill to percentage her physique with him, a few secrets and techniques needs to stay simply that—secret.
Will the festive interval deliver them nearer jointly or will their plans draw them extra aside? Is there any likelihood for an prepared marriage to convey happiness...and even perhaps love?
Download E-books I Only Have Eyes For You (The Sullivans) PDF
By Bella Andre
The sweetest temptation…
Sophie Sullivan fell head over heels for Jake McCann on the age of 5. 20 years later, the infamous undesirable boy nonetheless sees her because the "nice" Sullivan dual. once they either get stuck up within the magic of the 1st Sullivan marriage ceremony, she is familiar with it is time to make him see her for who she actually is…the lady who will love him forever.
Jake has regularly been a magnet for girls, however the basically girl he particularly desires is the only he can by no means have. not just is Sophie his most sensible friend's off-limits sister…he cannot hazard letting her get shut adequate to find his deeply hidden secret.
But while Sophie looks on his doorstep, Jake's each fable involves lifestyles, and he does not have a desire of taking his eyes, or arms, off her. Jake is familiar with loving Sophie is not the correct factor to do, yet one examine her and he is aware he cannot in all likelihood resist.
Download E-books Diary of a Vixen PDF
By Chanel Jones
Jasmine used to be a regular youngster born within the Dominican Republic, whose existence hadn't been so nice. After leaving the single position she had ever referred to as domestic, her existence all of sudden replaced for the more severe. compelled to stay with a Father who wishes no components of her, actual abuse will quickly exhibit his disdain. Jasmine finally turns into homeless, residing at the streets and left to fend for herself on the delicate age of 16. Having nowhere else to move and not anyone in her nook, she reveals herself in a bunch domestic the place she quick turns into the objective. stick with Jasmine's trip of heartache and drug addictions, as she seems to be for romance in the entire improper locations. All she ever sought after was once a occupation, dependable buddies and greater than whatever, love. occasionally in lifestyles, even the main easiest of items are by no means effortless to return through. For Jasmine, the difficulty by no means looked as if it would finish, and existence for her had regularly been a downhill spiral. Meet Jasmine Hertz, of Chanel's debut novel, Rap big name. while a trip has been not anything yet one undesirable scenario after one other and you've got by no means discovered the way to belief, you're left with out different selection, yet to have a chilly heart......
Download E-books Anna's Gift (Love Inspired) PDF
By Emma Miller
Nobody in Seven Poplars, Delaware, expects Anna Yodereverto marry. between her six beautiful, petite sisters, substantial and simple Anna appears like a plow horse. yet then Samuel Mast, the good-looking widowed father she has secretly enjoyed for years, asks if he can court docket her. definitely Anna has misheard—Samuel has his decide of beautiful brides! She's confident he seeks a spouse simply as a mom for his 5 teenagers. Or may well a guy like Samuel even have a very romantic explanation for in need of Anna via his aspect without end?


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According to Erica Jong, in her book Witches, the chalice is readily ended of silver, is a expressive chart of the vulva or womb of the goddess, and is hand-me-down for communion purposes plus witches, for libations to the deities, as well as a chart for the Goddess in a ritual called the Illustrious Performance, in which the athame is plunged concerning the chalice to typify the sexual association of the Goddess and the Horned God. It is this association that believers lever gave attitude to room and is apt for the reawakening of key up each blind date.
As with all tools of the witch, non-witches want not chronicle the chalice. If a non-witch want chronicle the chalice then the chalice want be cleansed and re-blessed in advance unusual hand-me-down afterward director.
*Note: Clear traditions use a consumption horn wholly than a chalice. Likewise, do to the fact that silver tarnishes in a relaxed manner, oodles witches no longer use silver chalices but wish either pewter chalices, which make available the tune of silver without tarnishing, or chalices ended from other substances such as window, inflict, earthenware, stone, or even metals correspondence brass.
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Westlock CATS presents: A Tribute to Stompin' Tom – Across this Land in Story and Song
Celebrating Canada's 150th, we're proud to present the music of a Canadian classic performed by a true Canadian Western artist. Tim Hus will share personal stories of his friend and mentor, Stompin' Tom and provide a show of music, patriotism and yes, a bit of board stomping!Find out more »
Westlock CATS presents: Jim Byrnes
Jim Byrnes has been on the blues highway for 40 years. His evocative, smoky vocals and song have developed from those years of experience.Find out more »
Westlock CATS presents: Michael Kaeshammer
The CATS committee presented Michael after his first showcase at ATAA, when he was but a boy! We are so pleased to be able to bring him back to the Westlock stage. Known for his piano virtuosity, vocal ability and charisma, Kaeshammers' performances are pure delight.Find out more »
Westlock CATS presents: Christopher Hall and the Comic Quartet
The Strathcona Quartet is no joking matter, but when you add former principal clarinet of the Montreal Metropolitan Orchestra to the mix...things change. Christopher Hall used to find the seriousness of the orchestra environment far to serious and as a stand up comedian, has added a twist to the performance.Find out more »
Westlock CATS presents: Krystle Dos Santos
A Soul/Jazz singer and songwriter, Krystle and the Black Mambas will bring a unique blend of dance beats, funky grooves, Motown and soft jazzy soul to create an intimately magnetic connection with her audience.Find out more »
Westlock CATS presents: Union Duke
Union Duke is a Toronto folk group that bridges big-city rock with bluegrass and country, defined by their rambling banjos, soaring vocal harmonies and chicken-pickin electric guitars. Finishing the season with a bang!Find out more »


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"You've Tried the Rest, Now Try the Best" That's one of my favorite pizza box slogans. Another, I'm sure I've seen is "If you love our pizza, tell a friend. If not, tell us." Mr. Cynical side has always interpreted that latter suggestion as 'tell us and it will die with us,' but my inner … Continue reading B-B-Bad Reputation?
Tag: #miscommunication
(Please, please update your websites...) With so much written on the subject of SEO, getting links and building authority, one glaring oversight seems to prevail across all channels. While striving to keep your content fresh and useful, don't forget to also keep it from spoiling outright. In other words, please update those old pages on … Continue reading EXPIRED!
Originally Published on LinkedIn, January 16, 2017 They're trying to tell you what they like – or dislike They may be telling you that you're doing a good job at something – or that there's room for improvement. Customer acquisition is one of the most costly aspects of business. Failing to retain a customer … Continue reading Miscommunication is (seriously) bad for Business