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Based on this research http://bloodjournal.hematologylibrary.org/content/early/2011/12/19/blood-2010-12-326843.abstract?papetoc does this mean that CML will definitely come back if we go off the current meds that are available to us? Thanks.
Whatever it means, it only means it to mice with CML-like disease, not people with CML.
No one can tell you anything for certain with this disease. What they are saying is that TKI drugs do not appear to kill leukemia stem cells. So what does that mean? Depends on what you are trying to achieve and I don't mean to be difficult but it depends on what you mean by "will it come back". For practical purposes you are trying to figure out if you stop taking the drug will your disease relapse and will your blood counts start to go back up again, etc. The answer is that no one knows for sure. Most people who stop the drug relapse. But that is tricky because it also depends on the definition of relapse. Studies are going on to explore this. For instance if you are CMR and you stop taking the meds and you become detectable on PCR but stay at MMR level. What does that mean? Are you cured? Is your body keeping the CML under control? How long can it do it for? Is it possible this state could lead to mutations? There are just so many variables. What we do know is a small trial took place in France where they had about 100 people stop taking Gleevec who had been on it a few years and were CMR. Something like 60% of them relapsed, went back on the drug and went back into "remission". The others have been able to stay off the drugs for a few years now. They are now going back and doing the study again, but this time they are not going to restart the drug unless the person loses MMR. Essentially they are looking for a functional cure where you are off the drugs and your body controls the minimum residual disease. Some people will say this is a recipe for mutations to develop, who knows? For now the thing to keep in mind is that the number one reason people fail on TKI treatment is due to drug adherence. If you are not taking the med as prescribed, it is not going to be as effective. Until we hear definitively otherwise, this is where we are. Some people are braver than others and some are more willing to take chances. Others are perfectly happy staying on the drugs the rest of their lives rather than take a chance of it getting out of control. Unfortunately we just don't know enough yet to make these decisions with certainty. Add to that, when all is said in done, different people will likely have different outcomes regardless of what they think they may know.....
Keep in mind there are also multiple theories about whether or not you need to kill the stem cell. Right now they are focusing on killing the stem cell, but who says if they kill the very last one a new one won't replace it? We don't know the cause so we can't guarantee that even if you wipe the slate clean it won't come back. Another thought is why do you need to kill the stem cell, if you stay on the drug long enough, maybe the stem cell will die off on its own eventually.
Wow Lucky, that was a lot to think about! For right now I am thankful for the TKI's (even with the not-so-great side effects) and I tend to wonder if what Trey did (lower TKI dose) might be a better alternative for those who have been MMR or PCRU for a good length of time. So much has come about since my diagnosis in early 2009 and I am sure we will see great things come along in the next few years regarding treatments as well as trial outcomes. Thanks for all you offer to this group.Best Wishes, Skittles
I never thought about the possibility of the stem cell dying off on its own, I have thought about the disease coming back even if we wipe the last stem cell out as we don't know what caused it in the first place. That's why I wonder if people have a BMT how do they know the disease won't reoccur. Maybe the thing that caused it in the first place, if it's something going on within our body and not an environmental factor, will cause the CML to come back. As a side note-I made a donation to LLS, got a thank you note and on the back of the note it states that studies have established a causal relationship between AML and chronic exposure to benzene. Just another example of our environment making us sick, I have to wonder if chemicals play a part in AML do they play a part in CML?
1) I am the one who refuses to dance with snakes (STIM Trial) remember?
2) Quoting from my previous writings on the subject:
"On the other hand, I have wondered whether CML drugs might allow us to outlive the leukemic cells because they divide faster and might burn themselves out faster than normal blood stem cells. If so, the drugs would keep us alive until this LSC burn-out occurs over a decade or two or three. But I don't disguise that as "research", just a dream."
So on Trey's point number 1: that's not him because he doesn't dance with snakes.
On point number 2: Only time will tell. And yes, it's good to dream. The Impossible Dream:
To dream ... the impossible dream ...
To fight ... the unbeatable foe ...
To bear ... with unbearable sorrow ...
To run ... where the brave dare not go ...
To right ... the unrightable wrong ...
To love ... pure and chaste from afar ...
To try ... when your arms are too weary ...
To reach ... the unreachable star ...
(Two points if you know what musical this is from ..... )
Man of La Mancha, what do my two points get me, please?
Hi Pat - You get to dream the impossible dream: Freedom from CML and TKI's. ! "Free at last! free at last! thank God Almighty, we are free at last!"
"Another thought is why do you need to kill the stem cell, if you stay on the drug long enough, maybe the stem cell will die off on its own eventually."
Gary - This was a very nice summary. I believe I read here in this forum some time back that the Leukemic stem cell does not need the bcr-kinase pathway until it divides. When division kicks in, the leukemic stem cells are then susceptible to the TKI's and get killed off. It is this mechanism of apoptosis that depletes the stem cell population overall in order to enable normal bone marrow function to resume. What makes the disease difficult is that leukemic stem cells can survive without division for a very long time. Without division, the TKI is not taken into the cell. But over time - eventually - the cell divides. Both Susan and Trey have been PCRu for a very long time. Chances are they have exhausted their supply of non-dividing leukemic stem cells and only have normal cells now. If they stop taking medication will the disease resume? Who knows. Chances are it won't.
I do believe that translocating 9 & 22 chromosome that give rise to the Ph+ chromosome probably occurs naturally in the population. Just having it does not mean disease. We CML'ers, however, are unable to naturally control it. A cure probably lies in teaching the body's T-cells to recognize Ph+ cells and kill them - just like research at U.Penn has shown for B-cell Lymphoma (Dr. Carl June's work).
I am not that brave.
Is that what Trey looks like (the one in the hat)?
Actually he could be the rattle snake - if the cowboy was one of the "dumb a$$ed" doctors he refers to. LOL
Regarding your post ""We don't know the cause so we can't guarantee that even if you wipe the slate clean it won't come back.""
I am really confused here as to how you possible "wipe the slate clean of the PH+ with TKI's". The marrow continuously makes your stem cells, which makes your blood. You have 23 chromosomes. In fact number 23 chromosome is the xx & xy. If you are PH+ the chromosome #9 & # 22 are actually mature cells that become damage after they are mature. If they did not mature you have Acute, which is very, very bad, because stem cells that do not mature do not work at all. I think the myloid side fights infection and lymphoid side fight viruses, like In HIV they never have enough T Cell (or have low T Cells counts), because they are fighting fight off the HIV virus. and HIV Virus being a smart bugs moves around, and is often resistant to treatment, thus always changing comb of drugs At least Chronic CML or CLL cells do mature and does work somewhat, but of course the kinanse, turns the switch on and they take longer to die and meanwhile they are making copies instead of dying off like normal cells . If you have Chronic that means the stem cell produces a mature #9 & #22 but for some reason some of them become damaged, for lack of a better word, and some of them have breaking points. Mine are the b3a2 and the b2a2. Now I am not sure here, but I don't think all of the #9 & #22 break into, but stay healthy, like the other stem cells, is that right? So how in the world can you kill of all the bad stem cells when your marrow keeps producing them, otherwise you would not have granulytes, which are your, neutrophils, basophils,Esoinophils, which make up the Myloid White cell.
My understanding is we basically have two side of (blood) the white cells, immune system. The myloid, which is made of the neutophils, basophils, esoinophils. The Lympoid side which basically are the T Cell, B Cells and Lymph cells. I'm not sure if those are all of the white cells that are in the myloid and lymph, but I pretty sure that is the basics of the way it works.
Therefore, if you were to kill ever PH# your stem cells in your bone marrow are still continuously producing these white cells, other wise you wouldn't have anything to fight off infection and these myloid white cells are make up of the neutrophils, basophils, eosinophils.
Now my million dollar question is what makes this mature stem cell, chromosome #9 & #22 (ph# philly) break at certain points and create a protein that turn the switch on to make copies and how long does it take them to die off?
Hope I wasn't to redundant.
Well, your bone marrow is made up of the stem cells, it doesn't make the stem cells separately. So we can try to kill all the bad stem cells that make up the marrow and hope the good stem cell of the marrow take over.
I hope that makes sense although maybe I misunderstood your question
Hi Taylor,
I understand killing off the all the bad stem cells.
The bone marrow produces a stem cells, that turn into blood cells platelets, red cell, etc. Chromosomes carry out the DNA and we have 23 chromosomes. Not sure exact mechanism that all happens. Probably need to ask Trey. Help TREY!
But what makes you think whatever is causing your body; bone marrow that produces stem cells, that make chromosome #9 and #22 break into parts, will stop breaking into and fusing together, which creates the protein that causes them to make copies, so they don't die off normally, which becomes Chromosome #24. what makes you think the body will quite making these damaged chromosomes, or the damaged, abnormal chromosome, will die off on their own with out TKI drugs. This disease is Chronic, slow to come back depending on the deep response. Or how long you have been on a drug or again how deep the response, but it will come back unless they figure out a cure or what cause it.
It is my understanding none of the TKI are cures! Only cure so far is Bone Marrow transplant. I met one lady in 2005 at the hospital, her daughter a nurse. She had a transplant 10 or 12 years eariler. And all of her stem cell were 100% her sisters. It has been awhile, but I don't believe she was on any med's and she looked darn good. She said her doctor said I never say cured to anyone who has cancer but I will say if anyone was cured of cancer you are. Because she had her sister stems cell who produces normal healthy blood cells that worked as they should. I met another guy who had Transplant donor from France. He was in his 60's had CLL. Talked to him a few years ago and 97 % of his stems cells belong to his donor. He was having some difficulties but he was already have these issues before the transplant. He was doing well as a caretaker for his ill wife who was wheel chair bound.
I think until science figures that out, the cause or cure, the body will always be making the PH+. I think science is trying to figure out how to get a deeper quicker response, killing off more. But PH+ is chronic, slow, so depending how deep the response, and the individual, it will eventually show back up if you quit taking your med's. Unless again Science figures out the cause or cure. It makes sense to me. I have talked to the #1 leading cancer research docs here in Indiana, he didn't say it in those exact words, but that is the way I got it.
That why when people are asking about these drug holidays and how long it takes to come back it just depends. When I was first diagnosed and we took my white cell down to 1.7, well I had to go to the hospital and have IV antibiotics and sterile environment and food and drink, as that is a dangerous low. But the ideal was to get rid of as many bad as you could as the bad had crowded out the good. But in time the bad still come back, as for the some reason the chromosome #9 & #22 still continue to break and fuse together as mature cells, damaged cells that make copies.
Exert from WWW
How does Ph+ CML happen?
The soft tissue inside our bones, called the bone marrow, produces a type of cell called a stem cell. As stem cells mature, they can turn into platelets, red blood cells, or white blood cells. Ph+ CML happens because of changes in the genetic material of these stem cells.
Chromosomes are the parts of our cells that carry our DNA and genes—the things that give us our physical traits, such as blue eyes or brown hair, and that tell our body how to handle all the functions of life, including the process of making blood cells. Humans have 23 pairs of chromosomes. Ph+ CML happens when some genetic material from one chromosome (chromosome 9) switches position with some genetic material from another chromosome (chromosome 22).
The new genetic material on chromosome 22 is called BCR-ABL and leads to abnormalities in your body's process for making blood cells. When chromosome 22 has this abnormal BCR-ABL gene, scientists call it the Philadelphia chromosome. People with Ph+ CML have the BCR-ABL gene in their stem cells and white blood cells. The BCR-ABL gene produces a protein called Bcr-Abl. Scientists distinguish between the name of the gene and protein by how they are written.
The Bcr-Abl protein causes your bone marrow to produce more and more white blood cells and these white blood cells are often damaged. It acts like a switch that keeps your white blood cell production in the "on" position. Normally, your body would stop producing white bloods that weren't needed and damaged blood cells would die off, but the Bcr-Abl protein interferes with these processes. Instead, your bone marrow keeps making damaged white blood cells that, over time, crowd out healthy red blood cells and platelets.
For me it was interesting in that I never had over 21 thousand white cells, but I had over 2 million platelets, when diagnosed.
I'm not sure I understand your question but I'll give it a shot.
In healthy bone marrow, we have normal stem cells (see HSC in picture) from which all of the progenitor cells come from through division and maturation to create all of our blood cells. (Trey has an excellent summary of this somewhere in this forum). Stem cells also have the added property of being able to replicate themselves and make exact copies - leading to more stem cells. In these stem cells as in all of our bodies other cells, we possess the number 9 and number 22 chromosome. And this is all normal.
Then - for some reason that experts believe may be due to benzene or radiation or other factors, the number 9 chromosome and the number 22 chromosome translocate bits of themselves and a new gene, an oncogene is created that has function that is bad for the body. Once this gene is created, the subsequent stem cells that are replicated are now Leukemic stem cells and they divide making more leukemic stem cells as well as making daughter cells which in turn mature into white cells, red cells and the rest. The white cells, neutrophils, basophils, etc. have this leukemic bcr-abl gene that pumps out tyrosine kinase to signal - make more cells - and off they go. More and more stem cells are created and the bone marrow gets crowded out and less red blood gets made and the whole mess is in full swing.
It's important to note that the bone marrow at this point has both normal stem cells and leukemic stem cells, but the leukemic stem cells are now beginning to dominate and take over the marrow.
When Gleevec was invented - it was designed to fit in the ATP (Adenosine Tri-Phosphate) pocket of the newly created bcr-abl gene and essentially it would starve the cell from getting the ATP energy which is needed for cell division and other cell processes. The leukemic cell died and replication stopped at that point. In a short time, patients saw their white cell count plumment from 100,000's to normal in a few weeks as massive death in these leukemic cells occurred. And when a Leukemic stem cell went into division - it too would be killed by the TKI inhibitor - but only when dividing when energy demand is high. As this occurred, the normal unaffected stem cells now had room to replicate and restore the bone marrow since the normal stem cells when dividing were largely unaffected by the TKI. A long process that for some of us can take years. But slowly re-population starts to take over and the leukemic stem cell gets reduced....but only when it divides. When a leukemic stem cell stays quiescent and does not divide, it is unaffected by the Gleevec or other TK inhibitors. So they lurk - they are still there, but in numbers too low to be detected by Science.
Some patients were part of trial in Europe where they were taken off Gleevec and some of them became positive again for CML - but some didnt'. Those lurking Leukemic stem cells started to regain a foothold - re-generating the disease. It is believed that eliminating the leukemic stem cell is the path to cure.
But I believe that the creation of "leukemic stem cells" is natural in our bodies. It probably happens all of the time since translocating chromosomes is common in Mitosis. It's just that most translocations are recognized by the body and are destroyed - or the surviving cell apoptosizes on its own long before enough numbers are created to initiate disease and certainly low in count to be detected by PCR. We CML'ers somehow lost the ability to naturally detect and destroy these aberrations - and so we get CML.
There is debate here on this forum whether having a single leukemic stem cell constitutes CML. I don't believe it does. Our bodies failure to recognize the bad cell and delete it, that is what creates CML.
I follow most of your post. However this is where I get confused.
I copied and pasted a exert at the bottom, from a web site, but it didn't explain it totally in your words.
This is just my thoughts; The bone marrow produces or makes the stem cells which produce the blood cells, white, red, platelets, etc.
There are two side of the blood the Myeloid and Lymphoid side. The Myeloid side has the basophils, eosinophils, neutrophils, which carry the BCR ABL, #9 & #22 Chromosome, which is they called PH+, now creating a 24th chromosome. (Chromosome, which also are our DNA) The other side Lymphoid produce the white cell made up of T cells, B cells, etc.
Anyhow here is my problem, that I am having a hard time understanding?
In the beginning the bone marrow make stem cells, plural, lots of stem cells, then each stem cell, make 23 chromosomes, the blood, makes an adult normal cell #9 & # 22 chromosome, (they are made up of the neutrophils, basophils, eosinophils) then for some reason, do only some of the #9 & #22 chromosomes translocate and become PH+ BCR/ABL, while other #9 & # 22 chromosomes, never, ever translocate, they do their job and die off normally, the normal 9/22 do not make copies only the abnormal (adult) PH# makes copies. Therefore meaning only some stem cells from the bone marrow have something that goes wrong with this paticular stem cell, to begin with, that in the end causes this abnormality the BCR/ABL.??
Exert from WWW
How does Ph+ CML happen?
The soft tissue inside our bones, called the bone marrow, produces a type of cell called a stem cell. As stem cells mature, they can turn into platelets, red blood cells, or white blood cells. Ph+ CML happens because of changes in the genetic material of these stem cells.
Chromosomes are the parts of our cells that carry our DNA and genes—the things that give us our physical traits, such as blue eyes or brown hair, and that tell our body how to handle all the functions of life, including the process of making blood cells. Humans have 23 pairs of chromosomes. Ph+ CML happens when some genetic material from one chromosome (chromosome 9) switches position with some genetic material from another chromosome (chromosome 22).
The new genetic material on chromosome 22 is called BCR-ABL and leads to abnormalities in your body's process for making blood cells. When chromosome 22 has this abnormal BCR-ABL gene, scientists call it the Philadelphia chromosome. People with Ph+ CML have the BCR-ABL gene in their stem cells and white blood cells. The BCR-ABL gene produces a protein called Bcr-Abl. Scientists distinguish between the name of the gene and protein by how they are written.
The Bcr-Abl protein causes your bone marrow to produce more and more white blood cells and these white blood cells are often damaged. It acts like a switch that keeps your white blood cell production in the "on" position. Normally, your body would stop producing white bloods that weren't needed and damaged blood cells would die off, but the Bcr-Abl protein interferes with these processes. Instead, your bone marrow keeps making damaged white blood cells that, over time, crowd out healthy red blood cells and platelets.
Me; I think until science figures that out, the cause or cure, the body, bone marrow, will always be making from this particular single stem cell, the blood, and chromosome that translocates and becomes the PH+. I think science is trying to figure out how to get a deeper quicker response, killing off more. But PH+ is chronic, slow, so depending how deep the response, and the individual, it will eventually show back up if you quit taking your med's. Unless again Science figures out the cause or cure. It makes sense to me. I have talked to the #1 leading cancer research docs here in Indiana, he didn't say it in those exact words, but that is the way I got it.
Therefore the only know cure is a donor BMT that when your donor stem cell become 100 % your stem cell and all your stem cell totally die off, that is still the only cure.
Now recently Judy 2 said is there something else in your body that could even cause a donor stem cells to produce the PH+. I don't see how that could be possible, as the stem cell, your donors, are making the blood that runs the factory.
The BMT process sometimes does not kill all the leukemic stem cells, so the CML is never eradicated. It does not come from the donor.
Trey it is my understanding that when you have total radiation of your bone marrow, which still does not kill off all of your stem cells. You have a donor for a transplant, that when your donor stem cells are 100% yours and has totally taken over, and all your stem cells are dead, gone, You are cured!
Pam south.
Approx 15% of BMTs fail to cure the patient because some leukemic stem cells escape the chemo and radiation and re-start the leukemia. This is because the leukemic stem cells hide in the marrow niches and are protected by the bone mass from radiation and by the anerobic environment from the chemo.
Sorry I didn't read all the way to the end on you post before i reply back.
I really like the diagram. Although it does make me wondered why when diagnosed the most white cell count I had was only 21 thousand, but I had over 2 million platelets. I wonder if those 2 million platelets were normal. I do remember asking some cancer doctor if the BCR/ABL was somehow attached to the platelets, therefor making platelets copies. He said no Platelets are not nucleolus, or something like that.
Anyhow regarding the part of your post;
" It is believed that eliminating the leukemic stem cell is the path to cure.
But I believe that the creation of "leukemic stem cells" is natural in our bodies. It probably happens all of the time since translocating chromosomes is common in Mitosis. It's just that most translocations are recognized by the body and are destroyed - or the surviving cell apoptosizes on its own long before enough numbers are created to initiate disease and certainly low in count to be detected by PCR. We CML'ers somehow lost the ability to naturally detect and destroy these aberrations - and so we get CML.
There is debate here on this forum whether having a single leukemic stem cell constitutes CML. I don't believe it does. Our bodies failure to recognize the bad cell and delete it, that is what creates CML."
Are you saying that other chromosomes besides the #9 & #22 translocate as well but the body destroys them, just not the PH+ for CML? If that is correct it makes me wonder why the body destroys other translocations other the 9/22, except that 9/22 makes that darn tyrosine kinase protein that turns them on
Just wondering, lots of theories. Is there a web site with your theory?
Again does the marrow produce multiple stem cells. I was just reading on someones post, maybe I didn't understand that everything comes from on stem cells. But I believe the marrow is produces thousands or millions of stem cells everyday.
Pam South
The original question was about an article that simply re-states what has been well understood for a long time, that TKI drugs do not kill off the higher order leukemic cells (leukemic stem cells and higher level leukemic progenitor cells). This is because these higher order leukemic cells have alternate survival pathways in addition to the BCR-ABL pathway. So inhibiting the BCR-ABL pathway is not enough to kill the higher order leukemic cells.
The last paragraph of my "Genetics of CML" write-up also discusses this issue:
Trey, Wow, I have never in all of my 6 years with CML heard it explained to that depth.
Regarding the ancient or mothership stem cell, don't they all eventually die at some point, or are they forever.
I guess I just thought the ancient or mothership stem cells are produces by the thousands everyday but they die off leaving their young.
I never thought of them becoming dormant or hiding close to the bones where the T Cells or TKI can not get to them. What a genealogy to be stuck with. Come to think about it got a few in my family try that am stuck with, LOL.
However I am still wondering, I don't know weather to refer them good mother ships/ancient. I mean the bone marrow does produce some good ancient/mother ship every day, right!!!
Also I thought if you had a BMT from a donor and you had full radiation, your donor stem cells would finish killing off your BM Stem Cell and/or they would eventually all die off at your donor stem cells became 100% yours. In another words as you ancient stem cell comes out of hiding the donor stem cells would kill them off.
Thanks PamSouth
Trey, Now I think I understand in part, why, when I was diagnosed with CML in 2005, I only had 21 thousand white cell counts (apparently all bad, because when I went on HYDRO and Gleevec in a short time the White count went down to 1.7, no good ones), but 2 million platelets, perhaps because the mothership is playing with the other blood cells, even though platelets are not nucleus, they are perhaps not normal. Not sure why the platelets kept multiply?
Hi Scuba, Pamsouth, Trey and Everyone. WOW!!! I was out all day, just got back and read all the posts, what a lot of information. My question is this- Scuba said he believes the creation of leukemic stem cells is natural in our bodies but we CML'ers lost the ability to detect and destroy these aberrations. If this is the case and you have a BMT what makes you think your body will now be able to detect and destroy this natural aberration in the future?
Judy2, Because your donor stem cells take over your blood factory. Hopefully you donor stem cells kill off all your stem cells that even radiation didn't kill, residual, cause you got the Ancient, Mother Ship, top or leader of the pack of her children, in hiding close to the bone or dormat, where the T cells can't get to, to destroy and kill.
Trey said the ancient mothership (stem cell) or one of the children close to the top, may go dormat, hiding close to the bone, no oxygen can get to it for the T cells to kill stupid cancer, maybe it is not so stupid, we can't seem to find the cure to kill the mothership. Something like that, you would have to read Trey's post closely.
Your donor stem cells will be running the show, the blood factory. hopefully your donor has good stem cells that run a good blood factory that works like it is suppose to. I guess sometimes it takes a year or so, for your donor stem cell to multiply and get rid of your cells and, to make that happen. Of course there are all kinds of things that can go wrong. I hear it is still very tricky. If you don't have full radiation. Your body can reject you donor, or vice versa. Host vs Graft, Graft vs Host. Then of course of you have a transplant, you better be living in a sterile environment at least the first year. When I was diagnosed in 2005 the nurse intro to her mother who had a transplant 10 or 12 years prior. The daughter, said everyday she cloroxed/bleached her mothers bath room everyday, sterile her living quarters, food, drink, kept her isolated. I think that is why a lot die in the first year. Ever germ, mold, etc is looking for a host and if you immune is down to zero, that host would be you!!
However Trey said something about you could have your old stem cell the ancient mother ship hiding close to the bone for a long time. ( I sometimes wonder if that is why I have so much bone pain, not because of Gleevec but the CML living in the marrow. Bone Pain is a constant battle for me, long before I took Gleevec. But I would hope when she/the mother of all mother stem cells, comes out of hiding, the new donor cells would kill, kill, kill, kill, destroy, target, with all guns out, all of the bad, bad, cells. Until your stem cells are 100 % donors and yours are gone, gone, gone!! By-by, forever!!
I think the confusion in my mind is your stem cell or blood factory is not doing its job, so you have a new factory of blood cells from you donor. Trey refers it to something like a genealogy.
Did you read Treys report? In the end I am not sure that even Trey really thought that a donor could completely eraicate all your old stem cells or ancient mother ships in hiding. Kind of like a pyramid of the way it works. It is at the top of the pyramid where something goes wrong. The TKI only get to the last level when it actually become, CMl. Something goes wrong along the line before it get to that last stage. TKi don't kill the mother ship.
I think CML is a lot more complicated then most people think. Because we usually only understand the part of stem cell, blood, chronic, ABL/BCR, TKI. Most don't understand the whole chain of command, which would include me, but I am getting it!!
I think it is good to understand, so when Onc start talking their stuff we are on board and know whether it is bull or for real!
One ONC said in the old days they hit cancer patients hard and fast until they actually killed the patient with chemo before the cancer did! Yep the onc said this in one of his seminar for many ears to hear, in fact in is at Indiana University the number 1 premier of Indiana and been an onc over 30 years.
So I understand why it is good to have a deep response, but at the same time, in the back of my mind, what is the short/intermediate/long term effects of the drug, on the quality and length of my life and is the long term life, worth the quality or side effects of the drugs. I think the longer a drug is studied the more data, the more answers to those questions. I know everyone think the newer drugs are better, but I don't always think that is true. As they push these drugs thru quickly. I think Gleevec became a Study in 1998 and a patent in 2001, that is a short time, 3 years study, compared to other studies of 10 years or longer, for a drug to become a patient. But hey if it is working, and there are people dying and taking crampier drugs, why not go for it and take the risk.
I am six years out and so far the side effects vs quality of life are worth it!! I think part of my problems are old age. Then again I think the being tired is a lot from CML & Gleevec. I don't ever remember being this tired or easily stressed. I have to be so careful to not put to much on my plate, or I am down in bed, worn out! Some times not able to do that family member get sick or death or wedding, babies, grand children, etc. Sort of frustrating as have been an energetic person. I only have small groups over to my home to social and play down the holidays and stuff. I can't stand long over the kitchen stove and it makes me nervous. I use to cook a big meal for a large group. Not any more. I don't think my family and others really get that, as I look WELL! Even when my heart got out of whack a-fib earlier this year, the cardiologist, you don't look stressed, you don't look like anything is wrong, you look well, you look healthy!!
Hi Pam South. Thank you for taking the time to reply. As I read your post I couldn't help but think of the video game "Pacman". Thanks again.
Trey - Is there a "sticky" or some other mechanism in this forum to put posts like the one you did summarizing hematopoiesis? This is an excellent summary and should be more visible. I tried finding it earlier as was not successful. An FAQ section? Thanks
Yea Trey,
I tried to do a share your post, don't know if it worked, got a busy schedule today.
One of the best explanation of CML I have ever read. At least I know how from the origin of the stem cell works down to PH+,
I didn't realize it was the ancient stem cell at the top before (meyloid side) it leukemia, became, red blood cells, white, platelets. I guess I was stuck at the level of PH+. That explains a lot.
Actually I was a little disappointed realizing how much more complicated Leukemia is then I thought. As I was only thinking cure the translocation level.
But it is get rid of the origin leukemia at the top of the chain, the actual stem cell, before it produces the blood.
Makes Sense.
I just read Trey's wonderful overview of the genetics of CML. At the risk of sounding like a complete idiot I'm going to ask these two questions:
1) If CML starts with a very primitive stem cell and we don't know what causes this stem cell to go haywire, even if a person has a BMT how do we know that whatever caused that aberration won't occur again in our donor stem cells?
2) If what causes the chain of events that leads to CML is intrinsic in some people's stem cells (kind of like a ticking time bomb that we were born with and that somehow gets triggered at some point in life) could a donor pass this on to a recipient of a BMT. For example, what if 15 years ago I decided to be a stem cell donor, unaware that in the future I would develop CML would I be passing on this potential for CML to the recipient of the BMT?
3) If a tree falls in rhe forest and no one is there to hear it does it make a sound?
1) That is a question regarding whether lightning can strike twice in the same place. Not everything that is possible is probable.
2) That would assume CML has a genetic predisposition, which is unknown.
3) Faulty dilemma.
Thanks Trey, for all you do for everyone on this board.


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Realistic dinosaurs
By preschool teacher
from Eastsound, WA
About Me Grandparent
Comments about Jumbo Dinosaurs:
I am a preschool teacher and have grandchildren. I have seen and played with many dinosaur models over the years and these are some of the best I've encountered. I am happy with my purchase and so are my preschool grandkids!
Bottom Line Yes, I would recommend this to a friend
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Great toy
By hunter's mom
from houston, tx
About Me Education Oriented, Parent Of Two Or More Children
My son loves these. I like that they stand up on thier own and I can throw them in the dishwasher when he is sick. The kids at his playgroup love when he brings them becuase there are lots to share.
Good variety of dinosaurs
By AJ
from London, UK
About Me First Time Parent, Stay At Home Parent
My little one who is 2, absolutely loves the set and brings them everywhere with him. He knows the names of most dinosaurs and immediately recognised them when I first gave them to him. Although the recommended age is 3+ I felt the toys are large enough so as not to be harmful or dangerous for him to play with.
Wonderful Learning Tool!
By Tylersmommy
from Rancho Cucamonga CA
About Me Stay At Home Parent, Working Parent
This was one of the best purchases I've made for my son, still at 2 years oldhe loves these Dinosaurs! great quality, durable and great for learning.We have purchased all of the Jumbo Animals sets- they are the bestquality and wonderful size for him i've seen. The price was a little high for only 5 dinosaurs - but it's very much worth it!

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On the show, an audience member 'fessed up to Bethenny that her girls' night out indulgence is a round of chocolate martinis. Bethenny to the rescue!
Bethenny's Chocola-Tini
1 part Skinnygirl Bare Naked Vodka
1 part mocha liqueur
1 part espresso
1 tsp. chocolate sauce
In a shaker filled with ice, combine first three ingredients. Meanwhile, rim your glass by dipping in chocolate sauce. Strain cocktail into glass!
More From Bethenny:
Kale Cocktail: Delicious or Disgusting?
Summer Cocktails to Keep You Looking Bikini Hot
Bethenny's Skinnygirl Rules


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Time to get started
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Information Gathering
Click here to help find the info you need to make your decision.
Time to get started
Choosing a university is a big decision, but it doesn't have to be a stressful one. You can start by asking yourself a few simple questions such as "What are my goals and interests?" and "Do I want to stay close to home?" Then — with the help of this guide — you can begin to determine what's best for you, what will help you achieve your goals, and what will make a satisfying and memorable college experience.
College is a time when you can explore and broaden your interests, pursue your goals, meet lifelong friends and define yourself in ways you can only imagine now. This handy resource also will help you understand the college application process and compare institutions on factors that really matter. You will learn what questions to ask yourself, what questions to ask about the universities you're considering and how to get answers.
Why College?
As graduation approaches, you'll be confronted with the choice of accepting a job or entering college. Which choice is best for you? National research has found that college graduates with a bachelor's degree earn 84 percent more over a lifetime than someone with only a high school diploma. In fact, those whose education stops with a high school diploma may see their real wages decline over time.
How to Choose?
Choosing the right college for you means not only choosing where you'll live for the next four years, but finding the best fit for your personality and interests. The best way to compare several colleges is to make a list of the things that are most important to you and see how each of the colleges you're considering stacks up. What is a deal-breaker for you? Location? Cost? Size? Every university is different, each with its own personality and special traits – just like you. The more you personalize your college search process, the more likely it is you'll find the perfect fit.
Can I Afford It?
The cost of a college education varies widely. In addition to tuition, there are fees, textbooks, housing, food and other expenses such as parking. The good news is there are many ways to finance your education, including financial aid and scholarships. Other options for paying for college include grants, loans, work-study programs and campus jobs. Given how valuable it is, cost should not get in your way when pursuing a college education. There are many resources available that can help turn your dream of getting a college degree into a reality.
College Life
The main idea is to get a high-quality education while you're at college, but you can't study all the time! You need extracurricular activities to make friends, relieve stress and have fun. Most schools offer a variety of student organizations, intramural sports teams and leadership opportunities. Find out what clubs the college offers that match your interests and inquire about the organization's activities, members and qualifications.
Campus life also means football games and other athletic events, concerts, plays, dances, movies, and dozens of other activities. Don't be shy — you'll have a richer college experience if you get involved.
Getting Ready
Your application, transcripts, class rank and entrance exams scores determine your acceptance to most colleges and universities. The tests primarily used for admission to college are the ACT and the SAT. These tests are used with your high school record to evaluate your level of academic knowledge. You can take the PSAT, or Preliminary SAT, and get first-hand practice for the SAT, as well as determine which areas you might need to focus on in preparation for the SAT exam.
College Glossary
As you gather information about the colleges you're interested in, it helps to know the language and terminology used by universities to describe things like the grading system, coursework, admissions, etc. This glossary contains terms used by most colleges, although some definitions may vary slightly.
Contact UNT's ECHS coordinator -- Dustin Mayfield.


text:
State Agencies |
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Release date: 7/24/2012
This one-day event is bringing together representatives from 250 state agencies, the education community and first responders. They are focusing on a four-part approach to school safety that includes prevention and mitigation, preparedness, response and recovery.
Governor John R. Kasich, Attorney General Mike DeWine and Superintendent Stan W. Heffner are making special remarks."This is a great opportunity for local school district leaders to learn how they can strengthen their school safety plans and provide increased protection for the children of their districts," said Superintendent Heffner. "When students enter our schools, their safety is our number one priority."
Drs. Howard Adelman and Linda Taylor, UCLA, Center for Mental Health in Schools, are opening the Summit and addressing the need for schools and communities to work together on barriers to learning and teaching so disconnected students are re-engaged.
"Ohioans know too well how suddenly our normally peaceful schools can experience violence," said Attorney General DeWine. "The hundreds of participants at this summit is a clear sign that the safety of our children is paramount and we will continue to do all we can to make our schools safe." Attorney General DeWine urges Ohio schools to keep each school building's floor plan and safety plan up-to-date and filed with his office. School safety plans may be sent by e-mail to email@example.com. Hard copies of the plans may be mailed to the Attorney General's office at: School Digitization Project, The Ohio Attorney General's Office, 150 East Gay Street, 18th Floor, Columbus, Ohio 43215Participants at the meeting are discussing quality safety plans and components necessary to create positive school climates. They are sharing best practices and previous experiences including hearing from the school leaders at Chardon School District where three students were shot and killed by another student in February.
Additionally, the day will reinforce the importance of a network between local education agencies and local community partners and promote coordination of activities and maintenance of relationships to create a safe and supportive learning environment with Ohio's schools.
Materials from the conference are available at education.ohio.gov. Enter 2012 Safe Schools Summit in search.
Summit sponsors include Governor John Kasich, Attorney General Mike DeWine, the Ohio Department of Education and Great Lakes East Comprehensive Center. Other participating agencies include the Ohio departments of Alcohol and Drug Addiction Services, Health, Mental Health and Public Safety, as well as Ohio Family and Children First and the Ohio School Boards Association.


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Cellar/Tasting Notes "2006 Lafite Rothschild is a great, great wine made from a blend of 82% Cabernet Sauvignon, 16% Merlot, and 2% Petit Verdot. When I tasted it from barrel, it reminded me of their successful 1988, but it is dramatically superior to that vintage. Frankly, it may turn out to be as good as the 2005,..
Cellar/Tasting Notes "A somewhat under-the-radar La Mission, the 2006 was generally overlooked following the brilliance of the 2005. A young, dense purple-hued wine that is developing beautifully, it exhibits notes of Asian plum sauce, charcoal, barbecue smoke, roasted meats, graphite and background oak. Full-bodied..
Cellar/Tasting Notes "The 2007 Latour (the first wine made in the newly renovated cellars) exhibits a dense ruby/purple color as well as a sweet, expansive bouquet of black fruits and spring flowers interwoven with a striking minerality. The wine's dense, medium to full-bodied flavors are surprisingly evolved, with..
Cellar/Tasting Notes "Bottled very late (November, 1997), the 1995 has continued to flesh out, developing into one of the great classics made under the Mentzelopoulos regime. The color is opaque ruby/purple. The nose offers aromas of licorice and sweet smoky new oak intermixed with jammy black fruits, licorice, and..
Cellar/Tasting Notes "One of the greatest young wines I have ever tasted, the monumental 2009 Cos d'Estournel has lived up to its pre-bottling potential. A remarkable effort from winemaking guru Jean-Guillaume Prats and owner Michel Reybier, this blend of 65% Cabernet Sauvignon and the rest Merlot (33%) and a touch..
Cellar/Tasting Notes "A blend of 81% Cabernet Sauvignon and 19% Merlot, this wine represents only 34% of Lafite's total harvest. In a less than perfect Medoc vintage, it has been spectacular since birth, putting on more weight and flesh over the last year. This opaque purple-colored 1998 is close to perfection. The..
Cellar/Tasting Notes "As so often with Lafite, it is power that marks this wine. That, and density of texture. The additional element in this vintage, and at this stage of the wine's development, is a dominant wood element. The vanilla and tannins from the wood match well with the concentrated tannins of the fruit,..
Cellar/Tasting Notes "This is undisputably the wine of the vintage, a year that was clearly over-exposed and over-rated, largely because it was better than the four vintages that preceded it ... The 1975 La Mission-Haut-Brion, which consistently received perfect scores in its first thirty years of life, remains a..
Cellar/Tasting Notes "... The wine exhibits a good dark ruby/garnet color, a sweet nose of cedar, chocolate, cassis, and spices, good ripe fruit and extraction, and a weighty, large-scaled, tannic finish ... but this is clearly the second-best Mouton of the decade."
Cellar/Tasting Notes "... Complex aromatics of scorched earth, smoked herbs, and sweet red and black currants are followed by a full-bodied, silky-textured wine, but I have never felt this offering has possessed the concentration, texture, or multidimensional personality found in such vintages as 1989, 1990, and more..


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I worked at EY full-time for more than 8 years
Pros – Work with wonderful people and at top notch financial companies on interesting projects
Cons – It is a very large company and there is a lot processes that must be followed
Yes, I would recommend this company to a friend
I have been working at EY full-time for more than a year
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C2G USB 3.0 A Male to B Male Cable - USB cable - 9 pin USB Type A (M) - 9 pin USB Type B (M) - 10 ft ( USB / Hi-Speed USB / USB 3.0 ) - blackItem#: YYI1-DP7922 | Model#: 54175
Currently Out Of Stock!
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C2G USB 3.0 A Male to B Male Cable - USB cable Product Details
USB 3.0 (4.8 Gbps) provides ten times the capability of USB 2.0 (480 Mbps); it also provides up to 900 mA power instead of the 500 mA available with USB 2.0. Type A connections are backwards compatible to USB 2.0 and even USB 1.1. Finally, while USB 2.0 cables will work with USB 3.0 devices (at the lower USB 2.0 transmission speed and power), you won't enjoy the SuperSpeed of USB 3.0 without connecting with USB 3.0 cables!
Type: USB cable
Cable Features: Color-coded connectors
Length: 10 ft
Color: Black
Connector(s): 1 x 9 pin USB Type A - male
Connector(s) (Other Side): 1 x 9 pin USB Type B - male
Compliant Standards: USB / Hi-Speed USB / USB 3.0
Manufacturer Warranty
Service & Support: Limited lifetime warranty
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Shipping Weight: 0.3000 pound(s)
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Since I live in Chicago I've had my eye on the Western Michigan QB Alex Carder since late last year. I was hoping Dallas would bring him in as a UDFA during the initial signing period but they opted to go with Akron's Dalton Williams. I think Carder is better and is more mobile with a live arm. Let's hope the front office cuts another camp body and brings in Carder to compete for the '3rd/developmental QB' job on the practice squad. Especially since I don't think Dallas will get local product G.J. Kinne from the Eagles when they have their final cut down. Where I first wrote about Carder in Dec. 2012: http://www.bloggingtheboys.com/2012/12/22/3786676/a-few-good-udfas-part-ii-building-depth-on-offense Dolphins scouting report comparing Carder to ex-Cowboy Matt Moore: http://www.miamidolphinsdraft.com/2012/08/2013-nfl-draft-scouting-report-alex-carder-qb-western-michigan/ Look at it this way -- Carder can't be worse than our other camp arms.
The Pregame Meal is in Storrs, Connecticut. I am not sure where that is, but I am sure I'd rather be in Boston or New York. The goal of the pregame meal is to Hydrate, Nutritionate, and Player Hate. It is your bulletin board's bulletin board material
Kent State and Buffalo battle in the Queen City tonight in the first 2012 #MACtion game of the year. Black Shoe Diaries reviews its stranglehold on the college football world.
Greg Wolfe signed a letter of intent with Michigan State.
Jeff Blashill was hired as the head coach at Western Michigan.
Joe Bonnett interviewed for the Western Michigan coaching job.
Jeff Blashill interviewed for the Western Michigan coaching job.
Jim Culhane was fired as Western Michigan's hockey coach
It's rumored that Jim Culhane will be fired as Western Michigan's head coach once the season is over.
ESPN just announced that Rich Rodriquez has been linked to a booster that is banned by the NCAA. COLUMBIA, S.C. -- One of the business partners involved in the real estate venture at the root of a...
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En español l As I went through menopause, I noticed that I felt bloaty and gassy a lot of the time. My energy was low, and I was usually very uncomfortable. These symptoms seemed to worsen whenever I ate pasta. At first, I thought the offender was the marinara sauce. So I switched to clam sauce. My digestive system still growled. I had no clue what was wrong with me, so I wrote it off to getting older.
Subscribe to the AARP Health Newsletter
My doctor of 20 years did some tests and it turned out — ta-da! — I am gluten-intolerant. But I was unfamiliar with the condition, so never made the connection.
Now that I'm more educated on this topic, I've learned that gluten is a protein found in wheat, rye and barley, and if you're sensitive to it, as I am, it triggers an immune reaction that can damage your small intestines and prevent absorption of some nutrients. Hence the tummy pain and the fatigue.
(There is a more serious gluten sensitivity condition called celiac disease, an autoimmune intestinal disorder that causes severe allergies to gluten. About one in 130 people has celiac disease; many more people are gluten-intolerant.)
After the diagnosis, I eliminated gluten from my diet. Within two days, I dropped a whole size from my waist, the bloat disappeared and, best of all, I began to feel energized again.
Going gluten-free is challenging but manageable. I'll be honest: I miss bread, especially dark, chewy whole-grain bread, like the kind I grew up with. Giving up pasta wasn't as difficult, although I do cook with gluten-free pasta when I need my Italian fix. And if you don't want to prepare it yourself, a lot of restaurants now offer gluten-free pasta, even pizza. Regardless, I just feel so much better. My body was telling me that I needed to change a huge chunk of my diet, and I always listen to my body. The benefit is that I feel healthier than ever.
If you're considering going gluten-free, here's some advice:
- Don't concentrate on what you can't have. Concentrate on what you can have. Although I was initially challenged by a gluten-free diet, I've been able to find many alternatives to my favorite foods, from gluten-free beer to gluten-free oatmeal and bread.
- Get familiar with grains you can eat, such as brown rice and quinoa.
- Try new foods that are gluten-free. Gluten-free foods have gone mainstream, and they're easier to find than ever. Most major grocery stores now carry them.
- Read labels carefully, and look closely at the ingredients list. You'll be surprised at how many foods contain wheat and wheat by-products. Salad dressings, soups and sauces are usually thickened with wheat, for example. Packaged processed foods — anything that comes in a box — are loaded with preservatives and derivatives that often contain gluten.
- Be assertive (politely!) in restaurants. Ask the server if certain foods contain wheat or gluten. Fortunately, many restaurants now serve gluten-free foods.
- Consider taking digestive enzymes. These nutritional supplements further assist your body in fully digesting your food. I take a raw enzyme product, and it has helped me tremendously.
- Pay attention to how you feel once you've dropped gluten from your diet. I predict you'll feel much better and more energetic.
As for me, my symptoms have disappeared, and I'm happy with my stomach's decision to be gluten-free. All my life I've gone against the grain, and now I'm doing it with my diet.
Martina Navratilova is AARP's fitness expert.
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Carolina Herrera
OTHER COLLECTIONS BY: Carolina Herrera
2007 December 5
Carolina Herrera - Pre-Fall 2008
View Gallery
(NEW YORK) Birds of a feather have long donned Carolina Herrera's quintessentially elegant wares, but for her Pre-Fall 2008 collection, the designer repossessed the fine feather in print and appliqué. A hand-painted peasant feather gown was the belle of the ball, while an ostrich feather shrug added warmth and whimsy to simpler looks. Inspired by the Loire Valley in Paris during the fall season and the region's plush florals, the looks were feminine and graceful, such as the purple-and-silver painted gradient strapless dress with a sprinkling of detail. Aside from Herrera's classic evening looks, this season introduced long hand-fringed cardigans and interesting pairings of embellished tanks with satin tuxedo pants. Grey, eggplant, mauve, blush, and amethyst dominated the color palette with touches of rich black caviar ribbon. Mosaic jewels, sequins, and sparkle added a dazzling modern touch.


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From eLinux.org
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== Checking for bug ==
== Checking for bug ==
Revision as of 16:15, 28 May 2013
Testing Spam Whitelist
Testing Uploads
File:Liechtml.tar.gz test.tar.gz
Test of references
I want to test a reference [1]
Here's a simple link: [1]
Testing an internal link Screw_Connector_Breakout_Board
This is another test by swcai. It is great.
Is the database locked?
- ↑ Bird, T. (2006) This wikipedia reference thing is great. Journal of wikipedia greatness p. 2240
Testing Source Ref
class Whatever { public static void main() { int a = 0; while( a < 10 ) { System.out.println(a); } } }


text:
The contest was tight until the midway point of the third period, but Reno gradually pulled away over the next nine minutes and went on to pull out a 56-41 playoff triumph at Carson High School.
In an early season league matchup in December, Reno used a 17-2 run over six minutes to key a 58-41 home victory. Then in late January, Reno used a 14-2 burst to break open a close contest at SSHS, propelling it to a 57-39 win.
"For whatever reason, in all of our games against Reno, we've had a stretch that really hurts us," said Spanish Springs coach Christine Eckles, who coached her final game for the Cougars after announcing her retirement three weeks ago. "Ultimately, you just have to tip your hat to Reno. That's a very good girls basketball team. I thought our girls battled tonight and played really hard for 32 minutes, but just came up on the short end against a really talented Reno club."
On Friday night, on a neutral court at Carson, Reno put together another key outburst that doomed a Spanish Springs upset bid. Reno took a 25-17 lead into the locker room at the break, but watched Spanish Springs score eight of the first 12 points to open the third period. Cougars point guard Hannah Woytek capped the spurt when she pulled down a rebound on the run and went coast-to-coast, dropping in a layup in traffic. That bucket got Spanish Springs within four, 29-25, at the 4:21 mark of the third quarter.
Reno coach Shane Foster called a timeout and his Huskies responded. Reno closed out the third quarter with an 11-4 run to forge ahead 40-29, heading into the final eight minutes. The HDL champs didn't let up. They outscored Spanish Springs 15-6 through the first four and a half minutes of the fourth quarter to go on top 55-35, their largest lead of the night.
"We did a good job in that stretch at the end of the third and beginning of the fourth," Foster said. "Defensively, we did a good job contesting shots and making them shoot off the dribble."
Spanish Springs scored six of the final seven points in the game, but Reno's tell-tale span that bridged the third and fourth quarters proved too much for Spanish Springs to overcome.
"I just could not have asked for anything more from my girls," Eckles said. "They left it all on the floor. Reno is talented. Their guards can handle it and shoot it. Their posts are huge. At no point did anything come easy for us, but we still competed the whole way with great energy and passion. We have every reason to hold our heads high."
The loss eliminated the Cougars from the regional tournament and ended the most successful Spanish Springs season in school history. The SSHS crew finished its season at 22-7.
The defeat also brought to a close the prep career of two of the most celebrated Cougars in program history -- Lyndsey Anderson and Riley Holladay, both four-year varsity players. Anderson finishes as the all-time leader in scoring, rebounding and blocks for Spanish Springs while Holladay finishes as the school's all-time leader in assists and fourth-leading scorer.
Holladay and Anderson finished with 14 and nine points respectively to lead the SSHS offensive arsenal Friday.
"Lyndsey and Riley have given so much to our program," Eckles said. "They have set an example of how hard to work and how to do things right on and off the floor. I would have loved to have seen them, and our whole team, go out with a win, but in the end, only one team in the state really gets to do that."
There wasn't much offensive flow to the game in the initial quarter. The teams had combined for seven points through the first six-plus minutes of play. Reno led 8-4 at the end of the first quarter. The Huskies pushed their lead to 15-4 after a Gigi Hascheff 3-pointer at the 6:38 mark of the second quarter.
However, Spanish Springs did not roll over and play dead. The Cougars ripped off a modest 7-0 run and got back to within four, 15-11, after a Laneesha Terrance layup with four minutes left before halftime.
Reno outscored Spanish Springs 10-6 into the intermission, accounting for the 25-17 halftime margin.
"It was a little slow offensively early, for both teams," Foster said. "but we just kept preaching about keep working on defense and the offense will take care of itself."
Hascheff, who has signed to play her collegiate basketball at Sacramento State, paced the Reno offense with 14 points. Shalen Shaw added 13 points and Morgan McGwire 10 to the winning cause.
Reno, which has lost only once since returning from Christmas break, will get a chance to avenge that lone blemish when it meets Sierra League champion Bishop Manogue in northern Nevada's large-school girls hoop final, scheduled for today at 4 p.m. at Carson.


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Traveling families fill SA airport on Christmas Eve
Published On: Dec 24 2012 05:23:23 PM CST Updated On: Dec 24 2012 05:29:59 PM CST
Travelers are heading to San Antonio International Airport as they try to get to their loved ones in time for Christmas.
Copyright 2012 by KSAT.com All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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The Little Red Hen
Jerry Pinkney - Illustrator
Hardcover | $17.99 | add to cart | view cart
ISBN 9780803729353 | 32 pages | 18 May 2006 | Dial | 9.25 x 6.25in | 4 - AND UP years
School Library Journal Best Book
Summary of The Little Red Hen Summary of The Little Red Hen Reviews for The Little Red Hen An Excerpt from The Little Red Hen
Oh joy of joys! Thats the last line of The Little Red Hen, and it is also the perfect expression of how the book makes readers feel. The beloved story of the hardworking hen and her lazy neighbors, with its Golden Rule message and its sassy finale, is just as relevant and satisfying as ever. And who better to enliven it than the masterful Jerry Pinkney, who, through his warm, winsome, and slyly funny depiction, has created a definitive interpretation of the tale. Cheerful and classically beautiful, this is the ideal edition for every childs library."...perfect, as are the pictures, for sharing with one listener, or a crowd." -Kirkus Reviews, starred review
"Cheerful [and] luminous. Kids will gleefully chime in."—Publishers Weekly, starred review
"A lush light-filled rendition of a folktale staple."—School Library Journal, starred review
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Mock Draft Results and Analysis: Dec. 15 (H2H, 9 Cats)
In the midst of all the NBA insanity lately, I cleared a couple hours last night to participate in my first mock draft of the season. Here were the settings:
- 12 teams
- 14 rounds/roster spots (1 PG, 1 SG, 1 G, 1 SF, 1 PF, 1 F, 2 C, 3 Util, 3 Bench)
- Time per pick: 60 seconds
- Assumptions: head-to-head, nine categories
We had 12 humans sign up for it, but two didn't show and one got to the draft late. Regardless, I'm happy that so many readers were able to take part in this mock draft on such short notice.
Here's a quick recap and analysis of the mock draft, with picks I liked in green and picks I didn't like in red. (Auto-selected picks were not given color judgments — except for one.)
Round 1:
First-round comments: There was a brief discussion regarding taking KD or LBJ at No. 1. I consider it a coin flip in H2H. LeBron's FT% and TOs are kind of a drag, but he gets you more rebounds, assists and steals. Durant doesn't have any real weakness (though more assists would be great) and helps you more with threes and FT% — he's a foundation for a more efficient team than LeBron is, which is just a matter of strategy in H2H. I also think KD's ceiling isn't as set as LBJ's, which is what tips me to KD more times than not. Regardless, you can't go wrong with either at No. 1. Westbrook at No. 6 overall is too high for my tastes, but I understand. Love at No. 10 seems like great value.
Round 2:
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Wow!!! Just back from Can Fit Pro where MDA and Peak Pilates got major face time! We had a sold out Peak Pilates Basic Mat and the teachers that came were so excited by the flow. They were great and everyone came through with flying colors! We look forward to those 40 new teachers spreading the classical work! Some of their comments were -- Didn't know Pilates could be so much fun"-- "Wow that was like dancing on the mat"- "my body feels so great. I can't wait to help other people feel this way!"- "what a great course, when is intermediate mat?". This was such a great start to the event.
The convention was exciting with lots of variety on offer from Madd Dogg. We teamed up and had a blast doing circuit classes where attendees whirled through station after station exploring new ways of working with small excited and getting exciting new ideas to take home. It was great sharing time with Abbie, Stacey, Kathryn, and Nadine and catching the enthusiasm and energy that comes from group teaching.
My favorite workshop to lead there was the last- Pilates for Cyclists. After a long convention we had so many tight and sore bodies! It was awesome for them to get a chance to see how wonderful Pilates movement is to heal! And we didn't stop there as we dove right in and discovered how it could improve biomechanics, aerodynamics, stamina, and improve performance. It was a great time and we look forward to taking it to the next level in Canada!


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Whether treating a toddler in an emergency or supporting a teen through chemotherapy treatments, we are dedicated to the care of each patient. It's through teamwork at every level of Children's Healthcare of Atlanta and with you, the family, that we are able to achieve excellence in pediatric care.
See more about us
With a proven track record of providing world-class care to patients in more than 30 pediatric specialties, we are a model for other pediatric hospitals. Infants, teens and young adults belong in a children's hospital where they can get specialized treatment from caregivers who know the important differences between children and adults.
See our clinical services
Do you have a question about your child's health? This section offers information that may help you.
View age-appropriate health information for your child.
Research is a cornerstone of the Children's Healthcare of Atlanta mission to enhance the lives of children. In conjunction with Emory University School of Medicine, Georgia Tech and Morehouse, Children's seeks answers to the most challenging childhood medical conditions through teaching and research.
Children who are overweight are now suffering from diseases once seen only in adults, such as hypertension, liver disease and Type 2 diabetes. That's why Children's launched Strong4Life, a wellness movement designed to ignite societal change and reverse the epidemic of childhood obesity and its associated diseases in Georgia.
As a not-for-profit organization, Children's Healthcare of Atlanta relies on the generous financial and volunteer support of our community. Your donations directly impact the lives of each family served by Children's and support many initiatives such as clinical excellence, research, teaching, wellness and charity care.
Byler's disease occurs when bile ducts within the liver do not form normally. They become blocked, which causes a build-up of bile in the liver. Byler's disease is a progressive liver condition (autosomal recessive) initially seen in infants less than 6 months old.
Bile is not able to leave the liver through the bile ducts. This causes liver damage. Clinically it includes jaundice, itching, failure to thrive and death from liver cirrhosis.
Some patients with Byler's disease respond to medical therapy. In other children, liver transplant remains standard therapy.
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Soft Structured Carriers
Boba Classic Baby Carrier
" This carrier is amazing. I got it just after my son turned 2 years old. I have been carrying him for just about a year. And we love it. He loves the back carry but we also do front carries for when he is tired. I am a very small mama. 105lbs 5'2". And this carrier is perfect for me. My son does not care too much for the foot straps, But they can be a good thing. I also use this carrier..." --Kasey Goodnough
Boba Carrier Organic 2G
" I couldn't rave enough about the Boba Carrier. I love it so, so much and my son adores it as well. The bad around the waist is so nice and large it makes it very comfortable, along with the straps and the part that goes around baby is so large, you can tell they feel nice and supported inside it, and it also makes for a perfect carrier for older babies. So if you have a tall, big baby like I..." --Ps Mamae
Patapum Baby Carrier
" This was a gift and it was by far the most valuable thing I was ever given for my son. I still use this carrier today (although I have modified it to have a longer body for his nearly 4 year old self). We used this carrier daily for at least two years when my son was a baby. It goes on so easily, and I can get him off while asleep and remain asleep. None of the buckles..." --Pumpkin_Pie
Action Baby Carrier Nova
" I was searching different carriers, from WCs, Tulas and Kinderpacks. I found out about this one on TBW. I have been BWing with woven wraps for a while, and was looking to try an SSC since my LO is walking now. I was so surprised at the great reviews, the affordability and the quick turnaround to get one, since they are made in the US. Very easy ordering, and..." --NishaG
Patapum Toddler Carrier
" We got this carrier because at 6 months my daughter was 22 pounds, and we knew we would want to carry her past the weight limits of some of the other carriers. I used this carrier until she got to be tall enough to hit the back of my knees with her feet, which was at around 3.5 years old. I could still carry her in it at this point, but it would be kind of funny. Both..." --AdinaL


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Check out which companies are making headlines after the bell Thursday:
Intel - The chipmaker posted earnings of 48 cents a share, topping expectations for 45 cents a share, and reported revenue of $13.5 billion against expectations for $13.53 billion. In addition, the company provided a first-quarter revenue outlook of between $12.2 billion and $13.2 billion, versus projections for $12.9 billion. Shares edged lower in extended-hours trading.
(Read More: Stocks End Higher, Led by Industrials; Banks Lag)
American Express - The financial services company posted earnings of $1.09 a share, excluding one-time items, on revenue of $8.14 billion, both matching expectations. Shares dipped in extended-hours trading.
Capital One - The credit-card provider posted earnings of $1.41 a share on revenue of $5.62 billion, falling short of estimates for $1.58 a share on sales of $5.80 billion. Shares tumbled in extended-hours trading.
Xilinx - The technology company posted earnings of 38 cent a share on revenue of $510 million. Analysts expected the company to post earnings of 37 cents a share on revenue of $528 million. In addition, the company handed in current-quarter revenue estimates that were shy of expectations, sending shares lower in extended-hours trading.
Etrade - The financial services company appointed Paul Idzik as its new CEO. Interim CEO Frank Petrilli will continue to serve as Chairman. Shares were largely unchanged in extended-hours trading.
American Greetings - The greeting card company's holder Zev Weiss raised his offer to buy out the company to $17.50 a share. The Weiss family disclosed a 63.6 percent stake in an amended 13D filing. Shares jumped in extended-hours trading.
Piper Jaffray initiated coverage of Geron and Inovio Pharmaceuticals with an "overweight" rating, sending shares higher in extended-hours trading. Meanwhile, the brokerage initiated coverage of Oncothyreon with an "underweight" rating, pushing shares lower in after-hours trading.
Schlumberger - The oilfield services company raised its quarterly dividend by 13.6 percent to 31.25 cents from 27.5 cents.
(Read More: CNBC's Market Insider Blog)
—By CNBC's JeeYeon Park (Follow JeeYeon on Twitter: @JeeYeonParkCNBC)
Questions? Comments? Email us at firstname.lastname@example.com


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I don't want to hurt education...
DUmmies, no one is denying you a Masters in Basket Weaving or Wemyns Studies, we just don't want to pay for it. You want some useless degree??? Cool!! I have ZERO problems with that. BUT, I'm not paying for it. YOU pay for it.Sat May 19, 2012, 06:43 AM
How the Conservative Worldview Quashes Critical Thinking -- and What That Means For Our Kids' Future
The Conservative War On Education continues apace, with charters blooming everywhere, high-stakes testing cementing its grip on classrooms, and legislators and pundits wondering what we need those stupid liberal arts colleges for anyway. (Isn't college about job prep? Who needs to know anything about art history, anthropology or ancient Greek?)
Amid the din, there's a worrisome trend: liberals keep affirming right-wing talking points, usually without realizing that they're even right wing. Or saying things like, "The education of our children is a non-partisan issue that should exist outside of any ideological debate."
The hell it is. People who say stuff like this have no idea what they're talking about. The education of our children is a core cultural and political choice that reflects the deepest differences between liberals and conservatives -- because every educational conversation must start with the fundamental philosophical question: What is an education for?
Our answers to that question could not be more diametrically opposed.
A Question of Human Nature
Our beliefs about the purpose of education are rooted in even deeper beliefs about the basic nature of humanity.
And why does this really matter??? I read a thread on the All Knowing DU that College degrees are worthless!!!! So why all the hubbub, bub???


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We are located in Morayfield near Caboolture, halfway between Brisbane and the Sunshine Coast in Queensland, and provide a range of professional IT Support and Computer Services including Computer Repairs, Virus Removal and Spyware Removal, Website Design and Website Hosting, Custom Built Computers and Laptops, Computer Parts, Networking (both Wired and Wireless), Data Backup, and much more!!! A Mobile Computer Repair Service and Onsite IT Support is available, as is Remote Online Computer Repair.
In particular, we have extensive knowledge and experience in Spyware and Virus removal. Some viruses and spyware can be very difficult to remove and may take some time to effectively clean, so we HIGHLY RECOMMEND that you drop the infected system off at our office and leave it with us rather than opt for our mobile service as this is a more cost-effective and efficient solution. Windows security is something that shouldn't be taken lightly. Most people these days use their computer for online banking, paying bills, transferring funds between accounts and the storage of personal information and sensitive data. So if you are told that your computer can be cleaned of viruses in an hour or two, think twice, because I can assure you that to ensure you are absolutely virus free takes many hours.
Virus Removal
Looking for advice on the removal of viruses and spyware? Check out our Virus and Spyware Removal page. On this page you will find out the do's and dont's when it comes to viruses. If you want to download our Virus and Spyware Notes, there is a link on the page for a PDF file. You may also want to see what we consider to be the Top Ten Free Programs for Windows. Programs like Avast Free Antivirus and Malwarebytes. These are two of the best tools for preventing and removing infections from viruses, spyware, malware, trojans, keyloggers and so on.
Website Design
Another area in which we are expanding is Website Design/Development, and Website Hosting services. We can design and host your website, register a Domain Name, and provide e-commerce solutions as well. All of our websites employ a Content Management System (CMS), which means you can log-in to the back-end of the website and edit pages yourself, and if you include an e-commerce option, you can add, edit, remove products yourself without being reliant upon us to do it for you. So if you want an affordable, professional website, that showcases your business in the best possible light, why not contact us for further information and pricing, or click on the links for Plans and Pricing, or Domain Name Pricing.
Telstra Dealer
We are now also an authorised Telstra Dealer. Being an authorised Telstra Dealer means that we can supply all Telstra Business Services and products including Telstra Mobile Phones and Plans, process Phone Line applications, Telstra Wireless Broadband, Telstra Business Broadband and more. What this means to you is that you no longer have to physically drag yourself into a Telstra Shop and wait in a queue only to find that your technical questions can't be adequately addressed because you are talking to a sales person and not a technician. There are some things we don't do, like address errors in Telstra Bills, you will still need to call Telstra for those sorts of issues. Please note that we no longer process BigPond Residential applications.
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The flexible way to work
Telstra mobile broadband means you can connect to the internet wherever you have Telstra Next G™ coverage, using a 3G data capable device such as a laptop/netbook, smart tablet or smart phone. Why the Next G™ network? It's the largest and fastest 3G network in Australia with better in-building coverage for fewer drop-outs, network reliability and fast speeds.
If you're looking for the must-have mobile broadband choice for business, from individuals to entire workforces, you've come to the right place. Telstra has a range of options to suit your needs – and we now offer more value than ever.
Telstra Mobile Broadband uses the Next G™ network – Australia's Largest and Fastest Mobile Broadband Network. With Telstra Mobile Broadband, you can be connected in more places, meaning your business can work as hard as you do, giving you the edge by never missing an opportunity.
Need help setting up your Mobile Broadband, Wireless Broadband or ADSL Broadband? We can provide you with a range of advice and assistance for all flavours of internet access.
C-Tick Compliance
The next time you are buying a "white box" or "custom-built" computer, ask the supplier if they are registered with the Australian Communications and Media Authority (ACMA). Did you know that it is a legal requirement that if you sell electronic equipment in Australia (this includes computers), you are required by law to register with the ACMA, you need to document all the components used in relation to the assembly of the product, you need to fill out a Declaration Of Conformity, and you must label the equipment with the C-Tick endorsement that displays the manufacturers unique C-Tick identifying number. This is done in an effort to stop the shonky operators and protect consumers.
The C-Tick symbol shows that only parts that conform to the Australian Standards for Electro-magnetic Radiation are being used.
Spotty Dog Computer Services does of course comply with all these requirements. So when you are ringing around getting your quotes, it might just pay to ask a couple of more questions; Are you registered with the ACMA and do you have a C-Tick Identifier?
Coming Soon
Computer Repair, Virus Removal, Website Design
We service areas north of Brisbane including Morayfield, Burpengary, Caboolture, Bellmere, Beerburrum, Elimbah, Narangba, Kallangur, Petrie, Ningi, Bribie Island, Deception Bay, and other areas on a case by case basis.
Test your Broadband Speed


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The only place to watch the race for the title live
Watch highlights from every Football League match
Follow the latest from the written press with the best gossip and speculation from the papers.
Soccer Saturday's Jeff Stelling provides his predictions on each featured Super 6 game this week.
David Moyes could be in for a mixed reception when he returns to Goodison, writes Vinny O'Connor.
Luis Suarez has 11 goals in his last four games against Norwich. Can he improve that total?
Listen to Neil Reynolds and Jeff Reinebold's latest podcast as they discuss the state of the NFC West.
|team 1
|team 2
|No scheduled matches
|Player details
|Muttiah Muralitharan
|17th April 1972
|Batting Style
|Bowling Style
|Off break
Cricket legends Virender Sehwag and Muttiah Muralitharan will share the MCC captaincy during their trip to Abu Dhabi.
The Melbourne Renegades beat the Sydney Thunder by five wickets to go to the top of the table in the Big Bash League in Australia after two wins out of two.
Gloucestershire have agreed a deal for Muttiah Muralitharan to return for their Friends Life t20 quarter-final against Sussex.
Ian Saxelby took 4-16 as Gloucestershire defeated Northamptonshire by eight runs to claim their first Friends Life t20 win of the campaign.
Muttiah Muralitharan has confirmed that he will be returning to Gloucestershire for the 2012 Friends Life Twenty20 competition.
After flying in to join Gloucestershire, Muttiah Muralitharan was quick to dismiss any notion of him returning to the Test arena.


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I just built a budget XP system for Mom and I'm having a small issue with it.
Installed in the case are two identical SATA hard drives. Both are seen by the BIOS as well as the Windows Device Manager. BUT I can only see one hard drive in the Window's MY COMPUTER function (C:). The one that's visible is the one where Windows installed itself.
How can I get the second one to show up?


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Here we elaborate on distinguishing features of the MultiTox-Fluor Multiplex Cytotoxicity Assay and introduce the luminescent, next-generation technology: The CytoTox-Glo™ and MultiTox-Glo Multiplex Cytotoxicity Assays.
Andrew Niles1, Michael Scurria2, Laurent Bernad2, Brian McNamara1, Kay Rashka1, Deborah Lange1, Pam Guthmiller1, Tracy Worzella1 and Terry Riss1
Cell Notes 18, 15–20.
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1535 Elizabeth Ave, Charlotte, NC | Directions 2820435.214074 -80.826589
Monday - Saturday for dinner
Neighborhoods: Elizabeth
Elegant and accommodating – Our family of 3 enjoyed Carpe Diem for dinner. Not only did my husband and I enjoy the beautiful decore, attentive service and delicious food and wine, but our 7 yr old son found it a memorable night. Although it is not intended to cater to children, the staff accommodated our son by improvising a chicken breast into "chicken fingers" with mashed potatoes. Our son felt it to be a coming-of-age experience while my husband and I enjoyed dinner out in a lovely restaurant. And we prefer the pricing to many of the fashionable restaurants in Uptown. I can't wait to go back!
Great food, beautiful restaurant! – The food never fails to wow! The decor is fabulous! I really have a hard time finding faults! You can come in and order an "old favorite" like the warm goat cheese salad or the buttermilk fried chicken OR pick from their ever changing menu items! There is something there for everyone...even my young children enjoy it!
good date night restaurant – my wife and I just returned from a very pleasant meal at carpe diem. we will recommend this place to friends. we will return with our teenage daughters and we will return without them as well. food was very high quality, but wait staff was welcoming and friendly. not stuffy. requests were granted where possible. very acceptable alternatives were offered where requests could not be granted. credit a knowledgable wait staff. atmosphere was relaxing and conducive to conversation
Awsome Place – We went here during the Charlotte Restaurant week and were very impressed. The food was fantastic and so was the atmosphere.
We even stayed quite a while after we had finished your meal and the wait staff remained very courteous.
Very friendly and great food – I went to Carpe Diem for the first time and was very pleased. They were more than accommodating when we asked to move tables to the back room, even though we know it can be annoying since we are in the restaurant industry. Our server, Angeli, was delightful and made the whole experience even better. The best part is that the menu has something for everyone...fish, red meat, fried chicken (gourmet style of course), light, and heavy dishes. I love when an upscale place can prepare something like fried chicken to perfection, and it still fit the upscale style! I highly recommend this restaurant.
"Carpe Diem did not seize the day" follow up – This is a follow up to my previous review "Carpe Diem did not sieze the day." While our experiences here were not what I had hoped, I was pleased to receive an e-mail of apology from one of the owners. This is definitely service at a high level. Most places would have let this go and figured it was just one customer lost. It also leads me to believe that our night may have been an isolated experience and would be willing to possibly come back in the future.
Never Disappointed – I have been going to Carpe Diem for years but only since it arrived at its current location on Elizabeth. It is my favorite birthday and New Year's Eve restaurant and that is saying something because I have eaten just about everywhere. I am a vegetarian, my husband is a meat eater and we both love the food. I always have plenty of menu options and that is rare for a vegetarian! It is a little more expensive that Pewter Rose but definitely along the same theme. They have one of the coolest bars in Charlotte but you will only find adults drinking here. If the idea of another boring steakhouse puts you to sleep and you are ready to spend $100+ for a dinner for two, don't hesitate to try it!
In its new Uptown location, this restaurant shows diners what seizing the day is all about. – The Scene
Once located inside a historic florist's shop, this new location has come together just as beautifully. Photos of the former restaurant adorn "The Living Room," where clusters of sage-colored settees and ottomans sit around the curved bar among exposed brick walls, oak floors and textured cream walls. The nearly floor-to-ceiling windows along Trade Street are nothing less than stunning.
The Food
Entrees can be as light or as filling as you wish; try the inventive Peking Pancake or a special tuna salad made with grilled tuna steak. Other smart choices include warm beef and marinated chicken sandwiches or Asian soba noodles with shrimp, although the peanut sauce is just a tad overwhelming. Diners will enjoy beef tenderloin encrusted in Japanese breadcrumbs and Gorgonzola. Still have room? Try the raspberry creme brulee or the super-rich chocolate ganache.
casually elegant and never stuffy – We have followed this restaurant from one location to another for almost a decade. It is still one of my all time favorites. The menu is always interesting and the service is friendly and professional. The food is always prepared well and presentations are lovely without being over-wrought with trendiness. The little sorbet palate cleanser is a nice touch ignored by every other restaurant of this caliber in town.
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22-2842 - Tool Magnetizer and Demagnetizer
Magnetize or demagnetize steel screwdriver blades, tweezers and similar tools. Box is made of high quality, shock resistant, green plastic. Cadmium free.
96-2225 - RapidSlide Adjustable Wrench
Slide/control button in handle for fast, easy, and accurate jaw adjustment
SAE/metric adjustment markings
World famous Crescent® brand
For professional, industrial, or home use
1" maximum jaw opening allows each tool to work with more fastener sizes
50-14795 - Universal Television Stand, For Televisions 32" ~ 60"
Universal Television Stand
Perfect for flat panel televisions that were mounted to the wall, but are to be moved to tabletop use. Universal mounting plate attaches to all VESA standard sets from 200x200 through 600x400, and provides a secure and attractive mount...
50-14780 - Equipment Wall Bracket - Adjustable Length
White Equipment Wall Bracket
Designed for supporting microwave ovens from the wall, this bracket is ideal for any type of equipment.
555-11690 - Heavy Duty Laptop / Projector Presentation Stand
Heavy Duty Laptop / Projector Stand
The design of this versatile, heavy duty stand makes it not only great for holding sheet music, but holding a laptop or projector for presentation purposes as well.
Also available with Larger Tray
MCM Cat 57, Page 939
MCM Cat 56, Page 920