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Pulling off the whole tavern that doubles as a destination restaurant thing can be tough to do. On one hand, you want to be a cool place to hang and drink. On the other, it's a restaurant goddamnit, which means serving more than booze and bar bites. It's not impossible though, and there are great places that make it work. Son Of A Butcher is not one of those places.
Let's start with the positive, glass half full approach. We're into Son Of A Butcher as a local neighborhood tavern. The staff is friendly, waitpersons and bartenders alike, and it's a casual place to hang out. It's dark inside, and there are both deer heads and random pictures of pigs and old people on the wall - all of which seem very fitting for drinking something dark. We would even order easy bar food like a burger, fried chicken sandwich, or fries with chorizo gravy to go along with a whisky or beer.
The problem is Son Of A Butcher gets carried away with trying to execute a complicated menu. Aside from the previously mentioned items, the menu is very heavy in the entree department with things like steak frites, duck bolognese, and pulled pork by the pound. Some things are alright, while others are just bad, and none of it's that great. We wish Son Of A Butcher would stay in its lane, meaning ditch the entree style system that doesn't work and serve a menu full of quality pub food that goes along with the tavern feel. Until then, we suggest treating this place more like a neighborhood bar than restaurant.
Food Rundown
Fries with gravy and bits of chorizo. Good to share.
This isn't good. Rather than a singular meat pie, it's three different bad meat balls topped with smoke gouda. Nope.
Spaghetti noodles with duck bolognese, shaved parmesan, and a duck egg. Not bad if you want to share, but you don't need to come here for pasta.
Mussels and meatballs sound like a weird combo, and guess what, they are! It's basically just a pot of both of those things in a below average tomato sauce.
For $12 you get four chicken confit drumsticks. They're good as an appetizer, but if it's wings you're after then go get a dozen elsewhere for the same price.
If you want to eat here, we'd come to grab the burger or fried chicken sandwich at the bar.

subset: commoncrawl


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Tel: 01872 276633
The perfect location for your dream wedding with its traditional yet individual style, The Alverton Hotel and gardens present a stunning backdrop for your special day. From small ceremonies and receptions in the Library to much larger affairs in the Great Hall, you can be guaranteed a day to remember. Once a convent, The Alverton Hotel boasts stunning interior architecture, towering sandstone walls, mullioned windows and a Cornish Delabole slate roof and proudly defends its claim as a Grade II listed building of special historical interest. With such a unique venue you can have the solemnity of a traditional wedding whilst making the entire day personal to you.
Tel: 01404 41266 | Honiton
Set in 80 acres of grounds with extensive lawns and gardens and wonderful views of the River Otter across the valley, the Deer Park is the ideal setting for your special day. From small, intimate wedding parties through to groups of 180 in the stunning Georgian orangery, the Deer Park provides the perfect start for a new life together. Licensed for civil marriages you can choose from one of our three wedding packages or we can create a tailor-made day just for you.
Tel: 01752 862358 | Plymouth
Langdon Court dates back to Norman times and was family owned for 500 years. A truly historic venue surrounded by beautiful gardens, with a very romantic atmosphere, it is not difficult to imagine the lavish parties and celebrations that took place here over the centuries, a tradition that we want to continue. Perfect for your wedding in Devon.
Tel: 01752 822864 | Torpoint
This unique historic Fort with wide lawns, lovely gardens and own beach is only four hours from London. Secluded Polhawn Fort is yours exclusively for three or four days, to combine a relaxed wedding and holiday in complete privacy: play tennis, croquet or swim.
Tel: 01392 797444
Rockbeare Manor is an exquisite Grade I listed, Regency country house set in over 100 acres of glorious Devon parkland, just six miles from the centre of Exeter. Formerly a cherished family home, Rockbeare has now been given a new lease of life and will be opening its gates in 2016 as an outstanding, exclusive use venue.
Tel: 01752 275850 | Plymouth
Wedding venues dont come much grander than The Duke of Cornwall Hotel. With the accolade of being Plymouths First Luxury Hotel, this iconic building embodies striking Victorian gothic style in a superb city centre location. The hotel offers a flexible range of luxury wedding packages, with features that include fine dining, a red carpet entrance and a selection of beautiful bridal suites. Theres also a Master of Ceremonies and Wedding Co-ordinator to make your big day run smoothly. For a venue with everything you need for an unforgettably magical day, the Duke of Cornwall Hotel is the perfect choice.
Tel: 07872 64 77 30 | Liskeard
Trevenna is an utterly chic cluster of barns set within 142 acres of beautiful Cornish countryside. With leafy lanes and panoramic views Trevenna captures all that is romantic abut Cornwall and can be exclusively yours for 1,2 or 3 days. There is a choice of licensed settings to say your vows from the garden marquee and stylish threshing barn to the outside arbour, dining in a garden marquee with slate floor, wood clad walls and soft drapes, plus accommodation for up to 40 guests in luxury barns. All hosted by an in-house team and with flexible dining from hog roasts and fish and chips to 3 course gastro dining Trevenna provides a truly unique wedding experience.
Tel: 0845 548 1233
Introducing a stunning new venue set within 160 acres of Devon countryside with breath-taking views over the Blackdown Hills. Licensed for civil ceremonies, you can choose to say I do in our lovingly restored 17th century barn or under the oak arbour in our secluded walled garden. Perfect for couples searching for a stylish and contemporary blank canvas venue that is exclusively yours for your wedding, where you create a truly unique day that you and your guests will remember forever!
Tel: 01884 855 363 | Tiverton
The Bickleigh Castle Estate presents an 11th century castle with a 6th century chapel, croquet lawn, tennis court and is located within a thousand acres of green land stretching out around the Estate. The River Exe runs through the Estate offering you the chance to fish and enjoy the beauty of the Devon countryside. This presents itself as one of the most exquisite Estates in England.
Tel: 01884 842430
Hidden from public gaze for 240 years, a new chapter in the life of Bridwell Park is about to unfold Bridwell Park, the home of Lord Ivar Mountbatten, is an exceptional country house wedding venue set within 120 acres of magnificent Devonshire parkland. It is an idyllic setting of great prestige, in which to create a stunning wedding celebration. A choice of flexible and inspiring locations within the estate are available for civil marriage and civil partnership ceremonies, wedding blessings, wedding receptions and the most fabulous wedding parties!
Tel: 01392 833846 | Dunchideock, nr Exeter
This much sought after civil weddings and short breaks holiday venue in Devon is perched high on Haldon Hill and stands in 5 acres of woodland in the heart of the lovely Devonshire countryside some 6 miles from the cathedral city of Exeter. From its vantage-point, panoramic views extending to Dartmoor, Exmoor, the South Hams, the River Exe valley and its estuary can be seen. On a really clear day, the Isles of Purbeck and Portland Bill in Dorset are visible and even Wales.
Tel: 01822 852245 | Yelverton
From the picturesque gardens and moorland surrounds to the stunning Crystal Room, the Moorland Garden Hotel offers the perfect setting to celebrate your special day in style. Newly refurbished and nestling within nine acres of moorland garden on the edge of Dartmoor National Park, this luxury Devon hotel caters for wedding parties from 2 to 160, with the option of hosting up to 500 in a marquee in the grounds. Whether you choose to say I do in the elegant Crystal Room, or beneath the vaulted ceiling of the Mayflower, the Moorland Garden Hotel is your dream destination to tie the knot.
Tel: 01769 560501 | Burrington
Northcote Manor country house hotel in Devon provides a level of unsurpassed luxury, offering short breaks, last minute breaks, exclusive use weddings & weekend breaks. In the Devon Hills, a meandering, deeply wooded driveway provides the anticipation of something special to come.
Tel: 07738 094 179
Paschoe House is a grade II listed manor only 20 minutes from Exeter. The venue is currently undergoing renovations and will be opening to the public in August 2017. This luxury venue will seat up to 120 guests for weddings in the stunning Glasshouse, with 9 en-suite bedrooms and a restaurant. The Victorian walled garden will be perfect for your pre-wedding day hog roast. The weddings team would love the opportunity to chat to you about your big day and how it could work at Paschoe House, so please do not hesitate to get in touch.
Tel: 01579 350044 | Saltash
Pentillie Castle, on the Cornish bank of the River Tamar, and set in a 2,000 acre private estate, is exclusively yours for your wedding. Take over the Castle and gardens for an entirely private celebration with your close friends and family. Enjoy the opportunity to relax into the beautiful surroundings, luxurious award-winning accommodation and spectacular gardens of Pentillie Castle.
Tel: 01626 890243 | Exeter
Powderham Castle is a truly magical place to hold your wedding reception. The Music Room, Dining Room and Libraries were originally built to create an impression and designed for lavish entertaining - they still create a very memorable setting today.
Tel: 01647 252552 | Place Barton, Ashton
The Great Barn, known as the thatched cathedral is licensed for both marriages and civil partnerships. The sheer scale of the vast 45ft vaulted oak ceiling provides a spectacular backdrop for your most important of days, while its chic, clean interior is a blank canvass for you to create exactly the look you want. Outside, the medieval courtyard and beautiful walled gardens are perfect for drinks and photographs. Surrounded by the Place Barton private estate, exclusivity and privacy are guaranteed.
Tel: 01647 24641 | Hittisleigh Barton
The Oak Barn is a stunning wedding venue in the heart of rural Devon, featuring a medieval style hall that will seat up to 90 guests, a large lounge and modern kitchen. Their landscaped gardens with lawns and terraces are surrounded by beautiful Devon countryside and the gardens are overlooked by the medieval parish church of St Andrews. If you are looking for a wedding with a difference, you can get married in the barn itself, which provides the perfect backdrop for all types of weddings from the very sophisticated to the quirky and informal. We will work with you to deliver the Devon wedding of your dreams at a very competitive price.
Tel: 01803 762235 | Totnes
Kingston Estate is a magnificent wedding venue in Devon with a Georgian country mansion, a converted barn and beautiful formal gardens. We can offer exclusive use of the venue, plus we also have 9 luxury holiday cottages on site. Located near the river Dart, Dartington and Staverton, Kingston is right in the heart of the Devon countryside. You couldnt ask for a more romantic or unique setting for a wedding venue in Devon.
Tel: 01548 830888
With its unique combination of traditional and contemporary, Shilstone provides the perfect setting to deliver the wedding of your dreams. Set within 500 acres of Devonshire countryside, Shilstone has breath-taking views from every angle. Shilstone is a fully licensed wedding venue in Devon, providing fantastic opportunities for both indoor and outdoor ceremonies. With beautiful grounds and captivating scenery, Shilstone is the idyllic backdrop for your wedding photographs.
Tel: 01395 513252
With an exceptional location and spectacular bay views, Sidmouth Harbour Hotel is set to become the regions most desirable waterfront wedding venue following the hotels major refurbishment. Take your vows in our beautiful new wedding suite, sip champagne on the private wedding terrace and enjoy breathtaking photos against the dramatic Jurassic coastline.Whether you are looking for an awe-inspiring venue for an intimate coastal wedding, or a superb backdrop for a grander affair, the versatility of the venue allows you to really make the day your own.
Tel: 01822 832 528 | Tavistock
If fantastic food and stunning views are high on your wedding agenda, youll love The Horn of Plenty. This independently owned Country House Hotel has a string of recent accolades and awards, including Devon Small Hotel of the Year 2014/15 and "Devon's Best Wedding Venue 2016. Everything here is top-notch, and the team will bend over backwards to create the day youve dreamed of.
Capacity: 90 in the Main House or 250 in a marquee.
16 bedrooms, sleep 32.
Licensed for Civil Ceremonies and Partnerships.
Tel: 01392 873328 | Exeter
A unique and romantic wedding venue in Exeter within a Georgian manor house surrounded by parkland golf course. It is the perfect venue for couples looking for an elegant wedding venue, with a relaxed and friendly atmosphere.
At Exeter Golf and Country Club, you can get married near Exeter city centre yet still feel like your wedding is at a stately home in the countryside. Nestled at the edge of the city, this is a wedding venue which combines elegance and romance with convenience. Our Georgian manor house is the perfect place for your wedding ceremony and breakfast, with views across the putting greens and 18th hole of the golf course. We have a large, tastefully decorated function room for your wedding reception and a smaller, newly refurbished function room with outdoor terrace overlooking the outdoor pool and tennis courts. Both feature atmospheric lighting, AV equipment and bars.
There is a choice of wedding packages available, allowing you to plan a day that suits your needs, with an ESPA spa for bridal treatments and more.
Tel: 01752 344455
Once youre lucky enough to have found true love, theres no reason to stop falling. Visually stunning and seamlessly presented, 5* Boringdon Hall Hotel and Spa is a seductive setting for weddings in Devon. They specialise in original, distinctive celebrations as well as exclusive use weddings.
Tel: 01566 783179
Nestled in the heart of the beautiful and unspoiled West Devon countryside, lies Coombe Trenchard. This grade II 'Arts & Crafts' country house and garden, kept secret for decades, now offers a very special location for your perfect wedding day. Surrounded by park & woodland, with far reaching views towards Dartmoor, Coombe Trenchard offers you choice and flexibility when designing 'your wedding, your way .
Tel: 0844 5000 501 | Tavistock
Tucked away down a meandering lane, in the heart of a hidden valley, lies Ever After, an exclusive new wedding venue of understated elegance and style. Perfect for those yearning for a romantic garden wedding with a stylish, contemporary and completely personal twist, this eco-luxe venue will delight even the most discerning of wedding parties.
Tel: 01288 352352
Perched on the north Cornwall coast near Bude, Launcells Barton is a beautiful wedding venue set in stunning wooded countryside overlooking the ocean. The magnificent manor house is thought to date back to the 14th century and is steeped in a palpable sense of history, giving a regal air that smacks of classic old school romance. Having been lovingly restored by its current owners to provide an inviting world where contemporary luxe meets period charm, Launcells Barton is the epitome of elegance - and the perfect place to stage an ultra memorable celebration.
Tel: 07710 506 999 | Clyst Hydon
Having been restored to its original state, The Manor Hall can be used once again as the perfect wedding venue. The hall, with its stage and proscenium arch, will happily seat well over 100 for a civil ceremony and opens onto spacious lawns for marquees and receptions. The Manor itself, tucked away behind a high brick wall, sits in a landscape of parkland, woods and fields stretching as far as the eye can see providing an expansive rural backdrop for your event.
Tel: 01392 431 403 | Exeter
Pynes House is a stunning country house set in its own 37 acre park in the beautiful Exe Valley. Built in 1700, Pynes House offers grand state rooms, glorious rose and parterre terraces and luxury accommodation. Pynes House is the perfect year-round retreat for intimate groups or larger weddings.
Tel: 01822 870000 | Tavistock
'One of the most special places ever visited by STELLA - yes truly'.
'The prettiest spot in Devon' MARY GOSTELOW.
'We left this magical place beaming with delight' THE DAILY TELEGRAPH.
Tel: 01404 813511 | Ottery St Mary
A Cadhay wedding is a bit like getting married from home - albeit a manor house set around a courtyard with Tudor monarchs on every side. Occupy the entire house and magnificent gardens which are set around medieval ponds for a weekend or a full week. Many weddings take place outside in the wonderfully tranquil water garden but you can also get married in the house.
Tel: 01364 655918 | Ashburton
Holne Park House is one of the most romantic, stylish and unique wedding venues in Devon. Nestled on the southern slopes of Dartmoor National Park, set within the 90 acres of grounds and gardens of the River Dart Country Park, the House is an idyllic venue for your Devon wedding. All five reception rooms are licensed for civil wedding ceremonies and can accommodate over 200 people for your wedding reception o for larger parties, the large level-lawn area to the front of the house has an outside pavilion that is licensed for civil ceremonies and provides the perfect setting for a marquee.
Tel: 0300 555 0214 | Exeter
This enchanting house, nestled in stunning botanical gardens, provides nothing short of an idyllic backdrop for your special day. Licensed for civil ceremonies and partnerships, Reed Hall offers the flexibility to cater for weddings and receptions of all shapes and sizes. The combination of historical atmosphere, first-class cuisine and an exceptional personal service make Reed Hall the perfect venue for a unique wedding.
Tel: 01271 882243
Sandy Cove Hotel is situated on the stunning North Devon Coast and its unique location makes the whole day unforgettable, from your Wedding Ceremony which can be held outside in our gazebo overlooking the sea, through to your evening celebrations in our Cliff Top Marquee. We also offer exclusive affordable use of our Hotel.
Tel: 01271 890212 | Braunton
With its stunning location, fantastic food and elegant surroundings, the Saunton Sands Hotel is an inspired choice for your Devon wedding. When you choose us as your wedding venue, a dedicated wedding planner will be appointed to assist you with all the arrangements. The management will be more than happy to fulfil the duties of Master of Ceremonies and Toastmaster, and everything from the flowers to the food will be taken care of to your specifications.
Tel: 01752 344840 | Plymouth
For your wedding in Plymouth, St Elizabeth's House has to be one of the most romantic hotels to choose for your civil ceremony and wedding reception. St Elizabeth's beautifully landscaped gardens and sweeping lawns offers the perfect backdrop for memorable pictures and a casual setting for a pre-dinner wedding reception.
Tel: 01395 233382 | Woodbury
Surrounded by breathtaking scenery, Woodbury Park provides the ideal backdrop for romantic Devon weddings. Expect red carpet treatment, first class service & cuisine using only the finest local Devon produce. Perfect for intimate ceremonies & extravagant wedding receptions, youll find a variety of function rooms & menus to suit every taste. From traditional wedding breakfasts to informal receptions with hog roasts and luxury BBQs, our wedding co-ordinator will be with you every step of the way to ensure the smooth running of your special day.
Tel: 07768 241139 | Parracombe
Set within 4,000 acres of Exmoor National Park, the Woolhanger Estate offers complete privacy and seclusion as well as breath-taking panoramic views. The beautifully restored historic Music Room is an ideal setting for your perfect wedding. For more details see our website WWW.Woolhanger.com or contact Laurence Young on 07768 241139 or email: firstname.lastname@example.com for a viewing.
Tel: 01548 810514 | Bigbury on Sea
The Party Palace
Why not take over the whole hotel for your wedding, civil partnership or special party? At Burgh Island we have over a decade's experience of hosting memorable and romantic celebrations, ever since the owners were themselves married here in 2001. In 2011, readers of The Good Hotel Guide voted Burgh Island "the most romantic hotel in Britain".
| Filleigh
Castle Hill provides a wonderful setting for a wedding, with large beautifully-adorned rooms and immaculately maintained gardens which are ideal for photographs. The Library, Red Room and West Wing are all available for wedding ceremonies. Receptions can take place in the Red Room (50 people), or the West Wing (100 people). With the addition of a marquee on the West Lawn adjoining the West Wing, up to 300 people can be accommodated for a reception.
Tel: 01752 837645
Wedding venue Devon
Tel: 01392 665500 | Exeter
The Guildhall has served as the centrepiece of Exeter's civic life for more than 800 years. A structure of outstanding architectural interest, it is not merely an ancient monument but remains a busy working building - still in regular use for a variety of civic functions and full meetings of the City Council. Since 18 March 2011, it can also be hired for Weddings and Civil Ceremonies.
Tel: 01822 614253 | Tavistock
Fringing Dartmoor National Park near Tavistock, Mount Tavy Cottage - a 250 year old former gardeners cottage - is a magnificent wedding venue. Get married amongst 10 acres of beguiling landscape that feature a lake, organic walled garden and cider orchard and say your vows in their Greenhouse style function room overlooking the lake, spilling your celebrations outside into the beautiful grounds - or into a marquee reception, for an ultra memorable affair.
Tel: 01803 697500 | Paignton
Situated in the Torbay area of South Devon, Paignton Zoo provides a decidedly different wedding venue. Set in 80 acres of beautiful botanical gardens, the zoo accommodates all types of events - from intimate to grand scale. The Island Restaurant caters for larger parties, offering spectacular views of the Gibbon Island; while the Whitley Room adjoins the restaurant and is perfect for a smaller wedding breakfast, complete with outdoor terrace that looks out upon the stunning lakeside area. Why not even get married at their Tiger or Lion Viewing areas for a truly unforgettable day?
Tel: 01548 859000
A fantastic, contemporary boutique hotel right on the beach in South Sands bay, just outside Salcombe. Designed in a classic New England style the hotel has 22 beautifully appointed bedrooms. 5 opulent beach suites and a beachside restaurant and terrace that offer stunning views of the estuary.
The perfect environment in which to relax and unwind..
Wedding venue Devon
Tel: 01822 243145
Situated within its own spacious grounds at the heart of Tavistock opposite St Eustacius Church, The Bedford Hotel boasts a bevy of prime photographic opportunities, from the ornate bridge leading to a Walled Garden, to Gallery 26 - their stunning new function room recently awarded best Vernacular Award for architectural design. Fully licensed for civil ceremonies and partnerships, The Bedford provides couples with a winning combination of stunning setting, award winning food and fabulous function rooms for an ultra stylish and memorable day.
| Princetown
Set in 60 private acres amidst the stunning centre of Dartmoor National Park, Two Bridges is a scenic choice for a captivating country wedding. Offering spellbinding views along with sumptuous accommodation featuring four poster beds, deep spa baths, snug lounges and log fires, picture manicured lawns leading toward the River Dart for a truly magical backdrop to your day. Catering for up to 200 wedding guests with AA Rosette award-winning dining, the heavenly hotel is licensed for civil ceremonies and can tailor the look, size and feel of event to suit your specific needs - whether you wish for an al fresco summer wedding in the glorious gardens and riverside pagoda or an achingly romantic winter wedding where you can utter your vows by candlelight.
Tel: 07951 593599 | Liverton
Your big day is Your. Big. Day.
You deserve the wedding of your dreams. Whether youre a traditional romantic or a bit of a free spirit we are sure you will fall in love with your Yurtcamp wedding.
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Toyota of Puyallup
Review for Toyota of Puyallup
JULIE D. on 12/31/2014
"Price, how I was treated and am very pleased"
I liked the online price Negotiations. Friendly staff, you had exactly what I was looking for and the finance person was AWSOME.
Vehicle: TOYOTA COROLLA
Category: Sales
Sales Date: 12/30/2014
Review Created: 12/31/2014 06:26 PM


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Chocolate Lovers Delight Basket
Featuring a Chocolate Pizza---!!!
A fun and delicious milk chocolate treat topped with M&M's, white chocolate drizzle and then filled with mini marshmallows.
If you like graham crackers, you will love the milk and dark chocolate crackers! The only thing missing is a glass of milk!
Mouthwatering cookies and cream fudge mixed with crushed Oreos attractively placed in an elegant box. What could be yummier?
The two, rich, chocolate cream truffles are pure decadence to the taste buds!
A jar of dark chocolate fudge sauce is included for you to top off your favorite desserts or just eat it right out of the jar…
We've also included heart-shaped milk chocolate suckers and more! Two Hearts as one is the message of this basket and the colorful "Chocolate Lovers Delight" surely says it all!


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Journal of the American College of Cardiology
Impaired Endothelium-Dependent Relaxation After Cardiac Global Ischemia and Reperfusion: Role of Warm Blood Cardioplegia
Author + information
- Received June 20, 1996
- Revision received October 31, 1996
- Accepted November 26, 1996
- Published online March 1, 1997.
Author Information
- ↵*Dr. Pyng Jing Lin, Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, 199, Tun-Hwa North Road, Taipei, Taiwan, Republic of China.
Objectives. Experiments were designed to determine whether coronary endothelial dysfunction after cardiac global ischemia and reperfusion could be prevented by warm blood cardioplegic solution.
Background. The coronary endothelium produces endothelium-derived relaxing factor (EDRF) to prevent vasospasm and thrombosis. After ischemia and reperfusion, endothelium-dependent relaxation (EDR) is diminished as a result of G-protein dysfunction.
Methods. Dogs were exposed to extracorporeal circulation in 37°C (group 1) or 28°C (groups 2 and 3). The heart was ischemic for 120 min while continuous warm blood cardioplegic solution (group 1) or intermittent cold (4°C) crystalloid cardioplegic solution (group 2) was infused into the aortic root. Cardioplegic solution was not used in group 3 animals. The heart was then allowed to function for 60 min of reperfusion.
Results. Endothelium-derived relaxation in response to acetylcholine, adenosine diphosphate and sodium fluoride of the coronary rings of group 1 was significantly different from that of groups 2 and 3 but was not significantly different from that of group 4. In contrast, EDR in response to the receptor-independent calcium ionophore agonist A23187 was not significantly different between the four groups. Scanning electron microscopic studies showed that platelet adhesion and aggregation, area of microthrombi, disruption of endothelial cells and separation of the intercellular junction could be found in coronary segments of groups 2 and 3 but not in vessels of groups 1 and 4.
Conclusions. These experiments suggest that cardiac global ischemia and reperfusion impair receptor-mediated release of EDRF from the coronary endothelium with G-protein dysfunction. This type of coronary endothelial dysfunction can be prevented by continuous anterograde infusion of warm blood cardioplegic solution during global ischemia.
(J Am Coll Cardiol 1997;29:681–7)
The coronary endothelium regulates vasomotor tone and local tissue perfusion by producing endothelium-derived relaxing factor (EDRF) and endothelium-derived contracting factors that act on the underlying vascular smooth muscle ([1, 2]). With cardiac global ischemia and reperfusion, endothelium-derived relaxation (EDR) of the coronary endothelium was impaired ([3, 4]) and might lead to coronary vasospasm and thrombosis and to myocardial ischemia ([5, 6]).
Crystalloid or blood cardioplegic solution itself does not impair EDR of epicardial coronary arteries ([7–9]). However, EDR of the epicardial or microvascular coronary arteries after global ischemia and reperfusion with crystalloid cardioplegia was impaired ([10–12]).
Warm blood cardioplegic solution has become more popular in myocardial protection in recent years ([13]). The potential advantages of warm blood cardioplegic solution are most appealing. The heart is aerobic, perfused and at rest while warm blood cardioplegic solution is infused. Warm blood cardioplegic solution can therefore be considered an interval of myocardial resuscitation ([13]). However, its effect on the coronary endothelium, functionally or ultrastructurally, especially after cardiac global ischemia and reperfusion, is not clear ([12, 14]). The present study was designed to evaluate the effect of warm blood cardioplegic solution on EDR and the ultrastructure of the coronary arterial endothelium after global ischemia and reperfusion.
1 Methods
1.1 Animal preparation.
Healthy mongrel dogs (25 to 30 kg) of either gender were anesthetized with sodium pentobarbital (30 mg/kg body weight intravenous injection), intubated with a cuffed endotracheal tube and ventilated with a respirator. The left femoral artery was isolated and catheterized for blood pressure monitoring, and an intravenous catheter was inserted into the left femoral vein for venous access. The rectal temperature was monitored. Next, a medial sternotomy was performed and the heart was exposed. Animals were heparinized (250 U/kg) and cardiopulmonary bypass was instituted using a single right atrial cannula for venous return and an aortic cannula for inflow. The left ventricle was vented directly by a catheter inserted though the left atrial appendage. The electrocardiogram was continuously monitored by limb leads. Deferoxamine (20 mg/kg) and methylprednisolone (20 mg/kg) were infused intravenously 30 min before the establishment of the cardiopulmonary bypass. The dogs were then placed on total cardiopulmonary bypass. The dogs were then placed on total cardiopulmonary bypass using a bubble oxygenator (Bard, C. R. Bard, Inc.) with a flow rate of 50 ml/kg per min. Myocardial temperature was continuously monitored by epicardial thermistor probes (Shiley, Inc.). After stabilization, the ascending aorta was cross-clamped. A double-lumen aortic root cannula (DPL, Inc.) was inserted for delivery of cardioplegic solution and simultaneous measurement of aortic root pressure. All infusions of cardioplegic solution were administered at 50 mm Hg of pressure.
Animals were randomized into four groups, with 14 dogs in each group. In the dogs of group 1, the heart was protected by continuous warm (37°C) blood cardioplegia infused into the aortic root (anterograde infusion), with the rectal temperature at 37°C. Blood cardioplegia was delivered as a mixture of four parts oxygenated blood to one part of induction or maintenance solution using a Sarns MP-4 cardioplegia delivery system (Sarns 3M Health Care Group). The composition of the induction solution was 51 mEq of NaHCO3, 25 g of glucose, 100 mEq of KCl, and 10 U of regular insulin in 1,000 ml of lactated Ringer's solution. The composition of maintenance solution was the same as that of the induction solution except that the potassium concentration was 40 mEq/liter. Initial induction of cardiac arrest was accomplished by using induction solution with a potassium ion concentration of 20 mmol/liter, followed by continuous infusion of maintenance solution with a potassium ion concentration of 8 mmol/liter. After 120 min of aortic cross-clamping, the infusion of blood cardioplegia was stopped and the cross-clamp was removed.
In animals of group 2, cold (4°C) crystalloid cardioplegia (10 ml/kg) (Plegisol, Abbott Laboratories)—with the following electrolyte composition (in mEq/liter): calcium 2.4, magnesium 32, potassium 16, sodium 120 and chloride 160—was infused into the aortic root with systemic hypothermia (28°C). The cardioplegic solution was reinfused (4 ml/kg) at 20-min intervals during global ischemia. No topical cooling was used. After 120 min of cardiac ischemia, the cross-clamp was removed and the animal was rewarmed to 37°C.
In group 3 animals, the rectal temperature was kept around 28°C. The cardioplegic solution was not used. After 120 min of aortic cross-clamping, the cross-clamp was removed and the animals were rewarmed to 37°C.
After declamping, the animals were weaned from cardiopulmonary bypass with a mean arterial pressure of 80 mm Hg. When ventricular fibrillation occurred, direct current countershocks of 10 W-s were applied. Cardiotonic drugs and vasodilators were not used. The heart was maintained in the beating and working state for a total of 60 min, and then it was excised.
An additional 14 dogs served as the control group (group 4). After induction of anesthesia, intubation and median sternotomy, the heart was excised rapidly.
All animals received humane care in compliance with the "Guide for the Care and Use of Laboratory Animals" published by the National Institutes of Health (NIH publication no. 85-23, revised 1985).
Organ chamber experiments (12 animals in each group) for endothelium functional studies and scanning electron microscopic examinations (2 animals in each group) for the ultrastructure of the coronary endothelium were then performed.
1.2 Organ chamber studies.
The heart was quickly removed and immersed in cold oxygenated physiologic solution of the following composition (mmol/liter): NaCl 118.3, KCl 4.7, MgSO41.2, KH2PO41.22, CaCl22.5, NaHCO325.0 and glucose 11.1 (control solution). The left anterior descending and/or left circumflex coronary arteries were carefully dissected free and prepared as rings (4 mm in length). During dissection care was taken to remove as much of the surrounding tissues as possible and to avoid stretching and rubbing of the intimal surface against foreign material or the opposite wall of the vessel.
In some rings, the endothelium was removed by gently rubbing the intimal surface with the tip of a pair of watchmaker's forceps ([15–17]). The rings were suspended in organ chambers (25 ml) filled with physiologic solution (37°C, aerated with 95% oxygen and 5% carbon dioxide pH 7.4). Each ring was suspended by two stainless-steel clips passed through the lumen. One clip was anchored to the bottom of the organ chamber; the other was connected to a strain gauge (Statham Gould UC2) for the measurement of isometric force. Rings were placed at the optimal point of their length–tension relation by progressively stretching them at each level of distention until the contraction to KCl (20 mmol/liter) was maximal ([15–17]). In all the experiments, the presence or absence of endothelium was confirmed by the response to acetylcholine (ACh) (10−6mol/liter) of rings contracted with potassium ions (20 mmol/liter). After this procedure, the preparations were allowed to equilibrate at their optimal length for 45 min before the experiments.
1.3 Scanning electron microscopic studies.
The scanning electron microscopic procedures were reported previously by our group ([17]). After ischemia and reperfusion, the distal part of the ascending aorta of the reperfused hearts (groups 1 to 3) and control hearts (group 4) was cross-clamped during exsanguination while the heart was still beating. The coronary arteries were perfused through the aortic root cannula at a controlled pressure of 120 mm Hg for 5 min with buffered physiologic solution of the following composition (mmol/liter): KCl 2.7, NaCl 137.9, Na2HPO4·7H2O 8.1 and KH2PO41.1. Glutaraldehyde (1%) in buffered physiologic solution was then infused for 10 min. In this way, the coronary endothelium was fixed in situ at physiologic pressure before being processed for electron microscopic studies. Segments (2 cm in length) of the left anterior descending or left circumflex coronary artery, or both, were carefully harvested and kept in the iced perfusion-fixation solution. The specimens were then fixed with iced 3% glutaraldehyde in 0.1 mol cacodylate buffer (pH 7.2 to 7.4) for 2 h. Subsequently, the specimens were rinsed with cold perfusion-fixation solution several times and postfixed with 1% phosphate buffer osmium tetroxide (pH 7.2 to 7.4) for an additional 2 h. For electroconduction and stabilization of the surface structure, the tissues were immersed in 1% tannic acid in distilled water for 30 min at 4°C and then transferred into 1% osmium tetroxide in distilled water for 30 min at 4°C, followed by a rinse with distilled water. The tissues were then dehydrated in graded concentrations of chilled ethanol. The tissue was subjected to critical point drying. After drying, samples were mounted on specimen stubs and coated with platinum and palladium alloy 4-nm thick. The specimens were examined with a Hitachi S-5000 scanning electron microscope operated at 3 kV by Dr. Lee, who did not know the grouping of the specimens.
1.4 Drugs.
The drugs—ACh chloride, potassium chloride, adenosine diphosphate (ADP), calcium ionophore A23187, (±)isoproterenol hydrochloride, indomethacin, sodium fluoride, prostaglandin F2-alphaand sodium nitroprusside—were obtained from Sigma Chemical Co. Aluminum chloride was obtained from Aldrich Chemical. All drugs were prepared daily with distilled water, except for indomethacin, which was dissolved in Na2CO3(10−5mol/liter), and A23187, which was dissolved in dimethyl sulfoxide (Sigma) and diluted further in distilled water. The concentrations are expressed as final molar concentration in the organ chambers.
1.5 Data analysis.
The data were expressed as mean value ± SEM. In all experiments, "n" refers to the number of animals from which blood vessels were taken. Although not always mentioned in the protocol, the role of the endothelium in the observed phenomena was determined systematically by comparing blood vessels (rings) with or without endothelium to avoid repetition. The responses gained from rings contracted with prostaglandin F2-alphawere expressed as percent changes from the contracted levels. With regard to relaxations, the negative logarithm of the effective concentration (mol/liter) of agonist that caused 50% inhibition of the contraction (IC50) to prostaglandin F2-alphawas calculated. For contractions, the maximal response (in grams of tension) and concentration of agonist inducing the half-maximal contraction (EC50) were determined. The means of these values were presented. Statistical evaluation of data between groups was performed by analysis of variance (ANOVA), and the Tukey ttest was used when ANOVA showed significance. Statistical significance was set at p < 0.05.
1.6 Protocol of organ chamber studies.
Coronary artery segments with and without endothelium from the same animal were placed in our eight-bath organ chamber system, studied and compared. The following procedures were performed:
1.6.1 Studies of endothelium-dependent relaxation.
Coronary artery segments (with and without endothelium) from animals were suspended in organ chambers. They were contracted with prostaglandin F2-alpha(2 × 10−6mol/liter) and then exposed to increasing concentrations of ACh (receptor-dependent, 10−9to 10−4mol/liter), ADP (receptor-dependent, 10−9to 10−4mol/liter), A23187 (receptor-independent, 10−9to 10−6mol/liter) and sodium fluoride (NaF) (pertussis toxin–sensitive G-protein activator, 1 to 11 mmol/liter).
1.6.2 Studies of endothelium-independent relaxation.
To test the ability of the smooth muscle to relax, concentration-response curves to sodium nitroprusside (mediated by cyclic guanosine monophosphate, 10−9to 10−4mol/liter) and isoproterenol (mediated by cyclic adenosine monophosphate, 10−9to 10−4mol/liter) were obtained after they were contracted with prostaglandin F2-alpha(2 × 10−6mol/liter).
1.6.3 Studies of endothelium-independent contraction.
To test the ability of the smooth muscle to contract, concentration-response curves to potassium ions (5 to 50 mmol/liter, voltage-dependent) and prostaglandin F2-alpha(10−9to 10−4mol/liter, receptor-dependent) were obtained.
2 Results
2.1 Endothelium-dependent relaxation.
Acetylcholine (10−9to 10−4mol/liter) induced concentration-dependent relaxation in the coronary artery rings with endothelium of all four groups (n = 12) (Fig. 1). However, relaxation was significantly impaired in the rings of groups 2 and 3 (p < 0.05), and the concentration-response curve was shifted to the right (Fig. 1, Table 1).
Adenosine diphosphate (10−9to 10−4mol/liter) caused EDR in the coronary artery rings of all four groups (n = 12) (Fig. 2). However, as with ACh, relaxation was significantly impaired in the rings of groups 2 and 3 (p < 0.05), and the concentration-response curve was shifted to the right (Fig. 2, Table 1).
A23187 (10−9to 10−6mol/liter) induced comparable endothelium-dependent, concentration-dependent relaxation in the coronary artery rings of all four groups (n = 12, p > 0.05) (Fig. 3, Table 1).
Sodium fluoride (1 to 11 mmol/liter) caused comparable concentration-dependent relaxation in the coronary artery rings with endothelium of groups 1 and 4 (n = 12, p > 0.05) (Fig. 4). However, exposure to NaF induced concentration-dependent relaxation in the coronary artery rings with endothelium of groups 2 and 3 (n = 12) that was significantly less than that of groups 1 and 4 (p < 0.05) (Fig. 4, Table 1).
There was no significant change in tension in response to ACh, ADP, A23187 and NaF between the coronary artery rings without endothelium of all four groups (p > 0.05).
2.2 Endothelium-independent relaxation.
Increasing concentrations (10−9to 10−4mol/liter) of isoproterenol and sodium nitroprusside induced comparable concentration-dependent relaxation in the coronary artery rings with and without endothelium of all four groups. In all groups, the maximal relaxation induced by isoproterenol or sodium nitroprusside was not altered in coronary artery segments without endothelium, nor did this induction change the sensitivity to relaxation of the vascular smooth muscle (Table 2).
2.3 Endothelium-independent contraction.
Increasing concentration of potassium ions (5 to 50 mmol/liter) and prostaglandin F2-alpha(10−9to 10−4mol/liter) induced comparable concentration-dependent contraction of arterial segments with and without endothelium in all four groups. The maximal response or the sensitivity to these agonists did not result in any significant changes in the four groups (Table 3).
2.4 Scanning electron microscopic studies.
In the coronary arterial segments of group 1, scanning electron microscopic observations showed that the endothelium was continuous and was maintained in an integrated form without significant alterations of surface morphology in all specimens examined (Fig. 5). The smooth surface of the endothelium was consistently covered with flat endothelial cells. The interendothelial junctions could not be readily delineated. We rarely observed blood cells that adhered to the endothelial surface. These findings were not significantly different from those of control group 4 vessels. In the scanning electron microscopic studies of the vessels of groups 2 and 3, swelling and disruption of the endothelial cells with wide separation of intercellular junctions were frequently demonstrated (Fig. 6). Platelet adherence and aggregation on the endothelial surface were a constant finding in every specimen investigated (Fig. 6, B and C). In some areas, platelet microthrombi were noted (Fig. 6, B and C). In some instances, extensive disruption of the endothelium was seen (Fig. 6). Those surface morphologic changes of the endothelium were consistently noted on vessels of groups 2 and 3.
3 Discussion
The major finding of this study was that during cardiac ischemia, intermittent infusion of cold crystalloid cardioplegic solution (group 2) could not, but continuous anterograde infusion of warm blood cardioplegic solution (group 1) could, prevent reperfusion injury to either EDR or ultrastructure of the coronary endothelium.
3.1 Ischemia and reperfusion injury.
Endothelium-dependent relaxation of the coronary artery in response to aggregating platelets was impaired immediately or long after local ischemia and reperfusion ([18, 19]). After cardiac global ischemia and reperfusion, EDR in response to aggregating platelets and to the receptor-dependent agonists ACh and ADP was also impaired ([3]). Our studies confirmed these findings in that EDR was impaired after cardiac global ischemia and reperfusion (group 3).
G-protein dysfunction was found recently after cardiac global ischemia and reperfusion with impairment of EDR ([4]). In our study, EDR of the coronary endothelium in response to the receptor-dependent agonists ACh and ADP and to the pertussis toxin–sensitive G-protein activator NaF was impaired. However, EDR in response to receptor-independent A23187 was not impaired. This indicated that global myocardial ischemia and reperfusion selectively impaired receptor-mediated release of EDRF (nitric oxide) due to G-protein dysfunction. However, the ability to produce EDRF by the coronary endothelium was not impaired.
In the epicardial coronary artery, reperfusion injury appears to be an endothelium-dependent phenomenon ([18, 19]). In our study, smooth muscle contraction in response to potassium ions (voltage-dependent) or prostaglandin F2-alpha(receptor dependent) was well preserved after ischemia and reperfusion. The smooth muscle relaxation in response to isoproterenol (cyclic adenosine monophosphate mediated) or sodium nitroprusside (cyclic guanosine monophosphate mediated) was also preserved in all groups. These indicated that the vascular smooth muscle function was not injured by ischemia and reperfusion.
3.2 Endothelium function and cardioplegia.
In modern cardiac surgery, crystalloid or blood cardioplegic solutions have been used routinely for myocardial protection. Endothelium-derived relaxation of the coronary arteries after crystalloid cardioplegia and reperfusion was impaired ([10–12]). Warm blood cardioplegic solution has become more popular in myocardial protection in recent years and can offer a benefit in operations on hearts that are metabolically depleted or acutely ischemic ([13]). Previous studies suggested that warm blood cardioplegic solution could preserve EDR ([11, 12]). Our studies further demonstrated that warm blood cardioplegic solution can preserve G-protein function and prevent impairment of EDR after ischemia and reperfusion injury. Our experiments also confirmed that crystalloid cardioplegia cannot prevent ischemia and reperfusion injury to the coronary endothelium.
3.3 Ultrastructure.
The ultrastructural change of the endothelium after reperfusion injury is obvious. VanBenthuysen et al. ([20]) and Lin et al. ([17]) previously demonstrated significant coronary endothelial ultrastructural injury after ischemia and reperfusion by scanning and transmission electron microscopy. In the present study, significant surface morphologic changes of the endothelium could be found in the coronary arteries of group 2 and 3 animals (Fig. 6). The surface morphology of the coronary endothelium of group 1 (Fig. 5) was well preserved, indicating that warm blood cardioplegic solution could effectively protect the morphology of the coronary endothelium from ischemia and reperfusion injury.
3.4 Conclusions.
Global cardiac ischemia and reperfusion with or without intermittent cold crystalloid cardioplegia impair receptor-mediated release of EDRF from the coronary endothelium with G-protein dysfunction and damage the ultrastructure of the coronary endothelium. This kind of impairment can be prevented by continuous anterograde infusion of warm blood cardioplegic solution.
☆ This study was supported in part by Grant CMRP 421 from the Chang Gung Memorial Hospital, Chang Gung Medical College and by Grant NSC 85-0412-B-182-111 from the National Science Council, Executive Yuan, Taiwan, Republic of China.
- Abbreviations
- calcium ionophore A23187
- ACh
- acetylcholine
- adenosine diphosphate
- analysis of variance
- concentration of agonist inducing the half-maximal contraction expressed as mmol/liter for potassium-induced contractions and as −(log mol/liter) for prostaglandin F2-alpha-induced contractions
- endothelium-dependent relaxation
- endothelium-derived relaxing factor
- negative logarithms of the concentration (mol/liter) of agonists causing 50% inhibition of contractions (i.e., median effective dose) induced by prostaglandin F2-alpha(2 × 10−6mol/liter)
- NaF
- sodium fluoride
- Received June 20, 1996.
- Revision received October 31, 1996.
- Accepted November 26, 1996.
- The American College of Cardiology
- ↵
- ↵
- ↵
- ↵
- Vanhoutte PM,
- Houston DS
- Vanhoutte PM,
- Shimokawa H
- ↵
- ↵
- ↵
- ↵
- ↵
- Ko W,
- Zelano J,
- Isom OW,
- Krieger KH
- ↵
- ↵
- ↵
- Pearson PJ,
- Schaff HV,
- Vanhoutte PM
- Pearson PJ,
- Schaff HV,
- Vanhoutte PM
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Scratch a chore off the fall to-do list without the normal fuss. Simply "set the iRobot Looj 330 ($300) at one end of a gutter and watch it brush away debris at 500 RPM." Made by the same company that gave the world the Roomba robot vacuum cleaner, this gadget needs just five minutes to clear a 30-foot stretch of dirt and leaf clutter. The waterproof machine can even operate in damp gutters and be cleaned up with a quick spray from the hose. The detachable handle doubles as a remote control. Source: Better Homes and Gardens
Russian ads reportedly reached an estimated 126 million Facebook users during the presidential campaign, likely leaving some people wondering if they are among those who might have fallen for Kremlin propaganda. On Wednesday, the social media giant announced that it will be creating a page to help users identify which accounts they liked or followed that were discovered to be linked back to a Russian "troll farm," Axios reports. Facebook says to expect the tool to be available in its Help Center by the end of the year, The Hill reports.
The Senate Judiciary Committee's Richard Blumenthal's (D-Conn.) had demanded that Facebook "individually notify any and all users who received or interacted with [Russian] advertisements and associated content," issuing similar orders to Twitter and Google. Facebook, though, will not tell users "whether they were exposed to content from the [Russian troll farm's] pages in their Newsfeed, even if they didn't follow them," Axios notes.
Facebook admitted in September that it unknowingly sold $100,000 worth of ads to a Russian troll farm during the election. Check out one particularly humorous example of a Russian ad here. Jeva Lange
Trump's chief economic adviser apparently faked a bad cellphone connection to get off the phone with him
Sen. Tom Carper (D-Del.) told CNN on Wednesday that he once convinced White House chief economic adviser Gary Cohn to pretend he had bad cell service to get off the phone with President Trump. Trump apparently called Cohn during the middle of a meeting and talked for 15 minutes before Carper gave Cohn some advice, saying: "Gary, why don't you do this, take the phone … and just say 'Mr. President, you're brilliant but we're losing contact and I think we're going to lose you now, so goodbye.'"
Democratic Sen. Tom Carper says White House economic adviser Gary Cohn faked a bad connection to get President Trump off the phone so they could have a conversation on tax reform without him https://t.co/qcUnSEsysl
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CNN's John Berman held back laughter as he asked if Carper actually convinced Cohn to fake a bad connection. The senator replied, "I don't want to throw [Cohn] under the bus, but yes." Berman's co-host Poppy Harlow then quipped, "I think you just did."
Although Trump may not hear about this incident, as he claims to watch CNN only when forced, Carper's story would likely reignite the president's displeasure with Cohn. In September, The New York Times reported Trump was refusing to make eye contact with Cohn after the Goldman Sachs alum publicly disagreed with Trump's response to the deadly white nationalist rally in Charlottesville, Virginia, in August.
The White House has denied Carper's recollection of the phone call. Kelly O'Meara Morales
White House spokesperson tells @CNN: "Senator Carper's claim is completely false. Gary Cohn left the room and continued to speak with the President privately for several minutes before they concluded the call." https://t.co/7MFxTwn43Z
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Former Team USA gymnastics doctor pleads guilty to abusing 7 girls, including 3 under the age of 13
Former Team USA gymnastics doctor Larry Nassar admitted Wednesday to molesting seven girls, including three under the age of 13, NBC News reports. In total, Nassar, 54, is accused of having abused more than 130 of his patients during medical exams between 1998 and 2015.
Among Nassar's accusers are gold medalists Gabby Douglas, McKayla Maroney, and Aly Raisman. In an Instagram post Tuesday, Douglas, 21, said she didn't tell anyone about the abuse because "for years we were conditioned to stay silent, and honestly, some things were extremely painful." Maroney accused Nassar of repeated abuse, including drugging her: "He'd given me a sleeping pill for the flight and the next thing I know, I was all alone with him in his hotel room getting a 'treatment,'" she wrote. "I thought I was going to die that night."
While entering his guilty plea, Nassar said Wednesday: "I am so horribly sorry that this was like a match that turned into a forest fire out of control." He agreed to a sentence between 25 and 40 years. Jeva Lange
Larry Nassar after entering guilty plea: "I am so horribly sorry that this was like a match that turned into a forest fire out of control." pic.twitter.com/m8vMh9iric
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Former intern for Charlie Rose says he made her watch movie sex scene, asked her if she felt aroused
A former intern for Charlie Rose said Wednesday that the former talk show host made her watch a sexually explicit scene from a movie for 20 minutes under the guise of work obligations. Rose, a veteran journalist who was fired from PBS and CBS News after allegations of inappropriate sexual conduct were reported by The Washington Post, apparently additionally asked the intern, Sarah Gordon, if the scene made her feel aroused.
Gordon told NBC News that she was delivering mail to Rose's house when the incident occurred. "I proceeded to go into the living room, and he said I want to show you this scene from this movie," Gordon said. "And he said have a seat, you know, relax, and he proceeded to turn on the film Secretary, which is a sexually involved film involving S&M, unfortunately."
Although Gordon said Rose did not touch her during the incident, NBC News noted that the film in question "portrays a young woman becoming sexually involved with her boss." Gordon said that eventually, she was able to change the subject of conversation and leave the apartment.
Rose has been accused of sexually harassing young women who worked for him. On Monday, he issued a statement calling himself "an advocate for the careers of the women with whom I have worked" and apologized for his "inappropriate behavior," including reported inappropriate touching, sexually suggestive remarks, and exposing himself.
Gordon was rather forgiving of her former boss, telling NBC News, "I think he's probably troubled, and I have empathy for people that are troubled." Still, she added, his firings were justified: "I don't think someone like that deserves to have a position like that if they're going to abuse their power," she said. Kelly O'Meara Morales
President Trump got a head start on the holiday weekend Wednesday when he arrived at Trump International Golf Club in sunny West Palm Beach to play 18 holes. But don't let his 77th visit to a golf club since becoming president fool you — it is absolutely not a "low-key day," his staff insists.
The White House made the specification that Trump, who is golfing, is not having a "low-key day" after Washington Post reporter Jenna Johnson sent this pool report at 7:56 a.m. ET:
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A third pool report eventually followed: "At 9:26 a.m. the motorcade arrived at the Trump International Golf Club in West Palm Beach." Jeva Lange
After months of reticence, Secretary of State Rex Tillerson on Wednesday officially referred to the plight of the Rohingya Muslims in Myanmar as "ethnic cleansing." In a press statement, Tillerson reiterated his support for a democratic transition in the country, but added that the crisis in the northern state of Rakhine counts as "ethnic cleansing against the Rohingya."
In August, Rohingya insurgents attacked police posts in Rakhine, prompting a brutal retaliation from Myanmar's military which reportedly razed villages and indiscriminately attacked civilians. The violence led to the mass exodus of Rohingya people east to Bangladesh. Myanmar's government has claimed that the Rohingya decided to burn their own villages and then willingly self-deported to Bangladesh en masse — more than 600,000 have fled in the last three months — but that claim has been widely disputed and debunked by reporters on the ground.
The State Department had previously expressed concern over Myanmar's treatment of the Rohingya Muslims, but had stopped short of calling the situation ethnic cleansing. Rohingya Muslims in the majority Buddhist country of Myanmar have been denied citizenship since 1982 and are not officially counted as one of the country's official 135 ethnic groups.
The Hill speculates that Tillerson's decision to refer to the situation in Rakhine as ethnic cleansing will prompt the Trump administration to enforce new sanctions on Myanmar's government. But ultimately, ethnic cleansing holds no legal ramifications under international law. The U.N. recognizes genocide as a crime, but it is notoriously hard to prosecute and the international body is still deliberating whether the term is applicable for Myanmar's treatment of the Rohingya. Kelly O'Meara Morales


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- Mark Khazanov, Julian Jocque, John Rieffel
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Conventionally control can be achieved by attempting to simplify complex dynamics. The field of morphological computation explores how mechanical complexity can be advantageous. In this paper we demonstrate morphological computation in tensegrity robots. We present a novel approach to tensegrity actuation and explore the capabilities of our self-evolving… (More)
- Julian Jocque, John Rieffel, Cara Peterhansel
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In this paper I will detail my senior thesis work done on modeling opponents in board games using the estimation exploration algorithm. The paper first explains background knowledge to explain concepts relevant to the project. From there I build an outline of a system that could be used to model opponents in konane using the estimation exploration… (More)
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a sewing stitch made by passing the needle in and out repeatedly with short, even stitches.
running stitch
a simple form of hand stitching, consisting of small stitches that look the same on both sides of the fabric, usually used for gathering Sometimes called gathering stitch
Tagged: r
Read Also:
- Running-story
noun, Journalism. 1. a story continued in subsequent issues of a newspaper or magazine; serial. 2. a story sent to the compositor in takes.
- Running-text
noun 1. the body of text in a newspaper, magazine, or the like, as distinguished from the heads, illustrations, etc.
- Running-time
noun 1. Movies. the length or duration, usually expressed in minutes, of a feature film: The running time of the average film is 90–100 minutes.
- Running-title
noun 1. Printing. running head.


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Play free online games!
Car Assembling>
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Tuning 4 Dates
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DescriptionTry to score a date with your sweet ride! Tune your car and make sure that the girl loves the way it looks!
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Privacy Policy
Your safety is important to us: not only when visiting our concerts, but also on our website. The following statement explains and informs on the handling of personal data on our website www.elbphilharmonie.de.
1. Responsible Body
Responsible body as per the BDSG (Bundesdatenschutzgesetz – German Federal Data Protection Act) is the HamburgMusik gGmbH - Elbphilharmonie und Laeiszhalle Betriebsgesellschaft, Dammtorwall 46, 20355 Hamburg, Germany.
2. Web Analytics
In order to best align services according to the needs of our visitors, we capture and store click paths on www.elbphilharmonie.de using the web analytics tool »Google Analytics«. For this, so-called »cookies« are used. Cookies are files that store information on your computer and allow an analysis of the use of the website. This web tracking is done anonymously, by scrambling the last three digits of your IP address. We use this information to evaluate your use of the website, to compile reports on website activity and to provide other website and Internet related services with necessary information. In line with Google Analytics, your IP address is disclosed by your web browser and can not be merged with other data of Google. You can veto this creation of user profiles at any time. Alternatively, you can refuse the use of cookies by selecting the appropriate settings in your web browser software, i.e. by disabling the setting of cookies or by activating the »Do Not Track«feature in your browser. You can also prevent the data generated by the cookie and relating to your usage of the website (incl. your IP address) to Google and the processing of this data by Google, by downloading and installing this browser plugin, available at the following link: http://tools.google.com/dlpage/gaoptout?hl=de
3. Cookies
We use cookies on our website that are set by our web analytics tool. These are called up as soon as you visit our website www.elbphilharmonie.de. The cookies contain pseudonyms used by us to create user profiles in accordance with § 15 Abs. 3 Telemediengesetz (German Telemedia Act), for example, to recognize repeat visitors. You can object to the user profile creation at anytime. Disabling cookie functionality is possible: please follow the instructions under the heading »Web Analytics«.
4. Personal Data
We store your personal information until you wish to be removed as a visitor of our website www.elbphilharmonie.de, or until the purposes for which we use the data no longer apply. Further processing and utilisation of your personal data may take place only to the extent where a legal provision specifically allows or if you have explicitly consented to the data processing or data use.
5. Web Shop
Our web shop located at www.elbphilharmonie.de is operated by the Elbphilharmonie und Laeiszhalle Service GmbH, Dammtorwall 46, 20355 Hamburg, Germany. Registration is required in order to use our web shop and we save your user name and chosen password in our system. When you place an order through our web shop, we save all the data you provide. This includes required information, i.e. your first and last names, postal address (street address, postcode and town/city), telephone number and email address. We also save any optional information you provide, for example, your title, academic title, extra postal address information, gender, date of birth, place of birth, marital status, number of children, nationality, occupation, Umsatzsteuer-Identifikationssnummer and chosen payment and communication methods. We also save information related to your customer status (private, company or group customer), save the date when you became our customer and assign an individual customer number to you.
Furthermore, we save details of every individual ticket booking of HamburgMusik gGmbH (HHM) events in line with our web shop.
Usage information: in addition, we save the date and time of your last login to our web shop at ticketshop.elbphilharmonie.de.
We save and survey the above mentioned personal data for the following purposes:
The collection and use of your personal data will be carried out subject to the terms of the privacy policy of www.elbphilharmonie.de to process your order and for the delivery of the products ordered.
Furthermore, the collection and use of your personal data will be carried out to improve the internet presence of www.elbphilharmonie.de and our web shop at ticketshop.elbphilharmonie.de according to data protection legislations.
Your first and last names, postal address (street address, postcode and town/city) and preferred genre of event will be used for the postal distribution of HHM event information, so long as this has not been objected to. Your email address used to place your ticket order will be used for electronic distribution of email marketing and newsletters of HHM events, so long as this has not been objected to. Your first and last names, postal address (street address, postcode and town/city) and preferred genre of event will be used for telephone marketing of HHM events, but only when this has been explicitly asked for by you. Your first and last names, postal address (street address, postcode and town/city), email address and preferred genre of event will also be used for prize draws.
Cookies are used by us here to recognise registered users and for the realisation of the shopping cart function.
6. Links to Other Websites
The website www.elbphilharmonie.de may contain hyperlinks to other websites. We are not responsible for the compliance of data protection legislations by third party websites.
7. Changes to Our Privacy Policy
The development of the internet, our internet offers as well as our service portfolio can have an impact on the handling of personal data. We therefore reserve the right to change our privacy policy in the future within the context of data protection legislation. We advise you to visit the privacy policy of our website www.elbphilharmonie.de from time to time, in order to note any updates.
8. Questions, Comments and Information
For questions or comments on the handling of personal data on our website, please feel free to contact us, either by email at firstname.lastname@example.com or by telephone at +49 40 357 666 0.
Hamburg, April 2016


text:
Continental Capital Markets SA v GFI Holdings Ltd & Ors
November, 25-30 days, Commercial Court
For the claimant Conticap:
Rosenblatt partner Laura Clatworthy, instructed 11KBW's Daniel Oudkerk QC to lead 11KBW's Amy Rogers and Essex Court Chambers' David Craig, instructed by Clatworthy
For the defendant GFI Brokers:
Blackstone Chambers' Paul Goulding QC Blackstone Chambers' Tristan Jones, instructed by Olswang partner Catherine Taylor
This ground-breaking employment claim is believed to be the first time an action has been brought in the High Court concerning employees poached in another jurisdiction.
The case, which bears some resemblance to the 2011 CoA battle between Tullett Prebon and BGC Brokers, is scheduled to run for up to six weeks from November. Swiss interdealer broker, ContiCap, has instructed 11KBW's Daniel Oudkerk QC to lead the £20m fight.
Oudkerk also led Tullett Prebon's case against BGC, persuading the court that BGC should pay damages after it induced 10 brokers to break their contracts with its rival.
The Conticap claim was issued after a raid orchestrated by GFI Brokers from London of 30 brokers based in Switzerland. The contracts of employment are governed by Swiss law, as is the claim itself, yet the case is being heard in London.
It is thought to be the first time an action has been brought in the High Court in relation to employees hired in another jurisdiction.


text:
Elizabeth Staples
Sitting In The Dark - Poem by Elizabeth Staples
Sitting in the dark
I feel all alone
I stop in the Silence
And all I think is your name
They try to stop my love
Sitting in the dark
My blood pumps fast as you apear
My heart beats faster as you wrap your arms around me
Sitting in the dark
My body gets weak and shakes as you kiss me and say your famuse three words ' I love You'
The words fill up my brain
Sitting in the dark
I know it don't come around very often
So when you say it I know it's true
I see you care
Sitting in the dark
I know it's hard to love someone who seems so far away
You being right beside me feels so far away
Sitting in the dark
Growing up I just thought love was a word
But as I sit here looking at our life together I realized love is the truth
Sitting in the dark
You are my strength to my weakness
My love to my broken heart
My light to my darkness
Sitting in the dark
Can you show me forever
Can you show me a true man
Can you love me non stop
Sitting in the dark
No Cheaters
No Abusers
No lies
Baby and only happy crys
Sitting in the dark
Please don't hurt me
Be the love to our home
You hold the key to my heart
I'm trusting you
Please don't break it
Sitting in the dark
Confused with thoughts
Of how life can be so great with you
Sitting in the dark
Baby ' I Love You'
Come home to me
Show them you care
Show them your a man
And most of all show them you want the best in life for your family
Sitting in the dark.
Comments about Sitting In The Dark by Elizabeth Staples
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Elizabeth Staples's Other Poems
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Phenomenal Woman
Maya Angelou
Still I Rise
Maya Angelou
The Road Not Taken
Robert Frost
If You Forget Me
Pablo Neruda
Langston Hughes
Annabel Lee
Edgar Allan Poe
Caged Bird
Maya Angelou
Rudyard Kipling
Stopping By Woods On A Snowy Evening
Robert Frost
I Do Not Love You Except Because I Love You
Pablo Neruda


text:
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Computer software consultancy rendered to pharmaceutical companies in the field of drug pricing and medical device pricing
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