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SOURCE: Dept. of Otolaryngology UTMB Grand Rounds
DATE: October 30, 1996
RESIDENT PHYSICIAN: Kyle Kennedy, M. D.
FACULTY PHYSICIAN: Brian Driscoll, M. D.
SERIES EDITOR: Francis B. Quinn, Jr., M.D.
|Return to Grand Rounds Index|
This presentation will attempt to achieve the following objectives. The first is to provide a useful scheme for classifying these hetergeneous disorders so that they may be approached in a systematic manner. The second is to enumerate the distinguishing features of these entities to aid in their appropriate recognition. Finally, general management principles for the various conditions will be discussed.
Acute inflammation of the salivary glands is usually of viral or bacterial origin. Of the viral illnesses, mumps is the most common. This illness is caused by an RNA virus from the paramyxovirus group and typically involves the parotid glands bilaterally. Children are most often affected with peak incidence at approximately 4 to 6 years of age. Transmission is via infected respiratory droplets. The parotid swelling is accompanied by constitional symptoms such as fever and malaise, and many cases are mild and subclinical in nature. Onset of symptoms usually follows a 2 to 3 week incubation period, and infection may be documented by a rise in convalescent serum titers to viral antigens or to isolation of the virus from the urine for a period from approximately 1 week prior to and 2 weeks after onset of symptoms. Treatment is symptomatic. Serious sequelae are fortunately rare and often stem from involvement of other organ systems such as the CNS, pancreas, and gonads.
Salivary gland involvement may be seen in a wide range of other viral illnesses including those caused by cytomegalovirus, lymphocytic choriomeningitis virus, coxsackievirus A, echovirus, and parainfluenza virus type C among others. Again, treatment is symptomatic.
Acute suppurative sialadenitis is most commonly bacterial in origin and most often involves the parotid, and to a lesser extent, the submandibular glands. The more mucinous saliva produced by the submandibular glands is felt to confer more bacteristatic properties than the serous saliva of the parotids. The causative agent most frequently implicated is Staphylococcus aureus. Other aerobic organisms isolated are Streptococcus pneumoniae, Hemophilus influenzae, and Escherichia coli. Anaerobic bacteria such as Bacteroides have been involved as well. Stasis of saliva, often as a result of dehydration, is thought to be an integral component in the pathogenesis of this condition perhaps secondary to obstruction or decreased production.
Common clinical settings in which this entity may occur include the elderly postoperative patient after cardiothoracic or gastrointestinal surgery and perhaps more frequently the elderly nursing home patient. Onset is typically heralded by unilateral abrupt diffuse swelling of the parotid perhaps with accompanying induration and tenderness. Mucopurulent material may be expressed from the opening of Stensen's duct with massage of the gland, and a sample should be obtained for Gram stain and culture. Fluctuance is often not present due to the multiple fascial investments with the substance of the parotid gland. Therapy is initially conservative with adequate hydration, sialogogues, heat, massage of the affected gland, and the administration of an appropriate intravenous antibiotic, usually a penicillinase-resistant antistaphylococcal antibiotic. Improvement is expected within the first 24 to 48 hours. If this does not occur, operative intervention may be indicated. This usually consists of a standard parotidectomy skin incision and flap followed by creation of several openings within the substance of the gland parallel to the course of the facial nerve. A drain is then placed over the gland and the wound closed. Complications include possible septicemia or deep space neck infection. Mortality has been reported as high as 20% and is likely related to the severity patient's underlying medical condition.
Decreased salivary flow with stasis is a key factor in chronic sialadenitis. Like acute sialadenitis, this condition is more common in the parotid gland. Its development is often associated with a previous episode of acute suppurative inflammation with subsequent glandular destruction. Another possibility is the recurrent parotitis of childhood which has continued into adulthood. With the onset of the chronic inflammatory process, alterations in salivary chemistry and enzyme and immunoglobulin content take place. Sialectasis, ductal ectasia, and acinar atrophy occur, accompanied by a lymphocytic infiltrate. Symptoms include recurrent mildly painful swelling of the parotid which often accompany eating. Approximately 80% of patients experience permanent xerostomia.
Treatment is initially conservative with acute exacerbations treated similarly to acute sialadenitis. A thorough search is made for treatable predisposing factors such as a calculus or stricture. If conservative measures fail, ductal dilatation, ligation of the duct, tympanic neurectomy, irradiation of the gland, or excision of the gland may be performed. Only the last of these has been predictably effective.
Recurrent parotitis of childhood may affect children up to the age of 12 years and is more common in males than females and differs from the adult form in this regard. Symptoms usually include the sudden onset of uni- or bilateral parotid swelling with varying degrees of enlargement. There may be mild discomfort, but the child is usually not visibly ill and xerostomia is not present. Salivary chemistries are altered as in the adult. The condition may resolve at puberty or continue on into adulthood, as mentioned previously.
Tuberculous and non-tuberculous (atypical) mycobacterial involvement of the salivary glands may occur. Primary tuberculous infection of the salivary glands is uncommon and most often consists of unilateral parotid gland involvement. The infection is thought to arise in the teeth or tonsils and may result in acute inflammation or a chronic tumorlike lesion. Secondary tuberculosis more often involves the submandibular or sublingual glands and is accompanied by pulmonary disease. Diagnosis may be made with the application of a PPD skin test and staining for acid-fast bacilli from saliva or fine needle aspiration biopsy.
Atypical mycobacterial infection may be more difficult to diagnose. Therapy consists of administration of the appropriate antituberculous chemotherapeutic agents. Excision may occasionally be required.
Cat scratch disease may involve the parotid gland by direct extension from periparotid lymph nodes. Treatment is symptomatic for this self-limited illness. Actinomycosis may involve the salivary glands directly from direct extension from a focus of infection in the teeth or tonsils. Treatment consists of incision and drainage with long-term administration of an appropriate antibiotic.
Sarcoidosis is a chronic granulomatous disease of unknown etiology and is characterized by the presence of noncaseating granulomas in the involved tissues. There is often multisystem involvement typically with prominent pulmonary and cutaneous findings, as well as involvement of the liver, spleen, and various locations in the head and neck. Constitutional symptoms of fever, weight loss, anorexia, fatigue, and night sweats may be noted with evidence of hilar adenopathy on chest roentgenography. The diagnosis is one of exclusion and is made only when other possible etiologies have been ruled out. Histologically, the noncaseating granulomas are composed of aggregations of epithelioid histiocytes often with the presence of Langhans' or foreign body-type giant cells. Schaumann bodies (laminated concretions of calcium and proteins) and asteroid bodies (stellate intracytoplasmic inclusions) may also be seen microscopically.
Salivary gland involvement may occur as an isolated head and neck finding or as a component of uveoparotid fever (Heerfordt's syndrome). This syndrome consists of uveitis, parotid swelling, and facial nerve paralysis. It usually begins with a prodrome of constitutional symptoms and involvement of the submandibular, sublingual, and lacrimal glands may occur. The swelling may last months to years and usually resolves spontaneously. Treatment is usually symptomatic with steroids being most beneficial when administered in the acute phase of the illness. They are particularly helpful with regard to the facial paralysis, but in most instances, the paralysis is transient even without treatment. Approximately 65 to 70% of patients may achieve remission with little or no evidence of residual sequelae.
Benign lymphoepithelial lesion (BLL) results in the non-neoplastic uni- or bilateral enlargement of the major or minor salivary glands or lacrimal glands and may be associated with an autoimmune disease. The enlargement is usually unilateral and involves the parotid. Unless infection is present, the swelling is asymptomatic. Females are slightly more often affected than males, and Sjogren's syndrome may or may not be present or develop. Histopathologically, a diffuse or nodular lymphocytic infiltrate is present with acinar atrophy and metaplasia of the ductal epithelium. With proliferation of ductal epithelium and infiltration of lymphocytes, ductal lumina are obliterated with creation of epimyoepithelial islands surrounded by a chronic mixed inflammatory cell infiltrate. Treatment is symptomatic with a good prognosis, and spontaneous resolution may occur. Benign lymphoepithelial lesion has been associated with the development of lymphoproliferative disorders such as lymphoma and with lymphoepithelial carcinoma. The latter lesion has shown an increased incidence among individuals of Eskimo extraction.
Sjogren's Syndrome
Sjogren's syndrome is an autoimmune disorder which results in immunologically-mediated destruction and inflammatory enlargement of the lacrimal and salivary glands. Other exocrine glands throughout the body may be involved as well. This leads to the development of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) also known as the sicca syndrome or primary Sjogren's syndrome. When the keratoconjunctivitis sicca and xerostomia are also associated with another autoimmune disorder, most commonly rheumatoid arthritis, the secondary form of Sjogren's syndrome exists. Other possible associated disorders include systemic lupus erythematosus, scleroderma, dermatomyositis, and mixed connective tissue disease. Mickulicz's syndrome is a general term applied to concomitant enlargement of the lacrimal and major salivary glands which may occur as a result of a wide variety of disorders including Sjogren's, sarcoidosis, and lymphoma. This term has sometimes been used synonymously with benign lymphoepithelial lesion. As mentioned previously, Sjogren's syndrome may occur in the presence of BLL. There appears to be no histopathologic difference between BLL occuring alone and that which occurs in association with Sjogren's syndrome.
Approximately 90% of the time, the disorder occurs in adult females aged 40 to 60 years, and patients typically present with complaints of burning oral discomfort and what is described as a "sandy" sensation in the eyes. Uni- or bilateral salivary gland enlargement, usually the parotid, occurs in approximately 80% of primary and 30 to 40% of secondary cases of Sjogren's syndrome.
The lymphocytic infiltrate is predominantly of T cell origin, and serologic evidence exists for the presence of B cell dysfunction and possible loss of immunoregulation. Numerous autoantibodies have been indentified, and the two most important serologic markers for Sjogren's syndrome are anti-ribonucleoprotein antibodies termed anti-SS-A (Ro) and anti-SS-B (La). Of the two, anti-SS-B appears to be more specific for Sjogren's syndrome. Certain genetic differences have also been noted between primary and secondary Sjogren's syndrome, such as associations with different HLA types. Various other autoantibodies which have been identified include those to salivary duct cells, gastric parietal cells, smooth muscle mitochondria, and thyroid antigens. These may account for some of the other findings in this disease. Minor salivary gland involvement forms the basis for labial biopsy in the histopathologic diagnosis of Sjogren's syndrome. The specimens are graded on the basis of lymphocytic infiltrate with focus scores of greater than l focus/4 square mm proposed as diagnostic.
Treatment for Sjogren's syndrome is primarily symptomatic. In those instances in which persistent complications arise or in which marked glandular enlargement results in cosmetic deformity, excision of the involved gland may be necessary. Of important note is the recognition that Sjogren's syndrome has been associated with an increased incidence of lymphoid malignancy, particularly of B cell origin. It has been estimated that this risk is increased perhaps 40-fold, and close observation of these patients is warranted.
Mucoceles and mucous retention cysts most often involve the minor salivary glands of the lower lip, buccal mucosa, and floor of the mouth. Mucoceles lack an epithelial lining and are therefore not true cysts. They are thought to result from ductal obstruction or trauma and represent accumulation and extravasation of mucus into adjacent tissues. Mucous retention
cysts do have a true epithelial lining. The simple ranula is a form of mucous retention cyst
involving the ducts of the sublingual salivary gland and typically presents as an asymptomatic soft, fluid-filled mass in the lateral floor of mouth. Management of these lesions consists of marsupialization or complete excision. The plunging ranula represents a form of mucocele which has extended outside the mucous membranes of the floor of mouth inferiorly into the submental or submandibular triangle via a defect in the mylohyoid muscle. They present as neck masses in these areas and require complete excision in continuity with their salivary gland of origin.
The formation of salivary gland calculi occurs in the submandibular gland approximately 80 to 90% of the time and in the parotid gland the remaining 10 to 20%. The sublingual and minor salivary glands are rarely involved. Stone formation is thought to be more common in the submandibular gland secondary to the higher mucin content of its saliva and the anti-gravity flow of saliva within the duct. Its saliva is also more alkaline and has a higher calcium and phosphorous content. Submandibular stones are usually also larger in size. Serum calcium and phosphorous levels have no known correlation with the formation of calculi. Calculi may be found within the ductal system itself or within salivary gland parenchyma. In most cases of sialolithiasis, a single calculus is involved. Stone formation occurs via the deposition of calcium phosphate and an organic matrix of carbohydrates and amino acids about a nidus of debris or other material. With the occurrence of ductal obstruction, stasis of saliva may occur with varying degrees of surrounding inflammation and possible ascending bacterial infection. Streptococcus viridans is a common offending pathogen.
Stone formation most often occurs in middle-aged males and may result in intermittent salivary gland swelling and discomfort, especially with eating. Calculi have been associated with the existence of chronic sialadenitis and may present as an acute suppurative sialadenitis.
During an episode of obstruction complicated by acute infection, mucopurulent material may be expressed from the duct orifice with massage of the involved gland. Gout is the only systemic illness associated with the formation of calculi, and these are composed of uric acid. Plain radiograpy (e.g. submentovertex or occlusal films) is occasionally useful in the diagnosis and location of calculi. 90% of submandibular calculi are radiopaque while 90% of parotid calculi are radiolucent. Sialography is very accurate in the diagnosis of sialolithiasis but is most often unnecessary. Sialolithiasis may also result in subsequent ductal ectasia and stricture formation. Smaller stones may pass spontaneously with appropriate conservative management including adequate hydration, sialogogues, heat, massage, and appropriate antibiotics for intercurrent infection. Stone removal may be performed transorally for those calculi located distally within the duct. However, adequate removal of those calculi located
near the hilum of the gland often require complete excision of the involved gland.
Stenosis, stricture, or congenital atresia represent much less common causes of salivary ductal obstruction. Kussmaul's disease (sialodochitis fibrinosa) is a condition in which ductal obstruction occurs due to the presence of fibromucinous plugs in the ductal system of certain dehydrated patients.
Salivary gland tissue may arise in various aberrent locations within the head and neck. Probably the most common site is in periparotid lymph nodes. Other sites include the lower neck, sternoclavicular joint, thyroglossal duct, middle ear, tonsils, hypopharynx, and mandible. This aberrant tissue may be located within or on the surface of the mandible. That which is located within the mandible may at times be associated with the development of a malignant neoplasm (most commonly mucoepidermoid carcinoma), while that which is on the surface is usually represents benign salivary gland tissue.
Necrotizing sialometaplasia is a benign, self-healing process of unknown etiology. Ischemia is thought to play some role in its development. It is self-limiting, and no treatment is required. It typically involves the minor salivary glands of the hard palate but may occur in salivary tissue elsewhere. Presentation is usually as an asymptomatic mucosal ulceration or nodular lesion of the hard palate which may be misstaken clinically and histologically for a malignant neoplasm, especially squamous cell carcinoma or mucoepidermoid carcinoma. Histologically, lobular necrosis is present with squamous metaplasia of the remaining acini and ductal elements. This metaplasia is bland in appearance and native lobular architecture is maintained. Pseudoepitheliomatous hyperplasia may also be seen. Biopsy may be required to establish the diagnosis and may present diagnostic difficulties.
Cysts of salivary gland origin may be congenital or acquired. Most true cysts are located within the parotid gland. Congenital cysts like the first arch branchial cleft cysts comprise an uncommon form of branchial cleft anomaly. Type 1 cysts are of ectodermal origin and involve the first arch only. They represent a duplication anomaly of the membranous portion of the external auditory canal. Type 2 cysts are of ectodermal and mesodermal origin and involve both the first and second arches. They represent a duplication anomaly of both the membranous and cartilaginous portions of the external auditory canal. Recurrent infection of these lesions may obscure their boundaries, but all are known to lie in close proximity to the facial nerve and require great care during their excision. Dermoid cysts are another form of congenital cyst consisting of keratinizing squamous epithelium and skin appendages which require complete excision.
Acquired cysts may result from sialadenitis, sialolithiasis, ductal obstruction, trauma, BLL, or neoplasm. These typically require no treatment unless symptomatic or if they occur in association with a neoplastic process.
Salivary gland irradiation either for diagnostic or therapeutic purposes may result in disruption of serous acini which are extremely sensitive to the effects of radiation. Leakage of enzymes into the surrounding salivary tissues results in an acute inflammatory process with subsequent development of a painful, swollen gland. If the irradiation is discontinued, the inflammatory process typically resolves. However, if the radiation is continued, glandular atrophy and xerostomia are the result. Neoplasms have been known to arise in irradiated glands as well.
Penetrating or blunt trauma most commonly involves the parotid gland. The submandibular and sublingual glands are afforded some protection by the mandible.
Penetrating facial trauma may involve the parotid duct and/or facial nerve, and a thorough assessment of facial nerve function should be performed in any case of facial trauma. If the injury occurs posterior to the anterior border of the masseter muscle, parotid duct injury may be suspected, and exploration of the wound should be performed to evaluate this possibility. If ductal injury has occurred, identification of the proximal and distal segments with primary reanastomosis is the ideal therapy. Reanastomosis is performed over a polyurethane catheter which may be removed when adequate healing has occurred. Closure of salivary gland parenchyma may usually be managed conservatively with interrupted sutures for the parenchyma and fascia. A salivary fistula may be a complication, but this usually heals with repeated aspirations and application of a pressure dressing. If this is not the case, gland excision may be necessary.
The wounds of penetrating facial injuries must be assessed for disruptions of the facial nerve. If injury has occurred posterior to a vertical line from the lateral canthus to the mental foramen, an attempt is made to identify proximal and distal nerve segments with subsequent primary reanastomosis. If injury has occurred anterior to this line, recovery will usually take place even in the event that obvious dysfunction is present at the time of injury.
Blunt trauma may result in the formation of a hematoma. This requires adequate drainage to prevent its subsequent organization, fibrosis, and possible cosmetic deformity.
Sialadenosis is the term used to describe the non-neoplastic, non-inflammatory enlargement of the salivary glands, usually the parotid, which occurs in association with many systemic disorders. The involvement is usually bilateral, and the etiology of the often asymptomatic enlargement unclear. Obesity, malnutrition of many causes, and alcoholic cirrhosis are common associations. Any condition affecting nutritional absorption may be involved, as well as hypothyroidism, gonadal atrophy, diabetes mellitus, and other endocrine abnormalities. Salivary gland enlargement usually resolves with treatment of the underlying condition.
Cheilitis glandularis represents hypertrophy of labial salivary glands which may result
in eversion of the lower lip and require vermilionectomy for repair. Pneumoparotitis may arise in instances of large increases in intraoral pressure. A variety of medications may result in salivary gland enlargement including phenothiazines, iodide-containing compounds, and heavy metals, among others. Lastly, infection with the Human Immunodeficiency Virus may result in diffuse, symmetric, bilateral parotid (and possibly submandibular) gland enlargement. Also commonly associated with HIV infection is the development of lymphoepithelial cysts which may become quite large and require frequent aspiration or other intervention.
The heterogeneous nature of the non-neoplastic salivary gland diseases requires a useful classification scheme to assist in the systematic approach to these disorders. The enumeration of their sometimes subtle characteristics serves as an aid in their recognition and subsequent appropriate management. It is also beneficial to always bear in mind that a significant number of these disorders have other important disease associations and that these entities may require careful attention as well.
Cotran RS, Kumar V, Robbins SL, eds. Diseases of Immunity. In: Robbins Pathologic Basis of Disease. Philadelphia: WB Saunders, 1989: 5.
Kane WJ, McCaffrey TV. Infections. In: Cummings CW, et al, eds. Otolaryngology-Head and Neck Surgery. St. Louis: Mosby-Year Book, 1993: 59.
Rice DH. Diseases of the Salivary Glands-Non-Neoplastic. In: Bailey BJ, et al, eds. Head and Neck Surgery-Otolaryngology. Philadelphia: JB Lippincott, 1993: 37.
Rice DH. Non-neoplastic Diseases of the Salivary Glands. In: Paparella, et al, eds. Otolaryngology. Philadelphia: WB Saunders, 1991: 19.
Samuelson TE, Bailey BJ. Degenerative and Idiopathic Diseases. In: Bailey BJ, et al, eds. Head and Neck Surgery-Otolaryngology. Philadelphia: JB Lippincott, 1993: 13.
Wenig BM. Non-neoplastic Lesions of the Oral Cavity, Nasopharynx, Tonsils, and Neck. In: Atlas of Head and Neck Pathology. Philadelphia: WB Saunders, 1993: 8.
Wenig BM. Non-neoplastic Diseases of Salivary Glands. In: Atlas of Head and Neck Pa2AM ogy. Philadelphia: WB Saunders, 1993: 18.


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Don't know how any of you passed this deal up.
Also gotta say how great Nutra & USP are for swapping the Super Sap for Bulk P-Slin for me when I requested with my order. I love Super Saps but I have a few bottles already that I'm going to run along side this stack.
My only regret is not ordering 10 of these.

subset: commoncrawl


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Resource Spectrum – Los Angeles, CA
Im looking for a senior RPG programmer/analyst with heavy experience with JDEdwards World with an emphasis on manufacturing and distribution. Must… Getit.me
Resource Spectrum – Los Angeles, CA
I need a very strong senior RPG/ILE programmer with heavy ILE experience and very strong analytical skills. Must be able to mentor less experienced… Getit.me
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Totem Figures Interview with Steve Dawson
Steve Dawson is an award winning musician and producer. His totems include Ry Cooder, The Band, Daniel Lanois, Leo Kottke and Bill Frisell.
Totem Figures Interview with Corin Raymond
Singer/songwriter and Beams and Struts contributor Corin Raymond talks about Tom Waits, Sam Cooke, the Rolling Stones, Howlin' Wolf and The Band.
Totem Figures Interview with Dr. Gabor Mate
Gabor Mate is a doctor and best-selling author. His totems are Gautama Buddha, Yeshua (aka Jesus), Karl Marx, Albert Einstein and Sigmund Freud. Beethoven's in there too.
Totem Figures Interview with C.R. Avery
C.R. Avery is a musician, spoken word artist, beat boxer, poet and much else. His Mt. Rushmore includes Tennessee Williams, Patti Smith, Sam Shepard, the blues and hip hop.
What are Totem Figures?
If you had a personal Mt. Rushmore, who or what would be on it? Why those things? And do those things say about you?
Totem Figures Interview with Lindsay Robertson
Lindsay Roberston is a Vancouver based singer/songwriting, originally from Guelph Ontario. Her totems are Bob Marley, Tom Waits, Bob Dylan, Martin Tielli and Bessie Smith.
Totem Figures Interview with Mark Meer
Mark Meer is an Edmonton based actor, writer and improvisor. His totems are Jim Henson, John Cleese, Alan Moore, Doctor Doom, and Tom Waits.
Totem Figures Interview with Ivan E Coyote
Ivan E Coyote is a spoken word artist, novelist, storyteller and columnist. Her totems include Bill Cosby, writers Barbara Gowdy, Sherman Alexie and Tom Spanbauer, musicians Veda Hille, Laurie Anderson and Rufus Wainwright.
Totem Figures Interview with Gretta Vosper
Gretta Vosper is a progressive United Church pastor, who believes the way we live is more important than what we believe. She believes this so much she wrote a book about it.
Totem Figures Interview with Kahlil Ashanti
Kahlil Ashanti is a writer and performer. In this interview he talks about who would be on his Mt. Rushmore: Richard Pryor, Don Knotts, Eminem, and various formative experiences and friendships.
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2011 Kia Forte
People often say, "You don't get much for your money nowadays," but perhaps that's simply because they've been looking in the wrong places. I've just spent a week in the new Kia Forte 4-door EX and not only is it a pleasurable vehicle to drive, but also fairly inexpensive to purchase, and offers considerably more than one might first expect. Let's take a closer look at the Kia of today.
When the company originally came into Canada, it sold its products much like its sister brand, Hyundai. In fact, for several years the two companies showcased a remarkably similar lineup. I feel this often confused buyers and I'm glad to say that this situation has finally been addressed. Today, whilst Hyundai aims slightly more up-market with products like its Genesis & Equus models, both of which have received highly favourable reviews of late, things on the Kia side of the fence are also looking pretty sweet.
Kia has been busy reinventing its product line and is quickly establishing itself as the sensible choice for the younger generation of Canadian go-getters, and with good reason. The Forte may be priced in the entry-level category (prices start at just $15,995, with the coupe starting at $18,995), but the features included on this vehicle make it a rather tempting option for those looking to "have it all" without paying the price typically associated with that phrase.
The entry-level LX gets you a smart looking 4-door sedan with a 6-speed manual transmission. The vehicle is a decent size with a fairly spacious trunk and, although I only sat in the rear seat for a moment or two, simply to test it out, I would imagine it to be pretty comfortable back there, even on a long journey. The interior has been well thought out and, although the new wave of soft touch plastics has perhaps missed a spot or two, particularly on the door panels, I'll readily admit to feeling suitably impressed. It's comfortable, with good all-round vision, and the controls have been well placed and are easy to understand. In fact, taking into consideration the price of the vehicle, I think the company has done a grand job of making you feel good behind the wheel.
In fact, the only exception to what I've just said, and perhaps I'm being a little picky here simply because the rest is so good, is that the steering wheel would benefit by a visit from the soft-touch genie. You'll frequently hear me rant about this on a lot of vehicles, and I won't stop until the car companies finally take note, but what's the most important fixture in an automobile? It's everything you constantly touch, and what part of the car do you touch the most? You've got it, the steering wheel. You know, it's all well and good to make the dashboard soft and luxurious, but when does anyone drive along caressing that? Trust me on this one Mr. Kia; improve the feel of the steering wheel in this vehicle and you'll be hitting a home run.
Moving on, all Forte models are powered by a 156hp 2.0L I4 engine which, I have to say, is quite sprightly for its size and, whether you go for the stick or the automatic, they're both six-speed versions. Now that's something which few manufacturers can boast of on a vehicle in this price range!
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CHARTER View all Charter Content
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At Home Afloat | December 05, 2013
A first overnight sail with the kids makes for a memorable Thanksgiving indeed. Read full blog
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A few days ago, my friend from Cape Town sent me this picture with a short message at the back: "This is Cape Town."
Cape Town is one of the best locations in the world for sailing adventures. With exquisite beaches, stunning, scenic coastlines, this is a typical sailor's paradise. Picture yourself relaxing on a boat or marvelling at the Table Mountain. This place has a lot to offer. |
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The Vesper Marine WatchMate Vision is arguably the most advanced Class B AIS transponder ever built, and was honored with an Innovation Award in Miami.


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divineirony: The Gun Justice Fantasy
The idea that several people shooting in a dark, crowded, tear gassed theater is better than one, because everyone who can get a gun is obviously an expert marksman with crisis intervention training and nerves of steal.
"If only people would have had guns to fire back!"- Fuck off with this argument. It's a complete fantasy.
Agreed — the 'everyone should carry a gun' argument is completely stupid. For the reasons you say and also because just like Ta-Nehisi Coates is arguing in that post by azspot this morning, James Holmes was wearing body armor. Are we all supposed to wear body armor now too?
I wouldn't trust 98% of the people around me to be able to identify the correct target, let alone hit it in a dark theater, with people screaming and running, alarms blaring, and their blood pressure skyrocketing. There's good reason for use of force / tactical training.
And has there ever been one situation in modern history where an 'armed' citizen (who wasn't former or current LE) saved the day? Ever?
One last thought: you want to be 'that guy' who starts shooting back in a crowd? Good luck with all the lawsuits!
A gun in every cold, dead hand. The NRA is a lobby for firearm manufacturers and gun dealers. Money. That's what it's always all about.


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Complications (6)
- Diabetic retinopathy
- Amputation and diabetes: How to protect your feet
- Liver problems
- see all in Complications
Lifestyle and home remedies (11)
- Diabetes nutrition: Eating out when you have diabetes
- Diabetes nutrition: Including sweets in your meal plan
- Reading food labels: Tips if you have diabetes
- see all in Lifestyle and home remedies
Prevention (2)
- Couponing and other frugal food shopping tips
- Diabetes prevention: 5 tips for taking control
Tests and diagnosis (3)
- Glucose tolerance test
- Glucose challenge test
- A1C test
Amputation and diabetes: How to protect your feet
Good diabetes management and regular foot care help prevent severe foot sores that are difficult to treat and may require amputation.
By Mayo Clinic staffDiabetes complications include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly and are difficult to treat. Proper diabetes management and careful foot care can help prevent foot ulcers.
When foot ulcers do develop, it's important to get prompt care. A nonhealing ulcer that causes severe damage to tissues and bone may require surgical removal (amputation) of a toe, foot or part of a leg.
Here's what you need to know to keep your feet healthy, and what happens if amputation is necessary.
Preventing foot ulcers
The best strategy for preventing complications of diabetes — including foot ulcers — is proper diabetes management with a healthy diet, regular exercise, blood sugar monitoring and adherence to a prescribed medication regimen.
Proper foot care will help prevent problems with your feet and ensure prompt medical care when problems occur. Tips for proper foot care include the following:
- Inspect your feet daily. Check your feet once a day for blisters, cuts, cracks, sores, redness, tenderness or swelling. If you have trouble reaching your feet, use a hand mirror to see the bottoms of your feet, place the mirror on the floor if it's too difficult to hold, or ask someone to help you.
- Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Use a pumice stone to gently rub the skin where calluses easily form. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.
- Don't remove calluses or other foot lesions yourself. To avoid injury to your skin, don't use a nail file, nail clipper or scissors on calluses, corns, bunions or warts. Don't use chemical wart removers. See your doctor or foot specialist (podiatrist) for removal of any of these lesions.
- Trim your toenails carefully. Trim your nails straight across. Carefully file sharp ends with an emery board. Ask for assistance from a caregiver if you are unable to trim your nails yourself.
- Don't go barefoot. To prevent injury to your feet, don't go barefoot, even around the house.
- Wear clean, dry socks. Wear socks made of fibers that pull (wick) sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid socks with tight elastic bands that reduce circulation, as well as thick bulky socks that often fit poorly and irritate your skin.
- Buy shoes that fit properly. Buy comfortable shoes that do not fit tightly and that provide support and cushioning for the heel, arch and ball of the foot. Avoid high heels or narrow shoes that crowd your toes. If one foot is bigger than the other, buy shoes in the larger size. Your doctor may recommend specially designed shoes (orthopedic shoes) that fit the exact shape of your feet, cushion your feet and evenly distribute weight on your feet.
- Don't smoke. Smoking impairs circulation and reduces the amount of oxygen in the blood. These circulatory problems can result in more severe wounds and poor healing. Talk to your doctor if you need help to quit smoking.
- Schedule regular foot checkups. Your doctor or podiatrist can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Schedule foot exams at least once a year or more often if recommended by your doctor.
- Take foot injuries seriously. Contact your doctor if you have a foot sore that doesn't begin to heal within a few days or other persistent problems with your feet. Your doctor will inspect your foot to make a diagnosis and prescribe the appropriate course of treatment.
(1 of 2)
- Brownlee M, et al. Complications of diabetes mellitus. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-3/0/1555/0.html#. Accessed June 7, 2011.
- Heitzmann J. Foot care for patients with diabetes. Topics in Geriatric Rehabilitation. 2010;26:250.
- Foot complications. American Diabetes Association. http://www.diabetes.org/type-2-diabetes/foot-complications.jsp. Accessed July 14, 2011.
- Diabetes. American Podiatric Medical Association. http://www.apma.org/MainMenu/Foot-Health/FootHealthBrochures/GeneralFootHealthBrochures/Diabetes.aspx. Accessed July 14, 2011.
- McCulloch DK. Evaluation of the diabetic foot. http://www.uptodate.com/home/index.html. Accessed July 14, 2011.
- Amputation. Society for Vascular Surgery. http://www.vascularweb.org/vascularhealth/Pages/amputation.aspx. Accessed July 14, 2011.


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Schuster AR-15 Roll Pin Starter Punch Set 2-Piece Steel
Product #: 694883
Schuster #:
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- DPMS Forward Assist Assembly Round AR-15, LR-308 Matte... $11.99 Available
- Magpul PMAG M3 Magazine AR-15 223 Remington 10-Round Black... $13.25 Out of Stock, Backorder OK
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- Schuster AR-15 Bolt Catch Punch Steel... $15.99 Available
- Wheeler Engineering Delta Series Pivot Pin Detent and Roll Pin... $5.99 Out of Stock, Backorder OK
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Product Information
This is a set of 2 double ended pins for a total of 4 different sizes. These pins help align the roll pins for easy installation on the AR-15. Made in the USA. Lifetime factory warranty. Parkerized.
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Aligns and assists in driving roll pins.
Accomodates 3/32", 1/8", 1/16" and 5/64" sized roll pins.
Technical Information
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You're watching...
Around the World: Glacier snaps off Greenland ice sheet
Massive chunk is twice the size of Manhattan
Jul 19, 2012
You're watching...
Massive chunk is twice the size of Manhattan
Jul 19, 2012
Also in this playlist...
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Auto-advanceThis transcript is automatically generated
Russia amateur video shows that are involved in flames and western province.
Three explosions only injured the -- senior Muslim leaders around the same time -- deputy was killed in the shooting outside his home.
At last word no claim of responsibility but Russian anti terror officials say the injured leaders -- a voice of moderation.
That the attack may be -- work of Islamic extremists.
Cops arrested the suspected Colombian drug lord in the northern city after a joint intelligence operation -- Colombian authorities.
Local media reports the suspect flew into Honduras was stolen plane earlier this year.
He's been extradited back to Colombia where he faces murder and drug trafficking charges.
And ice -- twice the size of Manhattan tore off one of the country's largest glaciers.
It's the second massive shock to break free and less than two years.
Some scientists claim that continued melting could dramatically raise sea level.
Hundreds of clowns saying in days through the streets during a march through Mexico City church.
Annual tradition started from thirty years ago members of the -- -- of Mexico.
Meet at the iconic church if things for their jobs.
On this box trip around.
In 82.
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text: Weapons Edit History Talk0 8,727pages on this wiki Category page Sorting type: Most visited Most visited Alphabetical Recently edited | This category contains a list of weapons used in all Grand Theft Auto games. v • g • d • eWeaponsListsAll Weapons | Category | Beta Weapons | Pistols | Melee Weapons | Shotguns | Machine Pistols | Sub Machine Guns | Assault Rifles | Sniper Rifles | Heavy Weapons | Thrown WeaponsWeapons inGTA V | Chinatown Wars | GTA IV (The Lost and Damned, The Ballad of Gay Tony) | Vice City Stories | Liberty City Stories | Advance | GTA San Andreas | GTA Vice City | GTA III | GTA 2 | GTA 1 and London PacksCategoriesGTA V | Chinatown Wars | GTA IV (The Lost and Damned, The Ballad of Gay Tony) | Vice City Stories | Liberty City Stories | Advance | GTA San Andreas | GTA Vice City | GTA III | GTA 2 | GTA 1 and London PacksRelated topicsDrive-By Shooting | Pickups | Ammunation | Shooting Ranges (VC Shooting Range, SA Shooting Ranges and Phil's Shooting Range) | Cover System Pages in category "Weapons" " The Nailgun is a weapon that was cut from Grand Theft Auto: Vice City. Not much is known about... Nailgun Double Barreled Shotgun " The Gaff Hook is a melee weapon in Grand Theft Auto: Vice City Stories. It is similar to the... Gaff Hook ElectroGun " Proximity Mines are weapons used in Grand Theft Auto: Chinatown Wars. When placed, they will not... Proximity Mines " The Fully Cocked License is a weapon license purchasable at the AmmuNation.net in GTA: Chinatown... Fully Cocked License " Were You Looking for the Similar looking Weapon in GTA V? Go Here M82 is a weapon that was cut... M82 Chisel Hockey Stick " The Flashbang is a projectile weapon in Grand Theft Auto: Chinatown Wars. It can be bought from... Flashbang Silenced Machine Gun " Crates are weapons in Grand Theft Auto: Chinatown Wars only for use during the mission Stealing... Crates " The Barbeque Tank is a gas canister that features in Grand Theft Auto IV, Episodes from Liberty... Barbeque Tank " The Laser Sight is an attachment that will be featured in the game Grand Theft Auto V. It is a... Laser Sight " A machine pistol is a sub-class of submachine gun. Machine pistols are often not much larger... Machine Pistol " A Vehicle Mine is a car mounted weapon in Grand Theft Auto 2. If a car or pedestrian comes in... Vehicle Mine Back 1 ... 5 6 7 8 9 Next Subcategories Weapons in GTA Online Weapons in GTA V Weapons Melee Weapons Shotguns Heavy Weapons Pistols Weapons in GTA San Andreas Back 1 2 3 4 Next


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Man cautioned for abusing referee
A man has been cautioned for sending abusive Twitter messages to a Premier League referee.
Mark Halsey made a complaint to police in his home town of Bolton about online posts sent after his officiating of Liverpool's home league defeat to Manchester United on Sunday.
Mr Halsey, 51, sent off Liverpool midfielder Jonjo Shelvey in the first half of the match and awarded their opponents a late penalty which secured three points in the 2-1 victory.
It is understood that several messages referred in derogatory terms to Mr Halsey's recent battle against throat cancer.
Police said a 27-year-old man they interviewed from the Newcastle area admitted being responsible for some of the messages. He was subsequently cautioned.
Officers say they are continuing attempts to trace anyone else responsible for posting the abusive messages.
Mr Halsey made the complaint at about 5.50pm on Sunday. Officers met with him and launched the investigation into offences committed under the Malicious Communication Act.
Detective Sergeant Tony Lunt said: "Clearly the victim and his family were very distressed by the extremely offensive comments posted on Twitter. We take all reports of abuse on social networking sites very seriously as these remarks can and do have a devastating impact on people's lives.
"As a result of our investigation, we have cautioned a man who has admitted responsibility for some of the messages. This individual was very apologetic and realises that in a moment of stupidity he posted deeply derogatory remarks about the victim and completely regrets his actions.
"Our inquiries are ongoing to identify anyone else who posted these offensive messages."


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SAS CEO Jim Goodnight speaks at Analytics 2013 about SAS's commodity hardware, such as servers, racks, blades, and their Intel® Xeon® processors.
Costa Coffee's digital barista uses Intel® technology to generate real-time analytics of consumers and offer options for a custom cup of coffee.
Tutorial: Demos how to create a three-zone campaign with images, videos, and RSS feeds using Intel® Retail Client Manager for digital deployment.
Demonstrates schedule functions in the Intel® Retail Client Manager, including schedule type, import/export, and basic/recurring schedules.
Tutorial describes Intel® Retail Client Manager tickers, showing how to create and configure tickers as a campaign zone and as display entities.
Intel® Active Management Technology allows retailers in Israel to dynamically and wirelessly update consumer campaigns with in-store digital signage.
Chris Aubrey explains working with Intel to create the adidas Virtual Footwear Wall*, highlighting the increase in sales generated at adidas stores.
Intel® Active Management Technology helps your retail connected in-store devices stay current, available and protected with energy efficiency.
A connected retail platform engages consumers to personalize their shopping experience with digital signage for product information.
Intel's Brian Roberts demos the Clear Channel interactive outdoor advertising solution, with immersive engagement capabilities for campaign tracking.


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could have sworn that he had spoken in MuyLinux Fuduntu but no, but I knew this distribution long , it seems that I have never found the time to talk about it.
Well, this is a great time, as developers have released version Fuduntu 14.12 which also serves to commemorate the first anniversary of this project to merge the best features of two popular distributions: Fedora and Ubuntu .
In fact, the original version was based on Fedora 14, but this issue is now about to fulfill his official life cycle, something that has made Fuduntu strive to create a fully independent fork Fedora , and this is the first fruit of that work. As explained in the official announcement:
Today I wanted to officially announce that we have completed the fork. This means that we are now self-contained and self-hosted distribution. Fuduntu is constructed from Fuduntu repositories, and by default only packages we take Fuduntu repositories.
14.12 (do not quite understand the numbering) is the first edition of this distro no external dependencies, and among the new features are the use 3.0.7 kernel, X.org 1.11.1, and Flash 11 .
The truth is that the appearance of this distribution is interesting , so we have to download and test distribution, is not it? To do this, you can access the following download links:


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Can you believe it?
Summer's over—at least on the school calendar—and some 10,275 Bedford County students are headed back to school Monday. The buses will be rolling; books will be passed out. And while students will have less time now to play those video games at home, some might find technology playing a bigger part in their learning experience for the 2012-2013 school year.
The Bedford County School Board started out with a list of $60 million in projects, but by the time its work session looking at future capital improvement needs was finished last Thursday, that figure had doubled. "This is by no means the final version," School Superintendent Dr. Douglas Schuch told the board as the meeting started. And he was right.
Students participating in extra/co-curricular activities in Bedford County Public Schools will have to meet policy guidelines approved by the county school board last week. The policy states that participation of students in those activities "is a privilege extended to students and not a right" and is therefore dependent upon compliance with the applicable rules and regulations. The policy states that VHSL standards will also apply to participants.
Club sports in county schools may soon come under the direction of Bedford County Public Schools, if a proposed policy is adopted by the school board. Several area residents urged board members to do just that at a meeting last Thursday. Jennifer Willoughby said the proposed policy ensures student standards while allowing for flexibility at each individual school. She said the schools don't have to be "mirror images" of each other.
The Bedford County School Board appointed principals for Moneta Elementary and Staunton River Middle School during action at Thursday's meeting.
Melanie Simmons is the new principal at Moneta ES, taking over for Barbara Rezzonico, who has moved over to Bedford Science and Technology Center.
For Staunton River High School student Laura Ellis, the action taken against bullying by the Bedford County School Board Thursday is not the end, but rather just a beginning. "I will be pushing for a statewide bullying prevention program to be put in every high school," she told the school board, prior to its vote on the policy last week. And, the 16-year-old Ellis said, she might just take her initiative nationwide.
The Bower Center has teamed up with the YMCA to provide art and dance for 169 children attending Y programs this summer. The children come in from Bedford, Forest and the Goodview areas.
According to Sara Braaten, the Bower Center's director, the 5- and 6-year-olds came in the morning and the older children, 8 through 12 years old, came in the afternoon.
The Bedford County School Board would like a new middle school in the Liberty Zone to be built either adjacent to the current Liberty High School, or at least nearby.
Nancy Kenton and The Great Haredini spent last week making appearances at all the Bedford area's libraries.
The Great Haredini is a big pink rabbit puppet. Nancy Kenton is the person behind Haredini's act.
For the second time this year the Bedford County School Board had to fill a vacancy on the board. And, for the second time in its history, it chose to interview candidates in an open meeting.
Six candidates applied to fill the District 2 school board seat vacated by David Vaden. School board members interviewed each candidate, asking each the same set of questions. Candidates waited their turn in a separate room so that none of them would have the advantage of hearing the questions in advance.


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From Abject Horror to Witty Play: The Oscillating Modes of the Supernatural in Nineteenth Century Japan
Starts: Nov 15 2012 - 4:30pm
Ends: Nov 15 2012 - 7:00pm
Daniel McKee, adjunct assistant professor and Japanese Bibliographer, Cornell University
Japanese prints from the Edo period (1600 - 1868) often feature haggard ghosts, vengeful demons, and mischievous beings. Collector McKee will discuss these prints in connection with literary, theatrical, and political discourses, reading them as a medium of socio-political critique.
Fantastic Stories: The Supernatural in Nineteenth-century Japanese Prints is organized on the occasion of the 25th anniversary of Asian Studies at Bowdoin College. The exhibition features forty prints by well-known artists such as Utagawa Kuniyoshi, Kawanabe Kyosai, Utagawa Kunisada, and Katsushika Hokusai. November 9, 2012 through March 3, 2013
Brunswick, ME 04011


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I went to the Ocean State National last weekend. I was 3 weeks out of knee surgery and on Antibiotics. I was blind sided by the "New" rule of on No canopies or umbrellas, even hand held. I was in the mist of cleaning my car and was holding it to shade myself from the sun as per doctors orders. I told this to the wonderful person who told me I had to put it away. So now I'm stuck. I can't finish cleaning my car because I can not stay out in the sun even after taking a bath in sunscreen. I've won 6 firsts with my car and received a 3rd this time around. This I'm not complaining about,I knew it wasn't as clean as it could have been.
My question is, Will the MCA cover a persons medical expense for sunburns because all shows are held out in the open and hopefully on sunny days?
I know why there shouldn't be any canopies on the show field, but hand held umbrellas? Not like it's going to fly away from a persons hand.
I believe the "New" rule, which by the way wasn't written in any of the show material, should be modified to allow hand held umbrellas.


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//Rate Your Purchase
Are you getting the most bang for your buck? With ads and sales everywhere, it's not always easy to know how to spend your cash. One way is to figure out how much something would cost each time you use it. This is called, "rating your purchase," and it's easy to do. Simply calculate your Cost Per Use (CPU) and see for yourself.
Here are some examples:
Example 1: A new pair of jeans
Cost: $50
Usage: 2 times a week for 1 year = 104 times
CPU (cost ÷ usage): $0.48
Example 2: A new video game
Cost: $60
Usage: 5 times a week for 1 month = 20 times
CPU (cost ÷ usage): $3.00
If your CPU equals:
$0.00 to $0.50 = Great bargain
$0.51 to $2.50 = Pretty useful
$2.51 to $10.00 = Weigh your options
$10.01 to $25.00 = Are you kidding?
$25.01 + = Special occasion only, like prom or graduation
Now it's your turn:
Next time you're trying to decide if you should buy something, calculate the CPU to see if you're getting the best value for your money.
Back to Spending Money Articles


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You're watching...
Democrats threaten January 1st tax hike on all Americans
Former Democratic pollster Pat Caddell reacts
Jul 16, 2012
Pat Caddell
You're watching...
Former Democratic pollster Pat Caddell reacts
Jul 16, 2012
Pat Caddell
Also in this playlist...
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Auto-advanceThis transcript is automatically generated
You know usually it's Republicans have got the mainstream media rapper he obstructionist.
How's that same media now going to play Democrats bragging about pushing this country to the brink.
We're gonna soon find out because democratic leaders have just Smart their line of the budget sand.
So if we can't get a good deal.
A balanced deal that calls on the wealthy to pay their fair share.
Then I will absolutely continue this debate -- -- thirteen rather than -- in a long term deal.
This year that throws middle class families under the bus.
All right so either Republicans commit themselves to raising taxes or Democrats will commit themselves -- -- shutting down the government.
And letting all the bush tax rates expire.
To -- says it's a losing game at a bad plan.
But they're gonna risk we have spoken -- -- -- I think well it depends on how.
The Republicans play.
Because they've been now given the the -- -- -- played OK just -- -- would kill the Democrats.
The -- they division between those who won a million dollars in the president to 5200.
Police force and -- -- -- -- the Republicans.
-- we get up and say this is part of my -- last week.
I'm gonna live Purcell OK you wanna deal could never get it but here's the deal will -- summing up people who make over a million dollars maybe.
But here's the -- requirement per -- give us X amount of cuts in real spending and secondly since you don't -- -- -- middle class and we don't.
A bomb attacks I think that's got to go in if you'll give us that which course they can't.
But Democrats will be -- it would not know what to do all the Republicans it's like playing poker.
This they've they've just thrown out this this bluff.
Well played better card and -- fault and it's like but instead because they're confident the Republicans will always wrong like through the French general staff.
In 1914.
Or 1940 foot -- -- today.
Dates this sort of -- -- -- whatever you wanna call on the view on the view that Republicans are getting.
Inconsistent on the titles they're looking into what exactly what they're saying its top 67% of people say they want rich people pay more OK well let's one.
In the same breath -- -- all the numbers are using a good time to raise taxes no you think you'll hurt you know.
What they're thinking is we can with a site on and -- police said last week about taking certain.
-- sports equipment awful players.
They think they've got them on the run all the Republicans got to do is play what I said just give them say okay we'll negotiate.
Here's what we'll do what we want this in this then you tell us why you're gonna tax middle class people -- -- let's say that doesn't happen and we're left with -- Democrats just say don't got to back off I understand.
What will those suffers in the event I was in Washington last summer -- ever gone through that brought down everybody does and I thought everyone suffered a -- who suffered the most.
Who's the president.
Note to not Susan because so you've got your parents -- you suffered so I think I suffered more than anyone in the country but the Republicans in the congress took a real hit.
And from that moment to what -- thank -- -- and so there are Democrats.
Say one the president.
The Democrats the -- -- supper he suffered -- -- one because he's the president.
His worst numbers in the last two years -- not after the 2000 election it was August that's why he won on this offensive.
People he's got a problem now with what he's doing I mean somebody's have been me today and it was a great line from became -- demand he said it's a transparency stupid into the president's got a problem in the Romney people calling.
This is the Republicans need in messaging that's more aggressive well -- a lot of -- that Republicans respond more aggressively it's of the Bain attacks.
You -- do you feel they're not ready -- -- -- -- aren't aren't -- some damage it looks desperate but let me just say.
Romney's got to deal with that but it's also gives them a way to be on the offensive as he said about fast and furious at the least.
But but here's the thing in 1980 I keep going back to the -- folks of important election.
Of this.
Jimmy Carter got labeled by the Washington Post the press -- mean.
President Obama is teetering if Romney answers these questions.
He's then going to discover that -- -- problem for -- elected to be transforming.
In unified and he is doing things or weird that thing in Virginia where range and he gets -- and Romney is the problem the Republicans -- the problem.
Was I mean that's a shot that was really bizarre and the other thing when he just and his interview with.
When he said well you know -- Washington hasn't changed I'm disappointed -- ahead of Washington.
This is you open yourself to these things you know into the jobs are there's -- for the Republican be on the offensive the Democrats are working with balls confidence.
And they play card like they did today the one you're talking about and they could blow up in their face or my friend would supplies are always learn something.
Smartest -- a politics bar -- Barton on.
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text:
The CS44600 and CS44800 pin-compatible Class-D digital audio amplifier controllers provide a simple, small and cost-effective solution for DVD receivers, home theater recorders and entry-level audio/video recorders and home-theater-in-a-box systems.
These multichannel digital-to-PWM (pulse width modulation) audio system controllers include interpolation, sample-rate conversion and half- and full-bridge PWM driver outputs. The architecture uses a direct-to-digital approach that maintains digital signal integrity to the final output filter, minimizing the effects of analog interference that negatively affect system performance.
The 6-channel CS44600 and the 8-channel CS44800 offer technology enhancements that allow system designers to lower costs while improving audio quality. These products integrate on-chip digital volume control, peak detect with limiter and seven general-purpose I/Os that allow an easy interface to many power stages. The PWM amplifier can achieve 90 percent efficiency or more, allowing the design of smaller device packages, fewer heat-sink requirements and smaller power supplies.
In addition, each chip incorporates Cirrus Logic's patented power-supply noise rejection technology, which compensates for the inherent power-supply noise that can hurt audio quality; as a result, a system designer may purchase lower-cost power supplies, reducing bill-of-material (BOM) costs. The power-supply noise rejection technology also enables single-ended outputs, further reducing component count.
The integrated sample-rate converter minimizes the effects of clock jitter, thus enabling better audio quality with a system dynamic range of greater than 100 dB. These amplifiers also feature Cirrus Logic's patented Popguard technology, which helps eliminate power-cycling clicks and pops.
Engineered for performance, the CS44600 and CS44800 deliver professional audio quality at breakthrough price points for applications such as audio/video receivers, home theater recorders, DVD recorders, digital TVs, set-top boxes, automotive entertainment systems, professional audio products and musical instruments.
Part | Resolution (bits) | Dynamic Range (dB) | THD+N (%) | Max Sample Rate (kHz) | Power Supply (V) | Comments | Package |
CS44600 | 24 | 100 | <0.05 % | 192 | VD = 2.5 V; VL = 3.3 to 5 |
6-Channel digital amplifier controller | 64 LQFP |
CS44800 | 24 | 100 | <0.05 % | 192 | VD = 2.5 V; VL = 3.3 to 5 |
8-Channel digital amplifier controller | 64 LQFP |
CS44600/800 | Not Recommended for New Designs |


text:
- March 7, 2013
- 3:41 p.m.
- Suggest removal
- Reply to this post
dadum writes:
in response to washingtonian:
It is sad that our society rarely believes the accuser but, that may explain why so many incidents go unreported. No one ever thinks their husband/wife, daughter/son, brother/sister, aunt/uncle, grandma/grandpa, etc are capable of any crime or wrong doing but, it happens every single day. This man is not incapable of being in the wrong no matter how good of a doctor he is. The truth of the matter is, you never truly know anyone and/or what they are capable of, especially not some one you see maybe once a month in a professional setting. I am sure the investigators have enough evidence to believe there is something to this case even if the Kitsap Sun does not have all the facts. I think most of us would be appalled to know what happens in our own neighbors homes and vise versa. No human is incapable of wrongdoing.
well said. It's so simple to understand.
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Opportunities and Connections for All
The School District of Menomonee Falls, Community Education & Recreation Department will use this blog to share information relative to upcoming events, classes, programs, workshops and seminars for people of all ages, from preschool to older adults. Jason Husslein, Recreation Supervisor, will post information and maintain this blog, along with contributions from other staff members. Residents are encouraged to e-mail questions of interest to email@example.com. Your questions may be answered in our blog.
Community Blood Drive - January 19, 2009
Menomonee Falls Community Education & Recreation in partnership with the Blood Center of Wisconsin is hosting a Community Blood Drive Monday, January 19 from 2:00 PM to 7:00 PM in rooms 102A & 102B of the Community Center. The Blood Center of Wisconsin needs donors to help with this worthy cause.The Blood Center of Wisconsin is the sole supplier of blood, blood products, research and diagnostic laboratory testing for 54 hospitals in our SE Wisconsin 28 counties. Our 4 Waukesha County hospitals alone use over 20,000 components annually to meet the needs of our friends and loved ones. You have the opportunity to help us meet local patient need by making your commitment to donate blood by signing up for an appointment with the Community Education & Recreation Office. Make an appointment online at www.fallsrec.org or call (262) 255-8460.
When considering whether to donate blood or not, ask yourself the following question….."In the event my loved one/friend needs a life-saving transfusion, would I not expect a safe & adequate blood supply to be there for him or her?" One in every five people each of us knows will need a blood transfusion in our lifetime! Help us help them on January 19th….schedule an appointment today!
Your generosity is greatly appreciated!
Celebrate the Holidays at the Menomonee Falls Teen Center
Students in grades 6 - 12 are invited to come to the Teen Center Friday, December 19 and Saturday, December 20 to celebrate the holidays with their friends and win some great prizes! Raffles will take place every half hour and everyone in attendance will be put into a drawing for a second semester TPass. Students will also have the opportunity to win (2) tickets to the Milwaukee Bucks game against the Raptors at 7:00 PM on Monday, January 5. Drawing for the TPass and the Bucks tickets will take place at 9:30 PM on Saturday. Students do not need to be present on Saturday to win. Winners will be notified by phone.
Teen Center Hours
Fridays (Grades 6-8)
6:30 to 10:00 PM


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Tag Archives: NSMB2
Thu, Oct 25, 2012 | 14:39 BST
New Super Mario Bros. 2 DLC announced for Japan
New Super Mario Bros. 2 will receive two new downloadable content packs today in Japan, Nintendo announced during its Nintendo Direct stream this morning. The DLC contains a Gold Mushroom Harvesting Pack with 2/5 difficulty, and a Record Challenge B Pack with 3/5 difficulty. A North American Nintendo Direct occurs later this morning at 10.00am EST, and it's possible Nintendo will announced the content for the western region as well during the presentation. Watch it here.
Sat, Aug 18, 2012 | 18:01 BST
Nintendo doesn't want gamers to feel "cheated or deceived" with DLC, says Iwata
Nintendo president Satoru Iwata has said the firm is "determined" not to take advantage of customers with DLC, as only content which enhances the length and enjoyment of the game will be released.
Sat, Aug 11, 2012 | 14:23 BST
New Super Mario Bros. 2 launch trailer released
New Super Mario Bros. 2 releases next week and to set yourself up for the occasion, Nintendo has released what appears to be the launch trailer. Watch it below, courtesy of NintendoVideoFrance. The platformer lands in EU on August 17; Australia on August 18; and in the US on August 19, which is when 3DS XL lands at retail in the region.


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Specifications & Dimensions
Dimensions and Capacity: | |
Throat Depth (in.): | 2.5 |
Product Overview: | |
Item Weight (lbs.): | 2.13 |
Type: | Bar & pipe clamps |
Ratings & Reviews
Overall, others give this:
Morton Grove, IL
via sears.com
I've gotten more and more into larger woodwork. I purchases a cheap bar clamp similar to this for a project that absolutely did not work. I returned it and decided to go and spend the money on a few quality ones. I love Craftsman tools and all the Craftsman stuff I have has never failed me. These clamps are no exception. They're very sturdy and durable. The steel construction is a big plus. They slide easily when they need to and provide plenty of clamping pressure and do not slip as the cheap "home store" brands do. I also like the larger handle as I have pretty big hands and the pads on the ends which stay put and also don't damage your workpieces. If you need clamps I highly suggest savingthe frustration on cheap stuff and getting these. These are at a good price too. They're just as good as Jorgensen.
Plano, TX
via sears.com
with different colors in ************** in less then $5
Jacksonville, NC
via sears.com
Odessa, TX
The Craftsman 18 inch Steel Bar Clamp is a very handy little clamp to have in your collection of clamps. I have various sizes of bar clamps, but this is probally the most used size of this clamp in my collection. The steel constuction makes it a strong clamp to have and with the protective coverings for the feet of the clamp, you don't have to worry about marking up your project pieces. I have learned that you don't have to clamp a piece extremely tight, but you need a clamp that will not slip or slide while it is clamped in place and these clamps do just that. They stay in place. I use these clamps a lot while I am making exact duplicate pieces and use these clamps to hold the pieces in place while I use my flush trim bit or pattern bit on my Craftsman router. I also use these clamps to hold pieces in place, while I drill pilot holes so they don't slide or move around while I ma making these holes. I use these clamps for glue projects or when I am using construction adhiesive to bond different pieces together. These clamps even hold my pieces to my work bench while I am sanding on them or making cuts with my C3 jigsaw. I used thse clamps just a few days ago to hold mulitple boards togehter while I made muliple kerf cuts to make notches to assemble my project. These clamps are very easy to grip and to tighten or loosen while you are working and they can be used with one hand, if needed. The slide operates very easy to adjust to the width of the porject piece you are working and so far, I have not had any of these clamps slip on the bar. A very dependable clamp.
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Travis Ruiz is the Social Media Manager and Interactive Managing Editor for FOX21 News.com
UPDATEThe man who drove a vehicle the wrong way on Interstate 25 Wednesday evening is being charged with Driving Under the Influence of Drugs.
Read more: http://www.coloradoconnection.com/news/story.aspx?id=860596#.UR0XIKUqavY
A man was arrested Wednesday afternoon after he was driving the wrong way on Interstate 25.
The man, who has yet to be identified, is currently being tested for DUI.
At about 2 p.m., police received reports of a vehicle going southbound in the northbound lanes on I-25 around North Nevada.
Traffic cameras indicated he pulled over near Garden of the Gods but then got back in the vehicle and took off again, police said.
Police used stop sticks to try to stop the man but he kept driving with flat tired.
The man was eventually stopped about one-fourth of a mile south of Fillmore.


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- Quicklinks
- Resources
Disabled American Veterans (DAV) Mobile Service Office
Primary Category:
Campus Life » Student Union
Campus Life
Campus Life » Office of Disability Services
Campus Life » Students » Veterans
Current Students
Date (Start and End):
Wednesday, October 23, 2013 - 10:00am to 5:00pm
Location description:
Student Union Visitor Lot 2
Event Webpage:
Housed in a fleet of well equipped "offices on wheels" DAV's Mobile Service Offices (MSOs) travel to smaller towns and rural communities across the country to counsel and assist veterans to educate veterans and their families on the benefits and services available to them in thanks for their service.
Aided by Department and Chapter Service Officers, the MSO program provides support to veterans developing, filing and winning claims for benefits administered under federal, state and local laws. National Service Officers counsel and assist with the development of evidence, completion of required applications and prosecution of claims, bringing benefit and services education to veterans and their families where they live.
See http://www.dav.org for more information.


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Get the cyber-pet widget and many other great free widgets at Widgetbox! Not seeing a widget? (More info)
Conditions of Use
Article posted May 16, 2012 at 01:50 PM GMT0 • comment (9) • Reads 751
Oh So Fresh!
Article posted May 4, 2012 at 02:28 PM GMT0 • comment • Reads 547
Hey Juliet
Article posted May 4, 2012 at 02:21 PM GMT0 • comment (9) • Reads 504
Sing It Out
Do you know a song that relates back to the story Romeo and Juliet? The song that I picked is called "Hey Juliet" by LMNT. This song talks about Romeo and Juliet, but do you believe this song has an accurate allusion of the passage?
This song talks about a guy who loves a girl who doesn't really notice him, but he wants to be her Romeo. He says how he's begging her to be with him, how she's so fine, and how he wants to run away with her. She doesn't even acknowledge him when he says "hey hey Juliet."
I believe that this song doesn't have an accurate allusion of Romeo and Juliet at all. He says how he wants to run away with her, which does some-what resemble the passage, but it says how she doesn't even notice him. In the passage Juliet loves Romeo and wants to be with him all of the time.
Do you agree why I believe that this song doesn't have a good portray of Romeo and Juliet? I believe that it doesn't at all. Now it's your turn to find a song that has a good or bad representation of Romeo and Juliet.
Be Confident On Who You Are!
Article posted April 16, 2012 at 12:09 AM GMT0 • comment (7) • Reads 775
Run Hard Or Go Home!
Article posted March 7, 2012 at 03:00 PM GMT0 • comment (1) • Reads 720
March Freewrite:
The season has finally come! Track and Field has started up. The pain and agony has began once again. We have start back up on eating healthy, trying as hard as you can, and never giving up. This is what makes up the sport Track and Field.
Nobody ever likes to eat healthy all of the time, but our coach says we have to. He says thats what will make us stay fit. Not everybody will follow that rule though. During the night, you always are in the mood for a nice cookie, or a piece of chocolate cake. When thats in your house, you usually say...."just one won't hurt me." I know that is what I always say. Then the next day you just work harder to get rid of what you ate the night before. Also you need some of the fats that are in those unhealthy foods, so don't just give up on those tasty treats.
"You gotta run to the wall and push it each time you get to it." Our coach says that all of the time. When ever we get to our strongest point we are supposed to try even harder to get even better. For jumping, the wall is when you hit your farthest jump. When you hit that jump you feel like you'll never get a better jump, but you just keep pushing and then one day you finally get it. When you break "your wall" you feel so accomplished knowing that you just broke your own goal. Maybe our coach was right saying to "go to the wall and push it!" You're supposed to never give up, but sometimes you can't be to harsh. Track is about having fun and being involved to keep in shape. Sometimes our coach pushes a little to hard though. I hate when we can't have fun because we're supposed to never give up and push on and on. Those are some things that happen during track. Eating healthy, trying as hard as you can, and never giving up. That is what goes on during the fun/tortureous season of track and field!
We represent COLORS!!
Article posted February 21, 2012 at 11:29 PM GMT0 • comment (5) • Reads 751
"All colors are the friends of their neighbors and the lovers of their opposites." ~Marc Chagall I believe that my friends represent colors for all of our different personalitys! The colors that are the best for my friends are yellow, pink, purple, orange, and red.
That is how my friends personalitys represent colors! Some are happy all of the time, some are all girl, some are loyal, some are crazy and fun, and finally some are all out loving.
In a rich man's world!
Article posted February 8, 2012 at 03:01 PM GMT0 • comment (2) • Reads 838
Lauren, Zach, and Shane....MARXISM!
Article posted February 8, 2012 at 02:39 PM GMT0 • comment (5) • Reads 814
Make your own slide show at Animoto.
RUMORS and DRAMA!
Article posted January 24, 2012 at 03:16 PM GMT0 • comment (3) • Reads 655
Heaven's Very Special Child
Article posted January 20, 2012 at 03:29 PM GMT0 • comment (4) • Reads 1020


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Gilles Mezzomo
Artist Mezzomo, Gilles
Available series in store category "Comic books"
Gilles Mezzomo in the
"Gilles Mezzomo worked with the French National Railways before beginning his career in comics. He showed his work at the editorial offices of the magazine Spirou in 1991, and was assigned to take over the series 'Le Roi Vert' after the death of Jacques Armand. Mezzomo made four albums of..." [ Read more ]


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this shaft has a very nice feel aswell as distributed weight . it is light and nothing should change about it
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(4) Louisville vs. (7) Florida Preview
Senior NBA & College Basketball Editor
Follow @Yannis KoutroupisYannis Koutroupis
(4) Louisville Cardinals
The Cardinals' hot streak continued in the Sweet 16 as they made surprisingly easy work of the Michigan State Spartans, defeating them 57-44. The Cardinals were tenacious defensively, holding the Spartans to 28 percent shooting from the field and 23 percent shooting from deep. They also forced 15 Spartan turnovers. The catalyst behind their defense was sophomore center Gorgui Dieng, who never stepped off the court. He blocked seven shots, tying his season-high, while also hauling in nine rebounds and getting three steals. On a night where Peyton Siva and Kyle Kuric were quiet, Chane Behanan rose to the occasion with 15 points and nine rebounds. It will be all about perimeter defense for the Cardinals in the Elite Eight. The Gators have explosive players at each guard position who drive them. Keeping them in check is a necessity if they are going to move onto the Elite Eight. Dieng needs to avoid foul trouble because his presence as the last line of defense is game changing.
(7) Florida Gators
For the second time in the tournament the Gators' three-point shot was off and it could not have mattered less either time. The Gators made up for their offensive shortcomings with their defense, which was lacking nothing at all. They held Marquette's stars Jae Crowder and Darius Johnson-Odom to 10-30 shooting from the field as they eliminated them 68-58. The big dance has really turned into a coming out party for freshman Brad Beal. With the poise of someone far older, Beal had himself a heck of a ballgame with 21 points, six rebounds, four assists, two steals and two blocks. He's really played like a star these past three games. The Cardinals are going to give him a lot of attention defensively, making sure he works for everything. He'll have to handle that the same way he did Kentucky's pressure in the SEC Tournament, not the first two match ups. Since the Cardinals have an imposing defensive anchor inside like Dieng, it's important for the Gators to be on from distance and attack him when they try to take it away.
HOOPSWORLD's pick: Louisville. In a classic match up between the master and his former apprentice, we expect Pitino to show his former player that he's still got it in a favorable matchup for his team.
Who do you think is going win? Chime in by leaving a comment below!


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This is one of the best parts of Curtis Hazel's job as the 2012 Players Championship general chairman: He and the past chairmen also known as "the Redcoats" get to play Santa about five weeks early.
But what the PGA Tour's major championship is bringing to First Coast charities on an annual basis is much more than toys and candy.
The Tour and The Players announced Wednesday that a record $6.5 million will be donated to charity, breaking the 2011 record of $5.9 million and pushing the total amount of charitable giving by The Players to $52.8 million since the tournament moved to the First Coast on a permanent basis in 1977.
The Players has donated money to more than 300 area charities.
"I've told our volunteers this many times," Hazel said of the 2,200 people who help put on the tournament each year. "This is our payday."
All-Access: Lead letter: The Players Championship is a growing major charity
The announcement was made during a nighttime ceremony billed as "Evening Under the Lights," at the signature hole of the tournament, the par-3 17th of the TPC Sawgrass Players Stadium Course. The event brought together leaders of area charities, the leadership of The Players and the PGA Tour and Tour partners in the business community to hear Tour Commissioner Tim Finchem announce the donation.
Finchem praised tournament organizers, volunteers and First Coast golf fans for contributing to the record amount.
"As more people get involved, they understand that when you buy a ticket, buy a Coke, or hospitality, a lot of that money goes to help people," Finchem said. "Then there's the job the volunteers do to make it happen. They're the reasons we will continue to grow this."
The charity dollars came from a mix of corporate hospitality areas (most of them surrounding the iconic finishing holes at Nos. 16, 17 and 18 of the Stadium Course) and ticket revenue.
Players Championship executive director Matt Rapp said the increase in charity dollars could be directly traced to a 20 percent increase in ticket sales for the 2012 Players and corporate hospitality space that is more than double of the average PGA Tour event.
The total square footage of hospitality areas at The Players was more than 200,000 this year, Rapp said. Other Tour events average round 75,000 square feet.
The charity output also comes at a time when the economy still faces challenges.
"Everybody worked harder," Finchem said. "But America is a giving country ... We have enormous philanthropy. The economic downturn focuses people even more on the difficulties in area such as school budgets and the cutting of resources in areas that are fundamentally important to kids' development that it cries out for the private sector to step in and do more."
The event Wednesday night was part of the Players "Giving Bank Month" in November, which concludes next week with the Redcoat Ride Out on Monday. Past Players chairmen will deliver checks and Thanksgiving food baskets to three area charities: the City Rescue Mission, Sanctuary and MetroKidsKonnection.
On Nov. 8, 16-time PGA Tour winner Jim Furyk of Ponte Vedra Beach and his wife Tabitha helped unveil The Players Playroom in the new Wolfson Children's Hospital Tower. The golf-themed playroom will provide a respite for children who are undergoing treatment at the hospital.
While donations have been made by The Players over nearly four decades to charities involving health, wellness, fitness, the underprivileged and the elderly, the focus in recent years has been on children's and youth charities.
That includes a share of the $50 million the Tour and The Players pledged to youth-related and educational charities over a 10-year period. To date, more than $11 million has been raised towards that goal.
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