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Look Through Box (Art history keeps copying me) (2012)
This piece is rife with self-reference.
Materials: Plywood, enamel/latex paints, Quote piece, photographs, LEDs, extension cord
Dimensions: 37"x14"x14"
Stop Cart (2012)
Simply put, I built this cart to go so that I could stop it with an oil painting. The brake pads are made from one rolled canvas cut in half and the cart's useful life span is limited by the wear on those pads.
Video: I did actually lose control and those are actual skid marks.
Divided Boxes (2012)
I took three notebooks, one per box, filled each page with an ink drawing and did not review or edit the images once completed. I built three simple plywood boxes, each with two separate, vertical spaces and a slot for access to each side. The boxes were permanently closed and the spaces were sealed.
Each box represents a different, two option question and contains 100 drawings apiece. I went through each notebook, looked at the drawings for the first time since sketching and judged them according to the assigned criteria. Each drawing was then folded and inserted into the correct slot. I tallied the results and wrote them on the bottom of the pieces.
Good 50, Bad 50 (cherry)
Keep 54, Toss 46 (red chestnut)
Love 49, Hate 51 (dark walnut)
Given the rest of my work, this piece is fairly self-explanatory. One (36x36") oil painting removed from the stretcher bars, attached to a custom box frame and covered with for sale signs. The name of the first buyer of this piece will be written in one of the white owner boxes and if they are willing, also the price. It would be interesting to see if other names and prices would need to added as the painting changed hands and values.
Pages (2012)
Instead of displaying another notebook or creating a structure to conceal a whole book again, I decided to choose a few pages from one. As with most personal writings, each entry represented a different time period and frame of mind, so revisiting the material in this way was more uncomfortable than using a closed journal. I chose pages that were important or significant to my progress at the time.
I sandwiched one page per module and nailed it shut. The folded paper caused a small gap to occur between the blocks of wood so that upon closer inspection, the viewer would see the outline of the page inside. I assembled the pieces first and applied the stain, paint and polyurethane second, to further accentuate the crack.
The blue, yellow and white modules contain an original page each, while the purple module acts as a table of contents with the page numbers documented on its paper inside.
Thread Paintings (2012)
This series was the second branch of the failed food processor painting, being done alongside the 10 ft. Watercolors. If linen was indeed too sturdy to be shredded mechanically with my capabilities, I could certainly shred it by hand. So, I painted an oil canvas and pulled it apart, strand by strand. The weave I was using was fairly loose and I eventually worked out a technique where I could dismantle it easily enough. But the properties of the weave only allowed one strand at a time - even two threads would cause binding.
Once the painting was shredded, I took the threads and tied them end to end. Then I wound them onto the spools and arranged them inside the kits, as if there never were any paintings to begin with.
10 ft. Watercolors (2012)
This series came from a desire to shred a painting with a food processor. Primed canvas, however is extremely tough and that idea didn't pan out at all. I still wanted to reduce a painting to pulp, so the next attempt was with watercolor paper. That also proved to be too thick for the processor blades to handle, even after soaking it for a week, so the pulp idea was abandoned.
The next obvious step was a paper shredder. I started painting sheets of watercolors, but I don't particularly like the medium, so I needed to do more than just shred them. I found braided nylon tubing in 10 foot lengths and started stuffing them with the paper shreds. Despite the finished product's visual predictability, it's actually a long, tedious process to complete. I discovered that the front and back of each page had to be fully painted or the tube would have too much white. It took about 1.6 (11x14) pages per foot of tube and the density of the paper actually had a noticeable effect on the linear footage achieved. In order to avoid jamming, small hand-rolled wads of paper had to be forced into place with a pushrod. And because of the tube's length, the paper had to be inserted from both ends to reach the middle. The overall result, however is extremely benign, especially when left rolled like a common hose.
Noodle Doodles (2012)
After working for so many months without showing an image, it became increasingly difficult to leave a drawing simply as a drawing. A sketch did not feel complete until it was stuffed into an appropriate container. The Noodle Doodles use simple latex tubing to conceal a single page each. The surface of the tubing is very tacky and forcing a rolled piece of paper inside proved challenging. However, this friction also acts as the locking mechanism for these pieces and the corks are merely for visual confirmation. A single brass nail pins the tubes to the wall and the rolled papers actually provide structure and shape in the otherwise floppy latex.
Video: Get a Noodle Doodle tutorial.
The Windsor (2012)
Tubes started showing up in my work in early 2012 for a number of reasons. They provided yet another place to stick art. They have structure. They can bend and hold shape. They come in all sorts of finishes. And they're self-explanatory. No one questions why a tube exists. It must hold or do something.
The Windsor was one of the first tube pieces to stop using fasteners as the closure mechanism. This piece consists of one small oil painting stuffed into a flexible discharge pipe. A small cuff of the pipe was positioned over the seam to lock it into place.
Notebooks (2011)
Alongside the painting explorations, I started going through my other materials, namely notebooks and sketchpads. I was interested in the embodied information inside these compact containers. Some of the books were filled with drawings, others were mainly ideas and philosophy.
There were several approaches to concealing the personal information. I took techniques learned from the canvas pieces and applied them to the new material. Drilling through paper, however, is more difficult than it sounds. The thin paper wants to rip and tear, and also mats into tight wads from the force of the drill bits.
This left the pages disfigured, but not ruined, so there was a level of exposure not present in the rolled canvases. My private ideas and sketches are placed in easily reachable displays, with varying degrees of controls placed around them. Some could be dismantled quickly to see the contents. Others, like the Notebookbox would take a complete destruction of the art object to get to the content inside.
Magazine (2011)
When an oil painting is taken off its support and folded while wet, it ceases to be a one sided painting. The backside of the linen gets paint rubs and the front image loses it visual integrity. If the painting is left to dry while rolled, the paint film is damaged and possibly already cracked. For this piece, I combined that process with a glossy magazine shell for protection and a linchpin to hold it all together. The textural dissonance between the two surfaces and the weight from the linchpin creates an unusual hand feel combined with the visual commonness of a rolled magazine.
Ball (2011)
Ball was worked into place while the paint was still a bit wet and I intended to expose the color from the outset. Rolled paintings are fine, but there is only so much that can be expressed with the backside of primed linen. I had tried to expose images before this piece, but the results were always too decorative. So I decided to use color blocking instead, to render a painting that could be partially shown without telling a story or giving the eye too many distractions.
Book (2011)
Every canvas has a predetermined shape, depending on its original features and the material itself. The folds occur fairly naturally and unless forced, result in an object that is tailored to the painting's intent. For this piece, the bookcase was raided for a pair of old French books whose covers had the same smooth luxuriousness as the folded linen. It feels surprisingly normal to hold, thanks in part to the familiar texture and feel of bound schoolbooks, and the painting sits open on top, to be leafed through like pages.
Roll Cart (2012)
This piece went further than Pipe Cart in terms of the role of the painting. It wasn't structural, it was functional. Roll Cart was originally built to sweep the floor and it worked well. The oil painting would catch all the dirt and dust as it scraped along the floor and the linen took on a great dinginess. The dragging sound was pleasing, the handle allowed a vacuum-like sweeping motion and although the painting was being "destroyed", the net effect was still positive. That, however wasn't good enough, so I decided to take it on the road. We were able to hit a top speed of 25mph and travelled for about a mile. More importantly, Roll Cart handled like a dream.
Video: See Roll Cart get its asphalt badge.
Pipe Cart (2011)
This was the first piece to move beyond simple clamping and its construction greatly shaped my process moving forward. Following the decisions made with the Oil Painting Plus pieces, I gutted my painting back stock, removing unwanted paintings from their stretcher bars to harvest material for new work. Pipe Cart started with three 36x48" Black Line paintings, the original three in fact, and two bed rails. I knew from the OP+ pieces that primed and painted canvas is heavy, stiff and difficult to manipulate, but that also meant that they could be used as supporting members due to their material strength. If you look closely, you will notice that the canvases are actually the structural core of the piece, with support screws running through them both vertically and horizontally. Conversely, the frame is working as a clamp against the canvases to keep them aligned. Aside from some rubber washers, the only visual flourish added is the pipe, which acts as an actual black line to help the eye move over and around the cart.
Video: Watch the Pipe Cart commercial.


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Multitalented Freshman Shows Above-average Enthusiasm
Mary L. Hayes knows to achieve her goals she has to be better than average. The incoming freshman student from Oakland has interests in medicine, law and music as well as entrepreneurial aspirations.
"I want to be something where I can help somebody, and to do that I'll have to know a little more than the average person," she explains. "I know I haven't learned everything, and I never will, but I want to keep learning my whole life."
With her natural hunger for knowledge, Hayes has excelled at Castlemont East Oakland School of the Arts, supported by the devoted grandparents who have brought her up.
"They have supported me all the way, absolutely, in all my endeavors and accomplishments," Hayes says. "They believed me, saw success in me and helped me pursue it."
Among the activities Hayes has pursued is Youth Sounds, which mentors young people recording their musical creations at its Bay Unity Music Project (BUMP) recording label. Hayes is contributing to two albums through BUMP that will be finished in the latter months of this year. She's also picking up entrepreneurial ideas and skills through the project. She hopes to continue working with Youth Sounds on her visits home, but also plans to participate in starting a singing group at UC Merced.
"Merced is just far enough away from home that I can learn and grow independently," she says. "I heard so much about it, and knowing I wanted to develop something of my own, it was my perfect opportunity. I'm going to be a new student, so why not start at a new school?"
Hayes is preparing to arrive on campus this fall by working this summer and pursuing independent scholarship opportunities to supplement the grants and loans she's receiving. Meanwhile, her contagious excitement is building.
"I'm really, really, really excited about meeting all the other people who are trying to learn, like me," she says. "I'll be living on campus, where I can experience more, meet more people and make more friends. I think I'll really get into the atmosphere at UC Merced."

subset: commoncrawl


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Developed by Subcommittee: D04.26 | Committee D04 | Contact Staff Manager
1. Scope
This Standard describes the test method for measuring dynamic modulus of bituminous mixtures using the indirect tension testing method. This method is intended for dense or gap-graded mixtures with nominal maximum aggregate sizes of up to 25mm. It will also be useful for the evaluation of cores of bituminous mixtures collected from the roadway.
Recently, a significant amount of effort has been given to the development of test protocols to determine the dynamic modulus of hot mix asphalt and other bituminous paving materials. This effort has resulted in a test protocol that calls for the use of axial compression. Axial compression testing requires the use of 100mm diameter and 150mm tall specimens. When conducting pavement forensic studies or rehabilitation designs, this sample size can be problematic. This standard will allow the user to generate dynamic modulus data using the indirect tensile (IDT) mode from road cores which are typically less than a 75 mm in height.
KeywordsPhase Angle, Master Curve, shift factor, viscoelastic, axial compression, time-temperature superposition
The title and scope are in draft form and are under development within this ASTM Committee.Back to Top
Date Initiated:
Technical Contact:
Richard Steger
Draft Under Development


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Female X-Men
So, in April, Marvel is relaunching the X-Men series with a new #1 issue and an all-female team of X-Men. Yes! This has the potential to be so, so awesome, and it would be amazing if something like this took off. While the series is still being written and illustrated by men (Brian Wood and Olivier Coipel, respectively), it should prove to be one of the more interesting reboots in the comic world. Even though three of the six ladies in the illustration above may be wearing sexy catsuits, at least half of them have on sensible, ass-kicking outfits. As long as this series doesn't revolve around crying over men, I'm totally on board. (via Wired)—Katie


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Hi! I'm trying to use iTALC 2.0.1 in our classroom. The computers are running with Win7 Enterprise.
Everything works fine except the both demo modes. Although they start correctly, the client screens freeze after some seconds. Not all at the same time. When i turn the demo mode off, the client screens show their desktop again.
Has someone an idea, how i can solve this problem?
Me again. I tried to use iTALC2 in another classroom with different hardware. These PC's are running too with Win7(64bit). I tried iTALC2 64bit and 32bit. The results were always the same.
J.T. Demel
I've same problem here. 12 Clients / 1 Master with Win7 Pro. Everything works fine, except Demo (windowed or fullscreen). There is only a black screen with a sandclock an messages that connection will be establishes on port 11400.
I tried to shutdown firewalls (master/clients) without effect. Also only use demo on one client didn't work.
Any fixes? Ideas?
Kind regards
J.T. Demel
Which Demo Server did you use? You have to take the iTALC Server, not the VPN.
I have the same problem. Can someone fixed it?
THis software is very great! But why we cannot use the demo mode? Have any updates of the ver.2.01?


text:
via TopGear.com:
Every day, something mental happens in Russia. Today is no different.
This is a truck. A big yellow truck. And it's stuck in a river. There's only one way to get it out - floor the blighter. Then continue flooring it until, like the Lady of the Lake offering up Excalibur, it extricates itself in a blaze of damp glory.
(Source: youtube.com)
This is the Hennessey HPE800 Twin Turbo Jeep Grand Cherokee SRT8…
That 800 in the moniker stands, naturally, for how many horses have been strapped under the Santa-spec red bonnet. 805bhp, to be precise, that ride shotgun with 823 torques to give a 0-60mph time of 3.1 seconds. That's fractionally, fractionally faster than a Ferrari 458 Italia. Mr Hennessey tells us it'll do the standing quarter mile in 10.9 seconds, travelling at 130mph.
That massive 6.4-litre V8 gets rebigulated to 7 litres, treated to two turbos and mated to an upgraded transmission and torque converter. It also gets 20in wheels, much leather and Alcantara, a Brembo brake system, lowered sports suspension and a carbon fibre lip spoiler.
Just 24 will be built, with prices starting from £150,000 ($235,000).
Want to learn more about this beast? Visit TopGear.com
Truck. Snow plow. Jackknife. Close call. Very.
via TopGear.com
Yes, Smart has a new line of commercials out and yes, they never went away, but without a new vehicle to show outside of the fortwo, they had pretty much fallen off of our radar. And then there was this:
People of the Web, meet the Smart For-Us. It is a zero-emission, roofless pick-up headed for next year's Detroit motor show, which kicks off on 14 Jan, 2012.
According to Smart's logic, it marries the practicality of a pick-up truck to the 21st century reality of urban traffic. Which means it's a miniaturised carry-all for the city.
At 3547mm long and 1506 wide, it's the same dimensions as a Fiat 500 (but a lot taller), with a cargo area measuring 900mm.
It's a strict two-seater - mimicking a 'hammock-like' feel - and the drivetrain mirrors the ForTwo ED, on sale next year. A magneto-electric motor with 73bhp and 74lb ft powers the For-Us concept, allowing a top speed of 75mph, and an estimated 0-37mph time of around 6.5 seconds.
Not bad, eh? Click through for more info.
When Jeremy, James and Richard had a go at building their own campervans, it didn't go entirely well. There were fires. There were altercations with petrol stations. There were rubbish Bauhaus gardens.
But what if we'd been given a budget of $3,000,000 instead of, well, £3? We may well have come up with this - it's the eleMMent Palazzo. And the roll call of gadgets is rather more attention-grabbing than some MDF and a few lightly soiled sleeping bags. We'll give them that.
Visit TopGear.com for the full story.


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Letters to the Editor
|| Print |
Need revenue? Try a sales tax and 5% cuts
Until the Oregon politicians address the unrealistic PERS payout formula and cut all state expenditures by 5%, Oregon is going to be in bad financial shape [GAME'S UP, November]. The state of Oregon has more government than the population can afford. I fear in 2009 when PERS runs short, as it did previously, the state will quietly bolster it with general obligation bonds.
Support for undies
For years men have wanted us women to wear nice undergarments and we got stuck with them in white jockeys! [THE BOXER REBELLION, December] After spending the summer in Italy, I was amazed by the interest and selection of fine men's boxers. It's about time!
Banking on it
Another choice?
|College Hacker
|Gender Code
|A Good Leap Forward
|Fast Food Slows Down
|A Taste of Heaven
|Tight and Loose
|Startup or Grow Up?
Is your business ready to join us in the call for action? This opening panel includes Oregon businesses who will discuss why they signed the Oregon Climate Declaration, the investments they are making to reduce carbon emissions, and how their actions are affecting their companies.
Get ready for two days of special events produced with the EPA, Portland Timbers and ISOS before and after the GoGreen Conference on October 16.
Bank of America partners with nonprofits to create opportunities for women and drive economic growth.
How one Portland startup tracks devices around the world, making the Internet a safer place for businesses and consumers.
First Call Resolution targets employee well-being and client satisfaction.
The Oregon Entrepreneurs Network (OEN) is pleased to announce 12 finalists—from a record number of 67 nominees—for the 2014 OEN Tom Holce Entrepreneurship Awards
The Oregon Entrepreneurs Network (OEN) is pleased to announce three finalists for the inaugural OEN Game Changer Award.


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Duncan Hines
Decadent Cupcakes
|Nutrition Facts
|Serving Size 1/12 cake mix
|Servings Per Container 12
|Amount Per Serving
|Calories 180
|Calories from Fat 25
|% Daily Value*
|Total Fat 3g
|Saturated Fat 1.5g
|Trans Fat 0g
|Cholesterol 0mg
|Sodium 190mg
|Total Carbohydrate 40g
|Sugars 31g
|Protein <1g
|Vitamin A
|Vitamin C
Cake Mix (Sugar, Enriched Bleached Wheat Flour [Flour, Niacin, Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid], Vegetable Oil Shortening [Palm Oil], Strawberry Flavored Bits [Sugar, Corn Syrup, Corn Cereal, Partially Hydrogenated Vegetable Oil (Cottonseed and/or Soybean), Modified Food Starch, Citric Acid, Natural and Artificial Flavors, Red 40, Blue 2], Leavening [Sodium Bicarbonate, Sodium Aluminum Phosphate, Dicalcium Phosphate, Monocalcium Phosphate]. Contains 2% or less of: Wheat Starch, Emulsifier [Propylene Esters, Mono- and Diglycerides, Sodium Stearoyl Lactylate], Salt, Dextrose, Cellulose Gum, Xanthan Gum, Citric Acid, Natural and Artificial Flavor, Artificial Flavor, colored with [Red 40 Lake]). Frosting Mix (Powdered Sugar [Sugar, Corn Starch], Cream Cheese Powder [Cream Cheese (Cream, Milk, Skim Milk, Whey, Cheese Cultures, Salt, Enzymes), Whey, Natural Flavor, Tocopherols and Ascorbyl Palmitate (to protect flavor)], Natural and Artificial Flavor).
You Will Need: For the Cupcake Pouch: 2 eggs, 3/4 cup water, 1/4 cup oil. For the Frosting Pouch: 2 teaspoons water, 1 stick butter (softened). Cupcake Instructions: 1. Preheat oven to 350F. Line muffin pans with baking cups. 2. Empty contents of large pouch into a large bowl. Blend cake mix, water, oil and eggs in a large bowl at low speed until moistened (about 30 seconds). Beat at medium speed for 2 minutes. Spoon batter evenly into the 12 cupcake liners (approximately 1/2 full). 3. Bake: Bake in center of oven at 350F for 18-23 minutes. Cupcakes are done when toothpick inserted in center comes out clean. Cool 5-10 minutes in pan then remove and place on wire rack to cool completely. Frosting Instructions: 1. Mix softened butter with electric mixer on high for 1 minute or until light and fluffy. Scrape. Slowly add frosting mix to butter while mixing on low speed for an additional 1 minute. Scrape. Add water. Start mixing on low. As frosting starts to come together, gradually increase speed to high. This step may take up to 3 minutes. Mix on high for an additional 3 minutes. 2. Fill provided pastry bag with frosting (place bag in tall glass to make filling with frosting easier). Cut approx. 1/2 inch from the tip of the pastry bag. Insert cut pastry bag into top of cupcake and squeeze gently to fill cupcake with approx. 1 tablespoon of frosting. Slowly remove pastry bag and swirl approx. 1 tablespoon of frosting on top. For an even richer cream cheese flavor replace 1 stick of butter with 2 ounces brick cream cheese and 4 tablespoons butter. Mix as directed. 9-Inch Round Cake: Preheat oven to 350F. Grease sides and bottom of pan with shortening or oil spray. Flour lightly. Mix as directed. Bake at 350F for 32-37 minutes. High Altitude (over 3,500 ft.): Cupcakes: Preheat oven to 350F. Stir 1 tablespoon flour into mix. Mix as directed. Bake at 350F for 18-23 minutes. 9-Inch Round Cake: Preheat oven to 350F. Grease sides and bottom of pan with shortening or oil spray. Flour lightly. Stir 1 tablespoon flour into mix. Mix as directed. Bake at 350F for 28-33 minutes.


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The provisional programme for the 4th Workshop of Experimental Philosophy Group UK is now available on our website: http://sites.google.com/site/experimentalphilosophygroupuk/fourth-workshop
There are also a few Analysis Trust student bursaries available - these offer up to 50% of the cost of registration and accommodation. Email firstname.lastname@example.com, giving your name, affiliation and the cost of your accommodation, and register here: http://shop.bris.ac.uk/browse/product.asp?compid=1&modid=1&catid=661 to apply for a bursary.
Registration will close on 5 September at the latest.
This event is a BIRTHA Conference, and we are grateful to the University of Bristol, the Mind Association and the Analysis Trust for their support.


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Lady Gaga had Little Monsters on Facebook doing a double take this weekend with a sexy bedtime selfie that could have passed for the late Amy Winehouse.
Gaga fans immediately noticed the resemblance, which was not mentioned by Gaga, pointing out the comparison in the comments time and again.
"Off to Australia. Will be dreaming of my Aussie Monsters," wrote Gaga, with black hair and wing-tipped eyeliner nearly identical to Winehouse's signature look.
The Lady is currently in the middle of her artRAVE: The ARTPOP Ball tour, and is next scheduled to make six stops in Australia starting August 20.
At 28, she has already lived a woman she once called her inspiration.
Amy Winehouse died at age 27 in July of 2011 due to extreme alcohol intoxication after years of drug and alcohol abuse and ending a promising career.


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HEIDELBERG TOWNSHIP, YORK COUNTY—A man who had to fight to survive is now fighting for a cause.
George Bollinger from Heidelberg Township in York County waited two years for a liver transplant after being diagnosed with Primary Sclerosing Cholangitis, a chronic liver disease.
He soon after was diagnosed with bile duct cancer that made having a transplant impossible for him.
George and his wife managed to find a doctor in Minneapolis that would treat his cancer with radiation and prepare his body for a transplant.
It took two years and a half before he got the call.
"Did a lot of praying and the next day I got a call that a liver was available," said George Bollinger.
He said had it not been for a 25-year-old South Dakota woman, who died in a motorcycle accident and donated her lungs, he may not be here today.
Now he's back on his mountain bike and riding 60 miles to raise awareness for organ donation.
He will make the trip with his organ coordinator in Minneapolis.
"People waiting on transplants can say here's a guy 7 years out and look wants he's doing, it's just to give them hope," he said.
"He's an amazing person, really he's an amazing person," said his wife, Carla.
To find out more about organ donation, visit these helpful sites:


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Drake - 9 AM in Dallas
Artist: Drake
Producer: Boi-1da
Album: Thank Me Later [iTunes Bonus Track]
Avg Rating: 4.0 ( 75 total votes )
Dedicated Drake lovers (Drakeonians? Drizzyites? Aubrey's Army?) undoubtedly copped Drake's lyrical exploration 9 AM in Dallas when it leaked to the interweb a couple weeks ago, but now that the track has resurfaced in mastered form as a Thank Me Later iTunes bonus track, we thought Booth nation at large would enjoy hearing Drake in pure rap mode (or at least enjoy tearing the track apart – hi haters). Produced by my new favorite beatsmith Boi-1da, who overlays a grinding, electronic base with an angelic choir, 9 AM is first and foremost bulletin board material as Drake drops line after line sure to be obsessed over for at least the next couple days: "People say that old Drake, we started to miss it / you need to be a little more specific / is this what y'all want?" Well? Is it? We'll begin to finally find out if Drake's dream of crafting a platinum-selling album will come true when Thank Me Later finally officially drops tomorrow, June 15. March on Aubrey's Army, march on.
Listen to More: Drake
Written by Nathan S. on 06/14/10
YMCMB/Universal Motown
First DJ Booth Appearance:
"Brand New (Remix) ft. Lil' Wayne" (2008)
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Sign up for Yardbarker's daily Top 10 newsletter, the Morning Bark! Customize to get news on your favorite sports and teams.
Found February 17, 2013 on Celtics Life:
PLAYERS: Paul Pierce, Rajon Rondo
TEAMS: Boston Celtics
TEAMS: Boston Celtics
Before Rajon Rondo was lost for the season he was dominating the NBA in triple doubles, with 5 (no other Celtic had any). Since Rondo's been gone Paul Pierce has taken over that role by recording 2 triple doubles of his own (the only player in the NBA with more than one in that time span), which puts him tied for second in the league on the season behind Rondo. Over the 38 games that Rondo played this year, amazingly he led the Celtics in both assists and rebounds in 9 of them (no other Celtic did once). But in Rondo's absence Pierce has now accomplished that same feat 3 times in 9 games (he's also led Boston in assists alone on 7 of 9 occasions). When Rondo's injury occurred Pierce was averaging 18.8 points, 5.7 rebounds, and 3.8 assists per game. Since? 17 points, 9.4 rebounds, and 7.2 assists. Halfway through his 15th NBA season, at 35 years of age, the Celtics #2 all-time scorer has dramatically changed his game in order to make up for the loss of his ...
Original Story: http://www.celticslife.com/2013/02/pa...
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Frustrated with the dark circles and hollows under my eyes
- Ray1982
- Australia
- 4 years ago
I'm 27 and feel abit insecure about the way dark circles and hollows under my eye look. I always get comments like you never sleep. I care about my body and always get 9 hours sleep a day.
I was wondering what type of surgery or fillers I should consider?. What causes this type of problem ? I am only looking for improvements and have a realistic expectation. Need help.
View 7 doctor answers to Under Eye Hollowing and Dark Circles Recommendation?
Comments (2)
Hi! I just had bleph on my upper lids (one super droopy eyelid before), face and neck lift and am ecstatic with the results. I only have one nagging thing left that bugs me and has for years. I have no fat under my eyes and so they always look dark. Concealer is my best friend! I've read too much here about fat injections and have decided it's not worth the risk. I would rather keep Laura Mercier in business! Besides major surgery (I've had mine and I'm good!), is there any help for my dark under eyes?
- Reply
I have had dark circles all of my life and I am looking for permanent solutions on getting rid of them. Even though I'm only 18 years old I have very little fat underneath my eye naturally and they always have a very purple color to them. As you can see in the pictures included, my eyes are very sunken in. What surgical procedures can I look into that can significantly improve my dark circles? Also, I have been using a lightening cream underneath the eyes. Will this help at all?
- Reply


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All posts tagged symptoms
O'Donnell to women: 'You're worth it, take care of yourself and know the symptoms' of heart disease
In retrospect, Rosie O'Donnell realizes she put herself at risk of heart disease. She was very overweight at 220 pounds, and admittedly "was not exercising at all." Plus, she had a strong family history of heart disease. Even when symptoms …
SimpleScience@Heart: After ER visit for chest pain, trip to heart doctor may save your life
A lot of folks treated for chest pain in emergency rooms don't follow up with a heart doctor — possibly increasing their chance of dying. That's the finding in
Keep Heart Safe In The Heat!
As we head into this holiday weekend which is the official start of the summer, it's important to keep your heart safe while exercising or participating in any
Simple Science @Heart: Worst headache of your life could be a stroke — get to the ER!
A sudden, severe headache — so powerful it's like a thunderclap inside your head — is a classic symptom of a less common type of stroke. Aneurysmal subarachnoid hemorrhage


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This week's Agent Spotlight features Sarah LaPolla of Curtis Brown, Ltd.
About: "Sarah LaPolla began at Curtis Brown in 2008, working with Dave Barbor and Peter Ginsberg. Sarah is interested in literary fiction, narrative nonfiction, urban fantasy, paranormal romance, science fiction, literary horror, and young adult fiction. She loves complex characters, coming-of-age stories, and strong narrators. Sarah graduated from Ithaca College with a degree in Writing and English, and went on to receive her MFA in Creative Writing from The New School. She is always on the lookout for debut authors and welcomes email submissions at [see website]." (Link)
Status: Accepting submissions, actively building her client list.
What She's Looking For:
General fiction, literary fiction, narrative nonfiction, memoir, pop culture, urban fantasy, paranormal romance, mystery, fantasy, science fiction, literary horror, magic realism, young adult fiction. (Link)
From an Interview (04/2011):
"I really want to see more horror, dark mystery, and fairytales (fractured or otherwise) for YA. Dark mysteries for adult would be great too. Also, adult dystopian, as long as it's original in execution." (Link)
Related to the above:
"I want horror too. Like HOLY-CRAP-SCARY horror. No more demons/ghosts w/ hearts of gold. They should want to kill the MC." (Link)
"I've always been a huge fan of fairytales, the more fractured the better. They are strange and fantastic and wonderful, and the real, folklore kind are dark." (Link)
From an Interview (01/2011):
"I do still like witches, aliens, ghosts, and (if you follow me on Twitter, you know this) centaurs! (Seriously, it doesn't have to be the main character; just plop one in your next fantasy submission.) Of course, you need a solid plot to back up these characters, no matter what."
"I get a lot of queries for 'magical realism,' but they always turn out to be fantasy. So, I wish I got more magical realism. I'd also like to see more horror and mystery, both on the literary side, for YA and adult. A great YA or MG ghost story that's scary instead of romantic would be fabulous." (Link)
From an Interview (06/2010):
"My favorite type of YA is for older teens, or anything that can have crossover appeal. I like urban fantasy and paranormal lit, but I'd also love to see a return of realistic fiction. Usually what hooks me in YA is a strong narrator. That's true for my adult preferences too, but I think it's even more important in YA to have a voice that readers can connect with." (Link)
From an Interview (05/2010):
"I'm looking for literary fiction, young adult, urban fantasy, narrative nonfiction, and anything that can be called quirky, speculative, or magical realism.
"I would love to see some strong female protagonists, especially in YA. I also look for multi-faceted characters. I like being surprised by the people I'm reading about." (Link)
What She Isn't Looking For:
"Vampires! Werewolves! Angels! Zombies! No more please. Some creatures are still OK, but I need an indefinite break from those others." (Link)
"On the 'less of' side, I am still getting vampire queries, so that makes me cringe. Anything with 'creatures of the night' I stay away from. I also steer clear of anything labeled 'women's fiction,' which for some reason I get a lot of. Anything written with the intention of excluding half your audience not only makes little sense, but usually ends up being rife with gender stereotypes." (Link)
"I'd like to add gods and other forms of shapeshifters to the list of non-humans I don't want to see anymore too. I just have no interest." (Link)
"I send instant form rejections to picture book, chapter book, self-help, general nonfiction, and traditional romance queries. I will never have an interest in those genres." (Link)
About the Agency:
"Curtis Brown currently employs 32 people in our New York and San Francisco offices. Since its inception, the agency has handled more than 50,000 contracts. Our clients include many bestselling authors, award winners, and some of the leading minds and voices in the world. Curtis Brown boasts innovative and successful film and foreign rights departments, and is one of the few literary agencies that handle ancillary rights in-house, providing a motivated team working on our clients' behalf across all platforms. We are well positioned to take advantage of the new opportunities afforded by technological innovations, and we are aggressive in achieving the best possible terms for our clients. With the media industries constantly changing, Curtis Brown continues to evolve and excel while maintaining its commitment to the principles that have made it a key player in the publishing and entertainment world for nearly a century." (Link)
"Do your research. There are a million blogs, guides, and websites devoted to how to query and who to query. Choose an agent who represents your genre. The other key thing to remember is to not get discouraged. Rejection is a huge part of publishing. It's practically a rite of passage. Embrace it, move on, and keep looking for someone who loves your project as much as it should be loved!" (Link)
"Maybe it's my background in being around aspiring writers, but I love supporting debut authors. I think the most satisfying part of my job is being able to tell a writer that someone is going to publish her book. This is exciting for any author, but everything is so fresh and new for debut authors. It makes it more special that way. Plus, debut writers have the advantage of offering a fresh voice. People get excited to hear something new." (Link)
Editorial Agent?
"I'd want a writer whose work I am in love with and who will be in it for the long hull. I also like to be a part of the editorial process, so it's important for me to have mutual trust and respect in our relationship. So far, I've been lucky." (Link)
Dislikes (Don'ts):
"Improper grammar and misspelled words are huge pet peeves. Seeing mistakes like that make me question the person's ability as a writer." (Link)
"It bothers me when it is very clear the writer has done no research whatsoever before querying me. Another pet peeve is when authors compare their books, whether for better or worse, to other popular novels. I've been getting a lot of Twilight-meets-blank lately and then realize that the only thing remotely close to Twilight in the book is that a vampire shows up. I want writers to be able to describe their work without relying on anything else other than their own story." (Link)
"Cliched phrases! I've also been noticing the word 'ravenous' a lot in fiction lately, so I'm adding that to my 'cliched words' list. I'm also tired of lame female characters, especially in YA. I don't want to see any more female protagonists who don't really come alive until some boy - be it a vampire, werewolf, zombie, or human - enters her life andthensuddenlyeverythingchanges! It's upsetting, and insulting, and needs to end." (Link)
Feliza-Rose David, Nathan Graziano, Pam Harris, AJ Larrieu, Shana Silver, K. M. Walton, among others.
As 04/11, Ms. LaPolla is listed on Publisher's Marketplace as having made 1 deal in the last 12 months and 1 overall. Recent deals include 1 contemporary young adult.
NOTE: PM is usually not a complete representation of sales.
Query Methods:
E-mail: Yes (preferred).
Snail-Mail: Yes.
Online-Form: No.
Submission Guidelines (always verify):
"Please paste your query letter and the first five pages of your project into the the body of the email. No attachments." (Link)
See Ms. LaPolla's Publisher's Marketplace page and the Curtis Brown website for complete, up-to-date submission guidelines.
Query Tips:
"Be succinct and get to the point. Before I even read a query, if I see it is only two or three paragraphs, I am already relieved. And if the first paragraph is a three to five sentence plot overview, even better. All I do is search for that anyway, so you might as well put it up front." (Link)
"Honestly, I gloss over a synopsis. It is never a deciding factor for me. If I'm hooked by the query, I'll go straight to the sample pages and decide whether to request the manuscript from there." (Link)
"Query Tip: Try not to refer to people w/ more commercial taste as 'low class readers.' It does not sound the way you think it sounds." (Link)
"The only time I delete something without reading it is if the query letter is sent as an attachment. Everything else, I send at least a form rejection." (Link)
Response Times:
Ms. LaPolla's response time on queries seems to range from minutes to a week or two. Requested material usually gets a response within days to a couple months.
Web Presence:
What's the Buzz?
Fabulous so far! Sarah LaPolla became an agent at the highly respected Curtis Brown agency around April of 2010. She's made at least one sale in her first year as an agent and is actively building her client list.
I recommend following Ms. LaPolla on Twitter @SarahLaPolla and subscribing to her blog, Glass Cases.
Worth Your Time:
Interview with Sarah LaPolla of Curtis Brown at Janet Sumner Johnson's blog (04/2011).
Agent Interview: Sarah LaPolla at Y(A)? Cuz We Write (01/2011).
20 Questions Answered by Sarah LaPolla of Curtis Brown, Ltd. at WOW (02/2011).
Agent Pitch Contest (includes a mini interview with Ms. LaPolla) at Market My Words (09/2010).
Agent Advice Interview with Sarah LaPolla at Guide To Literary Agents (08/2010).
Interview with Literary Agent Sarah LaPolla at Blame It On the Muse (06/2010).
Agent Interview: Sarah LaPolla at Ramblings of a Drifting Mind (06/2010).
Interview with an Agent: Sarah LaPolla at Mother. Write. (Repeat.) (05/2010).
Publishing Interviews: Sarah LaPolla, Curtis Brown at YA Highway (04/2010).
Selected Blog Posts:
Pitches and Strikes (01/2011).
You Are Not Original (and that's OK) (01/2011).
Crossing Over with YA (01/2011).
The Obvious Symbolism Police (11/2010).
Lessons from Peggy Olson (10/2010).
Write a Paranormal Bestseller W/out the Paranormal (09/2010).
Voice, Balance, & How to Avoid Mary Sues (08/2010).
Age Ain't Nothin' But a Number (07/2010).
It's Not Me, It's You (Or, My Breakup With Vampires) (06/2010).
Dear Sir or Madam (06/2010).
Around the Web:
Curtis Brown, Ltd thread on AbsoluteWrite.
Curtis Brown, Ltd at P&E ($, Recommended).
Client Feliza-Rose David's query that gained her representation with Ms. LaPolla.
Please see the Curtis Brown website for contact and query information.
Profile Details:
Last updated: 4/07/11
Agent Contacted For Review? Yes
Last Reviewed By Agent? 4/07/11
Have any experience with this agent? See something that needs updating? Please leave a comment or e-mail me at agentspotlight(at)gmail(dot)com
Note: These agent profiles presently focus on agents who accept children's fiction. They are not interviews. Please take the time to verify anything you might use here before querying an agent. The information found herein is subject to change.


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Is CP/CPPS an Infectious Disease?
J. Curtis Nickel, MD, Queen's University, Kingston, Ontario
[Infect Urol 13(2):31-38, 2000.]
Chronic prostatitis is a common clinical entity. The only known etiology is related to microbial infection of the prostate gland. The majority of patients with chronic prostatitis are treated with long courses of multiple antibiotics, despite conflicting culture results (if cultures are done at all). Have we established the role of microorganisms in this disease entity? Historically, it was believed that all cases of prostatitis were related to bacterial infection. Traditional dogma states that only a small percentage of patients have prostatitis with a bacterial etiology, while basic and clinical research reported over the last 3 decades can be used to substantiate claims that either all or none of these conditions are related to microbial infection of the prostate. Is prostatitis an infectious disease?
Is chronic prostatitis an infectious disease? There is no doubt that prostatitis is a commonly diagnosed disease. Prostatitis results in more than 2 million office visits per year: 8% of total urologic visits and 1% of family physician visits.[1] Its prevalence among men at risk is believed to be between 5% and 8%.[2,3] Despite negative bacterial cultures (and in many cases no cultures at all), the majority of patients are treated with antibiotics.[1,4,5] There is no doubt that acute bacterial prostatitis is a bacterial infection of the lower male urinary tract.[6] There has never been an established relationship between acute bacterial prostatitis and the chronic form of the diagnosed syndrome. There is also no doubt that uropathogenic bacteria can be cultured in the rare patient with a chronic prostatitis syndrome. Many researchers feel that the majority of patients with prostatitis do, in fact, have a microbial etiology for their disease, but that we are just not culturing the correct organism. Others feel that the majority of cases of prostatitis, especially those in patients with no demonstrable inflammation, do not have a microbial etiology. To complicate things further, many asymptomatic patients in whom a diagnosis of chronic prostatitis has not been made have had both inflammation and microorganisms identified in prostate-specific specimens.
This confusion has led to the development of a new classification system by the NIH workshop on chronic prostatitis that was convened in Bethesda, Md, in 1995 (Table 1).[7] This new classification recognizes that, for the majority of patients, we do not really know if they have an infectious basis for their symptoms. The majority of patients with this syndrome would be classified as having chronic pelvic pain syndrome. These patients complain of genitourinary pain with variable voiding and sexual dysfunction problems and have no uropathogenic organisms cultured or identified on prostate specimens employing standard or traditional techniques. This classification is further divided into inflammatory and noninflammatory categories, based on the presence or absence of inflammatory cells in the prostate-specific specimens. The classification also identifies a category of asymptomatic prostatitis: inflammation and/or microorganisms identified in prostate-specific specimens, including biopsy, in asymptomatic men who would not have a diagnosis of prostatitis. Three years later, the International Prostatitis Collaborative Network, which met in Bethesda in November 1998,[8] confirmed the usefulness of this classification system in scientific studies and clinical use. The question remains, however: Is chronic prostatitis an infectious disease?
An Historical Perspective: Prostatitis as an Infectious Disease
In the late 1800s, many investigators were studying bacteria within the normal and infected urethra, and it was generally recognized that bacteria normally inhabit the urethra in both health and disease. It was recognized early on that gonococci associated with urethritis could also be present in prostatitis.[9] The first definitive microscopic analyses of prostatic fluid were being performed by 1906,[10] and cultures of prostatic fluid from patients with prostatitis were being done by 1913.[11] In 1926, Nickel[12] focused attention on the important role of bacteria found in various focal infections, including those of the prostate gland, and in chronic inflammatory processes. Causal relationships between the organisms and the inflammatory lesions produced were established by isolation of bacteria from the lesions, whereas the blood and other tissues proved sterile. This was an important observation at the time and led Nickel,[12] Von Lackum,[13,14] and others to study bacterial localization in chronic prostatitis.
In a landmark 1930 study, Nickel[15] described the results of 3,500 cultures of prostate glands and seminal vesicles obtained from patients who had some ailment that might be attributable to prostatitis. He also examined 100 cultures of tissue from the prostate glands of healthy males. The majority of cultures grew streptococci, staphylococci, bacilli, and diphtheroid organisms. These findings were confirmed by studies previously reported by Von Lackum[13] in 1927. In elaborate microbiologic analyses, other investigators identified Staphylococcus as the most important causative organism.[16] By the mid-1940s, it was generally accepted that prostatitis was an infectious disease.[17,18] However, by the 1950s, doubts and controversy erupted about the significance of leukocytes and bacteria in the prostate secretions.[19,20] It was becoming generally recognized that perhaps inflammation of the prostatic parenchyma may exist as a nonbacterial congested process.[21]
In the 1960s, many investigators found it difficult to correlate evidence for infection with chronic symptomatology. In 1968, Meares and Stamey[22] published their landmark paper in Investigative Urology and heralded what was thought to be a new age for the understanding of the prostatitis syndrome. These authors concluded that chronic bacterial prostatitis was rare and could only be diagnosed when uropathogenic bacteria were identified in greater numbers in the prostate-specific specimens (expressed prostatic secretion [EPS] or urine obtained after prostatic massage) than in cultures of urine from an initial stream and midstream. It is interesting to note that this conclusion was based solely on longitudinal studies of the bacteria localization patterns in only four patients with chronic prostatitis.[22,23] This concept was not really challenged for almost 3 decades.
Traditional Urologic Dogma: Some Chronic Prostatitis Is an Infectious Disease and Some Is Not an Infectious Disease
Historically, prostatitis has been classified into four clinical entities:
Acute bacterial prostatitis.
Chronic bacterial prostatitis.
Nonbacterial or abacterial prostatitis.
Traditional dogma accepts that the first three types of prostatitis have an inflammatory origin, the first two have an infectious microbiologic origin, and the fourth (prostatodynia), despite similar clinical symptoms, is neither related to inflammation nor infection. The distinction between a so-called noninfectious abacterial prostatitis and noninflammatory, noninfectious prostatodynia was based on a belief that men with prostatic inflammation would demonstrate microscopic findings in the EPS with numerous leukocytes (and perhaps lipid-laden macrophages), whereas healthy men would not show this finding. However, no clinician or researcher was sure of what cutoff for white blood cells per high-power field should be suggested for inflammatory disease versus noninflammatory diease.[25,26]
The traditional category of chronic bacterial prostatitis is much easier to accept. For patients in this category, the most important clue is a history of recurrent urinary tract infections (UTIs) with variable symptoms between these symptomatic infections. These patients traditionally show leukocytosis and uropathogenic bacteria in the EPS. In one of the largest recent prospective studies, Weidner and colleagues[27] found significant bacteria counts in prostate specimens in 4.4% of patients with symptoms of chronic prostatitis. Most researchers accept the finding that chronic bacterial prostatitis (prostatitis as an infectious disease) is an important but uncommon disease. The most common causes of bacterial prostatitis are gram-negative pathogens, predominantly strains of Escherichia coli that have been identified in 65% to 80% of infections.[27,28] Pseudomonas aeruginosa, Serratia species, Klebsiella species, and Enterobacter species are identified in the remainder. Although infections are commonly caused by a single organism, there have been reports of infections caused by up to four pathogens at the same time.[29] Traditional dogma states that most gram-positive bacteria identified in prostate-specific secretions do not represent pathogens that cause bacterial prostatitis,[30] whereas enterococci are accepted by many as a cause of bacterial prostatitis[31] and the UTIs associated with it. The traditional dogma is that Staphylococcus saprophyticus, Staphylococcus epidermidis, hemolytic streptococci, diphtheroids, Mycobacterium, and Chlamydia are doubtful candidates for causative agents.[26,32] Many researchers, however, remain unsure about the role of these organisms.[33-35]
If the majority of patients presenting with a chronic prostatitis syndrome do not have a microbiologic etiology for their disease, what is the cause of the patient's symptoms and/or inflammation? The following are various hypotheses put forward by researchers over the last several decades to explain the etiology and pathogenesis of this large group:
Dysfunctional high pressure voiding[36-41] plus or minus intraprostatic ductal reflux.[36,37,42]
Autoimmune or immunologic pathogenesis.[43-45]
Chemical problems.[46]
Neuromuscular problems.[47-49]
The Case for Chronic Prostatitis: An Infectious Disease
A number of related and unrelated clinical and research observations provide empiric support for the concept that all or at least the majority of patients with prostatitis may have a microbiologic cause for their syndrome.
The pattern of practice in North America is to treat patients presenting with chronic prostatitis with antibiotics.[1,4,5] This practice continues despite the fact that almost all standard localization cultures are negative (in most cases, cultures are never formally performed). The reason for this therapeutic paradox must be that the average practicing clinician feels that any antimicrobial therapy benefits many patients with prostatitis. In fact, clinical trials tend to confirm that as many patients with demonstrable infection (ie, chronic bacterial prostatitis) as without respond to antibiotics.[50] The successful culture of microorganisms in prostate-specific specimens is complicated by the presence of inhibitory substances known to exist in prostate secretions[51] and by the history in most patients of multiple previous courses of antibiotics.[50] Then there is the almost insurmountable problem of interpreting the microbiologic findings of EPS and semen in the presence of contaminating, indigenous flora of the urethra. The prostate-specific specimen, EPS, ejaculate, and postprostatic-massage urine must be cultured after passage through the contaminated urethra.
Repetitive prostate massage, the traditional and standard therapy for prostatitis for decades (abandoned after 1968), has become repopularized. This is, in part, because of the failure of traditional medical therapy to improve the symptoms of most patients with prostatitis, but also because of a belief that chronic bacterial infection exists in the prostate gland in blocked ducts or microabscesses.[52] In fact, more bacteria are identified in specimens of prostatic fluid expressed after repetitive prostate massage than are identified in an initial single localization study.[53]
Gram-positive organisms, particularly gram-positive cocci, are identified in prostate-specific specimens in patients with prostatitis syndromes. Traditionalists will argue that these patients usually do not have a history or documentation of bladder infection with these organisms. It is also argued that these organisms are picked up as prostatic fluid passes through the urethra. The significance of gram-positive cocci in patients with chronic prostatitis has been debated for most of the 20th century. As described above, gram-positive cocci were accepted as etiologic agents for most of the century. However, over the last 3 decades, the consensus was that these organisms are seldom, if ever, causative. However, it is now generally agreed that Enterococcus faecalis may cause chronic bacterial prostatitis and related recurrent enterococcal bacteriuria.[31,33] In our 1992 study,[54] we isolated coagulase-negative bacteria in cultures of EPS as well as identified similar organisms in sparse and focal microcolonies in prostate biopsy specimens. Others have also implicated coagulase-negative Staphylococcus in this disease.[55,56]
Chlamydia trachomatis has been identified as a possible causative agent in many cases of chronic prostatitis, yet the evidence is confusing. Mardh and Colleen[57] found that one third of men with chronic prostatitis had antibodies to C trachomatis, compared with 3% of controls. Shortliffe and associates[58] found that 20% of patients with nonbacterial prostatitis had antichlamydial antibody titers in the prostatic fluid. Bruce and co-workers[59] found that 56% of patients with subacute or chronic prostatitis were infected with C trachomatis (identified from early morning urine, prostatic fluid, or semen). In a follow-up study, Bruce and Reid[60] found that 6 of 55 men with abacterial prostatitis, including 31 believed to have chlamydial prostatitis, met strict criteria for positive diagnosis of chlamydial prostatitis based on identification of the organisms by culture or immunofluorescence. Kuroda and colleagues[61] identified C trachomatis in the urethras of 20% of men with prostatitis.
Other investigators have reached similar conclusions.[62,63] Poletti and associates[64] isolated C trachomatis from prostate cells obtained by transrectal aspiration biopsy of the prostates of men with nonacute abacterial prostatitis. Abdelatif and co-workers[65] identified intracellular Chlamydia employing in situ hybridization techniques in transurethral prostate chips from 30% of men with histologic evidence of chronic abacterial prostatitis. Shurbaji and associates[66] identified C trachomatis in paraffin-embedded sections from 31% of men with histologic evidence of prostatitis, compared with none of patients with benign prostatic hyperplasia (BPH) without inflammation. Koroku and colleagues[67] detected C trachomatis- specific IgA in 29% of men with chronic nonbacterial prostatitis. All these studies suggest that Chlamydia may invade the prostate, that chlamydial antigen can be detectable in prostate-specific specimens, and that the presence of Chlamydia may be related to the development of chronic prostatitis.
Many investigators have suggested that Ureaplasma urealyticum may be an important cause of chronic prostatitis. Weidner and associates[68] found high U urealyticum concentration in prostate-specific specimens in patients with signs and symptoms of abacterial prostatitis. Fish and Danziger[69] found significant U urealyticum concentrations in 13% of patients with prostatitis. Treatment with specific antimicrobial therapy cleared the organisms in all cases and resolved the symptoms of prostatitis in 75%. Isaacs[70] cultured U urealyticum from prostate secretions in 8% of patients with chronic nonbacterial prostatitis.
A number of observations support an association between Trichomonas vaginalis and prostatitis.[71-74] In one study, the prevalence of Trichomonas exceeded 85% in men who had symptoms of prostatitis that persisted despite their receiving antibacterial therapy.[75]
Anaerobic bacteria,[76] yeast such as Candida,[77-79] and viruses[80,81] have also been implicated in prostatic inflammation. Similarly, diphtheroids and Corynebacterium species,[82,83] usually acknowledged as prostate nonpathogens, have also been suggested as potential etiologic agents in this disease. Domingue and colleagues[82] suggest that the difficult-to-culture coryneforms could be missed by routine culture of EPS. Direct Gram's staining of the EPS showed gram-variable pleomorphic coccobacillary rods that do not grow on routine media. The presence of these pleomorphic swollen rods was also shown by fluorescent acridine orange staining. Biochemical identification of these organisms indicated two different species of Corynebacterium. Employing an rRNA-based molecular phylogenetic approach to the identification of bacteria in prostatic fluids from patients with prostatitis, Tanner and co-workers[84] noted positive bacterial signals, primarily related to Corynebacterium, in 65%. We may also not be culturing the bacteria because cell wall-deficient microorganisms[85] may be implicated in this disease.
It has also been suggested that we may not be growing the bacteria because they exist in aggregated "biofilms" adherent to the prostatic ductal walls or within obstructed ducts in the prostate.[86,87] Nickel and Costerton[86] reported that 60% of patients with previously diagnosed chronic bacterial prostatitis who progressed to having sterile EPS cultures but had continued symptoms despite antimicrobial therapy had positive cultures (similar to the initial organism) from prostate biopsy specimens. Berger and associates[88] cultured urethral, urine, and transperineal prostate biopsy specimens specifically for commensal and fastidious organisms. These investigators demonstrated that men with EPS indicating inflammation were more likely to have bacterial isolation, positive cultures for anaerobic bacteria, higher total bacteria counts, and more bacterial species isolated in prostate biopsy cultures than men without EPS indicating inflammation. These observations support the concept of bacterial colonization/invasion of the prostate and may be associated with negative EPS cultures.
Krieger and co-workers[89] used a combination of clinical, culture, and molecular biologic methods (polymerase chain reaction [PCR]) to evaluate a well-defined population of men with chronic idiopathic prostatitis. Prostate biopsy tissue was obtained using a double-needle technique to limit potential contamination and evaluated using PCRs for C trachomatis, T vaginalis, Mycoplasma, herpes simplex viruses, and cytomegaloviruses, as well as broad-spectrum PCRs for both tetracycline-resistant and 16S rRNA. Of the 135 subjects this group evaluated, 8% had positive PCR assays for one or more specific microorganisms. The broad-spectrum PCRs demonstrated tetracycline-resistant and coding sequences in 25% of subjects and 16S rRNAs in 77% of the patients.
The results of these two PCR techniques were highly correlated. The investigators also found a strong correlation between inflammation and EPS and detection of 16S rRNA and prostate tissue. These findings further suggest that the fastidious and nonculturable microorganisms might be important in the etiology of chronic inflammatory prostatitis.
It has been estimated that less than 10% of all environmental bacteria have been identified, so it is inevitable that we have not yet identified potential prostate-specific pathogens.[85] The evidence presented here strongly suggests that chronic idiopathic prostatitis may in many, most, or even all cases represent an infectious disease (Table II).
The Case for Chronic Prostatitis: Not an Infectious Disease
While much of the evidence discussed in the previous section is provocative and certainly can lead one to the conclusion that prostatitis is an infectious disease, substantial evidence exists that points to exactly the opposite conclusion: prostatitis is not an infectious disease.
Numerous studies have pointed out that antibiotic therapy for prostatitis associated with a cultured uropathogen produces dismal long-term results.[50] Although eradication of bacteria is successful in 40% to 80% of cases, the long-term resolution of symptoms and the effect on long-term relapse rates is questionable (in most cases, unknown). In fact, numerous studies have demonstrated that patients with chronic nonbacterial prostatitis have the same symptom improvement rate as those patients treated for cultured pathogens (ie, chronic bacterial prostatitis).[50,90] It could be suggested that this response rate of 30% to 40% in both categories may represent the placebo response, such as seen in other benign prostatic diseases.[91]
Most patients with a diagnosis of chronic bacterial prostatitis have a history of recurrent bacterial cystitis.[92-94] However, these patients are usually asymptomatic between episodes of UTIs. During UTIs, cystitis can be cleared with an antibiotic such as nitrofurantoin, and the bacteria will be cultured subsequently in prostate-specific specimens. In patients who are not suffering from an acute UTI episode, the bacteria can also be cultured from the prostate-specific specimens. The inference, then, is that the bacteria associated with chronic bacterial prostatitis persist in the prostate gland without producing symptoms and really only act as a reservoir for recurrent lower UTIs in the bladder. The majority (95% at least) of patients with prostatitis syndrome do not have uropathogenic bacteria localized to their prostate-specific specimens, nor do they suffer from recurrent lower UTIs.
In the previous section, evidence that a variety of microorganisms might be implicated in prostatitis was presented. The other conclusion that can be drawn from the same data is that these organisms are indeed present in the prostate gland in patients with prostatitis but that they might just be innocent bystanders. Perhaps control patients without evidence of prostatitis also have similar colonization of the prostate gland. There might indeed be a normal flora (as there is in the urethra) within the prostate gland. Is there any evidence to suggest this?
Histologic evidence of prostatic inflammation is often present in biopsy, surgical, or autopsy material. Inflammation in autopsy series is reported between 5% and 15% in patients over 60 years of age,[95] while McNeal[96] found inflammation in 44% of sampled adult prostates obtained at autopsy. Evidence of prostatic inflammation was noted in 45% of aspiration biopsy specimens taken because of suspicion of carcinoma.[97] Kohnen and Drach[98] discovered that up to 98% of surgically resected prostates removed for BPH contained at least some foci of significant prostatic inflammation. This finding has been confirmed by other researchers.[99] Bacteria, uropathogenic or otherwise, have also been documented in BPH without symptoms of prostatitis. Gorelick and associates[100] discovered that 21% of patients undergoing prostatectomy yielded positive, single-organism bacterial growth in prostate tissue. In a study recently completed in our institution, we noted that 100% of specimens demonstrated some degree of prostatic inflammation, while 44% of the prostate specimens demonstrated bacterial growth.[101] Eighty-seven percent of the organisms cultured from the deep prostatic chips were potentially uropathogenic. These findings suggest that inflammation and bacteria (uropathogenic and nonuropathogenic) are routinely associated in the prostate glands of asymptomatic men.
Although Mardh and Colleen[57] suggested that C trachomatis may be implicated in as many as one third of men with chronic prostatitis, their follow-up studies using cultures and serology could not confirm C trachomatis as a causative agent in idiopathic prostatitis.[102-104] Berger and colleagues[105] could not culture C trachomatis from the urethra in men with chronic prostatitis nor did they find a serologic or local immune response to C trachomatis in such patients. Shortliffe and co-workers[45] came to a similar conclusion when they evaluated antichlamydial antibody titers in prostatic fluid. Twelve percent of controls (compared with 20% of patients with nonbacterial prostatitis) had detectable antibodies.
Doble and associates[106] were not able to culture or detect Chlamydia by immunofluorescence in transperitoneal biopsies of abnormal areas of the prostates of men with chronic abacterial prostatitis. Although in the previous section evidence was presented that Chlamydia may be related to the development of chronic prostatitis, many of these studies had absent or inappropriate controls, did not control for urethral contamination, and employed many different techniques of variable sensitivity and specificity to detect Chlamydia. Krieger and colleagues[89] were only able to find Chlamydia in 1% of prostate tissue biopsy specimens from men with chronic prostatitis.
Similarly, the data on U urealyticum as a causative agent in chronic prostatitis are suspect. Other investigators were unable to implicate U urealyticum in patients with nonbacterial prostatitis.[107,108]
T vaginalis has also been suggested (see previous section) as a possible cause of prostatitis.[71-73] While it is accepted that this microorganism can cause urethritis, Krieger and Egan[35] seldom isolated T vaginalis from the urethras of men with chronic prostatitis syndrome. The precise role of T vaginalis in nonbacterial prostatitis remains undefined.
Most investigators believe that coagulase-negative staphylococci localized to prostate-specific specimens, including those from prostate biopsies, represent only colonization. Some investigators found that staphylococci (in this case, S saprophyticus) disappeared from the male genital tract without any treatment at all.[55]
The study suggesting that anaerobic bacteria caused prostatitis[76] has been criticized because the investigators employed outdated bacteriologic methods.
In the previous section, the provocative work employing molecular biologic techniques by Krieger and co-workers[89] suggested that fastidious or nonculturable microorganisms might be important in chronic abacterial prostatitis. However, it may be that these findings represent contaminants. The method of PCR testing done in the study is extremely sensitive to contamination, although the investigators did control for it as much as possible. More important is the fact that just finding 16S rRNA or DNA sequences in prostate biopsy specimens from patients with chronic prostatitis does not establish an etiologic basis for these microorganisms. Keay and colleagues[109] have repeated similar studies in patients with prostate cancer without evidence of prostatitis and found very similar results. A conflicting study by Hochreiter and associates,[110] employing similar PCR methods, failed to duplicate these results, and these authors feel there is not a normal bacterial flora in the prostate gland.
These studies, therefore, suggest that the normal prostate in asymptomatic men may have a commensal population of bacteria and that focal prostatic inflammation is a ubiquitous finding (if one looks for it) in all or most men. In some patients who have prostate colonization by uropathogenic organisms (very rare), the bacteria act as a silent reservoir for recurrent UTIs. If this is the case, then we must look elsewhere to explain the symptom complex we observe in patients presenting with a "chronic prostatitis syndrome."
Is chronic prostatitis an infectious disease? It can be appreciated that the etiologic basis of chronic prostatitis symptoms has been poorly understood. Unfortunately, the field still remains confusing. Evidence can be found in the research literature to support the traditional dogma (that approximately 5% of chronic prostatitis is an infectious disease), or the hypothesis that chronic prostatitis is an infectious disease (but we are just not culturing or identifying the organisms in the majority of cases), or the theory that chronic prostatitis does not represent an infectious disease at all (and any microorganisms we may identify are innocent bystanders or normal flora and are not associated with the symptomatology). Is chronic prostatitis an infectious disease? As we enter the 21st century, that question remains unanswered.
Table I. NIH Classification and Definition of the Categories of Prostatitis[7,8]
Category I
Acute bacterial prostatitis -- acute infection of the prostate gland Category II
Chronic bacterial prostatitis -- recurrent urinary tract infection
Chronic infection of the prostate Category III
Chronic pelvic pain syndrome (CPPS) -- discomfort or pain in the pelvic region
No demonstrable infection using standard culture techniques Category IIIA
Inflammatory CPPS
Significant number of white cells in semen/expressed prostatic secretion/urine specimen after prostate massage (VB3) Category IIIB
Noninflammatory CPPS
Insignificant number of white cells in semen/expressed prostatic secretion/urine specimen after prostate massage (VB3) Category IV
Asymptomatic inflammatory prostatitis (AIP)
Evidence of inflammation and/or infection in biopsy/semen/ expressed prostatic secretion/ urine specimen after prostate massage
No symptoms
Table II. Microorganisms Implicated in the Etiology and Pathogenesis of the Chronic Prostatitis Syndromes
Acknowledged prostate pathogens
Gram-negative uropathogens (Escherichia coli, Klebsiella, Pseudomonas, etc) Probable prostate pathogens
Enterococcus faecalis Possible prostate pathogens
Staphylococcus aureus
Coagulase-negative Staphylococcus
Chlamydia species
Ureaplasma species
Anaerobic bacteria
Yeast (Candida)
Trichomonas species
Corynebacterium species
Acknowledged (?) prostate nonpathogens
Lactobacillus species
Cryptic nonculturable organisms
"Biofilm bacteria"
Cell wall-deficient bacteria
Microorganisms yet to be discovered
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