text:
By Brendan Conway
Attributing a day's decline in stocks to "loss of momentum" is a bit like the undertaker who, standing over the corpse dumbfoundedly, says, "He died from loss of breath."
And yet, it looks as though this is exactly the explanation for high-flying biotechnology stocks' Thursday selloff. There's no obvious news catalyst, and yet the charts have weakened steadily as the session wears on. Gilead Sciences (GILD) is down more than 4%. Sought-after ETFs iShares Nasdaq Biotechnology ETF (IBB) and SPDR S&P Biotech ETF (XBI) are down 2%-3%.
Notably, it's not just biotech. The technology sector is also weak today, as are small-capitalization stocks. The Nasdaq Composite is down a fraction and iShares Russell 2000 ETF (IWM) is off by 0.1%.
The combo of decliners today sure looks like momentum stocks taking a breather. In that vein, note that iShares MSCI Momentum Factor ETF (MTUM) is down 0.3% on the session.
Here's what Stifel Nicolaus ETF trader Dave Lutz told Barrons.com by email this afternoon:
GILD leading the way down, but feels the theme today is mean reversion – High fliers like 3D and Bio getting whacked, sleepy names like Refiners moving higher. Both Nasdaq and Russell2K in the red, while S&P and DJIA hold firm. Over the last 5 days, the major indicies have the following returns (including today) —> Utilities + 4.5%, NDX + 3.9%, RTY + 3.6%, S&P + 2%, Trans + 2%, and DJIA -90bp.
Market Vectors Biotech ETF (BBH) and ProShares Ultra Nasdaq Biotechnology (BIB) are also down by 2% and 4%, respectively.
So, biotech bulls, the interpretation is up to you: Is a selloff without a news driver something to give you worry, or does it simply strike you as a blip?


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Converse Chuck Taylor All Star Dainty Suede Mid-Top Sneaker - Womens
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The nostalgic retro styling of the mid-top classic Converse® Chuck Taylor® All Star sneaker will never go out of style and this one boasts a dainty, low-profile with a navy suede upper. Incorporate the lightweight Dainty vintage mid shoe, with a little less sole, into your casual wardrobe and make it your own, footwear for ladies in classic navy.
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text:
Jason Gregor
January 07 2014 10:30AM
Canada finally announced their 2014 roster for the Sochi Olympics, and without a doubt the biggest surprise is Claude Giroux not making the team.
There are eleven returning players on the 25-man roster, but in my eyes Rick Nash continues to be the most overrated player in the NHL. Nash has had one 70-point season, and since the 2010 Olympics he has scored 185 points in 228 games, 25th most amongst Canadian-born players. In that same time span Marty St.Louis has scored the most points, 271, while Giroux is third with 255.
Giroux is flat out more competitive game in, game out than Nash. Nash has only two goals in 16 NHL playoff games, but Hockey Canada seems to put more onus on the fact he has played well at the water-downed World Championships.
Nash did play okay at the last Olympics, but how much of that was because he was on Toews line, and Toews was the best player in the tournament.
Nash has 18 points in 27 games this year. No one can say he is playing well, or close to the level of Claude Giroux, but Hockey Canada choose him because he's played for them before. I guess Giroux should not play crappier in the NHL so his team could miss the playoffs and he can pad his stats at the World Championships.
Here is the roster, returning players have **.
- Roberto Luongo**
- Carey Price
- Mike Smith
- Jay Bouwmeester
- Drew Doughty**
- Dan Hamuis
- Duncan Keith**
- Alex Pietrangelo
- PK Subban
- Marc-Edouard Vlasic
- Shea Weber**
- Jamie Benn
- Patrice Bergeron**
- Jeff Carter
- Sidney Crosby**
- Matt Duchene
- Ryan Getzlaf**
- Chris Kunitz
- Patrick Marleau**
- Rick Nash**
- Corey Perry**
- Patrick Sharp
- Steven Stamkos
- John Tavares
- Jonathan Toews**
I still believe Canada is the favourite, because of the blueline and their top-six forwards; Crosby, Tavares, Stamkos, Getzlaf, Perry and Toews.
It will be an awesome tournament and I can't wait to watch, but picking Nash over Giroux makes little sense. Essentially they are basing it on seven good games that happened four years ago. Horrible decision.
Which decision surpised you?
Canada picked their best centers in the NHL
Canada picked their best 6 D in the NHL
Canada picked their best 2 goalies in the NHL
As for wingers most people have a problem with 2 or 3 players picked.
Wingers are not as important as Centers or D.
They picked players for speed and size and mostly 2-way players. It would have been a different team if it was on NHL ice.
The only player on this team pick on reputation rather than recent results is Nash. Hard to argue his results in international hockey.
Duchene must have been ahead of Giroux and MSL.
? must have been ahead of Logan Couture.
Logan is a 2 way player a Selke type player . So is Bergeron Toews and Crosby. Perhaps they wanted more speed and scoring touch.


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Kakashi Sharingan vs Kakashi no sharingan
Would Kakashi be stronger without Obito's sharingan. Please do not throw this idea out strait away
Kakashi was the Hokage elect and recognised as one of the strongest jounin in the village but he does not seem to be on a Sannin/Hokage battle level. I think you see this in the fight with Kakuzu that he seemed outclassed and naruto had passed him by that point before getting sage mode.
Kakashi no sharingan advantages
1. He would not have gained the traits of Obito. Ie late to training/less inspired to train and to be the best. Him going alone with his chidori at the start of the gaiden shows how he wanted to be able to take on elite ninjas on his own. Also remember how well Kakashi is able to analyse both Naruto and Sasuke to create training programs to best utilize their abilities you would think he would also be able to do this for himself. In manga 502, the flashback to Minato fighting the nine tails Gai wants to battle Kakashi but he does not want to train but rather play rock-paper-scissors
2. Creation of his own jutsu. At 13 he had created Chidori but it was incomplete because he did not have the eyes for it but still he had created a new elemental attack perfect if the enemy cannot counter. Also if you see the progress of chidori through Sasuke Kakashi may have been also able to make these improvements. He most likely has the rasengan at this point as well. I am guessing he learnt rasengan but without the ability to use both shape and elemental he used the same concept of chakra at a single point but just nature manipulation. You would think he would be able to create new jutsu if he was able to create Chidori at a young age. Since he gained the Sharingan he has created no new jutsu
3. Without a sharingan he would have been concentrating on other Jutsu. If he had already learnt the rasengan (presumed and explained in 2.) he may have looked at Minato's other ability's most notably his time space Jutsu. While it may have been impossible for him to learn and he would not have mastered it in the time they had left together (approx 1 year) he may have been able to gain the basics of this jutsu and master it over time. We do not know if kakashi ever looked at learning this jutsu but with gaining the sharingan he would have had to dedicate a lot of time to master it so would have never had a chance to learn space time jutsu. Also his mangekyou sharingan ability is a time space jutsu which may be his or Obito's affinity to time space jutsu's. Kakashi seems to not had Minato's technique explained to him at the start of the the gaiden he does not recognise the jutsu seal on the kunai he receives from Minato. This is not the only other technique kakashi may have concentrated on but he may have been better at ninjutsu. He definitely would not have more techniques than copycat kakashi but may have learnt how to utilise some better.
4. His progression as a Child. Graduated academy at 5 the youngest we see I think (Sarutobi[9], Sannin[6], Yamato[7], Minato[10?], Itachi[7]. He got promoted to Chunin a year later (so 6) and was a jounin at 13 the same age as Itachi becoming a ANBU captain, Now Kakashi is slightly behind Itachi but Itachi's promotion may be seen as part of Danzou's plan while Kakashi's may have been because of lack of strength because of the war but anyway lets say they are very close at this point. When they do fight outside konoha Itachi is way ahead. the split of both of them may be down to kakashi gaining the sharingan.
5. Progression of masters and students the general rule. Now while students do not always surpass their masters (Sannin probably did not surbass the 3rd) they seem to get close or surpass them. Now it went the 2nd Hokage (do not think 1st was the 2nd's master just his brother so probably sparred a lot) to the 3rd who was around the same maybe stronger (haven't seen 2nd's total potential including his time space jutsu) to Jiraiya who was slightly weaker but still legendary to Minato stronger to Kakashi who seems a lot weaker. He may have been able to reach his full potential if he did not have the Sharingan.
6. Sharingan a massive chakra user. Kakashi does not have a huge amount of chakra and especially since he is not an Uchiha it uses a lot of his chakra very quickly.
7. His father. Had potential to reach his father's strength whose name made the sannin's 'Pale in comparison' so may have had potential to have more abilities in that line. Master the white chakra blades presuming they will have some advantage over just putting chakra into a normal blade as what is the point of the bloodline ability. I am presuming his old blade broke in gaiden as he was not very proficient at it yet or just his lack of chakra meant it was not very strong. May also have had another summon. While his current summon are dogs most others have a giant beast and I would say his father may have had contact with wolves as summons often go with users techniques.
8. Kakashi is not a natural sharingan user so it has more drawbacks and if Kakashi without a sharingan got used to fighting dojutsu he may exploit copycat kakashi abilities
Kakashi sharingan advantages
1. copycat ability. Could copy any Jutsu the other kakashi used
2. better genjutsu. while used with his copycat jutsu a sharingan would give him better genjutsu
3. better sight in taijutsu, can be seen with his ability to use chidori after gaining it
4. use of ninjustsu previously copied. Is meant to have learnt 1000 jutsu he has copied
5. space time jutsu where he can sort of insta-kill someone or rip a limb off. Normally needs time to use and only uses if necessary.
6. Kakashi's fathers death. In the gaiden (Kakashi 13) Minato explains that the mission which White Fang saved his comrades instead of proceeding with the mission was 5 years earlier (Kakashi 8). This coincides with Kakashi slow down in progress remember he graduated at 5 and became Chunin at 6 after the second ninja wars when tensions were still high (third ninja war broke out only four years after second ended) so they may have needed more shinobi quickly but it may also be because of was what his father taught him as he was much younger than other genii to graduate (minato graduated at an older age during a war) so with his father no longer there he may not have become nearly as strong. Without his father he also would have most likely not been able to learn any more family jutsu (special uses of white chakra blade) or have proper contact with any more summoning creatures.
Wondering what other people thought who probably have more of an idea than me?
Him seeming weak to me just may be the need of progression of the story and while Naruto needs to progress super quickly Kakashi does not and him being a genius at a young age may be needed. I think fights that do not seem massive now drained Kakashi heaps.
Sorry for the shortness of sharingan Kakashi part but you have all seen his strengths in the manga/anime


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Fernando Amat, Philipp Keller, and William Lemon win first prize in the 2014 Olympus BioScapes Digital Imaging Competition for their video that captures the early development of a fruit fly embryo.
Researchers at HHMI's Janelia Research Campus have used motion-capture technology to reveal new insight into the sophisticated information processing and acrobatic skills of dragonflies on the hunt.
HHMI investigator Jennifer Doudna is among six scientists honored for transformative advances toward understanding living systems and extending human life.
Lattice light sheet microscopy, a new imaging platform developed at Janelia, lets biologists see 3-D images of subcellular activity in real time.
Six HHMI scientists have been elected to membership in the Institute of Medicine.
On November 19, Janelia group leader Gwyneth Card will deliver a talk, "Taking Action: How Small Brains Make Big Choices."
Eric Betzig, director de grupo en Janelia, gana el Premio Nobel por el desarrollo de la microscopía de fluorescencia de super-resolución.
Video, images, and related news resources for use by the media in covering the 2014 Nobel Prize in Chemistry.
Janelia group leader Eric Betzig wins Nobel Prize for the development of super-resolved fluorescence microscopy.
Retracing the ancient battles between jumping genes and the defenses human cells deploy to keep them in check.
Janelia scientists are learning how the brain switches between random and strategic modes.
HHMI scientists have shown that previously unrecognized groups contributed to the genetic mix now present in most modern-day Europeans.
HHMI expands the Gilliam Fellowships for Advanced Study, a highly successful program for graduate students who are pursuing a PhD in the life sciences and who are committed to increasing diversity among scientists.
HHMI Investigator Sangeeta Bhatia is recognized for designing and commercializing miniaturized technologies with applications to improve human health.
HHMI Investigator Peter Walter of UCSF shares the 2014 Albert Lasker Basic Medical Research Award with Kazutoshi Mori of Kyoto University.
New research by HHMI scientists shows that the emotional memory of an experience is malleable.
Janelia scientists are learning how the brain makes sense of new places.
HHMI scientists have devised a technique to identify hard-to-find gene mutations that crop up in a fraction of the body's cells.
By studying dirty flies, Janelia scientists hope to learn how animals carry out sequences of movements that make up more complex behaviors.
The September 17 lecture, "Unraveling Infectious Disease Mysteries Through Genomics," is free, but tickets are required for admission.
The Howard Hughes Medical Institute awards nearly $5 million in research fellowships to 46 predoctoral students from 24 countries.
Big data can mean big headaches for scientists. A new library of software tools from Janelia speeds analysis of data sets so large and complex they would take days or weeks to analyze on a single workstation — if a single workstation could do it at all.
Janelia researchers develop a new computational method that can essentially automate much of the time-consuming process of reconstructing an animal's developmental building plan cell by cell.
Fifteen outstanding researchers from 13 institutions are named HHMI Professors.
HHMI and GBMF announce the establishment of an Advanced Imaging Center at Janelia that will make leading-edge imaging technologies more widely available to the scientific community before the instruments are available commercially.
Every millisecond counts when a fruit fly is being hunted by a damselfly. Janelia scientists find that fruit flies can deploy two escape behaviors, depending on circumstances.
HHMI researchers find that a single-letter change in the genetic code is enough to generate blond hair in humans.
HHMI selects 37 research universities to receive $60 million in grants to improve how science is taught.
Through its 2014 Sustaining Excellence competition, HHMI is awarding new science education grants that will support activities at 37 research universities.
Peter Walter shares prize for discovery of the unfolded protein response of the endoplasmic reticulum.
The University of Maryland, Baltimore County, the Pennsylvania State University, the University of North Carolina at Chapel Hill, and HHMI are working together to learn how to adapt the Meyerhoff Scholars Program at more universities.
HHMI scientists are among ten newly elected foreign members.
HHMI scientists are among 84 newly elected members.
HHMI scientists develop new tool to silence neurons with an unprecedented level of control.
Ten HHMI investigators are elected to the American Academy of Arts and Sciences.
Seventy medical and veterinary students from 37 different schools across the country will be engaging in laboratory research for a full year as participants in the HHMI Medical Research Fellows Program.
Janelia researchers speed up image-processing time and get sharper microscopy images by employing techniques used by astonomers and ophthalmologists.
John P. Donoghue, Director of the Institute for Brain Science at Brown University, will speak on April 30 at 7PM at Janelia.
HHMI researchers have tested the olfactory capacity of human volunteers and found that humans are capable of discriminating at least one trillion different odors.
HHMI researchers show that rising temperatures can cause spread of malaria to areas where the disease had not been endemic historically.
Investigadores del HHMI demuestran que el aumento de temperaturas puede causar la dispersión de la malaria en zonas donde la enfermedad no ha sido endémica históricamente.
Howard Hughes Medical Institute (HHMI) scientists have created a portrait of a DNA-snipping protein called Cas9, a powerful research tool used in many labs for genome editing.
In the last five years, 4,800 students at 73 colleges and universities nationwide have taken HHMI's Science Education Alliance (SEA) Phage Hunters Advancing Genomics and Evolutionary Science (PHAGES) research course.
New research from HHMI scientists reveals how a foreign-DNA-destroying system, known as CRISPR, efficiently locates its DNA targets within a bacterial genome.
By studying which genes modern humans still retain from our Neanderthal ancestors, researchers are able to tell a clearer story about the biological impact of human-Neanderthal interbreeding.
In his "Dialogues of Discovery" talk at Janelia on February 26, 2014, HHMI investigator Jeremy Nathans will explore the diverse ways in which color vision has evolved.
HHMI seeks to appoint up to 25 new biomedical researchers through a national open competition.


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Shortbread comes from Scotland and was originally made as a large round cake with notched "spokes" radiating from the center to symbolize the rays of the sun. In the eighteenth century, the triangular wedges were called "petticoat tails."
Milk chocolate chips can be used for the semisweet chocolate chips.
Use vanilla for the almond extract for a slightly different flavor.


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Sometimes what you wear brings out the best in you. This super soft Fabrik tee from DC will complement your looks while making sure you're at the top of your comfort level. It features a scoop neckline, a woven clip tag at the hem and a printed DC logo on the front that's made to look as if it's stitched.
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Zeinâ Al-Rifai/AFP/Gettyâ Images
It began as a movement for a more open society and devolved into a dehumanizing debacle. How much do you know about the Syrian Civil War?
Start Quiz »
You scored
0 out of 30
Question 1 of 30
Who is the leader of pro-government forces that are attempting to stamp out resistance from many groups in Syria?
Salih Muhammed
Bashar al-Assad
His willingness to brutalize his own citizens is fuel for the civil war.
Ahmad Tu'mah
Question 2 of 30
How many Syrians have died in the conflict?
more than 500,000
more than 250,000
And more than 10 million have been displaced and forced to roam to avoid death and destruction.
more than 90,000
Question 3 of 30
Some evidence shows that the Syrian government may have executed at least how many detainees?
perhaps 4,000
perhaps 10,000
There's evidence of many other human rights violations, but the chaos makes it hard to substantiate many cases.
perhaps 70,000
Question 4 of 30
In what year did the Syrian Civil War begin?
And it shows no signs of stopping anytime soon.
Question 5 of 30
When was the country under emergency rule?
From 2011 to the present
From 1963 to 2011
The emergency rules gave the government abusive powers, such as banning public demonstrations.
From 1941 to 1962
Question 6 of 30
In this civil war, about how many soldiers make up the Syrian Armed Forces?
1 million
They are supported by tens of thousands of other soldiers allied with President Assad.
Question 7 of 30
What events triggered the civil war?
oppressive wheat taxation
a crackdown on illegal immigrants
pro-democracy protests
The Arab Spring caused pro-democracy demonstrations that were met by military action.
Question 8 of 30
After widespread protests, what happened on March 29, 2011?
The Syrian cabinet resigned.
The move was calculated to appease the unruly protesters.
Military units fired on unarmed protesters.
Protesters stormed a government building.
Question 9 of 30
In part to defuse protests, to what factor did President Assad attribute the uprising?
foreign meddling
He said that foreign influences were to blame for the instability.
violent terrorists
an attempted coup
Question 10 of 30
How did the government attempt to disrupt demonstrations?
It cut Internet and phone services.
The blackout cut off several cities from most modern communications and marked an ominous shift in the standoff.
It offered new legislation giving in to many of their demands.
It assassinated three protest leaders.
Question 11 of 30
In which city have a huge number of deaths occurred in comparison to the rest of the country?
The city was under siege for three years, inflicting massive suffering to its residents.
Question 12 of 30
As protests mounted, government officials said that they would treat demonstrations as if they were what?
a declaration of war
a threat to public safety
Ironically, security forces continued shooting protesters, obviously a public safety hazard.
an act of terrorism
Question 13 of 30
The Syria Civil War might be viewed in part as a proxy war between which two powerful nations?
U.S. and Russia
The Russians are backing government loyalists, and the Americans are helping the rebels.
Iran and Turkey
Russia and Iraq
Question 14 of 30
Both the U.S. and Russia oppose which force that is fighting in Syria?
Due to its brutality and intolerance, ISIS has found few allies in major governments.
Question 15 of 30
In August 2013, Assad's forces used which weapon of mass destruction to kill hundreds of people?
The government, in turn, blamed the rebels for the chemical attack.
mustard gas
Question 16 of 30
In 2012, Turkey estimated that about how many Syrian soldiers had defected?
about 20,000
about 130,000
about 60,000
But in some areas, the population and its forces are very supportive of Assad's regime.
Question 17 of 30
Of the nearly 5 million people who have fled Syria, what percentage have traveled to Europe?
The influx of refugees has caused numerous conflicts across Europe.
Question 18 of 30
What percentage of Syria's population has been displaced by the war?
more than 30%
more than 50%
Many of them don't have access to basic necessities for daily life.
more than 70%
Question 19 of 30
Defecting Syrian officers formed which rebel group to fight Assad's forces?
Islamic Front
Free Syrian Army
The U.S. is allegedly offering assistance to the FSA in hopes of ending Assad's reign.
Question 20 of 30
The Al-Nusra Front is a branch of which group?
It is made up mostly of Sunni fighters taking up arms hoping to create a fundamentalist Islamic state in Syria.
The Syrian Democratic Forces
Question 21 of 30
By one U.S. defense estimate, how many various rebel groups are a part of the fighting?
The chaos is so great that it's difficult to determine who is fighting whom.
Question 22 of 30
Which city is sometimes called "the capital of the revolution?"
Much of the city is completely destroyed, and thousands of people have been killed there.
Al Tabqah
Question 23 of 30
The Syrian Democratic Forces have leveled their guns primarily at which group?
The Free Syrian Army
The group's goal is to bring a new brand of democratic order to Syria.
Government loyalists
Question 24 of 30
About what percentage of Syria's population no longer has access to suitable drinking water?
about 40%
about 70%
Both sides are accused of leveraging civilian suffering for political gain.
about 85%
Question 25 of 30
How many countries in the U.S.-led coalition have conducted air strikes in Iraq and Syria?
They've carried out more than 10,000 strikes and still the violence continues.
Question 26 of 30
How many of the country's six UNESCO World Heritage Sites have been damaged during the conflict?
Hundreds of other culturally significant sites have been damaged or destroyed.
Question 27 of 30
About how many Syrian refugees has Turkey registered?
nearly 1 million
nearly 3 million
Neighboring countries like Turkey, Lebanon and Jordan have been forced to deal with millions of refugees uprooted by violence.
nearly 6 million
Question 28 of 30
Which group does Iran support in the fighting?
The Kurds
government loyalists
Even with Iran's help, Assad has been unable to control the unrest.
Question 29 of 30
Why did U.S. President Barack Obama threaten to attack Assad's forces?
He said Assad threatened America with terror attacks.
He said there was evidence of illegal chemical attacks.
In the end, Obama's threats were toned down, but the U.S. did eventually begin air strikes against limited targets.
He said that civilian casualties were getting out of control.
Question 30 of 30
Since the end of WWII, how long have civil wars lasted, on average?
five years
10 years
Which means that the conflict in Syria may have a long ways to go.
15 years


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Literature # 9PIV165
Glu-C, Sequencing Grade, is a serine protease that specifically cleaves at the C-terminus of either aspartic or glutamic acid residues. In ammonium bicarbonate and ammonium acetate the enzyme specificity is higher at the glutamic residues. In phosphate buffers cleavage occurs at the aspartic and glutamic residues. Glu-C activity is optimal in the pH range of 4.0–9.0. This sequencing grade enzyme can be used alone or in combination with other proteases to produce protein digests for peptide mapping applications or protein identification by peptide mass fingerprinting or MS/MS spectral matching. Glu-C, Sequencing Grade, is suitable for in-solution digestion reactions.
Printed in USA. Revised 8/16.


text:
Leafs, and fans, keep the faith
Steve Lansky
March 13 2011 04:30PM
"As a team, we gotta believe." Those words came out of James Reimer's mouth after the Leafs' 4-3 win over the Sabres. But, against Buffalo, was the perfect opportunity for the Leafs to begin their much-anticipated slide into oblivion. I say "much-anticipated" because there are legions of so-called fans out there who expect – even hope for – these collapses that the Leafs have supposedly become famous for. But they're forgetting one thing. These are not Mats Sundin's Leafs. These are not Darcy Tucker's Leafs. These are not Tie Domi's Leafs. And a collapse does not seem imminent.
These are James Reimer's Leafs. They are Luke Schenn's Leafs. They are Dion Phaneuf's Leafs and they are Mikhail Grabovski's Leafs. Those are the guy who will determine whether or not this club reaches the postseason for the first time since 2004. It will not be in the hands of the ghosts of Sundin, Domi and Tucker. And, with just 13 games remaining in the regular season, head coach Ron Wilson's Stanley Cup Playoff experience will start to come into play.
Wilson has led eight different clubs to the playoffs. He did it once in Anaheim, three times in Washington and four times in San Jose. His 1998 Capitals reached the Stanley Cup Final (where they were swept by Scotty Bowman's Red Wings). Wilson seems to have installed a reasonably calm demeanour on this club as winter nears its end. Even though there's lots of youth on this club, they're not really playing like a young team.
Oh, some players are. Phil Kessel is still wildly inconsistent. And Tyler Bozak disappears for weeks at a time. But that win on over the Sabres on Saturday was another character game for Toronto. They were trailing going into the third period. Perfect time to collapse and allow three more in a 7-2 loss, right? Nope. Not this time and, not in a long time.
I am not anticipating a collapse. There have already been way too many opportunities for this club to toss out the "We'll get 'em next season" bull. Hasn't happened. Not going to.
The Leafs have four games this week – Monday v. Tampa Bay, Wednesday in Carolina, Thursday in Florida and Saturday v. Boston. By next Sunday morning, the club could be sitting in eighth spot. But it will be tough, as Carolina visits Buffalo on Tuesday. Pray that one doesn't go to overtime. But it's the Sabres' only game until next Saturday. All they can do is sweat and watch the Leafs try to catch them.
James Reimer outplayed Ryan Miller on Saturday night. And he'll have to outplay the opposition netminder many more times down the stretch. Do you doubt him? Neither do I.
The way they're playing, these Leafs are poised to keep this run going and make the spring of 2011 very memorable for Toronto fans – especially the ones who are keeping the faith.
My dad kept texting me about the red wings game, I finally told him "sorry, only catching the wings game on the commercials right now...leafs are playing for a playoff spot". He told me he was flipping back and forth to the leafs game on CBC, but I was hooked to it. My wife and daughters kept asking where Bertuzzi & Datsyuk were... they are adorable like that.
What a third period. Wow. Loved the effort all around, and Reimer is looking great.
March 14 2011, 10:19AM
You want to believe it can be done, if only because it's been decades* since the Leafs have made any type of noise in late March and this group is putting in the effort. Despite the great play of Reimer and company, the playoffs still look like they will slip away on the Leafs. The math says so.
The Leafs and Sabres have 13 games left while the Rangers have 12. If one assumes that the Sabres and Rangers continue to collect points at the same rate they have all season, they will finish with 90 and 89 points respectively.
In order for the Leafs to collect 89 points, they will need to collect 19 out a possible 26 points. That leaves very little room for error and the Leafs, unfortunately, have some very tough games coming up. Tampa Bay, Boston (x2), Detroit, Washington, New Jersey, & Montreal. All high end teams or teams that are playing pretty good hockey at the moment.
Considering that the Leafs are 5-2-3 in their last 10 games, although you want to believe, you wonder when the clock will strike midnight on this group.
*slight exaggeration, it only feels like decades
What I am feeling right now, is that a couple of the teams in contention will slip. I feel that Buffalo or Carolina or New York are going to falter here, and the leafs will squeak a couple games in here and there and make a run at it. Is it likely, the numbers say probably not, but my heart would love to say it is.
We'll see, that's the fun of being a fan in this type of situation.
I just want the leafs to pull a 2010 Flyers and make it in on the last couple days of the season!


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|Posted by Vincent on May 11, 19100 at 19:24:20:
terry i live in a area with a high watter table I have noticed that when it rains heavy my basement toilet flushes verry slowly. Will a ejector pump help solve my problem? also will a ejector pump prevent watter from backing up into my basement through my septic tank?
|Replies to this post


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Archbishop on the Meaning of the Royal Wedding
Well, we may as well add to the deluge of posts about the royal wedding with a prenuptial video from the Archbishop of Canterbury, who presided over Prince William and Kate Middleton's wedding ceremony today. In this Lambeth Palace production, Rowan Williams shares his optimism in knowing that a young couple are still willing to commit to one another and discover each another during these modern times in a fast-paced world:
"Here are young people sending a message of hopefulness, sending a message of generosity across the world. And, it's my privilege to bless that in the name of God, to witness that in the name of God, and to send them on their way."


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We loved this deal too, but it's no longer available. Check out our other awesome deals here.
$179 for Two Nights for Two People in a One Bedroom Spa Bath Unit at Camelot Motor Lodge Palmerston North (value $364)
Discuss this DealStart the discussion
- Travel back to the spirit of adventure surrounding Camelot, yet enjoy all the modern conveniences such as SKY TV and wireless Internet.
- Grab two nights for two people in a one bedroom spa bath unit, at Camelot Motor Lodge, Palmerston North for only $179.
- Experience welcoming hosts in executive accommodation.
- Central, yet quiet location.
Camelot is a place of mystery and legend. Born in Britain and transported all the way to Palmerston North. King Arthur may of gone, but his legendary hospitality still remains alive, right here in the heart of Pamerston.
Grab two night for one or two people in a one bedroom spa bath unit at Camelot Motor Lodge, Palmerston North for only $179.
Experience executive accommodation in a quiet central city location. When you stay at Camelot Motor Lodge in Palmerston North, you will receive a friendly welcome and first-class service. This spot is perfect whether you are on business, holiday or ready to relax and unwind. Their central yet quiet location, with well-lit off-street parking, is the ideal place to stay. Camelot Motor Lodge also offers conference facilities for the corporate traveller.
The one bedroom unit comprises of a queen bed with television, a single bed in the living area with SKY TV a full kitchenette with tea and coffee and the best addition is the air spa bath with shower. As well as this, 30mb of free internet is included with this deal..
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ASHBURN, Va. – Barry Cofield's salary-cap restructuring has him talking.
The Washington Redskins defensive co-captain took a verbal shot at the NFC East rival New York Giants for "spearheading'' what Cofield thinks was an unfair punishment imposed on the Redskins for contracts awarded during the league's uncapped 2010 season.
PREDICTIONS: All the picks for 2013
Thanks to Cofield's contract restructuring from a scheduled $4.05 million in 2013 base salary down to a league-minimum $840,000, the Redskins were able to survive this second year of a league-imposed, $36-million salary cap penalty for the way the club structured 2010 player contracts.
Giants CEO/co-owner John Mara was chairman of the league's management council that docked the Redskins and, to a lesser degree, the Dallas Cowboys upon finding that they violated "the spirit of the salary cap'' during the uncapped season.
"I think everyone was aware. I was very aware and upset,'' said Cofield, who will play Monday night's season opener against the Philadelphia Eagles despite a broken bone in his right hand. "I felt like it was wrong and collusion and all those words that we try to get past.
WEEK 1: Predictions for every game
"What can you do? We won last year, won the division and were able to keep this team together. We use it as motivation, especially when a team in the division was spearheading the effort, a team I played for gives me even more desire to do good despite those penalties.''
Cofield played for the Giants from 2006 to 2010.
"You have to use those 'me-against-the-world' tactics,'' Cofield said. "We were able to keep our core almost at 100%. And we feel that continuity from year to year will hopefully help us early in the season.''
Defensive end Stephen Bowen also was approached by the Redskins, agreeing to join Cofield and defensive end Adam Carriker in restructuring deals that allowed the team to duck under this season's $123 million cap while setting its 53-man roster along with the eight-man practice squad.
"They just approached me and Barry about it. Really, whatever we can do to help,'' Bowen said. "It just shows how good our staff is, our organization getting quality players here, and we had a winning squad last year even with restrictions.''


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Notice of public hearing
Castle Dale City will hold a public hearing June 22, 2013 at 1:00
p.m. in the Castle Dale City Hall for the purpose of reviewing and
adopting all the city's 2013-2014 budgets. These budgets are open for
review prior to the hearing at the City Hall during normal working
Also as part of the hearing will be the opening of all the 2012-2013
City Revenue Budgets to include any unbudgeted revenues received and
to make any necessary additions or adjustments to these budgets. The
City Expenditure Budget will also be opened to make any necessary
budgeting additions or adjustments.
We invite all interested individuals to review the budgets and attend
this scheduled budget hearing.
Neal L. Peacock,
Published in the Emery County Progress June 11 and 18, 2013.


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|5| Excellent
|4| Good
|3| Average
|2| Bad
|1| Terrible
Gave birth to Zan? So it means this guy should be older than any shinigami who holds a zan and that includes Yama unless Yama spent quite a long time living before acquiring his zan.
sig made by me
Looks like they'll get their Zan's reforged on the next chapter.
But still this Nimaya guy must be something else if he created the Zan.
Props to Kubo for still finding a way to force in the fanservice!
I don't think he's necessarily older than all of the shinigami. I'm guessing he was just the first to develop the means of communicating with your inner spirit, and learning to pull it out and use it as your fighting power.
Proud (and confused) subscriber of Shonen Jump Alpha.
I called dibs on the fact that kirio is actually one hell of a hot chick lol. Thank god for that haha. But on a side note it seems like urahara is the combination of the whole damn zero squad...adapting the hot spring healing, the artificial soul n most probably the 3 day bankai training is another adaption of his...damn Urahara is some badass.
So aside from being stronger than the entire gotei13 combined... these 5 royal guards has also an impact in the history of SS, they were chosen as such........Hikifune for the "artificial soul" leading to the gikongan.....i wonder what kirinji made/invented? = healing techniques probably?....... and the next guy is the "The one who gave birth to the zanpaktou/ maker of the zanpaktou".... probably the forger..... now i can't wait to see what the others do....
Next chapter kon will probably jump towards hikifune's boobies before they leave her palace lols
good chapter
Maby they only used kido before they had zanpaktou
Great chapter. So the man who gave birth to the Zanpaktou is next. Well many of us have wondered how zans came into extistence in the first place and it looks like we are going to get our answers. Hopefully the next couple of chapters will be dealing with the reforging of their zanpaktous and some inner world convo between Ichigo and Zangetsu because I would hate for it to be done in all one chapter.
Urahara is brilliant.
A spa/hot spring owner - healer - the pointy haired guy (healed their bodies).
A cook - scientist - the big women (stuffed them with food).
A blacksmith - meditation trainer - the small guy (strengthened the bond between them and their zans ?).
A mechanic - scout - the chick with artificial arms (created a new even more fitting designs for their zans ?).
The guard chief - army leader - the bald guy (the actual training ;p ?).
All of them are strongly recognizing Urahara, in a way that seems like Urahara himself passed through all of those palaces...
So, shouldn't they have invited Urahara and Aizen for creating something almost impossible, like the Hogyouku (or only Kisuke since his was better) ? Anyway, this means that Ichigo will be invited to Squad Zero, since he brought great changes to SS and will certainly be an important historical character in the future of bleach universe.
It seems that the Zanpakutous, or only around 2000 years old. I guess that explain why they needed the hand to hand combat and demon arts, but now are currently concentrating on mastering Zans (they are simply more effective and their effect vary greatly).


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By JEFFREY O. DURRANTProfessor of Geography, BYU
In recent debates over motorized recreation I have, on numerous occasions, heard or read people express their belief that they had a "right" to drive their vehicles on public land.
And while this is an interesting debate, I have been wondering lately about another right�do we have the right to go out on public land and get lost, injured, or worse?
The recent news coverage of a truly epic self-rescue in Blue John Canyon led me to reminisce about not only my own experience in that canyon�but also the numerous search and rescue missions my wife and I participated on in the 1990s with our two dogs.
One instance that always stands out for me was the report of a Colorado man missing near Canyonlands Needles District. My dog, Ambush, and I drove to Moab where we spent the night waiting for the rest of the search team to assemble.
The next morning we located the missing man's vehicle and tent near Lavender Canyon and began our search on foot.
I started Ambush in the missing man's tent and he quickly picked up the scent and headed up one of several nearby canyons. Halfway up the narrowing canyon I knew we were closing in when I stopped to hoist my bag up a six foot cliff and Ambush jumped over my head and ran up the canyon. I caught up just as we came around a corner and found the body.
We found the body near the back of the canyon, and upon further examination it became apparent what had happened. He had either been trying to climb out or into the canyon when he fell and suffered a head injury. He then attempted to bandage his head before he stumbled several hundred feet before he collapsed. Only a scattered pack and streaks of blood along the canyon wall told the story. He was only a half-mile from his vehicle�a strong hiking companion could have carried him out.
Now most searches I went on did not end like that�in fact most were over by the time I got there.
But it's amazing how many people manage to get lost. But one of the beautiful things about public land is we have many places where it's possible to get lost.
Perhaps my favorite story of a lost person was when I took off for Rwanda and left my pregnant wife at home. Enroute to Africa I called home from England to see how she was doing and was told she had flown to Wyoming on a search.
I later found out that my pregnant wife ended up riding a horse up the mountain with her dog in search of two guys from Chicago. They ended up walking out on their own but it must have taken some of the luster off their adventure when they realized that a pregnant woman from another state had been flown in to find and rescue them.
But they took a risk, so did the guy from Colorado. And many of us take these risks all the time when we go into public land.
One of the things that draws so many of us to BLM lands is that there are not signs and rangers at every turn making sure that nothing goes wrong. In a meeting a few weeks back I heard the opinion expressed that it would be nice to have a sign at the back of Little Wild Horse Canyon showing people which way to Bell Canyon.
I can see why people feel the need for even more signs in this area�it is often busier than a national park. But hopefully we won't make BLM lands more and more like national parks. Despite the occasional tragedies I hope we can keep the possibility of problems alive.
When I went down Blue John Canyon a couple of years ago with three able companions we struggled down through one of the most amazing and difficult slot canyons I have experienced. It is easy to see why those seeking a challenge would head to this remote gem.
At the end of the day we found ourselves in a deep dark section standing in chest deep ice water facing a steep cliff. We had to back track and climb out the side of the canyon. It was exhilarating and when my legs thawed out I realized I had left a lot of skin on the sandstone walls.
A lot of the adventure and lure would have been lost if signs pointed the way, a permit was required, and we knew that if it got too difficult a ranger was always nearby.


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Vikings placed WR Greg Childs on reserve/PUP.
Kent Somers of AZCentral Sports reports the Cardinals have "zero interest" in Jay Cutler.
Vikings OC Pat Shurmur expects Sam Bradford to be better coming off a full offseason with the organization.
ESPN's Jordan Raanan reports the Giants are "genuinely trying to keep the defense intact."
Pro Football Talk's Mike Florio reports Kirk Cousins will not sign a long-term deal prior to the March 1 deadline for the Redskins to apply the franchise tag.
Alex Marvez of the Sporting News reports impending free agent LT Andrew Whitworth is expected to test the open market.
Dolphins acquired TE Julius Thomas from the Jaguars in exchange for a seventh-round pick in the 2017 draft.
Longtime NFL draft analyst Tony Pauline doesn't believe Oklahoma RB Joe Mixon will be selected in April's draft.
First Coast News reports Julius Thomas is drawing trade interest from at least one team in addition to the Dolphins.
The Black and Blue Review reports free agent Victor Cruz visited the Panthers over the weekend.
Jaguars released DE Jared Odrick.
The Miami Herald's Armando Salguero reports the Jaguars will acquire LT Branden Albert from the Dolphins in exchange for a conditional late-round 2018 draft pick.


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American Legion Post 73 has been working very hard to prepare for the upcoming Memorial Day observance. They will be at the Elmo, Cleveland, Lawrence, and Huntington cemeteries on Memorial Day to present the new memorial monuments in honor of all veterans.
The mayors and city council members of each town will be present to receive these presentations. The American Legion will do a full Memorial Day ceremony at each cemetery, including the Flag ceremony, the firing of weapons, and the sounding of Taps. Blake Jones will present the Ragged Ole Flag.
The times are: Elmo-9:45 a.m.; Cleveland-10:30 a.m.; Lawrence-11:15 a.m.; and Huntington-Noon. Everyone is welcome to attend, one or all of the ceremonies, to honor our veterans. They gave their "all" for us, now let us give them our "all" by being in attendance.


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Jan. 17 celebrity birthdays
These people of the present and past were born on this date:
Actress Betty White is 91.
Actor James Earl Jones is 82.
Longtime baseball coach and manager Don Zimmer is 82.
Talk-show host Maury Povich is 74.
Former heavyweight boxing champion Muhammad Ali is 71.
Singer Chris Montez is 71.
Singer Françoise Hardy is 69.
Singer William Hart of the Delfonics is 68.
Radio personality Jim Ladd is 65.
Former Rolling Stones guitarist Mick Taylor is 65.
Singer Sheila Hutchinson of the Emotions is 60.
Radio host Robert F Kennedy Jr. is 59.
Singer-songwriter Steve Earle is 58.
Singer Paul Young is 57.
Actor-comedian Steve Harvey is 56.
Singer Susanna Hoffs of the Bangles is 54.
Screenwriter and movie producer and director Brian Helgeland ("L.A. Confidential," "Mystic River") is 52.
Actor Jim Carrey is 51.
Author and documentary filmmaker Sebastian Junger ("The Perfect Storm," "Restrepo") is 51.
First lady Michelle Obama is 49.
Director D.J. Caruso ("I Am Number Four," "Disturbia") is 48.
Actor Joshua Malina ("The West Wing," "Sports Night") is 47.
Singer Shabba Ranks is 47.
Singer-guitarist Richard Hawley (Pulp) is 46.
Drummer Jon Wysocki (Staind) is 45.
Actor Naveen Andrews ("Lost," "The English Patient") is 44.
DJ Tiësto is 44.
Musician Kid Rock is 42.
Actress Youki Kudoh ("Rush Hour 3," "Memoirs of a Geisha") is 42.
Singer-songwriter Matt Hales (Aqualung) is 41.
Actor Freddy Rodriguez ("Six Feet Under," "Ugly Betty") is 38.
Model, TV personality and actress Carolina "Pampita" Ardohain is 35.
Dancer and TV personality Maksim Chmerkovskiy ("Dancing With the Stars") is 33.
Actress and singer Zooey Deschanel ("New Girl," She & Him) is 33.
Actor Scott Mechlowicz ("Cat Run," "EuroTrip") is 32.
Singer Ray J is 32.
Miami Heat guard Dwyane Wade is 31.
Country singer Amanda Wilkinson of the Wilkinsons is 31.
Actress, model and radio personality Andrea Lowell is 30.
Singer Yelle (Julie Budet) is 30.
DJ Calvin Harris is 29.
Actor Max Adler ("Glee") is 27.
Drummer Jeremiah Fraites of the Lumineers is 27.
Actress and voice actress Caitlin Sanchez ("Dora the Explorer") is 17.
Birthdays of the past:
1706 Benjamin Franklin, statesman; died 1790.
1867 Carl Laemmle, movie theater owner and founder of Universal Pictures; died 1939.
1880 Mack Sennett, movie director; died 1960.
1882 Noah Beery Sr., actor; died 1946.
1899 Al Capone, gangster; died 1947.
1920 Nora Kaye, ballet dancer and choreographer; died 1987
1927 Eartha Kitt, singer and actress; died 2008.
1928 Vidal Sassoon, hair stylist; died 2012.
1933 Shari Lewis, puppeteer; died 1998.
1949 Andy Kaufman, actor/comedian; died 1984.
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All About Kidney Cancer
What is the Kidney?
The kidneys are two bean-shaped organs that are located in the back of the abdomen, and that have many important functions essential for life. Among the most important are filtrating the blood, removing waste products from the blood and ensuring that the electrolytes within the blood are correctly balanced. The excess waste becomes urine. In addition, the kidneys produce erythropoietin, a hormone responsible for the production of oxygen carrying red blood cells, and a hormone called rennin, which helps control blood pressure.
Each of the kidneys can be divided into two main functional parts - the cortex and renal pelvis. The outer region of the kidney is called the cortex. The cortex consists of a series of tubes (called collecting tubules) and is responsible for the filtration of blood. The inner region of the kidney is called the renal pelvis. The renal pelvis contains medullary pyramids that collect the filtrate (urine) from collecting tubules in the cortex and send it through the ureters to the urinary bladder. Different types of cancers develop from the two different regions of the kidneys.
The kidneys are located in the back of the abdomen, directly in front of where the lowest ribs can be felt on a person's back. A physician can feel them in the abdomen at times, though often only if the kidney is enlarged or has a mass on it.
What is kidney cancer?
The definition of a tumor is a mass of abnormally growing cells. Tumors can be either benign or malignant. Benign tumors have uncontrolled cell growth, but without any invasion into normal tissues and without any ability to spread to distant parts of the body. A tumor is called malignant, or cancer, if tumor cells are able to invade tissues and spread locally, as well as to distant parts of the body. Therefore, kidney cancer occurs when cells in either the cortex of the kidney, or cells in the renal pelvis, grow uncontrollably and form tumors that can invade normal tissues and spread to other parts of the body.
Renal cell carcinoma is the most common type of kidney cancer and accounts for about 9 out of 10 cases of kidney cancer. In renal cell cancer, malignant tumors can be growing in either one or both kidneys and there may be multiple tumors. There are several types of renal cell cancer. The type is determined by the appearance of the cancer cell under a microscope. Types of renal cell cancer include:
- Clear Cell renal cell carcinoma - Accounts for about 7 out of 10 cases of renal cell cancer. Cells appear pale or clear.
- Papillary renal cell carcinoma - Accounts for about 1 out of 10 renal cell carcinomas. This type of cancer cell forms finger-like projections and when they absorb certain dyes they appear pink.
- Chromophobe renal cell carcinoma - Accounts for about 5 out of 100 cases of renal cell carcinoma. They appear pale or clear but the cells are much larger than clear cell carcinoma.
- Rare Types - These subtypes are rare and make up less than 1% of all occurrences of renal cell carcinoma. They include: collecting duct, multilocular cystic, medullary carcinoma, mucinous tubular and spindle cell carcinoma and neuroblastoma-associated renal cell carcinoma.
- Unclassified - Very rare. They are determined to be unclassified when more than one type of cell exists or the cell does not fit into a specific category.
Transitional cell carcinomas, also known as urothelial carcinomas, account for about 5 to 10 out of every 100 diagnoses of kidney cancer. Transitional cell carcinoma is cancer in the lining of the renal pelvis where urine is stored before it enters the ureter to then travel to the bladder. This type of kidney cancer looks similar to bladder cancer cells when viewed under a microscope.
Wilms Tumor is a tumor commonly found in children and that is very rare in adults. It can affect either one or both kidneys and prior to being diagnosed the tumors are usually quite large.
Renal Sarcoma is a rare type of kidney cancer that begins in the blood vessels or connective tissue of the kidney and accounts for less than 1% of kidney cancers.
Benign kidney tumors are non-cancerous, but can grow very large and have an effect on the body. These include renal adenoma, oncocytoma and angiomyolipoma. They are treated using surgery, radiofrequency ablation and/or arterial embolization.
Am I at risk for kidney cancer?
The American Cancer Society estimates that in 2015 about 61,560 new cases of kidney cancer, inclusive of all types, will be diagnosed. It is estimated that there will be 14,080 deaths from kidney cancer in 2015. The average age of a person when diagnosed is 64 and kidney cancer is uncommon in people younger than 45. Kidney cancer is more common in men than women. African Americans and American Indians/Alaska Natives have slightly higher rates of renal cell carcinomas than do Caucasians.
Risks include:
- Smoking - The most prominent risk is cigarette smoking. The increased risk is related to how much you smoke. Risk decreases when you stop smoking.
- Obesity - Obesity changes different hormone levels, which can lead to kidney cancer.
- Workplace Exposure - Exposure to cadmium, some herbicides and some organic solvents may increase risk of kidney cancer.
- Family History - The risk for kidney cancer increases in persons with a first-degree relative who has had kidney cancer.
- Other- Less commonly thought of factors include analgesic abuse, high blood pressure, and several uncommon hereditary diseases, including von Hippel-Lindau disease and polycystic kidney disease.
How can I prevent kidney cancer?
As cigarette smoking doubles the risk of kidney cancer, the best way to decrease your risk of developing kidney cancer is to quit smoking or never start. Maintain a healthy weight. Avoid toxins known to lead to cancer. The only other substantial risk factors for the development of kidney cancer are related to family history. The risk factor of having someone in the family with a history of kidney cancer, or rare genetic syndromes such as von Hippel Lindau and polycystic disease cannot be prevented. If you have this history, be sure your healthcare providers are aware.
What screening tests are available?
There are no screening tests for kidney cancer that are akin to mammography for breast cancer or colonoscopy for colorectal cancer. However, the use of CT scans and ultrasounds have enhanced the early detection of kidney cancer once signs or symptoms have developed (see below). Intravenous pyelograms (IVP) are used to assess kidney function. IVPs are done by injecting dye into a patient's arm and then taking x-rays of the abdomen to see that dye subsequently excreted by the kidneys as urine. Cytology is simply looking at urine under a microscope and looking for cancerous cells within the urine. Because they may cause early symptoms that lead to testing, kidney cancers that develop in the area of the collecting system may be detected earlier than those in other regions.
With the advent of CT scans and ultrasounds, 25-40% of kidney cancers are now detected incidentally during the work up of a different problem. These tumors are more likely to be smaller (hence causing no symptoms), and hence more likely to result in a cure.
What are signs of kidney cancer?
Kidney cancer presents as signs and symptoms of either the local tumor in the kidney or as signs and symptoms resulting from spread of disease to other locations in the body (metastatic disease). Symptoms resulting from local tumor growth include hematuria (blood in the urine), abdominal pain, and a flank mass. Hematuria, abdominal pain and a flank mass are the classic "triad" of symptoms of kidney cancer, though most patients will not have all three.
Hematuria is the most common symptom and presents as either gross hematuria, where the blood is visible in the urine, or as microscopic hematuria, where the blood is only detected by laboratory testing. Therefore, any presence of blood in the urine that is detected in a urine sample should be investigated.
Symptoms caused by metastatic disease include fever, weight loss, and night sweats (drenching sweats that require changing of clothes or bedsheets). Other symptoms include hypertension, increased calcium in the blood, and liver problems. These more unique symptoms are thought to be caused by chemical signals released by the tumor cells into the bloodstream and the body's reaction to them.
How is kidney cancer diagnosed and staged?
Work up of a kidney cancer usually starts after the patient develops symptoms, with the exception of those cancers that are found incidentally. Tests done prior to treatment of kidney cancer are used to determine the extent of disease that is present so that treatment can be prescribed accordingly. This includes documenting the extent of disease both locally, in the tissues and lymph nodes surrounding the kidney, as well as ensuring there is no spread distantly, outside the area of the kidney (called metastases).
The most sensitive test to document local disease is the CT scan. MRI scans may be used to ensure the tumor has not involved any of the large blood vessels that are in the vicinity of the kidney. Other tests, including basic laboratory blood tests and analysis of the urine may be used to evaluate general health and the extent of the cancer. In addition, chest x-ray and bone scan may be done, to ensure that metastatic spread to the lungs and bones, respectively, has not occurred.
All of these tests are helpful, however, to confirm a diagnosis of any cancer, tissue or cells must be examined by a pathologist. Therefore, to obtain a diagnosis of kidney cancer, a biopsy is often done by inserting a needle into the presumed tumor mass. There are also times that the CT scan and/or MRI is so convincing that the mass is a tumor, that the initial biopsy is done during a surgical procedure, which is done to ultimately remove the kidney as treatment for the kidney cancer. The most appropriate surgical approach must be determined on an individual basis.
The results of these tests are put together to determine the stage of the cancer. The staging of a cancer documents the extent of disease and is often extremely important in terms of what treatment is offered to each individual patient. Before the staging systems are introduced, we will first describe some of the ways that cancers may grow and spread.
Cancers cause problems because they spread and can disrupt the functioning of normal organs. One way kidney cancer can spread is by local extension to invade through the normal structures. This initially includes the kidney, hence causing hematuria, a mass, and abdominal pain. If more growth occurs, cancer can grow to involve the main vein that leaves the kidney (the renal vein), the large vein that returns blood from the bottom half of the body to the heart (the inferior vena cava), or into other organs-most commonly the adrenal glands which sit atop the kidneys.
Kidney cancer can also spread by accessing the lymphatic system. The lymphatic circulation is a complete circulation system in the body (somewhat like the blood circulatory system) that drains into various lymph nodes. When cancer cells access this lymphatic circulation, they can travel to lymph nodes and start new sites of cancer. This is called lymphatic spread. Kidney cancer can spread, at times, into the lymph nodes surrounding the kidney, called the perirenal lymph nodes.
Kidney cancers can also spread through the bloodstream. Cancer cells gain access to distant organs via the bloodstream and cause distant metastases. Cancers of the kidney generally spread locally into the fat surrounding the kidney, the adrenal glands, or the veins prior to spreading via the lymphatic system or the bloodstream. However, tumors, especially larger tumors, can access the bloodstream and spread to the lungs and bones, most commonly. Kidney tumors have also been known to spread to the testis and ovaries through the testicular or ovarian veins that are in close proximity to the kidney.
The staging system used today in kidney cancer is designed to describe the extent of disease within the area of the kidney, in the surrounding lymph nodes, and distantly. This staging system is the "TNM system", as described by the American Joint Committee on Cancer. The TNM systems are used to describe many types of cancers. They have three components: T-describing the size of the "primary" tumor (the tumor in the kidney itself); N-describing the spread to the lymph nodes; M-describing the spread to other organs (metastases). The numbers 0-4 indicate increasing severity.
The "T" stage is as follows:
TX: The primary tumor cannot be assessed.
T0: No evidence of a primary tumor.
T1: The tumor is only in the kidney and is no larger than 7 centimeters.
T1a: The tumor is 4 cm across or smaller and is only in the kidney.
T1b: The tumor is larger than 4 cm but not larger than 7 cm across and is only in the kidney.
T2: The tumor is larger than 7 cm across but is still only in the kidney.
T2a: The tumor is more than 7 cm but not more than 10 cm across and is only in the kidney.
T2b: The tumor is more than 10 cm across and is only in the kidney.
T3: The tumor is growing into a major vein or into tissue around the kidney, but it is not growing into the adrenal gland (on top of the kidney) or beyond Gerota's fascia (the fibrous layer that surrounds the kidney and nearby fatty tissue).
T3a: The tumor is growing into the main vein leading out of the kidney (renal vein) or into fatty tissue around the kidney.
T3b: The tumor is growing into the part of the large vein leading into the heart (vena cava) that is within the abdomen.
T3c: The tumor has grown into the part of the vena cava that is within the chest or it is growing into the wall of the vena cava.
T4: The tumor has spread beyond Gerota's fascia and may have grown into the adrenal gland (on top of the kidney).
The "N" stage is as follows:
NX-Regional lymph nosed cannot be assessed.
N0-no spread to lymph nodes.
N1-tumor spread to a single or multiple lymph nodes.
The "M" stage is as follows:
M0-no tumor spread to other organs.
M1-tumor spread to other organs.
The overall stage is based on a combination of these T, N, and M parameters:
- Stage I: T1N0M0
- Stage II: T2N0M0
- Stage III: T1N1M0, T2N1M0, T3N0M0 or T3N1M0
- Stage IV: T4AnyNM0, AnyTAnyNM1
Though complicated, these staging systems help oncology providers determine the extent of the cancer, and therefore make treatment decisions regarding a patient's cancer.
What are the treatments for kidney cancer?
Once your cancer is staged your care team will determine the best options for treatment. Your care team will be multidisciplinary; including providers from various specialties, such as a primary oncologist, urologist, radiation oncologist, pathologist, nutritionist, social worker and nurses. Your care team will take into consideration the stage of your disease, your overall health, possible side effects of treatment, probability of curing the disease and relief of symptoms when creating your care plan. Treatment options for kidney cancer include: surgery, radiation and chemotherapy. Less frequently used treatments include: ablation, active surveillance (monitoring the disease without active treatment), biologic therapy and targeted therapy. More than one treatment may be prescribed.
Treatment with Surgery
Surgery is the primary choice of treatment for kidney cancer. There are two types of surgical approaches associated with treatment of kidney cancer. A radical nephrectomy is the removal of the entire kidney, the adrenal gland that sits a top the kidney and the fatty tissue around the kidney. The removal of the kidney may be done through a large incision on the abdomen or back or may be done through a laparoscopic technique in which several small incisions are made rather than one large incision.
A second surgical treatment option is a nephron-sparing nephrectomy, also known as a partial nephrectomy. Only the part of the kidney affected by cancer is removed. It is the preferred treatment for early stage kidney cancer and is often used to remove T1a tumors and some T1b and T2a tumors. The benefit of a partial nephrectomy is to maintain as much kidney function as possible. A partial nephrectomy can be done through an open incision or through a laparoscopic procedure, the same as a radical nephrectomy. Each has benefits and risks associated, but the goal of these surgeries is good long-term renal function and cancer-free survival.
During both a radical and partial nephrectomy the surgeon may choose to perform a regional lymphadenectomy. In this procedure lymph nodes in the same region of the kidney are removed and checked for cancer cells. An adrenalectomy, removal of the adrenal gland, is always done in a radical nephrectomy but is performed during a partial nephrectomy at the surgeon's discretion.
With any surgery, there are risks and side effects to take into consideration prior to making surgery part of the treatment plan. Possible side effects include: uncontrollable bleeding, blood clots, infections, pain, damage to surrounding organs, hernia, kidney failure, leakage of urine from the kidney, pneumothorax (unwanted air in the chest cavity, and reaction to anesthesia.
Radiation Therapy
Radiation is the use of high-energy x-rays to kill the tumor. This treatment is very complex and should be performed by a radiation team trained in this specialty. Radiation can be given by two different ways: external beam (from a machine outside the body) or brachytherapy (also called internal radiation, from an internally implanted radioactive source). Kidney cancer is not very sensitive to radiation but can be the treatment of choice for a patient who is not healthy enough to withstand surgery. Radiation can also be used to ease symptoms and side effects of kidney cancer including pain and bleeding. Side effects of radiation include skin changes at the site where the radiation is given, nausea, diarrhea and fatigue.
Chemotherapies are medications, given either orally or intravenously, that are used to kill tumor cells. Kidney cancer cells are often resistant to standard chemotherapy, so it is not considered a standard treatment for kidney cancer. If your care team decides that chemotherapy will be part of your treatment plan, you may be participating in a clinical trial.
Biologic Therapy (Immunotherapy)
Immunotherapy is the use of medications to enable the body's immune system to fight and destroy cancer cells. The two immunotherapy medications primarily used to treat kidney cancer are interleukin-2 and interferon-alfa. Potential side effects of interleukin-2 include fatigue, hypotension (low blood pressure), difficulty breathing, heart attack, internal bleeding, fever and chills. Interferon is often used in conjunction with the targeted therapy agent bevacizumab (Avastin) and can cause fever, chills, muscle aches, fatigue and nausea.
Targeted Therapy
Targeted therapies are medications used to treat cancer that "target" a protein or receptor found on the cancer cell and interfere with the cell's activity or growth. They may cause fewer, yet different, side effects than traditional chemotherapy. These therapies are typically used for metastatic disease, with the goal of shrinking the tumor, slowing the growth of the cancer, and giving patients periods of "stable" disease. Each targeted therapy "targets" a different receptor or cellular function (you can learn more about each therapy at the following links). Some of these medications include: sorafenib, sunitinib, temsirolimus, everolimus, bevacizumab, pazopanib and axitinib.
The goal of your treatment plan will be to cure your kidney cancer or to slow the cancers growth while maintaining quality of life. Your oncology team will determine the best treatment plan based on the extent of the cancer, your health and available therapies.
Follow-up Care
Your follow-up care will be determined by your care team and will vary depending upon the type of treatment you received for your kidney cancer. If surgery was part of your treatment it is recommended that you have doctor visits, including a physical exam and blood work, every six months for the first two years and then yearly. A CT scan may be ordered three to six months after surgery to monitor for a recurrence of the cancer. Your care provider will determine a post treatment course that will vary if your cancer has been treated with a technique other than surgery. It is important to attend all of your appointments and to keep a list of any new side effects or symptoms you are experiencing.
After treatment, talk with your oncology team about receiving a survivorship care plan, which can help you manage the transition to survivorship and learn about long-term concerns and life after cancer. You can create your own survivorship care plan on OncoLink.
Additional Information may be found at these sites:
Niederhuber, J. E., Armitage, J. O., Doroshow, J. H., Kastan, M. B., Tepper, J. E., & Abeloff, M. D. (2014). Abeloff's clinical oncology, 5th edition (2186 p.).
American Urological Association. Follow-up Care for Renal Cancer.
The American Cancer Society. www.cancer.org
National Comprehensive Cancer Network. www.nccn.org


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Ping 59: Private Cloud strategy, Gadget predictions, Microsoft is the most social company, Free Robotics
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A Private Cloud
Bill Gates: Device vision- back in 2007
Microsoft is so VERY Social
Robotics for FREE
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Ping 60: Allard & Bach, Netflix, Hohm score, Halo Beta
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The Discussion
HOLY LAURA, Nice pick up on that w.g. vid.
True- but you can't develop apps on LinkedIn like you can on Facebook.
So, if Microsoft is the most "social" company... how come Laura barely uses her Twitter?
Correction- I may not Tweet all that often, but that doesn't mean I don't use Twitter. I check other Tweets and follow trending topics daily. Believe it or not- sometimes I'm more interested in what OTHER people have to say than myself
Bah -- other people are boring (present company excluded, of course. ). You, however, remain the life of the party.
Was is sunny in the studio? You both look kind of yellow in the shots taken from eye height...
Otherwise, good show!
The length of the show was good this time
I don't want t sound all complaining but the color saturation during close-ups is very, very bad
Not so negative Paul. Blogs are great, you just need to integrate them into Channel 9 and to have topic based syndication for blogs
The color saturation didn't influence me, the sound is much more important. Actually the saturation makes everything seem warmer heh.
Wow! This show is really great! I can't belive that so few watch it, need to tell my friends about this
Its great that you are nautral in the MS vs Apple thing, because if you did, this place would be trolled down!
Need to start build Lego-robots aggain since I learned how to do programming the last few years
Have a nice summer!
Yes, there is a goffy color issue. Whats is up with that, don't you have HD cams with color correct?
Yeah, we had something funky going on with the single shot cameras this week....but let's just call it "arty"
Does somebody over here know who is going to demo VS 2010 at the upcoming Apple's World Wide DevCon? I've heard Visual Studio is going to support iPhone development, but there is no details as to whether iPhone OS will be running in virtual PC just like Windows Phone Phone 7 does, whether developers will be able to write Objective C code in Visual Studio or may be Apple will open iPhone to Silverlight development?
Apple's policies forbid development on any platform/language/framework other than their tooling on a Mac. Period. It is doubtful that this will ever change.
This reflects my understanding of what I've read. I might be wrong.
Then why do they have Microsoft person scheduled to give a keynote about (VS 2010 ???) during their DevCon?
It was just a rumour which turned out, unsurprisingly, to be completely false.
It would be nice to have Silverlight on iPhone, though it would kill WP7.
So will Robotics Studio go free and then be shutdown in six months (e.g. Office Accounting, etc)? Hope not.
Notice the close-up on the clip with Bill Gates and not on Steve Jobs. Was it possible the Steve was jotting down notes as Bill was talking?? Or did Steve have a VOX-recording app running on his iphone? (lol)
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USA Pro Challenge Pedals into Success through the National Forests
It was hard to hear over the noise of screaming spectators chanting "USA, USA, USA" recently at the finish line of the USA Pro Challenge in downtown Denver. The city served as the end point for the more than 600-mile, seven-stage road cycling race held in Colorado for the third consecutive year. There were many excited faces in the crowd as 150 professional cyclists from 16 international teams sprinted through the finish line.
"This is not just a bike race," said a spectator who has attended the event every year. "It's about the people coming together to take part in creating a memorable event for something we love to do." Read more »


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