text:
Financial Aid
Scholarships, Awards, Grants, Loans
Student Employment, Veterans' Benefits
(Payment must be in U.S. dollars. Expenses are subject to change without notice.)
Tuition and all fees are due
and payable in full by registration day for each semester or summer term.
Please make checks or money orders payable to the
It is the policy of the
administration and trustees to keep the cost of a college education as low as
possible. Since UNC Pembroke is maintained by the people of
Tuition Surcharge on Undergraduates
The North Carolina Legislature
directed the Board of Governors to impose a twenty-five percent tuition
surcharge on students who take more than 140 credit hours to complete a
baccalaureate degree in a four-year program or more than one hundred ten
percent (110%) of the credit hours necessary to complete a baccalaureate degree
in any program officially designated by the Board of Governors as a five-year
program. The calculation of these credit hours taken at a constituent
institution or accepted for transfer shall exclude hours earned through the
College Board's Advanced Placement or CLEP examinations, through institutional
advanced placement or course validation, or through summer term or extension
No surcharge shall be imposed
on any student who exceeds the degree credit hour limits within the equivalent
of four academic years of regular term enrollment, or within five academic
years of regular term enrollment in a degree program officially designated by
the Board of Governors as a five-year program.
The undergraduate credit hours
to be counted for calculation in the surcharge requirement include:
* all regular session degree-creditable courses taken at this institution including repeated courses, failed courses and those dropped after your official census date (normally the last date to add a course); and
* all transfer credit hours accepted by this institution.
The hours excluded from the
calculation include:
1) those earned through the College Board's Advanced Placement (AP) and College Level Examination Program (CLEP) or similar programs;
2) those earned through institutional advanced placement, course validation, or any similar procedure for awarding course credit, and
3) those earned through the summer session or degree-credit extension division on this campus or at another UNC institution.
(Subject to change without notice.)
Sem. Hrs. |
In‑State Tuition |
Out‑of‑State Tuition |
Fees |
Ins. |
In‑State Total |
Out‑of‑State Total |
12+ |
$844.50 |
$5,564.50 |
$645.50 |
$225.50 |
$1,712.50 |
$6,432.50 |
9‑11 |
$633.38 |
$4,173.38 |
$484.14 |
$225.50 |
$1,340.02 |
$4,888.02 |
6-8 |
$422.25 |
$2,782.25 |
$322.75 |
0 |
$745.00 |
$3,105.00 |
1-5 |
$211.13 |
$1,391.13 |
$161.39 |
0 |
$372.52 |
$1,552.52 |
Rate |
Plan Rate (Minimum*) |
Semester (Minimum*) |
Year (Minimum*) |
Hall |
Double |
$1,425.00 |
$995.00 |
$2,420.00 |
$4,840.00 |
Single |
$1,705.00 |
$995.00 |
$2,700.00 |
$5,400.00 |
Private Double |
$1,775.00 |
$995.00 |
$2,770.00 |
$5,540.00 |
Wellons, Belk, and North Hall |
Double |
$1,350.00 |
$995.00 |
$2,345.00 |
$4,690.00 |
Single |
$1,715.00 |
$995.00 |
$2,710.00 |
$5,420.00 |
Double |
$1,770.00 |
$1,770.00 |
$3,540.00 |
Single |
$2,315.00 |
$2,315.00 |
$4,630.00 |
on 10 meals per week; rates for other options are listed below.
Meal Plan Options
Meal Plan Rate |
Meals Per Week |
Semester Bonus Money |
$995.00 |
10 |
125.00 |
$1,095.00 |
14 |
75.00 |
$1,130.00 |
19 |
0.00 |
TUITION: FULL-TIME STUDENT (per semester) |
$844.50 |
Out-of-State Residents ‑ Undergraduates |
$5,564.50 |
GENERAL FEES (Per Semester) |
Educational and Technology Fee |
$67.50 |
Health Services This fee is used to operate Student Health Services. |
$64.00 |
Other Required Fees This fee
is used to support various University programs such as Athletics, Band and
Chorus, Dramatics, Debt Service, |
$514.00 |
Students taking 9 or more
credit hours will be charged $158 per semester for health insurance.
If you wish to waive this
insurance, you must complete and return the insurance waiver form to the
Student Accounts Office no later than the published cut‑off date. The Student Health Services Office can answer
any questions you may have about the coverage or waiver process.
Application Fee This fee, paid at the time of initial application, is non-refundable and cannot be applied to meet any other charges. |
$40 |
Undergraduate Graduation Fee Graduate Graduation Fee This fee must be paid at the time the student makes application for graduation. It is used to pay for the cap, gown, and diploma. This is a non-refundable fee. |
$40 $70 |
Late Payment/Registration Fees Students who register and/or pay for classes after the scheduled registration date has passed must pay this fee. |
$25 |
Dormitory Deposit Fee (refundable) |
$125 |
Vehicle Registration Fee: |
Commuter (Day) |
$80 |
Commuter (night) |
$60 |
Dormitory Resident |
$90 |
Permits sold after April 30 will be half price. A vehicle registration permit is valid for one full year, commencing August 15. |
Transcript Fee |
Mailed |
$3 |
Faxed |
$5 |
Walk‑in |
$10 |
Returned Check Charge |
$25 |
REFUND POLICY (This Policy Is Subject to Change)
Tuition and fees, including
room and board will be refunded per the following schedules, provided a student
officially withdraws from the University.
and Spring Semesters |
Prior to the first day of classes |
100% of fees paid |
1 through 12 calendar days |
90% of fees paid |
13 through 30 calendar days |
50% of fees paid |
31 through 60 calendar days |
25% of fees paid |
after 60 calendar days |
no refund |
Second, and Special Five-Week Summer Sessions |
Prior to first day of classes |
100% of fees paid |
1 through 9 calendar days |
50% of fees paid |
after 9 calendar days |
no refund |
Session |
Prior to first day of classes |
100% of fees paid |
1 through 6 calendar days |
50% of fees paid |
after 6 calendar days |
no refund |
University counts calendar days beginning with the first official day of
classes (not the first day of particular classes). A completed withdrawal form must be filed
with Student Accounts Office in the Controller's Office. Forms for withdrawal during the first six
weeks of the semester, the first 9 calendar days of first, second, and special five-week summer sessions,
and the first 6 calendar days of intra sessions may be obtained from the
Registrar's Office. After these times,
forms may be obtained from the Office for Academic Affairs.
Reducing Hours
Students who officially drop
from full-time to part-time status or those who drop to a lower block of credit
hours will receive a refund equal to the difference between the amount paid and
the charge for the block of hours for which the student is officially
registered at the end of the registration (drop/add) period.
Refunds for withdrawing or
reducing hours will be processed after the registration period. Please allow
two weeks for processing of any refund. Students receiving financial aid will
not receive a refund until the Financial Aid Office determines if any funds
from an awarding agency must be returned.
If a return is required, withdrawal may result in a student liability to
the University.
The University will refund all
but $25 of the room deposit to incoming new students if written cancellation is
received by August 1 preceding the fall semester and December 1 preceding the
spring semester. The room deposit is non‑refundable
after these deadlines.
The $125 room deposit (less
damages and /or any other financial obligations owed The University of North
Carolina at Pembroke) will be refunded to established residents provided the
resident submits written cancellation by November 15 preceding the spring
semester and by April 15 preceding the fall semester. Established residents must follow check‑out
procedures as detailed in the Student handbook to ensure an appropriate refund
of the room deposit.
If a student withdraws from
the University prior to mid‑semester, the room deposit will be
forfeited. If a student withdraws after
mid‑semester, the room deposit (less damages if any) will be refunded,
provided checkout procedures have been followed.
The basis for determining the
appropriate tuition charge rests upon whether a student is a resident or a
nonresident for tuition purposes. Each student must make a statement as to the
length of his or her residence in
To qualify as a resident for
tuition purposes, a person must become a legal resident and remain a legal
resident for at least twelve month immediately prior to classification. Thus
there is a distinction between legal residence and residence for tuition
purposes. Furthermore, twelve months legal residence means more than simple
abode in
Initiative. Being classified a
resident for tuition purposes is contingent on the student's seeking such
status and providing all information that the institution may require in making
the determination.
Parent's Domicile
If an individual, irrespective
of age, has living parent(s) or a court-appointed guardian of the person, the
domicile of such parent(s) or guardian is, prima facie, the domicile of the
individual; but this prima facie evidence of the individual's domicile may or
may not be sustained by other information. Further, nondomiciliary
status of parents is not deemed prima facie evidence of the applicant child's
status if the applicant has lived (though not necessarily legally resided) in
Effect of Marriage
Marriage alone does not
prevent a person from becoming or continuing to be a resident for tuition
purposes, nor does marriage in any circumstance insure that a person will
become or continue to be a resident for tuition purposes. Marriage and legal
residence of one's spouse are, however, relevant information in determining residentiary intent. Furthermore, if both husband and his
wife are legal residents of North Carolina and if one of them has been a legal
resident longer than the other, then the longer duration may be claimed by
either spouse in meeting the twelve-month requirement for in-state tuition
Military Personnel
A North Carolinian who serves
outside the State in the armed forces does not lose
Grace Period
If a person (1) has been bona fide legal
resident, (2) has consequently been classified a resident for tuition purposes,
and (3) has subsequently lost North Carolina legal residence while enrolled at
a public institution of higher education, that person may continue to enjoy the
in-state rate for a grade period of twelve months measured from the date on
which North Carolina legal residence was lost. If the twelve months end during
an academic term for which the person is enrolled at a State institution of
higher education, the grace period extends to the end of that term. The fact of
marriage to one who continues domiciled outside
Minors (persons under 18 years
of age) usually have the domicile of their parents, but certain special cases
are recognized by the residence classification statute in determining residence
for tuition purposes.
If a minor's parents live
apart, the minor's domicile is deemed to be North Carolina for the time
period(s) that either parent, as a North Carolina legal resident, may claim and
does claim the minor as a tax dependent, even if other law or judicial act
assigns the minor's domicile outside North Carolina. A minor thus deemed to be
a legal resident will not, upon achieving majority before enrolling at an
institution of higher education, lose North Carolina legal residence if that
person (1) upon becoming an adult "acts, to the extent that the person's degree
of actual emancipation permits, in a manner consistent with bona fide legal
residence in North Carolina" and (2) "begins enrollment at an institution of
higher education not later than the fall academic term next following
completion of education prerequisite to admission at such institution."
If a minor has lived for five
or more consecutive years with relatives (other than parents) who are domiciled
in North Carolina and if relatives have functioned during this time as if they
were personal guardians, the minor will be deemed a resident for tuition
purposes for an enrolled term commencing immediately after at least five years
in which these circumstances have existed. If under this consideration a minor
has deemed to be a resident for tuition purposes immediately prior to his or
her eighteenth birthday, that person on achieving majority will be deemed a
legal resident of
Lost, but Regained Domicile
If a student ceases enrollment
at or graduates from an institution of higher education while classified a
resident for tuition purposes and then both abandons and reacquires North
Carolina domicile within a 12-month period, if he or she continues to maintain
the reacquired domicile into re-enrollment at an institution of higher
education, may re-enroll at the in-state tuition rate without having to meet
the usual 12-month durational requirement. However, any one person may receive the
benefit of this provision only once.
Change of Status
A student admitted to initial
enrollment in an institution (or permitted to re-enroll following an absence
from the institutional program which involved a formal withdrawal from
enrollment) must be classified by the admitting institution either as a
resident or as a nonresident for tuition purposes prior to actual enrollment. A
residence status classification once assigned (and finalized pursuant to any
appeal properly taken) may be changed thereafter (with corresponding change in
billing rates) only at intervals corresponding with the established primary
divisions of the academic year.
Transfer Students
When a student transfers from
The primary role of the
Financial Aid Office, located on the second floor of Lumbee
Hall, is to provide financial aid as well as financial counseling to students
requesting these services. This office coordinates a variety of State, Federal,
private and institutionally funded aid programs, each with different
regulations and requirements. While most of these programs require students to
demonstrate financial need, there are loan funds available to help students and
parents which are not need based. All students requesting consideration for any
type of financial aid, including loans, must apply each year. The application,
"Free Application for Federal Student Aid," should be completed, listing the
To be eligible for financial
assistance a student must have a high school diploma or GED; be enrolled as a
regular student in an eligible program; be a U.S. Citizen or eligible
non-citizen; generally, have a social security number; make satisfactory
academic progress; register with the Selective Service, if required; and, not
be in default on any federal loan or owe a refund on a federal grant. In
addition, a transfer student must submit to the Financial Aid Office a completed
Financial Aid Transcript from each institution previously attended. Financial
aid is awarded on the basis of academic achievement and demonstrated financial
need. The first responsibility of financing a student's education rests with
the student and the student's family. A student's parents are expected to
contribute towards his or her expenses insofar as they are able from income and
assets. A student is expected to provide funds for his or her own education
through savings, summer work, and other resources. Each student is individually
considered on the basis of the family financial situation.
A Financial Aid Brochure which
explains in detail the financial aid programs at UNC Pembroke is available in
the Financial Aid Office.
Scholarships, including
endowed scholarships, are provided by donors to the University: Friends, alumni, corporations and
foundations have provided funds to aid students in the pursuit of academic
achievement. A wide range of scholarships is available, some with specific
restrictions. Scholarships and endowed
scholarships are available in these categories:
Alumni Sponsored Scholarships
General Scholarships
Departmental Scholarships
Specialized Scholarships
For application information, a
student is encouraged to contact the Office of Financial Aid or the Chair of
the Department in his or her major field.
For a complete listing of
scholarships and awards, see Appendix B.
For further information about
specific scholarships, their donors, and their honorees, please consult the
Office of Advancement.
Special awards are presented
to recognize outstanding graduating seniors.
Currently there are awards in the Social Work Program and the Teaching
Fellows Program.
Grants are provided by state
and national agencies.
North Carolina Grants
Funds for grants allocated by
the North Carolina Legislature are made available on an annual basis to
residents of North Carolina in attendance at UNC Pembroke. These grants vary in
amount according to students' demonstrated need.
Federal Pell Grants
This program is for students
who have financial need. The U.S. Government fixes the amount of financial
assistance a student may receive under the Pell Grant Program on the basis of
need. These grants are awarded upon enrollment in good standing in an
institution of higher education. Applications are available in the University's
Financial Aid Office and any high school guidance counselor's office. To apply
for a Pell Grant a student must complete the Free Application for Federal
Student Aid. A Student Aid Report will be sent to the student's home address.
Federal Supplemental Educational Opportunity Grants
The purpose of this program is
to provide Supplemental Educational Opportunity Grants to students who have
demonstrated exceptional need and who would be unable to enter or remain in
college without such assistance. Recipients must show academic or creative
promise. The grant may be renewed for each year of undergraduate study for a
period of up to four years if the student continues to qualify for assistance.
Students must reapply each year.
North Carolina Student Incentive Grant Program
This program is administered
by College Foundation, Inc. Funds are provided to the Foundation by the North
Carolina State Education Assistance Authority under the 1965 Higher Education
Act, as amended, from state and federal appropriations. To qualify for a North
Carolina Student Incentive Grant (NCSIG), a student must be a legal resident of
North Carolina, be accepted for enrollment as a regular student or be enrolled
full-time in good standing in an undergraduate program, and must demonstrate a
substantial financial need. Grants are based on an individual student's
demonstrated need in relation to resources and the cost of education, but may
not exceed $1,500 per academic year.
To apply for NCSIG, the
student's parents and/or the student and spouse must complete the Free
Application for Federal Student Aid, and mail it to the processor no later than
March 1. All North Carolina residents are encouraged to apply for this grant.
All students applying for the
NC Student Incentive Grant must also apply for the Pell Grant.
Vocational Rehabilitation Scholarships
Students who have disabilities
which constitute vocational handicaps are eligible for scholarships from the
North Carolina Vocational Rehabilitation Department. For information, qualified
students should write to the Department of Vocational Rehabilitation, Raleigh,
Minority Presence Grant Program
The Minority Presence General
Grant Program: Part I - provides funds for grants to white students at
predominately black institutions and to black students at predominately white
institutions who are residents of North Carolina, are enrolled for at least
three hours of degree credit course work, and demonstrate financial need; Part
II - provides funds for grants to Native Americans and other minority students
at the constituent institutions of the University of North Carolina who are
residents of North Carolina, are enrolled for at least three hours of degree
credit course work, and demonstrated financial need.
American Indian Student Legislative Grant Program
Established by the NC General
Assembly, this program provides assistance for resident North Carolina Indians
who demonstrate financial need according to federal guidelines. Recipients must
be enrolled at least half time in a regular degree-seeking program and
maintaining satisfactory academic progress.
Loans are available through
federal and state programs as well as through private donors.
Federal Perkins Loan
Assistance is available in the
form of loans which bear no interest while the student is enrolled at least
half-time in an institution of higher education. Interest begins to accrue at
the rate of five (5) percent and payment begins nine months after the borrower
ceases to be enrolled in at least a half-time course of study. Repayment may be
extended over a period of ten years as long as a minimum repayment of $40 per
month or $120 per quarter is made.
Loans are made to entering
freshmen and transfer students who are enrolled as regular students and to
returning students who are in good academic standing and who can demonstrate
financial need. The Perkins Loan program is funded by the federal government.
Federal Stafford Loan Program
Subsidized: Based on financial need, these are
low-interest loans made by lenders such as banks, credit unions or savings and
loan associations and insured by state guaranty agencies. Loan limits are based
on need and grade level.
Non-Subsidized: These loans
are not based on need. Interest accrues to the borrower beginning on the date
of disbursement by the lender. The borrower is responsible for the interest
during in-school and deferment periods.
N.C. State Scholarship Loan Fund for Prospective Teachers
Students desiring loans of
this type should make applications to the North Carolina State Department of
Public Instruction, Raleigh, North Carolina. This fund provides as much as
$2500 per year in financial aid for a prospective teacher. Repayment of the
loan is canceled for recipients who teach four years in North Carolina public
Student Loan Funds Provided by Donors
A student with special
financial needs may approach the Financial Aid office for information about
loan services provided by donors to the university. The Office of Advancement has additional
information about the donors of these loans and their honorees.
The student employment
programs help eligible students pay University expenses while attending classes
full time. Students participating in the programs are employed with the
Maintenance Department, Library, Cafeteria, Switchboard, Administrative and
Departmental Offices, and Laboratories.
The student employment
programs consist of the University Self-Help Program and the Federal Work-Study
Program, which is a federal assistance program. To participate in the programs,
a student must have a completed application for aid on file in the Financial
Aid Office. To participate in the Federal Work Study Program, a student must
demonstrate financial need.
A student's work schedule will
depend upon class schedules and can be arranged by the student and the
student's work supervisor. These jobs provide learning opportunities as well as
financial aid.
Vocational Rehabilitation
Veterans who enter the
University under Chapter 31, Title 38, U.S. Code, Vocational Rehabilitation for
Disabled Veterans, and have the approval of the Veterans Administration will
have their University fees paid directly to the University by the U.S.
GI Bill
Veterans eligible for the G.I.
Bill, Chapter 30, Title 38, U.S. Code effective October 19, 1984, and Chapter
32, Title 38, United States Code, effective January 1, 1977, must make
application for their benefits. For information regarding eligibility, or
application forms, contact the Veterans Administration, Regional Office, 251
North Main Street, Winston-Salem, N.C. or the Financial Aid Office, University
of North Carolina at Pembroke. Transfer students on the G.I. Bill should
complete VA Form 21E-1955, Request for Change of Program or Place of Training,
prior to the time they plan to transfer.
Once the veteran is enrolled,
he/she must attend classes regularly to continue receiving benefits.
NC National Guard, Chapter 106
Upon enlistment in the North
Carolina National Guard, students will be eligible to apply for up to $1000 per
year tuition assistance. The Tuition Assistance program was established by the
North Carolina Legislature to provide educational assistance for members of the
North Carolina National Guard. For further information students can write to:
Educational Opportunities, Att: AGRR
4105 Reedy Creek Road
Raleigh, NC 27607
Veteran Dependents
Children of disabled or
deceased veterans may receive financial assistance in the payment of tuition,
room, meals, and other required University fees. For information and
application forms, students should write to the North Carolina Department of
Veterans Affairs, Raleigh, N.C.
Chapter 35, Title 38, U.S.
Code provides for the training of sons, daughters, spouses, and widows of
veterans who died in service; who died as a result of a service-connected
disability; who became permanently and totally disabled as a result of a
service-connected disability; or who have been listed as missing in action,
captured, detained, or interned in line of duty by a foreign government or
Students enrolling under
provisions of Chapters 30, 32, 35 and 106 will pay fees at the time of
registration and receive a monthly education and training allowance from the
Veterans Administration. Since the first check is usually delayed, a veteran or
dependent should make arrangements as early as possible.


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text:
MIME-Version: 1.0 Content-Location: file:///C:/A518DA76/divertic-zenk-100526.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii"
TITLE: Zenker's Diverticulum
SOURCE: Grand Rounds Presentation,
DATE: May 28, 2010
MEDICAL STUDENT: Jill D'Souza, Class of 2011
FACULTY PHYSICIAN: Michael Underbrink, MD
DISCUSSANT: Michael Underbrink, MD
SERIES EDITOR: Francis B. Quinn, Jr., MD
ARCHIVIST: Melinda Stoner Quinn, MSICS
material was prepared by resident physicians in partial fulfillment of
educational requirements established for the Postgraduate Training Program =
the UTMB Department of Otolaryngology/Head and Neck Surgery and was not
intended for clinical use in its present form. It was prepared for the purp=
of stimulating group discussion in a conference setting. No warrantie,
either express or implied, are made with respect=
its accuracy, completeness, or timeliness. The material does not necessarily
reflect the current or past opinions of members of the UTMB faculty and sho=
not be used for purposes of diagnosis or treatment without consulting appro=
literature sources and informed professional opinion."
Zenker's Diverticulum is a rare cause of dysphagia worldwide. = Surgical management of Zenker's diverticulum is complex and requires the exper= tise of an experienced Otolaryngologist.
Descriptions of hypopharyngeal diverticula have appeared in scientific literature for over two hundred years. They were fir= st described by Abraham Ludlow, in 1764, and described by several pathologists= in the following years. The seminal work on hypopharyngeal diverticula was car= ried out in collaboration between German pathologists Albert von Zenker and Hugo von Ziemssen in 1867, titled Krankheiten des Oesoph= agus, or Diseases of the Esophagus.
Surgical repair of Zenker's Diverticulum w= as rarely attempted prior to mid-20th century due to high rates of morbidity and mortality. The first successful divertic= ulectomy was carried out by von Bergman in 1892, though surgical techniques had been postulated for decades. In 1909 Goldmann introd= uced a two-stage surgical technique which caused fistulizatio= n and rejection of the diverticulum. The late 193= 0s saw the refinement of technique into a single-stage procedure, and in 1951 the cricopharyngeal myotomy technique was introduced by Kaplan. Diverticulopexy with myotomy was first used in 1966 by Belsey and was successful in decreasing operative tim= e and hospital stays. The importance of myotomy in the treatment of Zenker's Diverticulum was highlighted by studies done by Einars= son and Hallen, which showed the decrease in recurr= ence rate when myotomy is performed. Endoscopic techn= iques were first attempted in the early 1900s, but the mortality rate was conside= red unacceptably high, and the procedures were abandoned. In the 1960s, Dohlman and Mattson introduced diathermy as a method = to divide the common wall of the diverticula and the esophagus. Von Overbeek continued this endoscopic trend and over the= next thirty years improved on the Dohlman technique,= using the CO2 laser rather than diathermy. In 1993, Collard et al introduced what= is now widely considered to be the standard surgical approach to a moderate-si= zed diverticulum, the endoscopic stapling technique.
Anatomy and Physiology:
Zenker's diverticulum is a posterior esoph= ageal outpouching of mucosa through an area of weakness between the inferior constrictor muscle and the cricopharyngeus. The neck of the diverticulum is proximal to the cricopharyngeus. This area of weakness, also known as Killian's triagle, or Killian's dehiscence, is the most common location for a Zenker's diverticulum. Rarely, two other areas can be involved: Killian-Jamieson area, between the oblique and transverse fibers = of the cricopharyngeus muscle, and the Laimer triangle, between the cricopharyngeus and the superior esophageal wall circular muscles.
Zenker's Diverticulum is found almost exclusively in humans, which is thought to be due to the fact that the human larynx is larger and located more caudally in humans than in other animals.= The caudal location results in an oblique orientation of the constrictor muscle= s, and consequently areas of weakness develop through which esophageal mucosa = can herniate.
The incidence of Zenker's Diverticulum is
estimated at 2 per 100,000, with highest rates of diagnosis in the seventh =
eighth decades of life. Risk factors for development of Zenker's
Diverticulum include increasing age, male gender, presence of hiatal hernia,
and/or gastroesophageal reflux disorder (GERD). Up to 94% of patients with
pharyngeal pouches have concurrent hiatal hernias or GERD. This link is also
supported by the fact that Zenker's diverticulum is extremely rare in
Asia and
Zenker's diverticulum is a pulsion-type diverticulum, the result of herniation of the esophageal mucosa and submuco= sa through the area of natural weakness. As such, it is a false diverticulum, meaning it does not involve the muscularis layer. Evagination of the cricopharyngeal sphincter is believed to occur secondary to chronic increased pressure over esophageal areas of weakness. = The presences of abnormal esophageal motility, esophageal shortening, and upper esophageal sphincter dysfunction have all been implicated in the pathogenes= is of Zenker's Diverticulum. Data supporting these hypotheses have been obtained through manometry studies, and consensus opinion is that occlusive mechanisms are the most important. Uncoordinated swallo= wing, allied with impaired relaxation and spasm of cricopharyngeal muscle leads t= o an increase in pressure in distal esophagus, so that its wall herniates through the point of maximal weakness – Killian's triangle.
The mucosal outpouching of a Zenker's diverticulum can be visualized via a barium swallow study. Two-thirds of Zenker's diverticula protrude directly in the midline, and the remain= ing preferentially protrude to the left. This is lik= ely secondary to the more lateral location of the carotid artery on the left, and subsequent esophageal curvature. Contrast radiography can confirm the diagnosis. Two commonly used classification sch= emes are Brombart (1980) and Morton and Bartley (1993). Other classification sch= emes include vertebral body measurements, and simple radiologic appearance, but categories are becoming increasingly complex and incorporate elements from several of the classic methods of classification.
Clinically, Zenker's diverticulum presents= as a progressive dysphagia. Intially, patient can describe minor throat irritati= on, foreign body sensation, and coughing. Symptoms worsen as the diverticulum enlarges, and pouch becomes large enough to contain food, sputum or even medications. Patients can complain of food regurgitation several hours afte= r a meal, and typically describe weight loss. Cachexia and malnutrition can dev= elop with Zenker's Diverticulum, particularly in the elderly who develop a "fear of eating" secondary to choking spells. The most common complication of Zenker's Diverticulum is aspiration pneumonia, which occurs in up to 30% of patients. Other complications include compression of= the trachea and esophageal obstruction with large diverticula, as well as ulceration secondary to retained aspirin. Development of squamous cell carc= inoma of the diverticulum can occur in 0.3-0.5% of patients.
Due to the high risk of complications if untreat= ed, surgical intervention is the mainstay of Zenker's Diverticulum therap= y.
Standard treatment is excision of diverticulum and cricopharyngeal (CP) myotomy, including upper 3cm of posterior esophageal wall. Size of the diverticulum determines which procedure to carry out. If diverticulum is less than two centimeters, a CP myotomy alone is sufficient. If diverticulum is between t= hree and six centimeters, endoscopic or open procedure must be used. When the diverticulum exceeds 6cm, an open approach is generally considered a more favorable procedure.
Cricoph= aryngeal myotomy must always be performed in the course of a Zenker's diverticulum repair, as without it there is an unacceptably high rate of recurrence.
style=3D'font:7.0pt "Times New Roman"'> =
Cricopharyngeal myotomy
style=3D'font:7.0pt "Times New Roman"'> =
Endoscopic techniques:
o =
Endoscopic staple
o =
CO2 laser
o =
style=3D'font:7.0pt "Times New Roman"'> =
External techniques:
o =
Cricopharyngeal myotomy=
with diverticulectomy
o =
Cricopharyngeal myotomy=
with diverticulopexy
Surgical Preparation
For all procedures, patient should undergo a pre-operative evaluation to determine cardiac function and hemodynamic stat= us. Evaluation of diverticulum should guide the choice of procedure as described above.
Cricopharyngeal myotomy
External cricopharyngeal myotomy can be performed under local or general anesthesia. Endotracheal intubation provides distention of the cervical esophagus to aid in visualization of the muscle. Left-sided anterior cervical incision is made = over the cricoid cartilage, and subplatysmal skin flaps are retracted to expose superior and inferior border of cricopharyngeus muscle. Anterior border of sternocleidomastoid is identified and then retracted posteriorly to reveal the carotid sheath. The omohyoid may be sectioned to provide greater exposure= of the surgical target. The larynx is be rotated to the right, bringing forward the distended cervical esophagus. Fibers of the cricopharyngeus are visualized = with a magnifying loupe, and then sequentially incised until t= he underlying mucosa appears. The myotomy is often four to fi= ve centimeters in length to ensure complete release of the muscle.
Wound should then be irrigated, drain placed, platysmal borders re-attached and skin incision close=
Endoscopic staple diverticulostomy
Endoscopic staple diverticulostomy is performed = under general endotracheal intubation, using a modifi= ed laryngoscope to expose common wall between lumen of esophagus and diverticulum. A magnified view of the procedure can be obtained by using a rigid 0- or 30- degree telescope connected to a camera. With a suturing device, retraction sutures are placed on the lateral aspect= s of the common wall. The common wall is then positioned between the blades of t= he stapler, and divided. The retraction sutures are cut and removed. By dividing the common wall, an internal cricopharyngeal myotomy is performed, creating a single lumen without removal of the pouch. The telescope is then used to carefully inspect the esophagus and incision area to evaluate for surgical debris such as staples. Patient can be discharged on same day as surgery if no post-operative complications arise in the three or four hours following the procedure.
CO2 laser
Transoral tissue bri= dge dissection with CO2 laser is carried out under general anesthesia with endotracheal intubation. For optimal exposure of the = common bridge, a Weerda laryngoscope is inserted transorally and opened, tightening the muscular septu= m. After evaluation of the tissue bridge, debris is suctioned from the diverticulum. Microscope with manipulator and CO2 las= er are focused on the common bridge at a working distance of 400mm. Laser dissecti= on begins in the center of the tissue bridge, causing a split of the muscle fi= bers and allowing increased visualization of the esophagus. The tissue bridge is dissected to the base of the diverticulum,
Esophageal diverticulotomy<= /span> with electrocautery is carried out under general anesthesia with endotracheal intubation. A modi= fied, slotted, Holinger 9mm x 30 cm esophagoscope is inserted to trap the common wall, where the upper lip of the instrument = will be placed in the esophagus and the lower lip in the di= verticulum. The common wall is thus isolated and then divided using insulated electrocautery and laparoscopy scissors. The common w= all is cauterized until it thins near the base of the diverti= culum, and incision is continued to ensure division of the cricopharyngeus muscle also.
Cricopharyngeal myotomy with diverticulectomy
Cricopharyngeal myotomy with diverticulectomy is
carried out under general anesthesia with endotracheal=
intubation. An anterior cervical incision is made over cricoids cartilage, =
alternatively, along anterior border of sternocleidomastoid muscle. Dissect=
of soft tissue underlying the incision follows, with medial retraction of
trachea, strap muscles and thyroid gland, while the sternocleidomastoid mus=
is retracted laterally. This allows exposure of the di=
and the cricopharyngeus muscle. Once identified, the cricopharyngeus is
divided, and the diverticulum is excised. The d=
can be closed by purse-string suture, or by stapler.
Cricopharyngeal myotomy with diverticulopexy
Following the same operative technique as the diverticulectomy procedure, cricopharyngeal muscle an=
d diverticulum are identified. After a cricopharyngeal
myotomy is performed and the diverticulum is fr=
the hypopharyngeal pouch is tacked with 2-0 silk sutures superiorly to the =
prevertebral fascia. The suspension reverses the depe=
positioning of the pouch in the erect patient, and. Ideal for diverticula
between 1 and 4cm.
Potential Complications of Surgical Management of Zenker's Diverticulum
Esophageal perforation
The esophagus lacks a serosal layer, and thus is= at higher risk of rupture or perforation. Patient should be allowed nothing by mouth after midnight and broad-spectrum antibiotics given. Gastrografin study should be obtained to evaluate level of possible perforation. Perfora= tion of cervical esophagus can be managed with close observation or with explora= tion and drainage procedure. Thoracic esophagus perforation requires early exploration. If symptoms reso= lve in 7-10 days, one repeats the gastrografin to eval= uate resolution of perforation, and antibiotics can be discontinued if there is = no evidence of infection. Close monitoring of vital signs and white blood cell count is essential.
Once esophagus is ruptured, retained gastric con= tent, saliva, bile, and other substance may enter mediastinum. Patient will prese= nt with severe dyspnea, chest pain and fever, Diagnosis can be confirmed with = CXR or CT scan which will show the characteristic mediastinal widening. Aggress= ive therapy is required: mortality rate is between 14-40%. Treatment consists of aggressive drainage and IV antibiotics, as well as close monitoring by a thoracic surgery team.
Laryngeal nerve damage
The recurrent laryngeal nerve courses below the
inferior constrictor muscle to innervate the laryngeal muscles (with the
exception of the cricothyroid.) This muscle is
innervated by the superior laryngeal nerve). Damage sustained during diverticulum surgery is usually unilateral, and so pa=
may present with post-operative hoarseness but without airway impairment. <=
Discussion by Dr. Michael Under= brink – Zenker's Div= erticulum 2010-05-26
Dr. Underbrink: That was an excellent presentation. It was very tho= rough and complete and it gave us a lot of information about the pathogenesis and treatment options for Zenker's diverticulum. = I think the important things to realize is patient selection for the type of surgery that you have. As far= as grading the Zenker's by one of the classification scales noting that in small diverticula= , are you going to be able to treat these by myotomy alone? This can be done endoscopically although most people prefer an open technique for that. The size = of the diverticulum as was presented being between thr= ee and six centimeters is a good size for the approach endosc= opically which also reduces the complication rate.&= nbsp; So that in some patients, case selection is impo= rtant. And inb= etween that you'll be watching for the most common complications postoperati= vely which we all know. The most devastating would be mediastinitis. Good talk. Thank you.
Dr. Francis B. Quinn: How do you = find the opening of the diverticulum endoscopically?
Dr. Underbrink: The answer is that using the instrumentation we have in our operating room, the Wer= dacope opens in two directions, both distally and proximally, as you enter under t= he cricoid cartilage just opening a small bit the poster= ior tine will find the diverticulum, and the anterior tine if opened correctly = will find the esophagus and you're looking for a double bubble on your exam and when you see that you're advancing slowly being careful not to perforate a large diverticulum with your poster= ior tine. That might be one of the complications of placement. Y= ou want to make sure that the cricopharyngeus musc= le or the bridge of mucosa over the muscle easily visible so you can place sutures and retract that so you can make the incision.


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But he didn't know his final call would come early in his career.
A team playing bag pipes started the procession, followed by Sgt. Johnson's casket draped in the U.S. flag.
His wife carrying their young son followed the casket into the Maverik Center arena where thousands of law enforcement stood at attention.
"Go forth my brother to fill the calling you have answered," his brother Darin Johnson told those in attendance. "There is not a moment that will go by that I will forget you."
Governor Gary Herbert also spoke at the funeral. He quoted from scripture saying "greater love hath no man than this, that a man lay down his life for his friends. Sgt. Johnson has demonstrated his love for his family in our community."
His brother says Sgt. Johnson was a tireless officer. And on September 1, when he was gunned down allegedly by a man in a car, Darin Johnson says his brother was only doing what he did every day.
"This truly exemplifies your dedication and courage," says Darin Johnson. "You could have just drove by wrote that car off but you stopped to assist as the humble servant that you are. In a moment you were taken from us and my heart bleeds. But I know you were needed somewhere else."
Those in attendance learned Sgt. Johnson's smile was magnetic and could light up a room when he entered.
"He is my only brother and I love him," says his sister-in-law Amanda Fralick. "Make sure you smile today because that's what he would want."
His sister recalled Sgt. Johnson wanting to become an officer at a young age and practiced police maneuvers on her. But it was his dedication to his work that impressed her the most.
"I promise I will never forget you," says Desirae Johnson. "I will watch for signs of you everywhere I go."
It has been a rough week for the Draper police department. The police force and city workers were seated together near the casket. Those who worked alongside him recalled a man who loved wearing the badge.
"It didn't matter what time it was, he worked and worked," says Sgt. Pat Evans who also was Johnson's best man at his wedding. "I was jealous of his work ethic, his honesty, his integrity, he's the best."
His police chief was in awe of Sgt. Johnson's keen sense of law enforcement, attention to detail and understanding the police handbook and offering recommendations.
Chief Bryan Roberts says he will be missed but his department will carry on.
"It's going to be tough dealing through this but we will do it that what we do in law enforcement. to protect and to serve," says Chief Roberts. "We never falter. We will always serve the public and we will continue to do that we will do it in Derek's honor."


text:
Students hope to stop emigration with 'internships', but enterprise and jobs are what's needed.
Posted on Thursday, October 14, 2010 at 08:25 AM
Recent Posts
- Prominent Irish politician in social media slip with "MILFS of the Day"
- Half of Irish 30 somethings have tried marijuana but disapprove of drunk driving
- Dublin Web Summit puts Ireland at center of the tech map
- Ireland's Senate referendum poster boy subject to racist abuse
- Constitutional Convention backs emigrant vote for Irish Presidential elections
The Union of Students in Ireland's daring bid to stop Irish student emigration by creating internships doesn't seem to be making much headway.
The glossy new policy document launched this September to help halt student emigration through a €52m internship creation programme seems to have vanished off the news pages,.
Perhaps the answer is because it will probably do little to solve or help the emigration problem.
The USI- the representative body of most Irish third level college students - does more 'slamming','hitting out' and marching than most other Irish trade unions combined, though seems unable to come up with meaningful solutions to assist the thousands of Irish students caught in this predicament of emigration or unemployment.
The idea behind this 'programme' they're offering is to offer employers fixed term PRSI rebates in exchange for keeping graduates on in full time employment after an initial internship period; the Union claims that this policy, to be implemented across both the public and private sectors, will take 20,000 off the Live Register (Ireland's unemployment register).
The problem, though, is that internships - usually either unpaid or poorly remunerated - are far down the priority list of most Irish students faced with the dilemma of leaving their home and family out of a want of other opportunities, and even if some of them are paid, students can't rely on an employers' tax rebate as an incentive for hirers to keep them on in the long run.
Parents struggling to make ends meet won't be too keen either on finding out that their children are on internships with only a possibility of getting a real job after all their effort getting Masters degrees in college.
I think a better idea would be a framework for bettering student enterprise, and making it easier for graduates to either join existing businesses, or even start their own ones. This way students could look forward to making their own opportunities, and maybe even giving jobs to other ones in the process.
Sold job prospects and not nebulous 'public sector internships' are what will make students think twice before hopping on to an Aer Lingus flight for JFK, and encourage them to stay in Ireland.
Yet it's probably too late for that now, as over 100,000 young Wild Geese have already left.
1 Comment
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PhilipOHayda | Oct 17, 2010, 08:16 AM EDT
Its going so black! hopefully I can get in to the army and use my money there to do a night course up in UCC.
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For more informataion about the Home Improvement Program please contact the Divison on Aging at 910-893-7578.


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Myleene Klass Tanning Collection
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Posts by Sarah Flanigan
John Oliver Chokes Up on Last Day at 'The Daily Show'
Sarah Flanigan at omg!1 day agoJohn Oliver bid a tearful goodbye on "The Daily Show with Jon Stewart" Thursday night, after seven-and-a-half years as the shows senior British correspondent.
The comedian — moving on to great things — recently signed a deal to host his own show on HBO, and he couldn't help but turn on the waterworks on his last day.
The moment came after Jon pulled together a few of his favorite clips of his colleague over the years, including some hilarious stunts, interviews, and most outrageous moments. With each clip better than the next, Jon found a way to make his funny friend's sendoff one for the ages.
"There's only one British royal I care about tonight, and his name is Prince John Oliver," Stewart said. "What I loved about what John brought to us was a broad range of characters from different backgrounds."
Check out this video to see John's emotional farewell, and tune in to "omg! Insider" on TV tonight for more of the latest in entertainment news.
To watch the full clip, check out Yahoo screen.
5 Tips for a Happy Holiday, Taylor Swift Style
Sarah Flanigan at omg!1 day agoTaylor Swift and Hailee Steinfeld are among our favorite celebrity BFFs to spawn in 2013, and though Hailee told E! News at the "Romeo and Juliet" premiere that she met T. Swift three years ago, it seems their friendship has really blossomed over the past few months, especially when it came to celebrating the holiday season.
The two posted a flurry of fun photos on social media Thursday … and we couldn't help but feel inspired! Between their cookie baking and tree trimming, we picked up a few few tips along their adorable way.
Check out the video for the five things we learned on how to have a "Merry Swiftmas and Hailee New Year!" And be sure to tune in to "omg! Insider" on TV tonight for more of the latest in entertainment news.
Howard Stern's Christmas Card is Anything But Ordinary
Sarah Flanigan at omg!2 days agoIt's not unusual to send out traditional Christmas cards to all your family and friends during the holidays, unless, of course, you're Howard Stern.
The shock jock might just have one of the most untraditional Christmas cards of all time! Dressed in full-on drag, the "America's Got Talent" judge is shown on the front of the card sitting on Santa's lap, who is none other than his beautiful wife, Beth, in costume as Old St. Nick himself. Talk about bringing a little humor to the festivities!
Though this is certainly one of the most eccentric cards they've ever devised, the Sterns seem to love making their holiday card a big thing. In 2012, they sent out a greeting with Beth delivering cookies to a massive number of cats, all adorned in Christmas colors.
Check out the video above to see their quirky cards for yourself, and be sure to tune in to "omg! Insider" on TV tonight for all the latest in entertainment news.
How Katy Perry Surprised Fans at John Mayer Concert
Sarah Flanigan at omg!2 days agoKaty Perry and John Mayer seem like the perfect couple, and it definitely showed when the "Roar" songstress made a surprise appearance at Mayer's concert at the Barclay Center in Brooklyn, New York, Tuesday night.
Joining her boyfriend on stage for a duet of "Love Who You Love," it was obvious that the couple really has an insane amount of chemistry.
"Someone I know we all love – me a little more than you – please welcome the fantastic Ms. Katy Perry," Mayer told the crowd before his girlfriend walked out.
Upon hitting the stage, Katy was greeted with a ton of applause. The lovebirds also shared a sweet kiss before belting out their new hit song.
After an end embrace, Perry went backstage and reappeared with her handsome man and his band for their final bow.
The Hollywood power couple has been making the rounds to promote their duet, making an appearance together on "Good Morning America" Tuesday and debuting their sensual music video for the single later that same day.
Check out this video to see how true their song really is, and tune in to "omg! Insider" on TV tonight for more of the latest in entertainment news!
Two Divas, One Stage, and a Lot of Gold Lamé
Sarah Flanigan at omg!3 days agoTalk about one spectacularly shiny performance! Lady Gaga and Christina Aguilera got together on Tuesday's finale of "The Voice" for a very divalicious version of Gaga's latest single, "Do What U Want."
Dressed in outrageously amazing matching gold lamé outfits for their performance, it sure looked like they had known each other forever — but it turns out, it was their first meeting.
"This is the first time we've ever met," said Christina. "I have to say, when I heard she wanted to collaborate, I said, 'Of course! Lady Gaga! I've been waiting to meet her.' She's such an innovative artist and a risk-taker and, as a fellow female, I have so much respect for that."
Though the two were rumored to be feuding, it's pretty clear they've finally settled those rumors once and for all!
For more on this story, check out the video above, and for more of the latest in entertainment news, tune in to "omg! Insider" on TV tonight!
Sara Bareilles Helps 4-Year-Old Cancer Patient 'Be Brave'
Sarah Flanigan at omg!4 days agoA 4-year-old cancer patient received VIP attention when Sara Bareilles invited him up on stage for a duet while playing at House of Blues Orlando on her U.S. tour.
Joshua Chamber, who was diagnosed with leukemia last February and is now in remission, has a Facebook page entitled "Joshua's Journey — Be Brave" inspired by Sara's tune, so imagine his surprise when she let him jump in on his self-proclaimed theme song!
"Josh is one of the bravest little angels I've ever met, and he asked if he could come on stage and sing with all of you!" she told the crowd.
Not only did little Joshua sing, he did so like a pro. His delivery of the line "I want to see you be brave" was possibly the cutest rendition ever.
While Katy Perry's "Roar" has also become a battle cry for young cancer patients, the lyrics in "Brave" seem to fit perfectly for Joshua and it's no wonder it's his theme song.
Why Does Olivia Wilde Think She Has 'Devil Brows'?
Sarah Flanigan at omg!5 days agoOlivia Wilde may be one of the sexiest women in Hollywood, but would you believe she's not wild about her eyebrows?
The mommy-to-be told People magazine at Revlon's NEW Age Defying Collection Launch Event over the weekend just how much she dislikes her self-proclaimed "devil brows"!
"My eyebrows are so warped from years of abuse that I brush them to the side and then I pencil in the rest," she told the mag. "If I brush them up they look like crazy, pointy, devil horns. Everyone in my family has crazy pointy eyebrows, so I try to soften them and take them down a notch."
Not only does she have to work hard to keep her brows up, but the 29-year-old also revealed that she tried very hard while she was younger to shape them like the brows of one famous supermodel.
"I spent years trying to look like Kate Moss with wispy thin eyebrows, which was a horrible mistake and everyone told me not to do it. So now I'm obsessed."
Check out the video to see why Olivia compares her brows to those of an evil Disney queen, and be sure to tune in to "omg! Insider" on TV tonight for all the latest in entertainment news.
Zac Efron Back to Smiling After Breaking His Jaw
Sarah Flanigan at omg!5 days agoZac Efron's smile is back! Well, almost.
After breaking his jawlast month, the "That Awkward Moment" actor Instagrammed a picture on Sunday with the CEO and owner of the Indianapolis Colts, Jim Irsey, showing off his pearly whites and writing, "Thank you Jim for a truly memorable trip to Indie - congrats on the win, @Colts! –Z"
The actor slipped in a puddle outside his home on Nov. 10, and wound up with his jaw wired shut and stitches from a gash. This came just two months after Zac revealed he'd completed two stints in rehab.
The 26-year-old posed for a slew of selfies throughout the day, with fans and Colts players alike. Throughout most of them, he looks happy … if not in a little bit of pain. With a closer look, the smile is a little bit more crooked than usual, and there's a bit of a pained strain in Zac's eyes.
Kicking with @zacefron at the @colts game today. pic.twitter.com/lG39EXnr4Z
Justin Bieber's Skateboard Wipeout
Sarah Flanigan at omg!8 days agoOuch! Justin Bieber hit a skate park on Thursday, and let's just say things didn't go as planned.
The Biebs attempted to do a kick flip, but alas, totally wiped out. The 20-year-old even posted a video to Instagram of his skateboard fail, along with the caption, "Always get up when u get knocked down".
It seems that skateboarding has become a new thing for the superstar, as he's been sharing quite a few videos on social media displaying his skills.
He still insists on not wearing a shirt (or pulling up his pants), but we have to admit, the skateboarding is a much better hobby than the graffiti painting he got into in Australia!
Check out the video to see the Biebs hit the floor, and tune in to "omg! Insider" on television tonight for all the latest in entertainment news.
Snooki Poses With an Extra-Cute Santa Claus
Sarah Flanigan at omg!8 days agoWhy take your kids to the mall to pose with Santa Claus when they can just be the jolly one themselves?!
Snooki bypassed the lines and got into the holiday spirit by dressing up her son Lorenzo, 15 months, as Santa for a festive family photo — and he looks absolutely adorable!
The "Jersey Shore" star and her fiancé, Jionni LaValle, weren't left out of the festivities either, wearing coordinating Christmas outfits and posing for the professional photo shoot in front of their stocking-lined fireplace.
[Related: More Photos of Stars With Santa]
Snooki looked fit and fabulous in a red top, black sequin leggings, and matching red Valentino stilettos. She topped off the ensemble with a leopard print Santa hat — would you expect anything less!?
Check out the video to see super sweet family photo and be sure to tune in to "omg! Insider" on TV tonight for all the latest in entertainment news.


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Oops... EJ Manuel for H3ISMAN!!
But when the trumpets blew again and the knights charged, the name they cried was, "Stannis! Stannis! Stannis!"
Teh greatest 1 loss team evar!!11??1?
Made me smile a bit watching them go down...I was jumping up and clapping for NC State like it was my team. (with my UM jersey on, at the bar)
I laughed. A lot.
Forum Rules


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The two dogs have been in the court system for more than two years
GRAYLING, MI -- It appears that two pit bulls in the center of a long court battle over whether or not they should be euthanized will be allowed to live.
This case dates back to 2008, when a man says he was out riding on his bike and when the dogs approached him, he says he felt threatened.
The dogs' owners have been fighting for their pets lives ever since.
Back in January, the judge gave the dogs 90 days to be adopted under the stipulations he had set.
On April 25th, if they hadn't been adopted, the dogs would be put down.
Thursday, the dogs were offered two separate homes.
"They're excellent dogs," said Ken Minard, the former owner of the two dogs.
Minard says it's been the dog days of two summers and more than two years as he waits to see if his pit bulls, Riley and Shelby, will live or die. A court order says they can't live with Ken so he hopes someone will give them a good home. Ausable Valley Animal Shelter has been their home for the last two and a half years.
"It's been kind of a roller coaster for a couple of years, a lot of stress for a lot of people here," said Ausable Valley Animal Shelter Director Cheryl Postma.
The roller coaster ride started in 2008, when a man claimed the two dogs that were puppies at the time chased him on his bike and acted aggressively. Later that year, animal control took the dogs. In December, 2008, the judge ordered the dogs to be killed. January, 2009, the dogs were given a stay while an appeal moved through the courts. In January, 2010, three different experts testified the dogs weren't vicious. In April, 2010, the judge again ordered the dogs be put down. that order was appealed, and the case ended back in court in January of this year. The court finally agreed to let the dogs be adopted
"If we did not take up that option that the judge left in the order, then yeah, they would have been killed," said Richard Angelo, Ken Minard's layer.
In court Thursday, two potential people offered to adopt the dogs, including the director of the shelter where the dogs have been since this case began.
Shelter employee Melissa Plauman also offered her home.
"We just kind of tuned them up by doing basic obedience training, and a little more socializing, and whatever, and as you can see, they're pretty good dogs," said Plauman.
"We've suited their needs for the last two and a half years, we've made really good dogs out of puppies," said Postma.
The judge said he still needs time to decide where to place the dogs.
"I hope that it ends up being a win for the dogs, it's not a win for Ken, but it is kind of a win in a way for him because the dogs will not have to be killed," said Angelo.
"This is promise, can't believe nothing until it's in writing," said Menard.
The judge said he should have a decision made shortly.
Related Links


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Really? Got numbers? I keep people saying this and they have lots of nice micro benchmarks and whatnot.. but I never really seen a fair comparision of memory usage under real-world situations. (and no fair including applications like Firefox or OO.org.. they are not Gnome apps.)
Anyways (assuming that is true) just because QT is faster then GTK does not mean that GTK rewritten in C++ is going to be faster then GTK written in C.
A GNOME 3.0 plan
Posted Apr 2, 2009 19:21 UTC (Thu) by Cyberax (✭ supporter ✭, #52523) [Link]
Well, for example QT Creator launches in less than a second on my computer (from a hot cache) and is very snappy. Anjuta on the other hand, works noticibly slower.
As for microbenchmarks - compare QT tesselator which supports OpenGL and software-only Cairo.
Of course, it's possible to write large projects in C. But in case of GNOME they are now just re-inventing the wheel, trying to create objective language on top of C.
Posted Apr 2, 2009 19:38 UTC (Thu) by nix (subscriber, #2304) [Link]
And your microbenchmark compares something that uses OpenGL (thus hardware acceleration) with something that uses Render (thus completely different and until very recently unaccelerated pathways). Again, unrelated to anything that could be connected with the toolkit implementation language and only distantly related to the choice of toolkit (Cairo is not part of Gtk).
Posted Apr 2, 2009 20:25 UTC (Thu) by Cyberax (✭ supporter ✭, #52523) [Link]
"And your microbenchmark compares something that uses OpenGL (thus hardware acceleration) with something that uses Render (thus completely different and until very recently unaccelerated pathways)."
That's not the point of my argument. QT can use accelerated OpenGL tesselation (it can draw complex curves and polygons with hardware acceleration), but Cairo can't do it. Architecture of QT right now is simply much better.
For example: http://labs.trolltech.com/blogs/2008/12/02/widgets-enter-...
"Again, unrelated to anything that could be connected with the toolkit implementation language and only distantly related to the choice of toolkit (Cairo is not part of Gtk)."
Cairo is not a part of GTK, but GTK uses it draw majority of widgets
Posted Apr 2, 2009 21:25 UTC (Thu) by drag (subscriber, #31333) [Link]
Well not any more.
Well anyways. What I am saying is that you take a pure Gnome or Pure GTK desktop and have it perform X number of tasks and run for X number of minutes.. record the statistics, then do the same thing with KDE. It isn't that difficult, but any time I see it done it is never really conclusive. I've seen benchmarks comparing XFCE vs KDE vs Gnome and depending on the user's requirements XFCE used several dozen less megs of RAM to several dozen more megs of RAM compared to KDE or Gnome doing the same tasks.
Then after you compare KDE and Gnome you can then go onto explain why LXDE kicks the ever living crap out of both in terms of speed and resource usage and yet still uses GTK.
What does seem conclusive is the amount of features you have the amount of resources that is used up increases. It does not matter what language your using. The more the software does the more it is going to use up doing that.
In fact the benefits of C++ over C for the sake of having a object oriented language is so dubious at this point it's just silly getting into these language wars. C++ was written in C. There is nothing at all that you can do in C++ that you cannot do just as effectively in C. Saying otherwise is just rubbish. Any good programmer is perfectly and 100% capable of writing programs in a pure object oriented manner using C language.
The _REAL_ difference, then, between the two languages then is the amount of time and effort that you save in using C++ over C.
So that is the metric that you really need to look into. If your starting a new program then that is something that you should look into in a huge way, I mean it would be silly to start a new project in C if you needed a usable product in the foreseeable future if you thought that C++ was more efficient language.
Seeing how GTK exists in C right now, and it is already written, then I don't really see the benefit in rewriting it for the sake of using C++. Your not saving any time, your not saving any effort. In fact it would require a huge amount of effort, and years before you would even get back to the same level that you are already at.
Look at what happenned to KDE4. It has been almost FOUR YEARS since the last major KDE3 revision, 3.5... and yet KDE4 is still not up to were that was in 2005, in terms of usability and feature set. (and I am not talking about QT or KDE lib feature set, like plasma or whatever, I am talking about actually regular folks using software on it and getting work done). This was just a significant ABI/API change, not a complete rewrite or language change or anything like that.
The way things stand now is that GTK is established, it's compatible with all it's applications, it has lots of good language bindings so that people can use a multitude of different languages.
I can accept a change and getting rid of depreciated interfaces and thus abandoning compatibility with applications that have not been updated for years and years in a effort to improve usability and performance, but really I just don't see the benefit in what you guys are saying.
Posted Apr 3, 2009 4:36 UTC (Fri) by qg6te2 (guest, #52587) [Link]
Using the same logic one could argue that "there is nothing at all you can do in C that you can't do in assembler", including having an object oriented approach. There is a multitude of reasons why C++ exists, one of them being that much of the drudgery of handling objects is taken care of by the compiler.
There is ONE exception
Posted Apr 3, 2009 6:01 UTC (Fri) by khim (subscriber, #9252) [Link]
Using the same logic one could argue that "there is nothing at all you can do in C that you can't do in assembler", including having an object oriented approach.
Unfortunatelly it's not true at all. Yes, you can implement OOP in assembler (heck, TASM 3.0 included a lot of OOP-oriented constructs), but in the end the acholess heel of assembler is the fact that you can not write portable program in assembler. You even may need to call functions differently under different OS with the same CPU! Thus C makes sense as "high-level-portable-assembler".
There is a multitude of reasons why C++ exists, one of them being that much of the drudgery of handling objects is taken care of by the compiler.
Unfortunatelly it only means you must fight the compiler tooth and nail to make it produce somewhat sane code. Take a look on this and compare it with the same things in sane languages (Java or even GObject - even if it's not language it's must easier to make it do what you want and not what it wants).
Posted Apr 3, 2009 6:16 UTC (Fri) by qg6te2 (guest, #52587) [Link]
I'm not sure about "fighting the compiler tooth and nail". If one does that, it generally means one is fighting against the language rather than using it properly. Any language can be abused, and C++ is no exception. Furthermore, the link provided above leads to much Qt-specific code, which shouldn't be equated with all of C++ code. Qt has far more specific idiosyncrasies than gtkmm, for example.
Posted Apr 3, 2009 13:06 UTC (Fri) by nix (subscriber, #2304) [Link]
Posted Apr 3, 2009 15:07 UTC (Fri) by cybernytrix (guest, #5727) [Link]
Posted Apr 3, 2009 15:24 UTC (Fri) by boudewijn (subscriber, #14185) [Link]
And about the features of C++ Qt uses... Well, that was just silly hyperbole, right, not an honest question you'd like answered?
Posted Apr 3, 2009 14:39 UTC (Fri) by Cyberax (✭ supporter ✭, #52523) [Link]
I'll even make a prediction: by the time GNOME3 is released, it will be in the process of being abandoned in favor of KDE.
KDE4 was not just a significant ABI/API change, it was a major rewrite of most of parts of software. KDE 4.2 is fairly feature-complete now, with lots of new features compared to KDE 3.5.10.
On the other hand, you can count on GNOME to remove few features just to be "less confusing" to user.
Posted Apr 3, 2009 21:53 UTC (Fri) by drag (subscriber, #31333) [Link]
B.If QT is good and it is using C++ then what is the point to having two QTs? Why not just use KDE instead of Gnome? Why not just get rid of Gnome altogether if you think it should be all C++ or that it should be QT.. you already have everything you want, right?
Posted Apr 4, 2009 18:40 UTC (Sat) by Cyberax (✭ supporter ✭, #52523) [Link]
B) I would just throw out all GTK code right now If I could. But of course, there's just too much legacy code in GTK. So it's better to provide a clean migration path from GTK to QT.
Posted Apr 5, 2009 3:58 UTC (Sun) by Ze (guest, #54182) [Link]
How about because QT is nearly as hacky as GTK+? Some of us would like a nice C++ library that uses standard libraries (or boost) and not some Hack that relies on Macro's and throws away type safety.
Posted Apr 5, 2009 3:50 UTC (Sun) by Ze (guest, #54182) [Link]
Yes it'd be more work to rewrite the library than to use the existing one but that is always true. The whole point is that GTK+ is a horrible hack to write object oriented code in it. It takes far longer than using gtkmm and that is only slightly less ugly.
The fact is that c shouldn't be the implementation language ,it should be just another binding.
Ideally we'd end up with a C++ as the implementation language with bindings for other languages and GTK+ v2 compatibability library.
C as OO
Posted Apr 5, 2009 6:20 UTC (Sun) by quotemstr (subscriber, #45331) [Link]
Posted Apr 6, 2009 1:07 UTC (Mon) by Ze (guest, #54182) [Link]
Posted Apr 5, 2009 10:36 UTC (Sun) by oak (guest, #2786) [Link]
Without any info about your test setup, this comment is completely useless. Was this in KDE or Gnome desktop (which version)? Was "Qt creator" launched with kdeinit? Was Anjuta startup "hot" or "cold" (gconf etc not running etc)? What kind of X server acceleration you had[2]? Which versions of the software? Did you make sure you didn't have extra bg processes taking CPU? How much free memory you had? What theme was used[1]?
[1] Many distros setup KDE to force some horrible Qt theme on Gtk. I.e. make Gtk apps use a theme that sets them to load Qt libraries to do the drawing operations in addition to them loading the Gtk libraries do the higher level UI stuff...
> As for microbenchmarks - compare QT tesselator which supports OpenGL and software-only Cairo.
Cairo uses Xrender which can also be HW accelerated (due to complexity of Xrender, probably not completely). It depends on your graphics driver. As to HW acceleration, each operation has a setup cost. If the operations are too small or few, HW "acceleration" can actually make things also (significantly) slower too...
Cairo and GL also have different targets. Cairo aims for re-producible results, GL for fast ones.
Posted Apr 5, 2009 12:04 UTC (Sun) by Cyberax (✭ supporter ✭, #52523) [Link]
Of course, Anjuta was launched from a hot cache too, without any heavy background processes, etc.
X Server uses proprietary NVidia drivers, but I don't think it makes any difference. I've just retried it with NV driver (no acceleration at all) and there's no difference.
Cairo can use XRender (and OpenGL for that matter) only for compositing, it can't accelerate tesselation and curve drawing. QT also can use slower software renderer if you want quality.
Copyright © 2013, Eklektix, Inc. Comments and public postings are copyrighted by their creators. Linux is a registered trademark of Linus Torvalds


text:
Home > Haapsalu Shawl Museum
Haapsalu Shawl Museum
Address: | Ehte tn 4, Haapsalu | Show on map |
Mobile phone: | (+372) 566 00383 |
E-mail: | email@example.com |
Method of payment: | Cash |
Request info |
The Haapsalu Shawl, an extremely fine knitted shawl that can be pulled through a woman' ring, has been the symbol of Haapsalu since the last century. At that time, as well as today, they are highly regarded by women. The knitters of traditional shawls knitter are professionals; the skill is passed down from generation to generation. In the Shawl Museum, which is located in a jewellery workshop, you can see a permanent exhibition on the past and present of the Haapsalu shawl, examine the extremely fine patterns, and buy one of the masterpieces for yourself.
Interesting fact: Haapsalu shawls have been presented as gifts to the women of the Swedish Royal Family as well as the Estonian President's honoured guests.
Times and prices
Tuesday–friday: | 11:00 - 16:00 |
Saturday: | 10:00 - 15:00 |
Monday, sunday: | closed |
Is open advance bookings only
Free of charge.
- Exhibition
- Information boards
- Souvenirs
Additional services
- Workshops


text:
Diladele Web Safety is an ICAP server that integrates with an existing Squid proxy server and provides rich content and Web filtering functionality to sanitize Internet traffic passing into an internal home/enterprise network. It blocks pornography and explicit (adult) content by deep inspecting HTML content and URLs, blocks file downloads, performs filtering based on groups, controls Web usage by categories, removes annoying Web ads, and protects online privacy by disallowing access to Web trackers. It runs on any FreeBSD derived platform, RedHat, CentOS, Debian, and Ubuntu Linux, Raspberry PI, and Apple OS X, providing a comprehensive Web filtering solution easily manageable via a Web UI.
SBuild is a Scala-based build system. It features platform independence, multi project support, automatic detection of needed actions, automatic up-to-date detection, a flexible scheme handler mechanism, Maven repository support, Ant task integration, automatic cross-project resolving of dependencies, high speed, a simple "syntax" that requires almost no Scala knowledge, behind-the-sceens compilation of build script to bytecode for fast execution time, and built-in scheme handlers for HTTP and Maven.
Armadillo is a C++ linear algebra library (matrix maths) aiming towards a good balance between speed and ease of use. Integer, floating point, and complex numbers are supported, as well as a subset of trigonometric and statistics functions. Various matrix decompositions are provided through optional integration with LAPACK and ATLAS libraries. A delayed evaluation approach, based on template meta-programming, is used (during compile time) to combine several operations into one and reduce or eliminate the need for temporaries.
TEA is a powerful and easy-to-use Qt4-based editor with many useful features for HTML, Docbook, and LaTeX editing. It features a small footprint, a tabbed layout engine, support for multiple encodings, code snippets, templates, customizable hotkeys, an "open at cursor" function for HTML files and images, miscellaneous HTML tools, preview in external browser, string manipulation functions, Morse-code tools, bookmarks, syntax highlighting, and more.
Turn Watcher is a tool based on Dungeons & Dragons rules. It is used to track the initiative of your players and monsters. It includes an option to roll initiative on every round, roll will, listen, and spot, and it has a status column that shows you the current status of your players. When you enter a player or monster, you also enter all of its modifiers, so the computer can take care of rolling all the dice for you. Still want to roll initiative? You can simply order the characters with the Move Up and Move Down options.
WebIssues is a multi-platform system for issue tracking and team collaboration. It can be used to store, share, and track issues with various attributes, description, comments, and file attachments. It is easy to install and use but has many capabilities and is highly customizable. Desktop and Web clients are provided.
Marvin is an extensible image processing framework for Java. It provides features to manipulate images, to manipulate captured video frames, and to process images with multi-threading. Its features can be extended via plug-ins. Plug-ins can be integrated with the graphical user interface, and their plug-in performance can be analyzed. Every image processing algorithm is developed as a plug-in that can be plugged into the MarvinEditor, an image manipulation program that uses plug-ins developed using Marvin, or into third-party applications. Currently there are 55 plug-ins available.
XRoar is a cross-platform emulator for the Dragon 32, Dragon 64, and Tandy CoCo computers, all originally released in the early '80s. The emulator runs under Unix-like operating systems (including Mac OS X) and Windows, with older versions available for handhelds like the Nintendo DS and GP32.
Aspose.BarCode is a .NET component for generation and recognition of Linear and 2D barcodes on all kinds of .NET applications. It supports WPF with 29+ Barcode symbologies like OneCode, QR, Aztec, MSI, EAN128, EAN14, SSCC18, Code128, Code39, Postnet, MarcoPDF417, Datamatrix, UPCA, etc. Other features include barcode insertion in PDF, Word, and Excel documents. It can also take image input in BMP, GIF, JPEG, PNG, and WMF formats. You can also control image styles such as background color and bar color.
A massive parallel-processing computing platform that solves big data problems.


text:
Full Busted (C-G)
Madison Unlined Full Busted Bra
Show off your feminine side without weighing down your wardrobe with the Paramour Madison unlined bra. The delicate lace will take your -- or his -- breath away as it details the band, the cups and the straps.
Shop by:
- Size: DDD Remove This Item
- Price: $20.00 - $29.99 Remove This Item


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dotTech Promo: Free EaseUS Partition Master Professional Edition (v9.0.0)! [48-hours only]
August 15, 2011 43 Email article | Print articleUpdate: This promotion is now over. Sorry to those that missed it! To avoid missing promotions in the future, consider subscribing to dotTech: RSS Feed | E-mail | Twitter | Facebook.
Earlier this year we shared EaseUS Partition Master Professional v8.0.1 with you. Now dotTech and EaseUS are teaming up again, this time to bring EaseUS Partition Master Professional v9.0.0 (the latest version) to everyone for free!
Software Description
The following is a description of EaseUS Partition Master Professional as per the developer:
As Partition Magic alternative, EaseUS Partition Master Professional Edition is an ALL-IN-ONE partition solution and disk management utility. It allows you to extend partition, especially for system drive, settle low disk space problem, manage disk space easily on MBR and GUID partition table (GPT) disk under 32 bit and 64 bit Windows 2000/XP/Vista/Windows 7(SP1 included). The most popular hard disk management functions are brought together with powerful data protection including: Partition Manager, Disk & Partition Copy Wizard and Partition Recovery Wizard. Moreover, you can create bootable CD/DVD in case of system boot failure.
Top Benefits
- New! Safely merge adjacent partitions into one without data loss.
- New! Support dynamic disk – resize and copy dynamic volume, convert dynamic disk, etc.
- Extend system partition to maximize computer performance.
- Better disk management & PC performance optimization utility under Windows & WinPE based bootable disk.
- Copy Wizard to copy partition or migrate entire hard disk to another without Windows reinstallation.
- Use with EaseUS Todo Backup to ensure PC's performance and data security.
Main Features
Partition Manager
- Resize/Move partitions to avoid data loss, like extending NTFS system partition without reboot to maximize PC performance.
- New! Support dynamic disk – resize and copy dynamic volume, convert dynamic disk, etc.
- New! Safely merge two adjacent partitions into a bigger one without data loss.
- Create multiple-partitions, delete partition, or directly delete all partitions.
- New! Wipe data on unallocated space.
- Wipe disk or wipe partition to permanently wipe sensitive data on disk.
- Convert dynamic disk to basic disk and Convert FAT to NTFS file system.
- Convert primary partition to logical partition and vice versa: convert a primary volume to logical to create a fifth volume on a disk with 4 existed primary volumes.
- Speed up your computer by defragmentation.
- Disk surface test to check and find bad sectors and rebuild MBR to boot system again.
- Linux partition management: delete, create, format, recover EXT2/EXT3 partition, etc.
- Built-in WinPE 3.0 based bootable CD/DVD or Linux based bootable CD/DVD.
- Support all hardware RAID, multiple removable storage device, hard disk and GPT disk (support up to 2TB partition on MBR and 4TB size on GPT).
- Support under Windows 2000/XP/Vista/Windows 7 SP1 (32 bit & 64 bit).
Disk & Partition Copy Wizard
- Copy partition with fast file-by-file copy to protect your data.
- Copy entire hard disk to another without Windows reinstallation.
- Safely copy dynamic volume to basic disk and resize the basic disk, etc.
- Support GPT disk/partition copy.
Partition Recovery Wizard
- Recover deleted or lost partitions
- Recover lost partitions after repartitioned hard drive
dotTech Advice
I have said it many times before and I will say it again: EaseUS Partition Master Professional is one of the best partition management tools out there. I highly recommend this software to those that want or need it.
Freebie Details
For the next 48-hours, dotTechies can get EaseUS Partition Master Professional for free! This freebie is fully functional (has all the features mentioned above) except for one: It does not come with the WinPE bootable disk. It does, however, come with the Linux bootable disk.
This freebie does not come with free updates, but once you download it you can install/reinstall it whenever you want.
To get EaseUS Partition Master Professional for free, simply download and install it from the links below. The program comes "pre-registered" so there is no need to register it.
Version being given out for free: v9.0.0
Free updates: No
Supported OS: Windows 2000/XP/Vista/Win7 (32-bit) and Windows XP/Vista/Win7 (64-bit)
Download size: About 53 MB
Giveaway time-frame: This giveaway is available until August 17, 2011 00:10 PST. After this giveaway is over, you will not be able to grab EaseUS Partition Master Professional for free from dotTech. You can, however, install/reinstall the program whenever you want if you download it during the giveaway time-frame.
Note: This promotion is available to everyone – everyone may get it for free. However, this is a dotTech.org promotion. Please do not upload the installation file to any other website, server, file hosting services, etc. and please do not directly link to the download. If you want to spread information about this offer, you may link to this article by providing a permalink (alternative permalink) to your audience. If you respect our wishes, we will be able to continue to bring you great freebies. If you don't, we have no incentive to continue our promotions and they may stop.
[EaseUS Partition Master Professional Edition v9.0.0 Download Link]
[Download Mirror 1]
43 Comments »
Thanks for software giveaway Brazil. Obrigado por essa promoção em nome de todos aqui do Brasil.
26Very nice giveaway!
Great to see this site happening again, I almost gave up on checking it out! Guess I'll stick around a while longer.
Thanks Ashraf!28Thanks I got my partition redone Now I can try Linux hehe :). Or dual windows 7 if need too.
31yes. v9 also cannot hide/unhide truecrypt partititon. Hope you provide feedback to EaseUs so that they can improve on it for future version. Thanks.
32thank you so much, i hope you will success in living and working
33If people missed the offering here, it is being given today–August 17–at giveawayoftheday.com (note: needs to be installed today, and cannot be re-installed–Giveawayoftheday standards).
36Thank you for this cool giveaway. really very useful soft for managing partitions. Surely want it.
37I was so pleased when I read this post and in such a hurry to "get it 'fore it's gone" that I forgot to say thanks, so – THANK YOU! (Better late than never?)
38I lost my copy due to issues, so I dont have the file anymore. Can anyone please share?
39please i want this software.. i m really in need of this..!!!
please help me guys!!my id – firstname.lastname@example.com


text:
10 December
FLEXIcontent v1.5.6+ does not include phpThumb v1.7.9 which has a known imageMagick vulnerability
By George Papadakis-- There has been an article which was duplicated by a couple of other sites, stating that FLEXIcontent includes a phpThumb version (v1.7.9) which has a known vulnerability in server using imageMagick.
-- This is not true FLEXIcontent since v1.5.6+ does not include phpThumb v1.7.9,
instead phpThumb v1.7.11 is included.this change was made with revision r1321
7 December
FLEXIcontent was to JoomlaDay Bangkok 2013! see the slideshare
16 November
Flexicontent.org site, issues due to IP changed while webhosting installed new SSL certificate
By George Papadakis, the new SSL certificate is now active, it seems that the reason for flexicontent.org showing a search portal during DNS propagation is: -- that people accessing the old IP are being served with thi...
12 November
FLEXIcontent v2.1.1 r1793 for Joomla 3.1 is available, This is considered stable for new J3.1 sites (J1.5/J2.5 too) and RC for existing J3.1 sites Known Limitations for existing J3.1 sites: 1. Existi...


text:
A fallen tree crushed a car and blocked access to a Studio City neighborhood, and a new set of traffic lights were installed at a Sherman Oaks intersection. But two San Fernando Valley doctors won't let any road blocks stop them from developing a treatment for their rare genetic disease that will eventually leave them paralyzed.
Here are the top headlines from around the Valley: