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For Immediate Release - April 19, 2016 – The Frankfort Fire Department will soon be putting new procedures in place which they feel will increase the quality of care for cardiac arrest patients according to Fire Chief Eddie Slone.
Cardiac arrest occurs when the heart malfunctions and stops beating unexpectedly, which is caused by arrhythmias, including abnormal or irregular heart rhythms. When this occurs immediate attention is needed by starting CPR right away, using a defibrillator to shock the heart and establish a normal heart rhythm, and in many cases the administration of cardiac drugs. Without these tools death can occur within minutes of a cardiac arrest.
Frankfort Fire and EMS' new protocols... Read More.....
Frankfort Fire and EMS
Cardiac Arrest
Procedures Modified
Both the City of Frankfort and Franklin County Fire Departments have offered proposals for an Automatic Aid Agreement between the two agencies.
Automatic aid is a contractual agreement between two or more fire departments where one department will automatically be dispatched with their neighboring department to structure fires or other incidents according to Captain John Redfern of the Frankfort Fire Department.
City of
Frankfort, KY App
December 21, 2015, Frankfort, Kentucky – Need to report a damaged street sign? Pay a parking ticket? Find out when the next ArtWalk is taking place? Discover what's on the next City Commission Agenda for discussion? Well, all that and more can now be found at your fingertips thanks to the new Frankfort City App for Smart Phones, tablets and other devices.
The App, which is now available free of charge on the App store for IPhone users and on Google Play for Android users.
To find the App, search for City of Frankfort KY. The application is free and should only take a minute or two to download to your smart device. The App gives citizens access to the Frankfort/Franklin County Community Calendar, the City's Facebook page, Commission Videos, Parking Ticket and Property payments as well as access to the City's Website. The App also gives direct contact information to City Hall including email, phone and an interactive map.
The App can also be expanded to include additional functions as they are needed and the City welcomes citizens' input on what additions might be helpful.
For more information contact Rebecca Hall at firstname.lastname@example.com.
The Frankfort Police Department is creating a "We Care Kit" program that will focus on providing assistance to the homeless, victims of domestic violence, and other individuals in need living in our community. Learn how you can help....
Frankfort Police Department
"We Care Kits"
Frankfort Named One of Livability.com's 10 Best Cities for African Americans, 2016
Inaugural list identifies and ranks America's best cities for African Americans
April 4, 2016
In nearly every news cycle there's a story about the struggles faced by African Americans in our nation's cities. Sadly, no place has yet to solve all issues of inequality for its residents. However, many smaller to mid-sized U.S. cities offer more level playing fields than their larger counterparts. With this in mind, Livability.com has named Frankfort one of the10 Best Cities for African Americans, 2016.
Possible Street Relocation
At their November Work Session the Frankfort City Commission directed staff to research the possible realignment of Conway Street and the re-location of the Second Street Fire Station. No decisions have been made and public meetings to discuss the subject are being planned. Below is a rendering of the possible realignment/relocation.
Ready Frankfort App
The Frankfort-Franklin County Office of Emergency Management is proud to announce the launch of the Ready Frankfort App that is designed to encourage Frankfort and Franklin County citizens to be for a disaster. The app includes a module to help citizens create and share family emergency plans and identify/gather necessary supplies. Citizens will receive instant notification with access to emergency preparedness information and resources, including shelters and evacuation routes.
The Ready Frankfort App is free and available on iOS or Android devices and can be downloaded from the App Store, Google Play or by visiting
Frankfort Fair Housing
Juniper Hill Installs Solar Photovoltaic System
Earth Tools Inc., has installed a solar photovoltaic system at the Parks & Rec office at Juniper Hills Park. The solar system produces electricity that serves the Parks & Rec office and Pro Shop and is interconnected with the local electric utility. The energy production from the solar system is monitored online and visitors can view the usage. Click Here
Welcome to the City of Frankfort Online. Here you can find access to city departments and services.
Find out information about Police, Fire, EMS, Sewer and Public Works. Find contact information for City Officials and departments.
Here you will also be able to access a wide variety of services, such as an online search tool for property tax records, get an accident report, report a crime, pay your tax bills and garbage collection fees, and parking tickets too.
Information about employment opportunities, city ordinances and upcoming events are all available from this website.
City Events
Learn More..... and visit our new
From The Chief.....
I recently had the pleasure of meeting with the Frankfort Human Rights Commission. This outstanding group of people has volunteered their time to ensuring that our community is devoid of the discriminations and prejudices that have plagued so many towns throughout our nation. While the goal is a lofty one due to the personal perceptions of individuals who live in every town, it was invigorating to see just how closely the goals of the Frankfort Police Department mesh with the goals of the Commission.
I have said many times that "the police are the community, and the community is the police", but what exactly does that mean? Well, it simply means that crime is a social problem, not a police problem. The police are the service organization that deals with these issues, but we must all work together to ensure that our community is safe from crime and degradation. The police are not an occupying force. In a civilized society, it is important to consider that we are here to provide a service and not a controlling oversight. Certainly there are situations that require our skill set to maintain order and control. However, on a daily basis, we are simply here to assist wherever and however we may be needed.
You may have noticed the symbol of this nation's criminal justice system. Lady Justice is holding a balanced scale and wearing a blindfold. The scales are to illustrate that our checks and balances strive to weigh the facts equally to ensure justice. The blindfold is to signify that justice is blind. Blind to race, sex, orientation, nationality, and all other differences that make this nation what it was intended to be. Over the past few years, this question of blind justice has certainly been questioned. I cannot speak for every police agency in every community throughout the nation. However, I can assure the members of our community that the men and women of the Frankfort Police Department are committed to this concept of blind justice. Our number one goal is to illustrate through our words and actions that we are dedicated to policing human beings who are all entitled to fair and impartial treatment by police.
One common theme that troubles me, in the past few years' law enforcement use of force situations nationally, is the question of the existing police-community relationship prior to the tragic event(s). That theme seems to, consistently, be one of a strained relationship. These unfortunate events serve as a tipping point in communities that are already on edge due to lack of relationship and/or mistrust between the community and their police. We all have to get out in front of this and work daily to build these positive relationships. It truly is a win win situation for our community. In doing so, we can better function together to achieve our common goals of a peaceful, crime free community. And when we look at the troubling events that we see on FOX News or CNN, we can collectively shout from the highest mountain, NOT IN OUR TOWN!!
The Frankfort/Franklin County Community Calendar is sponsored by the City of Frankfort and the Franklin County Fiscal Court. Information for the calendar is supplied by the City, County, Downtown Frankfort, Inc., the Frankfort Area Chamber of Commerce, the Kentucky Capital Development
Corporation and the Frankfort/Franklin County Tourism Commission.
Quick links
Employment Opportunities
Invitation to Bid # 217002 - 62
Sealed CONSTRUCTION BIDS are hereby solicited for pavement resurfacing and restoration of related features from previous utility construction and maintenance of City roadways. Learn More...
Invitation to Bid # 217003 - 62
Sealed CONSTRUCTION BIDS are hereby solicited for general concrete sidewalk and curb maintenance, new sidewalk and curb construction, and miscellaneous storm sewer construction to be performed for the City of Frankfort Public Works Department on an as needed, cafeteria style project scope with bid unit prices to remain in affect for a period of one year from the stated bid opening date below. Learn More.....
Firefighter Recruit - The City of Frankfort, Kentucky is accepting applications for Firefighter Recruit. The Department is a full service agency providing both fire protection and emergency medical services. The City welcomes applicants with Paramedic or EMT credentials. Learn More...
Patrol Officer I
The City of Frankfort, Kentucky, seeks qualified applicants for the position of Patrol Officer I to join our Police Department serving the state's Capital City. The Frankfort Police Department is a State Accredited Law Enforcement Agency and is dedicated to maintaining a safe and attractive environment for its citizens. Learn More...
Website Designed and Maintained by Graphic Enterprises
The City of Frankfort is an Equal Opportunity Employer
City of Frankfort
City Hall
315 West Second Street
P. O. Box 697
Frankfort KY 40601


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Demolition began Monday on a retaining wall that surrounds the historic Logan County Courthouse. C&C Construction was selected by the fiscal court the end of October to tear down two sides, rebuild and place the iron back on top. The project cost is $115,500.
A large portion of the wall has been deteriorating and crumbling for some time. The wall is made of brick mixed with mortar. Parts of the wall could be as old as the courthouse itself.
"This project has been discussed for sometime. It is a project we had to face due to safety, as well as maintaining our courthouse," said Judge Executive Logan Chick.
When walking or driving past, you could see where chunks had fallen out of the wall, as well as previous repair over the years to try and keep it together.
"It's important to try and keep the historic look to our courthouse. Keeping the iron on top was important to the magistrates and myself," said Chick.
Specs for the project were handed out in August. The plans were drawn out by engineer Jeff Arnold out of Bowling Green. He was the lowest among two bids received for the plans.
The Logan County Courthouse was built in 1904, this is Logan's third courthouse. The courthouse has undergone many restorations and expansions since it was originally built. Court first met in 1793 in a two-story log structure known as the Cedar House. From 1822 through the late 1800's the courthouse was located in the middle of Park Square.
When the Justice Center was built across the street, the judicial branches moved, leaving the judge executive's office, child support and tourism behind. Fiscal Court is actively seeking tenants to fill the spaces left by the courts. Leaving with the judges was the funding given each year to maintain the courthouse by the Administrative Office of the Courts. That funding now goes to the Justice Center and the county must maintain the historic courthouse from it own coffers.
To contact Chris Cooper, email email@example.com or call 270-726-8394.

subset: commoncrawl


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A woman narrates the thoughts of a traveller as they are expressed in images and sounds from across the globe.
It's almost pointless reading a review of Chris Marker's extraordinary investigation into the inadequacy of the filmed image, as its entire purpose is to spark an individual reaction.
The scene shifts restlessly between Japan, Guinea-Bissau, Iceland and France, as well as the San Francisco locations for Alfred Hitchcock's 'Vertigo'.
Meanwhile, excerpts from the fictitious letters of itinerant cameraman Sandor Krasna suggest that, while photographic images may be able to enlighten, amuse or provoke, they can never reproduce the intimacy of memory.
Nor can they be relied upon, as cultural pre-conditioning, political spin, airbrushing and censorship can corrupt their meaning.
One of the gems of non-narrative cinema, this is less a documentary or an avant-garde travelogue than an audio-visual barrage of potent ideas that challenges you to keep pace with its quicksilver intelligence.
Beatifully framed musing on memory and human experience that extends to the viwing of this film itself. Relying on each personal response, this film begs to be viewed, and deservedly so.


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Stockton University volleyball player Rebecka Zabilowicz earned more recognition Wednesday, being named the Eastern College Athletic Conference Metro Defensive Player of the Week.
It is the fourth time this season Zabilowicz won the award. The senior libero earned her fifth New Jersey Athletic Conference Defensive Player of the Week award of the season Monday.
Zabilowicz had 10 digs and three aces in a win over Rutgers-Camden on Oct. 11 and 17 digs in a sweep of Rowan on Oct. 13. She finished her week with 21 digs against Stevenson and 24 against Bethany on Saturday.
She leads the NJAC and is 42nd in the country with 5.43 digs per set. She is sixth in Stockton history with 1,545 career digs and holds the season record with 706, which she set last season on her way to being named the NJAC Defensive Player of the Year.
The Ospreys (18-9, 6-1 NJAC) will play four matches at the Swarthmore Garnet Classic on Friday and Saturday.
— Michael James


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|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|Uday Subbarayan <uday.subbara...@yahoo.com>
|NPE- Consumer Example
|Thu, 26 Nov 2009 19:38:28 GMT
The default sample app in 5.3 is throwing a Null Pointer Exception for consuming the message. I see that message count is decreasing by 1, when i run the consumer sample app for 1st time. But it doesn't consume any more message and throws this NPE. Its on Mac. Any idea? Thanks, Uday. uday-subbarayans-macbook:example uday$ ant consumer -Durl=tcp://localhost:61616 -Dsubject=myqueue Buildfile: build.xml init: compile: consumer: [echo] Running consumer against server at $url = tcp://localhost:61616 for subject $subject = myqueue [java] Connecting to URL: tcp://localhost:61616 [java] Consuming queue: myqueue [java] Using a non-durable subscription [java] We are about to wait until we consume: 2000 message(s) then we will shutdown [java] Caught: java.lang.NullPointerException [java] java.lang.NullPointerException [java] at ConsumerTool.onMessage(Unknown Source) [java] at ConsumerTool.consumeMessagesAndClose(Unknown Source) [java] at ConsumerTool.run(Unknown Source) [java] at ConsumerTool.main(Unknown Source)
|View raw message


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If you wonder why electric cars aren't catching on with the public, look at Ford Motor's latest gimmick, a cross-country trip in a Focus Electric.
Men's Health magazine, which is participating in the expedition, is arranging for teams of drivers for the trip from New York to Los Angeles. Even though we would like to be on board during the stints with such drivers as Miss Indiana 2009 and Top Gear USA host Tanner Foust, what caught our eye is the recharging stops.
The team will stop "between 40 and 55 times to recharge the car's battery. Each stop is expected to take between 2 and 4 hours. Though it will use public and commercial charging stations, the team will crowd-source most of the trip, inviting readers and supporters to help make the record possible by offering their 240v, 40-amp outlets, such as those typically installed for clothes dryers," says a release sent on behalf of Men's Health.
What a fiasco:
Sounds like they will spend as much time at the charger as they do on the road. That's not far from the truth, considering that driving slower will conserve battery power and mean fewer recharges.
The average driver can go coast to coast comfortably in less than a week. For this test, the trip to the Santa Monica Pier in California is expected to take 10 to 12 days.
Now if they were in the Chevrolet Volt with its backup gas engine ... oh, it probably doesn't matter. Ford never would have allowed it.
Chris Woodyard is an auto writer for USA TODAY who covers all aspects of motoring. He revels in the exhaust note of a Maserati and the sharp creases of a Cadillac CTS. Chris strives to live a Porsche life on a Scion budget. More about Chris


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Desarrollador de Páginas Webs y Aplicaciones Móviles con más de 2 decadas de experiencia en desarrollos sobre Internet.Specializing in systems integration companies to manage, give mobility to the team, analyze the information and optimize resources company. Develops and distributes a complete package of solutions covering ERP / CRM, Workflow, Web tools, customer loyalty systems, e-commerce, via GPS fleet management solutions for mobile terminals, systems BI, OLAP and Reporting for decision decisions.
Developer of websites and mobile applications with over 2 decades of experience in development of Internet.


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All Items : Dolls : Vintage Dolls : Composition : Pre 1930 item #1275558
Antique Doll Treasures
Here for your buying pleasure is a 13-inch all original composition Shirley Temple doll from the 1930's era.
Little Shirley Temple was such a strong force during the 1930's! Raising the moral of America during that time with all of her up-lifting movies, generally of a poor little orphaned child...


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Workers asked to put the boot into construction injuries
Construction workers will receive $100 each if they buy safety boots with steel caps, soles and ankle protection, in a bid to cut the number of injuries on construction sites.
Last year, half the 18,000 site accidents were to feet.
The Construction Industry Training Authority will join forces with the Occupational and Safety Health Council, Hong Kong Construction Association and the Housing Authority to launch a programme from October 1, encouraging the use of safety shoes.
The Housing Authority will spend $800,000, sponsoring its 8,000 workers on public housing construction sites.
The programme is expected to benefit 30,000 of Hong Kong's 80,000 construction workers.
'Some private developers might not participate,' said Jason Wong Miu-chuen, senior consultant of the Occupational Safety and Health Council.
A choice of boots will be exhibited to workers at sites. They will cost between $200 and $300.
While younger workers were more aware of industrial safety, older colleagues complained the shoes were too heavy, said worker Wan Chi-fai, 32.
Most Popular
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Our nation was founded and built by immigrants "yearning to breathe free." I believe we should continue building on that proud tradition by welcoming newcomers into our nation while insisting that they learn and follow our language, laws, and history.
The federal government is directly responsible for enforcing existing laws to secure our borders and ensure the safe and legal movement of people, goods, and commerce across our borders. I have been successful in pushing a zero tolerance program that is dramatically reducing crime and illegal immigration along our southern border (see chart below). Under this strict enforcement policy, everyone caught crossing the border illegally is arrested, prosecuted, and jailed for up to six months. I helped to implement the program in the Laredo Border Patrol Sector recently and I am working to expand it from Brownsville to San Diego.
I am strongly opposed to amnesty for illegal immigrants. Respect for the rule of law is a hallmark of our democracy, and one of the reasons America has the largest immigrant population in the world. We must work to streamline and improve our visa system so that people who want to come to our country legally through the proper channels are able to do so without unnecessary delays. As a member of the Immigration Reform Caucus, I am working with my colleagues to overhaul our visa system.
I also believe that employers should be required to verify the legal status of all employees using the national e-verify database. This requirement will reduce the incentive for illegal immigration and provide employers with the information they need to hire legal, documented workers.
Source: http://culberson.house.gov/VotingRecord.aspx?Section=6


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|This disambiguation page lists articles associated with the same title.
If an internal link led you here, you may wish to change the link to point directly to the intended article.
60001 may be referring to:
- 60001 Building Stool (A LEGO Furniture set released in 2007.)
- 60001 Fire Chief Car (A LEGO City set released in January 2013.)


text: Has anyone in here noticed a little bit quicker of a drop in battery lately? I am not rooted and have always had excellent battery with this phone, but for the last two weeks I have been having a quick initial drop in the morning from around 7:30 until 10:30 it will drop to about 89% and then it will hold strong for a while, and then by night it will drop again. I was getting around 19-21 hours when I first got the phone, and now I get around 15-16 hours. Just curious if anyone else is experiencing the same thing? Rooted or not rooted, I would love to hear your experience.


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Washington (CNN)A bad day for the White House could turn out to be a good day for justice and democratic accountability and institutions.
Robert Mueller's appointment Wednesday as special counsel to probe Russian election meddling and any collusion by Trump campaign aides elevates the investigation clear of partisanship and the threat of White House interference.
It therefore may offer the best chance for a politically bulletproof accounting of the guilt or innocence of members of the President's inner circle.
Deputy Attorney General Rod Rosenstein's decision to opt for a special counsel is also an antidote to fears that the US political system still has the capacity to investigate itself and its most powerful players.
Political ramifications
But there are broad political ramifications that flow from Wednesday's announcement.
The appointment represents a significant loss of control of the Russia story for the administration. Previously, it appeared that the administration sought to influence the course of a House intelligence committee inquiry. Trump told NBC News that he was thinking of the Russia probe when he fired Comey. And The New York Times and then CNN reported Tuesday that he had asked the former FBI director to drop the probe into former national security adviser Michael Flynn before he fired him.
Mueller's arrival on the scene represents another learning experience for a President determined to wield wide executive power but who has been thwarted by checks built into the nation's political infrastructure, for example, the courts that blocked his travel ban for people from Muslim nations.
"They fired Comey because they wanted the Russia investigation to go away. It backfired. Now they have a special counsel and they have got someone who is going to be even less susceptible to pressure than Comey was," said Ohlin. "Their ability to influence and manage this situation has gone out of the window. Things have definitely gotten worse for the White House."
Mueller will also have discretion to take the investigation where he sees fit and will likely be well resourced, in terms of manpower and his own vast experience, and will be able to convene a grand jury and lay indictments.
"He will have the powers of a United States attorney, he will be able to issue subpoenas, get access to all the documents, potentially interview the President himself," said Susan Hennessey, managing editor of the Lawfare blog and a CNN national security and legal analyst. "He is going to be incredibly empowered. Bob Mueller has a remarkable, impeccable reputation."
Most concerning for the White House may be Mueller's investigative freedom. He could for example subpoena the President's tax returns, which Trump has refused to release publicly, and which his critics say could contain evidence of exposure to Russian debt or investments that could pose a conflict of interest or cloud his judgment. The White House would likely fight such a step in court, triggering what would be a damaging showdown that would have damaging political reverberations.
One early sign of trouble could come if Mueller seeks to block the release to congressional investigators memos written by Comey after Trump reportedly asked him to steer clear of Flynn. That could indicate that he is probing alleged interference in the FBI's Russia investigation by the President.
Past presidents have chafed at the way independent counsels and prosecutors have taken their probes well beyond their initial bounds. In theory that could mean that Trump and his aides could find their past lives, as well as their present arrangements, open to investigation.
David Gergen, an adviser to multiple presidents and a CNN senior legal analyst, noted how former President Bill Clinton was "investigated on Whitewater and it ended up way over with Monica Lewinsky. Presidents and White Houses really, really don't want to go here but they have to now learn to live with it."
The impact of a special counsel investigation is almost certain to sap severely drained morale in the White House.
Already, the West Wing mood was desperately grim. One White House official told CNN's Jim Acosta staff were exhausted by days of devastating reversals.
"It's just been three days straight of these 5:45 pm announcements," the official said.
Staffers now face the prospect that they will be examined by Mueller's probe and will worry about their own potential legal jeopardy, and must cope with the corrosive reality of working in an administration that will now be under a dark cloud of investigation and uncertainty for months or even years to come.
Chaotic storm of allegations
It is not just at 1600 Pennsylvania Avenue where the political impact of Mueller's arrival will be felt.
For Capitol Hill Republicans, who have been whiplashed by the chaotic storm over allegations of wrongdoing by Trump and the White House, there was an audible sigh of relief.
GOP leaders have been caught between the White House's increasing exposure on Russia and a desire not to offend the President's voters, who represent a substantial portion of their party's base and impatience that his troubles are slowing their best chance in decades to enact a conservative agenda.
Now, when House Speaker Paul Ryan is asked whether he will do more to investigate Trump, he can refer to the credible investigation that is being undertaken by Mueller. The GOP may get some space to push ahead with key goals like tax reform and hope for some insulation if Trump remains unpopular ahead of the midterm elections next year.
For Democrats, the announcement of Mueller's new job represented good news and bad news. On the one hand it is a validation of weeks of demands and pressure for a special counsel to investigate the Trump White House.
"A special counsel is very much needed in this situation and Deputy Attorney General Rosenstein has done the right thing," said Democratic Senate Minority leader Chuck Schumer. "Former Director Mueller is exactly the right kind of individual for this job. I now have significantly greater confidence that the investigation will follow the facts wherever they lead."
But conversely, the Mueller probe could slow other congressional investigations or deprive them of key witnesses and evidence, as Democrats seek to use the investigations to pressure and discredit the Trump administration.
It seems unlikely, for instance, that Comey will now testify in public in what would have been one of the most significant congressional hearings in recent times. There is also no guarantee that if he does not decide to recommend criminal prosecutions, Mueller will feel the need to release a report into his investigation. That is one reason why Democrats will continue to press the case for sweeping congressional probes.
"The appointment of a special counsel is not a substitute for a vigorous investigation in Congress and the House intelligence committee will take steps to make sure our investigations do not conflictand ensure the success of both efforts," said Rep. Adam Schiff, the top Democrat on the House intelligence committee.
More From this publisher : HERE


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2008-04-17 at 8:04:41 pm #19513
Kodak "very positive" on printer strategy
* Weak economy fears not derailing sales growth plans
* No plans to cut ink cartridge retail prices
NEW YORK, April 08 – Eastman Kodak Co remains optimistic about its unusual home inkjet printer strategy, and its inexpensive ink cartridges are selling faster on average than rival products, company executives said on Wednesday.The photography company, which has pinned growth plans on digital systems such as commercial printing and image sensors, said concerns about a weakening economy have not derailed its plans to increase sales by up to three times this year."There is no doubt that the economic issues are a headwind. But we are expanding the … retail channels that we are participating in, expanding the number of products and the number of countries that we are playing in," said Bob Ohlweiler, chief operating officer of Kodak's Inkjet Systems Division. "We are feeling very positive."
Kodak's printing plan, launched about a year ago, calls for consumers to pay higher prices than the industry average for hardware, but get replacement ink at a bargain. Rivals such as Hewlett-Packard Co and Lexmark International Inc sell low-cost printers or bundle them with the sale of computers.Last year, Kodak sold 520,000 of the new printers, exceeding its initial target by about 20,000 units. It expects those sales to double or triple in 2008, and sees sales of $1 billion and break-even profit from this segment by 2010.The line, initially available only at Best Buy stores in the U.S., has expanded to Office Depot shops, and can also be found in countries including France and Canada.Kodak still has a long way to go to catch HP and Canon Inc , who sell millions of units each year. Moreover, each has
many millions of loyal customers with older models who regularly buy replacement ink.
The weakening economy offers another challenge for Kodak, whose printers sell for $100-$200, more than rival inkjet printers that are typically priced at below $75.Consumers who print in high volumes see the value of Kodak's system as they buy cartridges priced at less than $20, which Kodak says is substantially lower than its competitors.Ohlweiler noted that even if the economy weakens further the company would not cut its ink prices."We have no plans on changing the cost of the ink cartridges," he said. "We are selling a long term value proposition. To move price on ink (is) not how we would react to a downturn in the economy.


text:
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Voyeur : October 2008
CONTENTS_1008_ WIN WIN WIN WIN WIN WIN WIN WIN WIN WIN WIN WIN 140 TECH Á PORTER What does your phone say about you in the style stakes? 159 GOURMET GOODS Top five places to dine alfresco, plus this month's food diary. 160 DRINK TO THIS Pink drinks, 25-year-old scotch, and a French sommelier. 162 STYLIN' UP Has increasingly elaborate food presentation gone too far? 166 THE DIRTY DOZEN Life's too short to drink bad wine – especially these tipples. 169 CITY GUIDES AND WHAT'S ON Samoan seafood, going for Gold in Perth, and much more. 194 PUZZLES Bend your mind around our sudoku and brainteasers. 196 WIN THIS! Relax in your own spa or on a luxury Medina getaway. 198 VIRGIN BLUE NEWS All you need to know about flying with Virgin Blue. 210 WISH I WAS THERE Hobart puts its best foot forward. 108 WHO WOULD YOU HIRE? How one dodgy shirt could cost you that promotion. WIN THIS CAMERA! PICTURE PERFECT The latest SLRs will turn your snaps into art. FASHION FORCE Iconic designer Carla Zampatti on standing the test of time – and looking good doing it. 143 144 012 VIRGINBLUE Do you have a favourite holiday photo from a Virgin Blue trip? Share it with us and you could win a new Nikon CoolPix S550! Boasting 10 megapixels of sharp resolution, the new CoolPix elegantly packs high- performance and advanced functions into its sleek body. Worth $349, it even has a 'smile mode' to let you know the exact moment your subject says cheese. For your chance to win, email us your holiday snap as a JPEG and tell us, in 25 words or less, why it's your favourite VB destination. Email your entry to voyeur@textpacific. com.au by 31/10/08. For terms and conditions, see page 196. In-flight health :: Deep vein thrombosis (DVT) is blood clotting in a major vein, most commonly in the legs or lower body, which causes the blood flow to slow down. :: Medical practitioners advise that certain people may be more susceptible to developing DVT. These include people who are immobile for periods of time, those with a personal or family history of DVT, people with certain blood disorders or who have recently undergone major surgery, smokers, people with heart disease, pregnant women and the elderly. We suggest you: :: Drink plenty of water and other hydrating fluids during and after the flight. Limit alcohol, tea and coffee consumption. :: Take regular walks around the aircraft when the seatbelt sign is switched off. :: Stretch and move your arms and legs at regular intervals. :: Avoid crossing your legs when seated. :: Massage your calves and thighs, and regularly move your ankles by circling and gently shaking your feet. If you experience abnormal swelling, tenderness or pain after your flight, we strongly recommend you see your doctor. This is not a comprehensive list. If you have any doubts about your particular health risks, you should talk to your medical practitioner. OBJECTS OF DESIRE Spring has sprung in the fashion world. ? 114 PHOTOGRAPHY :: ANDREW SHAW, BEN ROLLISON, LARNCE GOLD. Kristin Soper captured an idyllic Fiji sunset, complete with relaxing hammock.
November 2008
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Jose Luis Rodriguez Zapatero visits Equatorial Guinea
Jose Luis Rodriguez Zapatero visits Equatorial Guinea
Jose Luis Rodríguez Zapatero, who led the Government of Spain from 2004 to 2011, arrived on the morning of July 2 to the Malabo International Airport, and was received at the People's Palace of Malabo by the President of the Republic, H.E. Obiang Nguema Mbasogo.
The Equatorial Guinean Head of State received in audience Jose Luis Rodriguez Zapatero, at approximately 2 p.m. in the People's Palace of Malabo, who came with Jose Bono, former president of the Congress of Deputies, and Miguel Angel Moratinos, former Minister of Foreign Affairs.
This twenty-four hour visit occurs a week after the successful hosting of the 23rd Summit of Heads of State and Government of the African Union, held in the town of Sipopo (Malabo), and which had the active participation of the current Spanish Prime Minister, Mariano Rajoy, as a special guest.
According to statements by Rodriguez Zapatero to the media, the need to strengthen the ties of friendship and cooperation between the European country and the Republic of Equatorial Guinea was among the issues discussed at the audience, as well as the development of the African Union Summit. The former Spanish Prime Minister also expressed his pleasant surprise by the remarkable transformations that he observed during his visit and expressed his hope that, with economic development, the social cohesion in our country will be strengthened.
Text: Javier Obama.
Photos: Manuel Mangue.
(Presidential Press Team).
Sent by: Clemente Ela Ondo Onguene (D. G. Base Internet).
Equatorial Guinea's Press and Information Office.
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Young Artists Alliance - 4th Annual Fundraiser
The Young Artists Alliance
Saturday, June 1, 2013 at 3:00 PM (PDT)
Who's Going
San Francisco, California
London, United Kingdom
Florence, Italy
Event Details
This year's event will be held on Saturday, June 1, 2013 at the Tutor Family Center for the Performing Arts at Chaminade High School at 3:00 p.m. Performances will include live music, dance, spoken word, singing, and more. Through the arts, the YAA hopes to raise funds for the WE CAN Pediatric Brain Tumor Network.
All net proceeds from the event will be donated to the WE CAN Pediatric Brain Tumor Network. "We Can" offers information and emotional support to families whose children have brain tumors. WE CAN hosts a camp every spring designed to meet the ongoing challenges faced by families who have a child with a brain tumor. It costs about $200 to send a child to this annual camp and about $1000 for a family.
Visit www.YoungArtistsAlliance.org for more information.
When & Where
Tutor Family Center for the Performing Arts
at Chaminade High School
7500 Chaminade Ave
West Hills,
Saturday, June 1, 2013 at 3:00 PM (PDT)
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The Young Artists Alliance
Three years ago, several young musicians formed "The Young Artists Alliance" - a group of kids who got together to perform a special concert at the Pasadena Conservatory of Music. Proceeds collected over the years benefit various charities. Now the organization is entirely student-run as a club at Chaminade High School.


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I have played the Arrival DLC and I thought it was all right.
But it felt like that they were trying to put as much action as they can into an hour or so, which to me felt like that ME2 lost some of its gameplay element, And also the timer for when the Reapers invade felt like I had to rush though the DLC just to complete it.
But it did add some fresh twists to the gameplay like the sneaking section and that you are on your own for more or less the entire mission.
But that just me, I want to what see you thought about the DLC


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A, An axial T1-weighted magnetic resonance image demonstrating a saccular mass at the lateral wall of the left sphenoid sinus. B, A coronal T2-weighted image demonstrating a cerebrospinal fluid–filled meningoencephalocele involving the lateral wall and the pterygoid recess of the left sphenoid sinus.
An axial computed tomographic scan demonstrating a sagittal fracture of the posterior sphenoid wall (the clivus).
Coronal view of a high-resolution coronal and axial computed tomographic cysternogram demonstrating a cerebrospinal fluid fistula (arrowheads) at the lateral recess of the left sphenoid. R indicates right; L, left.
Tosun F, Carrau RL, Snyderman CH, Kassam A, Celin S, Schaitkin B. Endonasal Endoscopic Repair of Cerebrospinal Fluid Leaks of the Sphenoid Sinus. Arch Otolaryngol Head Neck Surg. 2003;129(5):576-580. doi:10.1001/archotol.129.5.576
© 2017
Multiple reports have demonstrated the efficacy of the transnasal endoscopic repair of cerebrospinal fluid (CSF) leaks of the anterior cranial base. The literature, however, lacks a comprehensive clinical study specifically addressing the transnasal endoscopic repair of CSF leaks of the sphenoid sinus.
To ascertain the factors that significantly affect the surgical outcome after transnasal endoscopic repair of CSF leaks of the sphenoid sinus.
We retrospectively reviewed the medical records of all patients who underwent an endoscopic transnasal repair of CSF leaks of the sphenoid sinus at our teaching hospitals.
Twenty-four patients with CSF leaks of the sphenoid sinuses that were repaired by the transnasal endoscopic approach were included in our study. Causes of the CSF leaks included trauma, surgery, neoplasms, and idiopathic causes. Obliteration was the most common technique used to repair the CSF fistulas (used in 15 [58%] of 26 procedures). Grafting materials included banked pericardium, mucosa, turbinate bone, and mucoperichondrium placed by underlay or onlay grafting or abdominal fat used to obliterate the sphenoid sinus. Twenty-two patients were successfully treated on the first attempt. A persistent leak in 2 patients with previously unrecognized high-pressure hydrocephalus was repaired during a second endoscopic surgery, quickly followed by ventriculoperitoneal shunting.
Assuming an adequate repair, other factors such as the cause, the size of the defect, the technique and material used to repair the defect, and perioperative management do not affect the surgical outcome significantly. Untreated high-pressure hydrocephalus can lead to a recurrence or persistence of the leaks and should be suspected in patients with posttraumatic, idiopathic, or recurrent CSF leaks.
THE POPULARIZATION of oncologic skull base surgery and endoscopic sinus surgery during the past 2 decades has produced more iatrogenic cerebrospinal fluid (CSF) leaks.1- 3 Unintentional injuries from craniofacial trauma and transcranial neurological surgery are other common causes of CSF leaks.3- 5
Initially, transcranial approaches were used to repair all CSF leaks. Extracranial approaches were subsequently developed and popularized.6 Continuing this trend, multiple reports indicating a high success rate for the transnasal endoscopic and/or microscopic repair of CSF fistulas have been published during recent years. Most of these reports, however, include a heterogeneous group of patients with CSF leaks that arise in various sites. Reports of transnasal endoscopic repair of CSF leaks of the sphenoid sinuses are limited to a few cases.
Cerebrospinal fluid leaks of the sphenoid sinus have their own features. Transcranial approaches to this area are extensive and associated with significant morbidity. Microscopic transseptal approaches may not provide direct visualization of the lateral walls (Figure 1). Thus, CSF fistulas at this site may not be visualized without angled-lens endoscopes. Furthermore, CSF fistulas in the lateral recesses may even require an extended sphenoidotomy approach through the pterygopalatine fossa (Figure 1 and Figure 2). Epidural (underlay) placement of the grafting material may not be possible in these cases because of the adjacent neurovascular structures. Obliteration of the sinus or the lateral recess is generally advocated for this reason.7
We present our experience with 24 patients with CSF leaks of the sphenoid sinus that were repaired using an endoscopic transnasal approach. We aimed to ascertain the effect of different factors, such as cause, associated disorders, grafting materials, surgical technique, size of the defect, and perioperative management, on surgical outcome.
We retrospectively reviewed the clinical data of all patients who underwent an endoscopic transnasal repair of a CSF leak of the sphenoid sinus from January 1, 1989, to March 31, 2001. Patients with CSF leaks at other sites and/or leaks that were repaired using approaches other than transnasal endoscopic approaches were excluded from the study. Cerebrospinal fluid leaks created during pituitary surgery and those that were immediately repaired (ie, single-stage surgery) were not included in our study.
Clinical data were retrospectively analyzed for the characteristics of the patients, the CSF fistulas, the surgical technique used for the repair, and adjunctive therapies. These variables were correlated to outcome (closure of the fistula and morbidity). They included cause; associated medical problems; timing of the repair; size of the fistula; presence of high-pressure hydrocephalus (HPH); type of grafts and surgical technique used for the repair; type of fixator and perioperative management, including the use of nasal packing, a lumbar spinal drain, or a ventriculoperitoneal (VP) shunt; and the use of perioperative prophylactic antibiotics. Data were recorded and analyzed using computer software (Statistix; Analytical Software Co, Tallahassee, Fla). Univariate analysis was performed by the Fisher exact test.
Between January 1, 1989, and March 31, 2001, 24 patients presented with a CSF leak of the sphenoid sinus. Our study population was composed of 16 male subjects (67%) and 8 female subjects (33%); their ages ranged from 12 to 72 years (mean, 31 years). Follow-up ranged from 6 to 126 months (mean, 36 months). Complications associated with the CSF leak (before the repair) included meningitis in 3 patients (12%), pneumocephalus in 3 patients (12%), and HPH in 4 patients (17%); 2 patients had more than 1 complication; there were no complications in 16 patients (67%).
Causes of the CSF leaks included surgery in 9 patients (38%), unintentional injuries from trauma in 7 patients (29%), idiopathic or spontaneous causes in 7 patients (29%), and neoplasms in 1 patient (4%).
Methods that were used to identify the site of the CSF fistula included nasal endoscopy in 15 patients, a computed tomographic (CT) metrizamide cysternogram in 8 patients, and intraoperative intrathecal fluorescein imaging in 1 patient.
Of the 24 CSF leaks, 22 were repaired after some delay from their onset. Abdominal fat was the most commonly used grafting material. Other grafting materials included homologous pericardium, mucoperichondrium, hydroxyapatite cement, and middle turbinate bone. In addition, a septal mucoperiosteal flap was used in 2 patients. The type of surgical repairs included obliteration in 15 patients, overlay grafting in 9 patients, and underlay grafting in 2 patients. Various materials were used to fixate the grafting materials, including fibrin glue, an absorbable knitted fabric (Surgicel), an absorbable gelatin sponge (Gelfoam), and an absorbable gelatin film (Gelfilm) (Table 1).
Perioperative management for the 26 procedures (2 patients required revision surgery) included perioperative prophylactic antibiotics (used in 25 procedures [96%]), nasal packing consisting of gauze or a sponge (Merocel) (used in 18 procedures [69%]), a lumbar drain (used in 16 procedures [62%]), and a VP shunt (used in 4 procedures [15%]). The lengths of lumbar spinal drainage and antibiotic management were 1 to 5 and 1 to 7 days, respectively.
Twenty-two fistulas were successfully repaired by a single endoscopic transnasal surgery. The size of the defect (data available for 18 patients) was less than 1 cm in 10 patients (56%) and 1 cm or greater in 8 patients (44%). Two patients required a second endoscopic surgery to control a persistent CSF leak. The 2 persistent fistulas were associated with untreated HPH, which had not been recognized previously. Both CSF fistulas were successfully repaired with the second endoscopic surgery, followed by VP shunting. The first patient presented with an idiopathic fistula of approximately 1 cm in diameter, located in the lateral recess of the sphenoid sinus. The leak was initially repaired by obliterating the left sphenoid sinus with abdominal fat. Recurrence of the CSF leak was noted within a month after the repair, and the sphenoid sinus was reobliterated with abdominal fat. To measure the CSF pressure, a lumbar spinal tap was performed 2 weeks after the second repair, corroborating the presence of HPH. A VP shunt was inserted.
The second patient had a CSF fistula in the midline of the posterior wall of the sphenoid sinus (ie, the clivus). This patient was injured by an industrial air blast and experienced severe craniofacial trauma that fractured and displaced the anterior skull base and clivus in the sagittal plane. The fistula was 1 cm in diameter and was initially repaired by an overlay technique using turbinate bone and hydroxyapatite cement. A persistent leak was noticed, and the sinus was then obliterated with abdominal fat and fibrin sealant (Tisseel; Baxter Company, Vienna, Austria). Posttraumatic HPH was diagnosed by measuring the CSF opening pressure via a lumbar spinal tap within 72 hours of the second repair. A VP shunt was inserted in this patient also. Neither one of these patients has experienced a recurrence of the CSF leak.
Cross correlations between the recurrence of a CSF leak and the variables contained in our database were submitted to univariate statistical analysis (Fisher exact test). A positive correlation was found only between the presence of HPH and the recurrence of the leak (P = .006).
After our experience with these 2 patients, we decided to identify patients at risk for HPH (namely, those after skull base surgery, those who suffered a closed head injury, and those who presented with spontaneous CSF leaks) and treat the HPH within the same hospitalization. This was performed by providing a temporary CSF diversion (ie, a lumbar drain after the repair), measuring the lumbar spinal opening pressure 3 to 5 days after the repair (the pressure will be low or normal during the early postoperative period), and immediate VP shunting if necessary. We applied this protocol in our last 2 patients, who presented with spontaneous CSF leaks. Both patients had HPH, and both underwent shunting successfully. Neither one has experienced a recurrence at a follow-up of 6 and 20 months, respectively.
Cerebrospinal fluid leaks of the sphenoid sinus may be the result of surgery, trauma, neoplasms, and HPH, or they may be idiopathic. Iatrogenic trauma is cited as the most common cause of sphenoidal CSF leaks in recent years.5,8- 11 Our study showed a similar incidence of iatrogenic and posttraumatic leaks to that reported in the literature. In this study, iatrogenic trauma and unintentional injuries from trauma were the most common causes of CSF fistulas; they occurred in 16 (67%) of the patients.
Idiopathic CSF leaks were also common in our series (occurring in 7 [29%] of the patients). An idiopathic or spontaneous CSF fistula presumably results from some type of congenital defect of the skull base and/or HPH.12- 14 Other less common, but important, causes of CSF leaks include erosive lesions of the skull base, such as mucoceles, fungal sinusitis, osteomyelitis, brain cysts, and primary or metastatic intracranial or extracranial tumors. Tumors of the pituitary gland are the most common neoplasms causing CSF leaks.2
Cerebrospinal fluid leaks of the sphenoid sinus have the potential to cause devastating intracranial complications, such as pneumocephalus, meningitis, brain abscesses, and seizures.15- 17 Indeed, meningitis and pneumocephalus are common pretreatment complications of CSF leaks of the sphenoid sinus.14,17 In our patients, the frequency of complications arising from the untreated CSF leak was consistent with that reported in the literature. Meningitis and pneumocephalus developed in 3 patients each (13%). Prompt treatment is critical to prevent these life-threatening complications.
Confirmation of the CSF leak is critical before commencing the treatment. Cerebrospinal fluid–related rhinorrhea may be suspected in the presence of a unilateral, watery, clear, nonsticky nasal discharge that is commonly associated with a headache. A gush of fluid that occurs with a forward tilt of the head suggests a collection of fluid in the sphenoid sinus.13 The result of a β2-transferrin test, which is a highly sensitive technique, confirms the presence of a CSF leak.5,8 An intranasal endoscopic examination may help to corroborate the diagnosis and establish the site of the leak. A clear pulsatile fluid arising from the sphenoid ostium can be seen with a 30° to 70° rod lens or with flexible fiberoptic endoscopes.9,17,18
Skull radiograms are minimally helpful and not cost-effective. However, they can show an intracranial aerocele, an opacified sphenoid sinus, an enlarged sella turcica, or an air-fluid level within the sphenoid sinus.19 Skull base defects are better demonstrated by high-resolution coronal and axial CT scans (Figure 2). A CT scan identifies the skull base defects in greater than 80% of the cases.15 Computed tomographic cysternography, using intrathecal metrizamide, is recommended to establish the site of a CSF leak that is not obvious on endoscopic or high-resolution coronal and axial CT evaluation (Figure 3).7,11,13 A false-negative result may be due to the temporary cessation of the leakage by swelling, inflammation, or brain herniation through the defect. An intrathecal injection of isotonic sodium chloride solution may be used to increase the pressure of the CSF fluid and demonstrate the leak. Contrast-enhanced magnetic resonance imaging in the presence of a soft tissue mass may be helpful for differentiating mucosal edema from a meningoencephalocele or a meningomyelocele.4,5 agnetic resonance cysternography is a noninvasive technique and does not require injection of a contrast agent. Further refinements to this technique may obviate the need for intrathecal contrast. Intrathecal fluorescein injection has gained wide clinical interest.8,15,17 Its major advantage is to allow a precise localization of the CSF leak using endoscopic visualization. Fluorescein, however, is toxic to the central nervous tissue and should be precisely diluted to avoid seizures or chemical encephalitis. In this study, most of the CSF leaks were diagnosed by an intranasal endoscopic examination complemented by high-resolution coronal and axial CT or metrizamide CT cysternography. Fluorescein dye was used in only 1 patient.
Cerebrospinal fluid leaks resulting from acute head trauma may be managed conservatively initially.2 The treatment generally consists of a trial of bed rest in a semisitting position, repeated lumbar spinal taps or a lumbar spinal drain, and advice to the patient to avoid nose blowing, leaning forward, and straining. If there is a long period between the trauma and the CSF fistula, or if the leak is spontaneous, conservative management is not indicated because these conditions rarely heal spontaneously. If an iatrogenic CSF fistula is recognized intraoperatively, immediate surgical repair is preferred.5,12,18
The transcranial approach was the first surgical technique used to repair CSF leaks. However, the need for a craniotomy or brain retraction carries significant risks, such as anosmia, a postoperative intracranial hemorrhage, and brain edema. Extracranial microscopic approaches, such as trans-nasal-trans-septo-sphenoidal or sublabial-trans-septo-sphenoidal approaches, are adequate for visualization and for reaching the roof and superior aspect of the sphenoid walls. Visualization of the lateral walls or lateral recesses of the sphenoid is often inadequate. Transnasal endoscopic approaches provide the simplest and most direct access to the sphenoid sinus, with excellent visualization of the lateral recesses.
Dural and skull base defects can be repaired using underlay or overlay grafting or by obliteration of the sphenoid sinus using different types of grafting materials. An underlay technique involves inserting the grafting material a few millimeters between the bone and the dura on all sides of the defect.4,11 If there is a risk of damaging nerves and vessels while dissecting the dura from the surrounding bone or while inserting the graft (ie, at the lateral wall of the sphenoid sinus), an overlay graft may be used.1,17 To complete this technique, the mucosa around the defect is removed and a free tissue graft is placed over the dural tear and is then secured with some type of fixator.
Different types of autologous or homologous materials, such as middle turbinate bone or mucosa, fascia lata, a septal mucoperichondrial graft, temporalis fascia and acellular dermal grafts, and rectus abdominis fascia, can be used as free grafts to repair a CSF fistula of the anterior cranial base. Fascia lata and middle turbinate mucoperiosteal grafts are most commonly advocated.4,15,16 However, poor visualization, particularly of the lateral aspect of the sphenoid sinus, may prevent proper placement of the graft. Obliteration of the sinus, alone or in combination with an overlay graft, is generally preferred to close the defect.10,15,16,18 Abdominal fat, muscle, hydroxyapatite cement, or acellular dural grafts can be used for obliteration.7,8,10,17 In our study, most of the CSF fistulas of the sphenoid sinus were repaired by obliteration of the sinus after thorough removal of the mucoperiosteum (15 [58%] of the 26 repairs). The use of different grafts was based mainly on the surgeon's preference, availability of the material, and ease of use. The most commonly used grafting material was autologous abdominal fat (used in 15 [58%] of the repairs). In addition, fibrin glue, an absorbable gelatin film, an absorbable gelatin sponge, and an absorbable knitted fabric were used to support or fixate the grafting material.
The size of the defect did not seem to affect the success rate in our study. Defects larger than 2 cm were closed successfully on the first attempt, whereas revision cases consisted of defects that approximated 1 cm in their greatest dimension. A mucosal or composite graft may be used, based on the size of the defect, for CSF leaks of the fovea ethmoidalis or cribriform plate. However, obliteration of the sinus regardless of size of the defect is the most commonly used technique by many surgeons for CSF fistulas of the sphenoid sinus.14,18
Perioperative management after surgical repair of the CSF leaks is important to prevent complications and promote healing of the repair. It includes the use of nasal packing, the administration of perioperative prophylactic antibiotics, and the insertion of a lumbar spinal drain or a VP shunt. Perioperative prophylactic antibiotics are recommended for skull base surgery.20 Perioperative prophylactic antibiotics were used in 23 (96%) of the patients in our study. Indications for a postoperative lumbar drain are not clearly defined in the literature. Lanza,17 Mao,7 and Wormald4 and colleagues used a lumbar drain postoperatively after the repair of the CSF leak. On the other hand, others1,8,10 reported a similar success rate without using a lumbar spinal drain. In our series, a lumbar drain was used only if HPH was suspected (in 16 patients). Our results support the notion that a lumbar drain is not routinely necessary for the successful closure of CSF leaks.
The literature4,10,14- 21 supports a high success rate, between 83% and 100%, for the endoscopic repair of CSF leaks of the sphenoid sinus. Our success rate was 92% (22 of 24 patients) after a single endoscopic repair, and the remaining 2 CSF fistulas (8%) were repaired during a second surgery. The type of grafting material, the type of repair, the size of the defect, perioperative management, and the cause of the CSF leak did not correlate with the recurrence of the leak. We found a significant correlation only between the presence of HPH and the recurrence of the CSF leak.
High-pressure hydrocephalus is defined as overaccumulation of CSF within the ventricular system, with a resultant increase in intraventricular pressure. High-pressure hydrocephalus may be the result of a subarachnoid hemorrhage due to trauma, stroke, or surgery. In addition, HPH could be the result of obstruction of the arachnoid villi, which absorb the CSF, as a result of infection or postradiation fibrosis. Untreated HPH in adults may present as cognitive changes, gait difficulty, balance problems, headaches, or visual problems due to optic nerve edema or paralysis of the abducens nerve (cranial nerve VI). In patients with CSF leaks, the subarachnoid space is decompressed by the fistula; thus, these symptoms are usually absent. Cerebrospinal fluid diversion after surgical repair decreases the CSF pressure in these patients, allowing healing of the reconstructive technique during the early postoperative period. An alternative treatment protocol would be to repair the leaks in all patients without concern for the presence of HPH, and to study and place a shunt in only those who experience a recurrence with the CSF leak. Although reasonable under certain circumstances (eg, patient's choice and temporary HPH), this may subject the patients to the risk of a recurrent CSF leak and the effects of HPH. Causative factors, particularly those associated with HPH, must be identified for the planning of proper adjunctive management.
In conclusion, CSF leaks of the sphenoid sinus may cause serious complications; therefore, once a diagnosis is established, the defect must be repaired. The transnasal endoscopic approach is the easiest way to access the sphenoid sinus. A high success rate can be achieved with minimal morbidity using an endoscopic transnasal approach. Obliteration with abdominal fat is most commonly used for the repair of a CSF fistula of the sphenoid sinus, particularly in cases with limited visualization at the lateral wall of the sinus. Our study also suggests that grafting material and technique used for the repair, size of the defect, and perioperative management do not seem to affect the success rate. The only variable that correlated with the persistence or recurrence of the leak is the presence of HPH.
Corresponding author: Ricardo L. Carrau, MD, Department of Otolaryngology, University of Pittsburgh Medical Center, Eye and Ear Institute Building, 200 Lothrop St, Suite 500, Pittsburgh, PA 15213.
Accepted for publication September 24, 2002.


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I have pain in the top of both of my hip bones and across my back. They also have muscle spasms that knock the wind out of me. Is this a back problem?READ MORE
I have hip pain with spazums that knock the wind out of me
You need to see your doctor to find out if the muscle spasms are causing the pain in your hips and back or if something else is causing the pain and contributing to the muscle spasms. As far as the spasms are concerned, your doctor may give you a muscle relaxer medication to help calm them down. Massage therapy can also be an excellent treatment for muscle spasms.
FROM OUR COMMUNITYYou should know Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Content posted by community members does not necessarily reflect the views of Remedy Health Media, which also reserves the right to remove material deemed inappropriate.DISPLAY TEXTLINK URL
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Tuesday, all hurdles had been cleared and the 6-foot-2, 215-pound athlete officially issued his oral pledge to Mark Dantonio.
How does it feel to put the process behind him?
"It feels good," said Williams. "It' just a big relief and it seems like everything came together all at once. Now I can concentrate on football and keeping my grades up."
Talk surrounding Williams placed him on his last visit to Michigan State in a special meeting with Spartans head coach Mark Dantonio. Williams stresses the talk was not that intense.
"It wasn't really a sit down talk," explained Williams. "I saw him after the game and he asked me to stick around. We then talked off to the side as there were other recruits there. It was more of a talk to make sure we were on the same page. We both agreed on some things and he told me he was going to talk with me that next week."
What happened on that call put the wheels in motion for Williams to be a Spartan. However, it was not a quick acceptance by the Spartans.
"When he (Coach Dantonio) called I told him I wanted to be a Spartan if they wanted me," said Williams. "He said we would talk again after he spoke with the other coaches. They went back and watched my film and discussed if they wanted me or not.
So after that they decided they wanted me at Michigan State and when we spoke again he said welcome to the family and told me to stay out of trouble and get ready to be a Spartan."
How hard was it for Williams as he waited on the Spartans call?
"I was waiting for that call," said Williams. "Michigan State is an exciting place to be and every time I go there I feel comfortable. I've been down there with a father figure, I've been down there with a best friend and with a couple of friends and it's always been a big atmosphere. I've seen how it is and I can see myself there all the way."
Another positive for Williams was the fact current teammate Damion Terry also plans on being a Spartan having given his pledge back in April.
"Having Damion there means I'll have someone over my shoulder that can help me," said Williams. "He'll have the same. It feels good knowing I'll have someone else going there I know and we can carpool back home to make it easier for each other."
With talk of Williams moving from safety to linebacker, he explains his options are open right now.
"I'm coming in as an athlete," said Williams. "They are bringing me in on defense but if I'm doing what I'm supposed to be doing they'll switch me back and forth and I'm ready for whatever they want. Linebacker, safety, running back or special teams, I'll be ready for anything."
Williams hope now to place all of his energy towards finishing out his senior year strong.
"We're 6-0 in football and my grades are where they need to be," said Williams. "I'm staying on top of everything and plan to keep doing what I need to be doing and be around the right people."
While his mother was sold on the Spartans early, Williams saw the things he needed during his visits to campus to place the Spartans at the top.
"I really like how the players are close to each other," said Williams. "I also see how the coaches work on the sidelines and like how they recruit people instead of just football players."


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MENA OTT revenues to quadruple
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Middle East & North Africa OTT TV episodes and movies will generate revenues of $1.75 billion by 2022; more than quadruple the $428 million recorded in 2016. According to the Middle East and North Africa OTT TV & Video Forecasts report, SV...
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Rotterdam Cube Houses
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Cube Houses of Rotterdam
The cubic houses are one of Rotterdam's icons. Visit the cube-shaped houses and notice how they don't fit the usual conventions of a house.
- An architectonic experiment inspired by the Ponte Vecchio.
- Expressive and colorful icon in the center of Rotterdam.
- The Kijk-Kubus museum residence can be visited from 11:00 to 17:00 daily.
The cube residences are among Rotterdam's icons. 38 conventional piled homes near the Blaak and the Oude Haven were rotated 45 degrees, becoming Holland's first cube residences. The cubes are located in a prominent location in the center of Rotterdam.
Representation of trees and a wood
Piet Blom designed the cube houses in 1984. His design represents a tree and all houses together make up a wood. Blom's concept was to design a kind of village within a main city, a safe haven in which anything could happen.
Cube House Interior
Experience what it is like to live in a cube home in Rotterdam. Most of the houses are occupied but one cube home, the Kijk-Kubus museum residence, is always open to receive visitors. You will find how the house plays with you because it does not comply with the usual conventions for residences.
Rotterdam Cube Houses
Spend in the night in one of the famous Rotterdam Cube Housesview the offer
All About:
Discover Rotterdam
Rotterdam is a young and dynamic city with a world-class port. The city of Rotterdam is internationally known for its modern architecture and design.Read more
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Sailing through UNESCO World Heritage Site Kinderdijk
Sail past the nineteen world-famous windmills in a quintessentially Dutch polder landscape.Read more
The largest windmills in the world.Read more
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Ripen your knowledge of Dutch food by enjoying a slice of Cheese Valley's history and attractions.Read more
Cycling past new Biesbosch nature
Take a wonderful cycling trip through old polders or past new nature reserves.Read more
Take a boating trip through the old harbours, spend a night in a water tower and cycle along Biesbosch creeks.Read more
Cycling Route Eiland van Dordrecht
This cycling route (30 km) leads through Dordrecht's centre, the peaceful polders and De Biesbosch.Read more
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Biesbosch, a rhythm of the tides
De Biesbosch is one of the few freshwater tidal areas in Europe.Read more
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Claire Duchen, Irene Bandhauer-Schoffmann, "When the War Was Over: Women, War and Peace in Europe, 1940-1956"
English | ISBN: 0718501799, 0718501802 | 2000 | 288 pages | PDF | 17 MB
English | ISBN: 0718501799, 0718501802 | 2000 | 288 pages | PDF | 17 MB
This work focuses on the experiences of women in Europe during the transition from war to peace. Popular images of women represent them as welcoming home the soldiers but this text asks "what happened next?"; "what did the end of the war mean for women?"; "how was the relationship between public and private altered by the war?" In the post-war decade, daily life and public life changed for women in different national contexts, most notably with the ending of fascist regimes in Germany and Italy, the re-establishment of independence in Austria and Finland, the end of the Occupation in France, Holland, Belgium and elsewhere, the descent into civil war in Greece, the realignment of European states leading to the Cold War, the Warsaw Pact and the founding of the state of Israel. This text asks about women's part in these changes and how women and men narrate, and looks at the symbolic use made of female imagery and highlights the plasticity of the female form. The contributors use a range of methodological approaches and they encourage the reader to question traditional historiography, the nature of historical evidence, the process of memory, the disparities between official discourse and personal narrative, and between written, visual and oral accounts.
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News By Tag
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Degree Attainment, Greater Employability, Study Abroad Advocates Launch New Website
New website is a platform announcing partners, current initiatives and raising awareness of study abroad's value to better prepare the students of MSI's for the global marketplace.
A shocking imbalance persists. 29.5 percent of four-year, college students are Latino and African American, 16.5 and 13.0 percent respectively yet, they remain underrepresented in study abroad, putting them at what appears to be a disadvantage in a global marketplace. The recent marginal gains in minority participation have not been enough to counterbalance the overall under representation. In addition, recent graduates of color have twice the level of unemployment over their White counterparts, according to the Economic Policy Institute (www.epi.org) who published: Graduate Employment Gap: Students of Color Losing Ground (2010) by Dr. Algernon Austin. Although they represent 30 percent of the total enrollment, African and Latino Americans collectively were only 11.7 percent of the participants in study abroad during 2010-11. Whites represent 62 percent of college enrollment, but nearly 78 percent of those who studied abroad during the same period. IERCEF and members of the Study Abroad/Global Engagement Partnership see these students of color graduating in a weak position for entering a competitive global workforce and are determined to do something about it. "About 12 million students attend four-year, colleges and nearly 4 million are Black and Hispanic, if they have an unemployment rate twice that of Whites it seems to be a no brainer that they need all the 'edges' they can get to compete in the marketplace"
IERCEF prides itself as being the only organization that has been trumpeting this issue and building consensus within this highered community for greater participation in international programs because of its benefits. They, with lead institution Livingstone College in Salisbury NC, established the Study Abroad/Global Engagement Partnership for that state's 11 Historically Black Colleges and Universities representing over 42,000 students.
"The new site is emblematic of our current position and heading. We wanted a platform to showcase our partners in developing new program content they are the best at what they do" says Steven Jones, President and CEO of IERCEF. The recent partnership last September with IES Abroad will produce a new 2014 sports medicine program in Jamaica. "We needed to tell everyone why it (study abroad) and our partners are important. These are to be scalable programs; reaching tens of thousands. This is just the beginning", he added.
About IERC Education Foundation (IERCEF):
The International Educational Resource Center Education Foundation (IERCEF) is a public, nonprofit founded in 2009 representing the study abroad program interests of the Study Abroad/Global Engagement Partnership which started with 11 Historically Black Colleges and Universities in North Carolina. IERCEF's mission is to diversify, among those underrepresented students attending 1,254 Minority-Serving Institutions across America, study abroad by incorporating with the cultural, innovative and tangible workforce valued, experiences.
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Doctor insights on:
Left Shoulder Tenderness Symptoms
I have pain and tenderness in the left breast and pain in my left shoulder blade area. Can these be symptoms of cancer?
More than likely NO!: Actually the pain could be a problem in your shoulder that maybe radiating into both places. Feel around your upper chest and back to find a super tender area. Apply constant pressure and if the pain get worse or goes away that is a trigger points which is a "sore" in the muscle. Heat, stretch and massage. Now...Get your mammogram and be seem by your primary doc. I like acupuncture! ...Read more
I have been experiencing an itchy and sore left shoulder. It's not super painful , but more annoying. Just curious what could be causing these symptom?
Sore Shoulder: A common cause of shoulder pain is soreness of the tendon (a cord that attaches a muscle to a bone) of the rotator cuff (the part of the shoulder that helps circular motion). Another common cause is soreness of the subacromial bursa (a sac of fluid under the highest part of the shoulder). ...Read more
I started a few weeks ago with pain and tenderness at the top if the spine. It has now moved down lower and to my left shoulder.
Left shoulder pain: Is always concerning for referred pain from heart (angina) or from abdomen. You should be evaluated by a doctor. It could be something as simple as tendinitis or bursitis, or something serious going on with your internal organs. ...Read more
I have been in pain since Monday with my neck and left shoulder blade. I have a swelling at top of spine which is very tender and painful?
Exam: I suggest the use of OTC Advil or Aleve (naproxen) if you are not allergic to these medicines. I strongly recommend OTC BioFreeze to relieve muscular pain. You MUST BE EXAMINED ...Read more
Pain for over a month started in left leg has spread to left shoulder. Under shoulder blade is tender to touch. What could this be? Its only the left
Could be myofasical: Chronic aches and pains in multiple parts of the body in a young female with otherwise healthy person is most probably myofascial/ fibromyalgia. Other possible causes like rheumatoid arthritis, lupus and Lyme disease not to be excluded by a physician who, after a thorough evaluation, may order additional testing ...Read more
Pain for over a month started in left leg has spread to left shoulder. Under shoulder blade is tender to touch. What could this be? Its only the left.
U need evaluation. .: Without a hands on exam & imaging & perhaps some labs. U can C Ur PCP or an internist 2 r/o significant underlying disease process. If need referral he/her can arrange it. ...Read more
Pain in my left shoulder, mid-trap on top of the shoulder for 5 days It hurts when i raise arm up or shrug Its also tender to touch No trauma suffered?
Sounds like muscle: Sure does sound like the trapezius. Sometimes overuse or carrying heavy loads can strain this muscle. Try soaking in a warm tub or hot shower. A topical pain reliever like Ben-Gay or Icy Hot may also help. If pain is worsening or not any better would see your doctor. ...Read more
I have a bone hard lump on my left shoulder. It hurts to move and it's tender to touch. The lump it's self has been there for about 4 months but it ha?
Lump: This will have to be examined by a physician for diagnosis. If it's movable and tender it could be an inflamed cyst. If it's bony hard and immovable it could be a bone tumor. If it's near the shoulder joint it could be a bone spur. Have it examined. ...Read more
Can you tell me if it is heart related, will the left shoulder, neck and especially the chest (below the shoulder blade) be tender?
Not heart: You can take this to the bank: if there's a tender part, it's not your heart. ...Read more
My left shoulder has had pain it sometimes shoots down into the arm. The tendons around the joint are tender. Its like aching pain bu not always there?
Rotator cuff: Depending on your age could be chronic tendinosis or even a rotator cuff tear. Rotator cuff pain often radiates down side of arm. In patients under forty to fifty this is often the result of tendinopathy or mild degeneration and will usually respond to nonoperative measures. Older patients often have a rotator cuff tear which depending on severity is sometimes best managed with surgery. ...Read moreSee 1 more doctor answer


text: Attended a seminar today on using fiber optic lighting as landscape lighting. Pretty high tech stuff. Amazing what we learned. It was put on by a new distributor. Therefore, no pricing as of yet. If you are familar with it, what is the approximate price of one 500 illuminator with a four color wheel with say three spots @150 fiber and 4 spreads @12 fiber. Using endglow fiber at 100 feet for each fixture. The manufacture is Supervision. Rex


text: I don't know how many Lost Fans have watch Buffy the Vampire Slayer but I just got the whole set and that got me thinking that the man in Black is a lot like the first evil in Buffy. They are both evil (or at least out for themselves), both are shape shifters that take on the forms of the dead and only the dead (the spider does not count I'm sure a spider died on the island before), they seem to manipulate people with psychological mind trick so they get people to do what they want done or just what they can't do themselves. Is it possible that the LOST writers saw Buffy and were inspired or am I just seeing pattern were there are none. Comment Below. --Addude 20:18, March 24, 2010 (UTC)


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Is it just me or is this mocking me! I must be old!
21 Replies
Sep 17, 2010 at 12:44 UTC
Payson Solutions Group is an IT service provider.
Oh yah, its real. way to very real.
insolent whiners that we call kids today. do they know how lucky they are to have parents who buy those games/consoles for them?
they think nothing of whining for the latest $70 game title, or the $300 update from the Wizbang 2000 console, to the Wizbang 2005 version ! like there is sooooo much difference between them. the 2000 plays my games just fine ;)
when I was their age, i had to beg for 4 quarters, just to be able to ride down to the doughnut shop 2 miles away, to play 4 games of Defender Stargate! If it was lucky, i could make that dollar last an entire thirty minutes!!!
Sep 17, 2010 at 12:50 UTC
Whats scary is I just bought Reach and got my ass kicked by some 12 yr old who kept headshotting me (stupid SWAT game type)
Sep 17, 2010 at 8:10 UTC
Not mocking you, you're just getting a little paranoid in your old age... j/k that is funnyand true though.
Sep 17, 2010 at 8:12 UTC
BTW headshots are fun! but I can't play FPS that are also multiplayer like that very well, I usually stick to single player RPG/action or if I feel like socializaton some Americas Army.
Sep 17, 2010 at 8:37 UTC
Is it just me or is this mocking me! I must be old!
Yeah, that's crazy... who stays up to 9pm???
Sep 17, 2010 at 8:48 UTC
I'm with Alex on this one. I do decently well in the single player campaign on most of those FPS games, but I'm horrible at multiplayer. Thus, I usually avoid them unless playing with my friends.
Oh, and those damn teenagers scare me! Now I must get back to my mall walking.
Sep 17, 2010 at 9:23 UTC
Let them find a job where headshotting in Halo gets you a fulltime paycheck...good luck with that. Oh BTW, get off my lawn. :)
Sep 17, 2010 at 10:38 UTC
well a job that pays well for head shots other then playing halo, USMC :-)
im with the rest of you on the teenagers, its difficult at best to play when as soon as you spawn your taken out. but the joy of kicking one of there a$$ is soooo much sweeter.
Sep 17, 2010 at 10:51 UTC
You just gotta work 500 times harder to kick their ass. I think as older more experienced people we would seriously outplay them in most strategy based games, or even FPS that utilize a great deal of strategy. In my assessment most of them find fun in not cheating per se, but in using tactics that are not honorable, like taking you out the moment you spawn. That's why I like Americas Army as a Multiplayer game, I'm still not really good at it, but if you play with the right people there is a strategy to it.
As far as a job shooting people in the head yes the USMC can provide that and so can the US Army, but taking someone out in HALO is much different than yielding a real firearm, and I would even hazard to guess that most of them wouldn't have the stomach to actually do it in real life even if their life depended on it.
Sep 17, 2010 at 11:35 UTC
Is it just me or is this mocking me! I must be old!
Yeah, that's crazy... who stays up to 9pm???
Sep 17, 2010 at 12:18 UTC
That comic is waaayyy too true.....I gave up playing up multiplayer stuff years ago and only do SP stuff now. Due mainly to kids now a days being way too good at FPS stuff (It is scary...) but also got tired of spawn kills, fraging your own teammates and plus the language kids use now a days....It is all F-word this and F-word that plus F-word, F-word, F-word and oh btw F-word you...... Its gets old very fast. Not worth my time.....
9pm and Baby Crying.....LOL!
Sep 17, 2010 at 12:25 UTC
At the moment I'm the perfect in-between. I just graduated from college and got a job in IT... so I can kick everyone's @ss at FPS games and build our company's virtual environment. A comment on Alex's post: It's not that the teenagers don't use strategy... they are using the strategy of memorizing spawn points and combining that with deadly accurate efficiency of moving about the map to places where they can kill someone and still get to the spawn point in time to take them out again.
Think of it as a preemptive strike. If you had the opportunity to take out an opponent (in real life or a game) and your goal was to take out the opponent before he takes you out, wouldn't you take him out when their is the least danger to you (when he's helpless)?
Also, generally the teenagers are very good at figuring out what parts of the level and what weapons and movements give the greatest advantages or risk/reward. That's strategy right there. I also think it's funny that kids are referred to as "whiners" and yet older people whine about the unfair advantage teens have (whether it be more time to play or quicker reflexes, etc).
Oh and the old saying "I could take them at (insert old game here)" usually doesn't apply. If kids spent as much time on an old game as the new games they'd probably still win. Let me know what you think. BTW I'm not a teenager, I'm 23, married, and have a job.
Sep 17, 2010 at 12:32 UTC
You still need to get off my lawn...JK
Sep 17, 2010 at 12:38 UTC
All I can say is AWESOME!!
and why isnt there a forum for the over 30's? ;)
Sep 17, 2010 at 1:04 UTC
Brian I concede you point, but real life doesn't have set points of entry and weapons caches in the same place all the time, generally recon is required first. In terms of real strategy I think older people would still perform better.
Sep 17, 2010 at 1:58 UTC
But real life does have choke points... And from that aspect it does have entry and exit points. Another thing to consider is that you can use every exploit that they do. If/When you ever kill one of them start killing them at the spawn points. Step 2: Massive amounts of trash talk about the PWNz0rz you put on them. :-) Believe me, I'm on the older gamer's side, I love destroying younger gamers. I just hope I don't lose my "young person" edge as I get older. Other the flip side, the more "wisdom and strategy" I can acquire the better.
What games do you guys play online? I have Dawn of War 2, Rainbow six vegas 1 and 2, tom clancy HAWX, Splinter cell chaos theory, Call of Duty WaW, Unreal Tournament 3, etc. IT guys unite to pulverize whiny kids!
Sep 17, 2010 at 3:31 UTC
I play WoW. /leave every chat channel and the game is fun.
Sep 17, 2010 at 3:48 UTC
Wow the newest games I played are a lot older than any of you guys. KOTOR, KOTOR 2, Oblivion, and Americas Army. Think I pleayed UT like twice in my life, never played HALO, Only have played SOCOMM Navy Seals, Final Fantasy X, and the Metalgear series, like only one of those is online play.
Sep 20, 2010 at 7:35 UTC
I think the biggest thing in the kids advantage is they have time. They don't always have a job and even if they do its not always a 40 hour a week deal. Most likely they are still at home and don't have to cook or clean. They have time to play the same map over and over and over and over and learn all those points. Then guys like us jump in and its boom... boom... boom then we log out.
I have some younger friends still in college they are much better at these games reaction speed and what not. We normally work pretty good together. We had some fun last night on Team Fortress 2, played two healers and one heavy. The fact that we talk on Vent and know what each other will do means.... well we owned the server. The main thing though is nobody on the other side played together as a team so it was easy to kill them.
I will say that as i get older though i can have fun picking the easy mode and not needing to prove anything by picked "extreme hard everybody has lasers and you a pocket knife" mode.
Sep 20, 2010 at 1:22 UTC
I will say that as i get older though i can have fun picking the easy mode and not needing to prove anything by picked "extreme hard everybody has lasers and you a pocket knife" mode.
Haha. You mean no playing Doom 3 on Nightmare using only the flashlight? (If you haven't tried attacking the enemies--especially the zombies and skeletons-- with the flashlight, try it... it's hilarious).
To Alex3031... Most of those games you named are awesome. I love KOTOR 1 and 2 as well as ALL of the Final Fantasy games... except maybe IX... Vivi was sweet but the rest of the characters were lame. I'm just looking for some people to play online with... or to use VPN to LAN and then play co-op on games like Ghost Recon Advanced Warefare 2, Rainbow Six Vegas 2, UT3, UT2004, Call of Duty World at War, etc. As I'm in the "real world" now I don't have too many friends to play with.
Sep 21, 2010 at 3:38 UTC
I got tired just reading...
Worse yet I don't like upgrading my PC to support the latest games...
Apparently my Commodore 64 just isn't up to snuff any longer and my Atari finally crapped out or the cassette tapes broke....
F'EM! (Language they learned walking past my house!)
This discussion has been inactive for over a year.
You may get a better answer to your question by starting a new discussion.


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