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Identify polysomnographic and demographic factors associated with elevation of nocturnal end-tidal CO2 in patients with obstructive sleep apnea.
Forty-four adult patients with obstructive sleep apnea were selected such that the maximal nocturnal end-tidal CO2 was below 45 mm Hg in 15 studies, between 45 and 50 mm Hg in 14, and above 50 mm Hg in 15. Measurements included mean event (i.e., apneas or hypopneas) and mean inter-event duration, ratio of mean post- to mean pre-event amplitude, and percentage of total sleep time spent at an end-tidal CO2 < 45, 45-50, and > 50 mm Hg. An integrated nocturnal CO2 was calculated as the sum of the products of average end-tidal CO2 at each time interval by percent of total sleep time spent at the corresponding time interval.
The integrated nocturnal CO2 was inversely correlated with mean post-apnea duration, with lesser contributions from mean apnea duration and age (R2 = 0.56), but did not correlate with the apnea-hypopnea index, or the body mass index. Mean post-event to mean pre-event amplitude correlated with mean post-apnea duration (r = 0.88, p < 0.001). Mean apnea duration did not correlate with mean post-apnea duration.
Nocturnal capnometry reflects pathophysiologic features of sleep apnea, such as the balance of apnea and post-apnea duration, which are not captured by the apnea-hypopnea index. This study expands the indications of capnometry beyond apnea detection and quantification of hypoventilation syndromes.
Jaimchariyatam N; Dweik RA; Kaw R; Aboussouan LS. Polysomnographic determinants of nocturnal hypercapnia in patients with sleep apnea. J Clin Sleep Med 2013;9(3):209-215.
Transcutaneous or end-tidal capnometry is commonly used in the polysomnographic evaluation of children in whom sleep disordered breathing manifests predominantly as obstructive hypoventilation.1 Alternatively, the role of capnometry in adult polysomnography has been more limited, usually for the quantitative assessment of sleep hypoventilation syndromes,2 or even less commonly, for the measurement of end-tidal CO2 (ETCO2) as an adjunct signal for the detection of airflow obstruction in sleep apnea.3,4 Few studies are available to assess the use or accuracy of capnometry for those purposes,5 and it therefore has not been routinely used in adult sleep laboratories.
However, current ETCO2 sampling devices are reliable and only slightly underestimate the arterial CO2, with a gradient of 5 mm Hg in patients with minimal ventilation-perfusion mismatch.6 In obese postoperative patients with obstructive sleep apnea, the mean arterial to ETCO2 gradient was 8.3 mm Hg.7 Even in patients with diverse neuromuscular and pulmonary disorders, the ETCO2 during sleep was found to underestimate a simultaneous arterial CO2 by ≥ 10 mm Hg in only 21% of the readings.8
In that context, in patients with sleep apnea but without suspected sleep-hypoventilation syndromes, we noted elevation of nocturnal ETCO2 that were unexpected in relation to the body mass index or the apnea-hypopnea index, indices usually associated with daytime hypercapnia in the obesity hypoventilation syndrome.9 We therefore sought to determine whether the nocturnal ETCO2 could reflect physiologic characteristics of obstructive sleep apnea not addressed by the apnea-hypopnea index or body mass index, and therefore expand its indication beyond the hypoventilation syndromes. For instance, contributors to the development of an elevated daytime arterial CO2 linked to obstructive respiratory events during sleep include post-event (subsuming apneas and hypopneas) ventilation as a function of CO2 load10,11 and apnea duration in relation to post-apnea duration.12
Current Knowledge/Study Rationale: Although end-tidal CO2 determination is reliable and accurate, its current application in polysomnography has been limited to the evaluation of sleep disordered breathing in children, the quantitative assessment of sleep hypoventilation syndromes, or as an adjunct signal for detection of sleep apnea. The aim of our study was to investigate whether end-tidal CO2 is associated with polysomno-graphic or demographic characteristics in patients with sleep apnea.
Study Impact: Daytime and nocturnal end-tidal CO2 are significantly related to post apnea duration, and to a lesser extent to apnea duration and age, but not to the apnea-hypopnea index or the body mass index. End-tidal CO2 monitoring can therefore be expanded beyond its current applications in apnea detection and hypoventilation syndromes, to its use as a marker of the pathophysiology, severity, and ventilatory burden of sleep apnea, all features that may be inadequately captured by the apnea-hypopnea index.
We therefore selected groups of obstructive sleep apnea patients with different severity of nocturnal CO2 elevation and assessed the relative contributions of demographic factors, sleep apnea severity, respiratory event and respiratory inter-event duration, as well as post-event amplitude relative to pre-event amplitude, to an overall measure of nocturnal ETCO2.
We reviewed polysomnograms and clinical charts of patients diagnosed with obstructive sleep apnea at our center from 2008 to 2009. Inclusion criteria were age > 18 years, total sleep time ≥ 6 h with a sleep efficiency ≥ 65%,13 and an apnea-hypopnea index ≥ 5. We excluded studies where central apneas represented > 50% of the apnea-hypopnea index, studies requiring oxygen administration, titration studies, and other conditions that could confound the nocturnal CO2 or impair the accuracy of the ETCO2 as a measure of arterial CO2 (i.e., chronic obstructive pulmonary disease, asthma, neuromuscular diseases, use of diuretics, alcohol or narcotics, or > 20 pack-year smoking history). To ensure an adequate representation of various ranges of CO2 values, we aimed for an equal number of patients in each of the following groups: maximal nocturnal ETCO2 < 45 mm Hg, between 45 and 50 mm Hg, and > 50 mm Hg.
All polysomnograms were recorded on Polysmith systems (Nihon Kohden, Foothill Ranch, CA), and scored using American Academy of Sleep Medicine guidelines.2 Capnometry data were obtained from calibrated Nonin RespSense devices (Plymouth, MN) interfaced to the Polysmith system. Those devices use a sidestream technology, with sampling obtained through oral/nasal cannulas (Salter labs, Arvin, CA). The sampling flow into the sample cell was 75 mL/min, the total system response time (including delay and rise times) was 4 sec, and the sampling rate for the capnograph tracing was 4 Hz. Apnea was defined as a drop in the peak thermal sensor excursion by ≥ 90% from baseline lasting ≥ 10 seconds. For the purpose of this study, a hypopnea was scored if the event met either the recommended or alternative definitions of the American Academy of Sleep Medicine (i.e., a drop in the nasal pressure signal excursion ≥ 30% from baseline for ≥ 10 sec in association with ≥ 4% oxygen desaturation, or ≥ 50% drop with ≥ 3% desaturation or an arousal).2
The quality of the oximetry and capnographic data was assessed by review of the pulse plethysmographic signal and capnographic waveforms, with exclusion of artifacts of oximetry due to loss of the pulse signal, and exclusion of CO2 waveforms without a clearly identified plateau, including those associated with deterioration of the signal due to obstructive events.
We collected demographic and polysomnographic variables at the time of the PSG: age, sex, body mass index, Epworth Sleepiness Scale score, sleep efficiency, sleep and REM latencies, sleep stage distribution, arousal index, apnea-hypopnea index, nadir oxygen saturation, and time spent below 90% oxygen saturation (as percent of total sleep time). Capnometric data were obtained from the trend report of the Polysmith system, and included stable awake end-tidal CO2 at the beginning of the study before the onset of slow-rolling eye movements (evening awake ETCO2), after completion of the sleep study just before the final calibrations (morning awake ETCO2), and sleep ETCO2. The latter included minimum and maximum sleep ETCO2 and the following 3 time intervals: percents of total sleep time spent with ETCO2 < 45 mm Hg (T45), between 45-50 mm Hg (T45_50), and > 50 mm Hg (T50). An integrated overnight CO2 was calculated as the sum of the products of the estimated average ETCO2 at each of those 3 time intervals by the percent of total sleep time spent at each corresponding time interval: [T45*(45 + minimum ETCO2) / 2] + [T50*(50 + maximum ETCO2) / 2] + [T45_50 *47.5]. The result was divided by 100 to provide an estimate of nocturnal ETCO2 had it remained constant through the night.
Respiratory event (subsuming apneas and hypopneas) and inter-event durations were measured in seconds. Inter-event durations were measured only if the subsequent respiratory event was within 30 sec from the termination of the preceding event. Pre-event and post-event breathing amplitudes were semi-quantitatively measured on the nasal pressure transducer signal on 60-sec epochs, as the amplitude of the last breath before the corresponding respiratory event and of the first breath after that event respectively (Figure 1). To compensate for expected variation in amplitudes as may occur with positional changes or migration of the oral/nasal cannula, the mean post-event amplitude was referenced to the mean pre-event amplitude.
Inter-event durations were included only if the subsequent respiratory event was within 30 sec from the termination of the preceding event. ad: apnea duration, pad: post apnea duration, hd: hypopnea duration, phd: post-hypopnea duration, apre and apo: pre- and post-apnea amplitude respectively, hpre and hpo: pre- and post-hypopnea amplitude, respectively. For each patient the mean of all event and inter-event durations across the polysomnography was derived and expressed in the text or tables as AD, PAD, HD, and PHD. Similarly, the mean of all pre-event amplitude and the mean of all post-event amplitudes was derived and expressed in the text as Apre, Apo, Hpre, and Hpo.
Schema illustrating event and inter-event duration, as well as pre-and post-event amplitude (with upward deflection of flow during inspiration)Inter-event durations were included only if the subsequent respiratory event was within 30 sec from the termination of the preceding event. ad: apnea duration, pad: post apnea duration, hd: hypopnea duration, phd:...
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The onset and offset of apneas and hypopneas were respectively placed at the nadir of the last normal breath and at the start of the first subsequent normal breath approximating the baseline (Figure 1).2 If the baseline amplitude could not be easily determined, the respiratory events were also terminated as per the American Academy of Sleep Medicine guidelines when there was a clear and sustained increase in post-event breathing amplitude, or re-saturation of ≥ 2%.2
For each patient we derived: mean apnea and mean hypopnea duration (AD and HD respectively), mean post-apnea and mean post-hypopnea duration (PAD and PHD), mean post-apnea and mean post-hypopnea amplitude (Apo and Hpo) expressed relative to the mean pre-apnea and mean pre-hypopnea amplitude (Apre and Hpre).
Sample size was estimated at 30 subjects based on a minimum meaningful correlation coefficient of 0.50, a power of 0.9, and α of 0.05.14 Groups were compared using a χ2 for categorical variables, and analysis of variance for continuous variables. The correlation between integrated overnight CO2 and demographic and polysomnographic variables was determined by the Pearson correlation coefficient. Comparison of correlations within a single sample was done using the Williams T2 statistic.15 Multiple linear regression analysis was performed to estimate the influence of covariates on the overnight CO2. Collinearity was measured by means of tolerance and the Variance Inflation Factor. Statistical significance was set at p < 0.05. Analyses were performed using SPSS, version 11.5. The study was approved by our institutional review board.
Forty-four consecutive studies meeting the inclusion criteria were selected such that maximal ETCO2 during sleep was < 45 mm Hg in 15 studies, between 45 and 50 mm Hg in 14 studies, and > 50 mm Hg in 15 studies. The mean age of the patients was 51 years (standard deviation 14, range 18-92), mean apnea-hypopnea index was 28 events/h (standard deviation 21, range 5.1-105), and the mean body mass index was 34 kg/m2 (standard deviation 9, range 20-57). There were 24 females and 19 males. None had a diagnosis of obesity-hypoventilation. There were no significant differences between genders in the body mass index, apnea-hypopnea index, mean apnea duration, mean post-apnea duration, and mean post-event to mean pre-event ventilation, though women tended to be older than men (54 vs. 47 years, respectively, p = 0.06), and to have a smaller neck circumference (38.7 vs. 41.4 cm, respectively, p = 0.07).
Demographic, polysomnographic, and laboratory data categorized by level of maximal ETCO2 reached during the sleep study are shown in Table 1. Neck circumference was higher in the combined groups with maximal ETCO2 ≥ 45 mm Hg compared to the group with maximal ETCO2 < 45 mm Hg (Table 1). Sleep efficiency, percentages of time spent at different sleep stages, percent of time in the supine position, arousal indices, and sleep and REM latency were not significantly different between the 3 groups.
Demographic, laboratory, and polysomnographic variables at baseline
Groups with progressively higher maximal ETCO2 had progressively shorter mean post-apnea duration, increased AD/PAD, and a smaller mean post-event to mean pre-event amplitude ratio (Table 2).
Comparison of possible variables predictive of end-tidal CO2 during sleep
There was a trend towards a positive correlation between the integrated overnight CO2 and age (r = 0.29, p = 0.06), as well as body mass index (r = 0.29, p = 0.06), and no significant correlation with apnea-hypopnea index, neck circumference, Epworth Sleepiness Scale score, sleep efficiency, sleep stages, percent time in the supine position, and percent time with oxygen saturation < 90%.
The REM latency correlated negatively with mean post-apnea duration (r = -0.41, p = 0.006), whereas REM time as percent of total sleep time correlated positively with the mean post-apnea duration (r = 0.34, p = 0.03).
The integrated overnight CO2 correlated with mean apnea duration (r = 0.41, p = 0.005) (Figure 2A), and mean-post apnea duration (r = -0.67, p < 0.001) (Figure 2B). The correlation of the integrated overnight CO2 with mean hypopnea duration or mean post-hypopnea duration was very poor and nonsignificant (r = -0.10, p = 0.53 and r = 0.11, p = 0.50, respectively). There was no difference between apnea and hypopneas as far as the correlation between the integrated overnight CO2 and the post-event relative to pre-event amplitude, with comparable correlation coefficients (p = 0.30), slopes, and intercepts. Therefore a mean post-event to mean pre-event (combining apneas and hypopneas) amplitude ratio was calculated, with which the integrated overnight CO2 was also correlated (r = -0.71, p < 0.001) (Figure 2C).
Each point represents one patient.
Scatter plots of the integrated overnight CO2 against mean apnea duration (A), mean post-apnea duration (B), and mean post-to mean pre-event amplitude ratio (C), with regression line, correlation coefficient, and significanceEach point represents one patient.
The evening and morning awake ETCO2 were nearly identical and closely correlated (40.7 ± 6.2 vs. 40.5 ± 5.8 mm Hg, respectively; r = 0.81, p < 0.001). The evening awake ETCO2 correlated positively with mean apnea duration (r = 0.42, p = 0.004), inversely with mean post-apnea duration (r = -0.81, p < 0.001), and inversely with mean post- to mean pre-event amplitude ratio (r = -0.80, p < 0.001).
Cross-correlation analysis indicated that collinearity was a concern, as the mean post-event to mean pre-event amplitude ratio was correlated with mean apnea duration (r = -0.43, p = 0.005), and particularly with mean post-apnea duration (r = 0.88, p < 0.001) (Figure 3). However, mean post-apnea duration was not correlated with mean apnea duration (r = -0.25, p = 0.10).
Scatter plots of the mean post-event amplitude to mean pre-event amplitude ratio against mean apnea duration (A), and mean post-apnea duration (B), with regression line, correlation coefficient, and significanceEach point represents one patient.
In a multivariable regression model, mean post-apnea duration, mean apnea duration, and age were each independently correlated with the integrated overnight CO2: mean post-apnea duration contributing the most to the variance in integrated overnight CO2 (45%), with mean apnea duration and age contributing an additional 6% and 5%, respectively, such that the total model explained 56% of the variance in integrated overnight CO2 (Table 3). The body mass index and apnea-hypopnea index were not significantly correlated with the integrated overnight CO2 in the multivariable model (p = 0.17 and 0.47, respectively).
Multiple regression of post-apnea duration, apnea duration, and age as predictors of the integrated overnight CO2
Our study shows that, in patients with obstructive apnea: (1) A shorter post-apnea duration is a greater contributor to an elevated integrated overnight CO2 than apnea duration, with older age as an additional lesser contributor; (2) Post-hypopnea amplitude is equally as important as the post-apnea amplitude with post-event relative to pre-event (combining apneas and hypopneas) amplitude contributing to the integrated overnight CO2, but also correlating strongly with apnea duration and post-apnea duration; (3) Post-apnea duration is not correlated with apnea duration; (4) The apnea-hypopnea index, body mass index, hypopnea duration, and post-hypopnea duration are not important contributors to the overnight CO2; and (5) The baseline awake end-tidal CO2 also correlated positively with mean apnea duration, and inversely with mean post-apnea duration and post-event amplitude relative to pre-event amplitude.
In our study, the post-event to pre-event amplitude ratio was tightly correlated with post-apnea duration (Figure 3B), suggesting that a common pathophysiologic mechanism, possibly airway collapsibility, underlies those two measures, and may explain our finding of an association between longer post-apnea duration and a more favorable REM architecture (with both a shorter REM latency and increased REM sleep). For instance, stable breathing correlated with passive collapsibility of the airway in patients with suspected obstructive sleep apnea.16 Consequently, multi-collinearity was seen between post-apnea duration and post-event to pre-event amplitude. Although ventilatory measures such as breath amplitude may be as important as post-apnea duration, the individual contribution of each of those two variables to the overnight integrated CO2 is difficult to discern in the context of collinearity. We therefore included only the apnea and post-apnea durations in the final model shown in Table 3, because durations were more sharply defined, less subject to variability in measurements (compared to amplitudes), limited to apneas (and therefore independent of the various hypopnea definitions), and independent of correction measures (such as square root modification of the nasal pressure amplitude signal17,18) to compensate for the nonlinear nasal pressure to flow relationship.
However, once the airway has collapsed and an apnea or hypopnea begun, the duration of the obstructive events may depend on factors other than collapsibility such as the arousal threshold. For instance, since arousals terminate an obstructive event, apnea duration has been considered a surrogate of the arousal threshold.19 These proposals, with separate determinants of apnea duration and post-apnea duration, are consistent with the absence of an inverse correlation between those two variables in our study as well as other studies.12
The integrated overnight CO2, did not correlate with hypopnea and post-hypopnea durations, perhaps reflecting the shape of the relationship between CO2 and ventilation (the metabolic hyperbola), such that the reduced ventilation during hypopneas, was either sufficient to prevent an increase in arterial CO2, or decreased our ability to detect such an effect within the technical constraints of our study. In that regard, the most important constraint is our removal of data associated with deterioration of the capnographic waveforms during obstructive events. This may have resulted in an underestimation of the true overall nocturnal CO2, and perhaps explain why apnea duration was not as strong a predictor of nocturnal CO2 as post-apnea duration in our study (an alternative explanation may be the constraint of the conventional 10-second threshold to the apnea definition). Note that loss of the capnographic signal during obstruction, which is considered an artifact in our study, has been used diagnostically to detect apneas,3 such that the lowered overnight end-tidal CO2, was shown to be associated with the apnea-hypopnea index severity.4 We confirm the results of other studies showing a relationship between a longer apneas or shorter post-apnea duration with a higher awake arterial CO2,12,20 and between an impaired post-event ventilatory response and a higher awake arterial CO2.10,11 Our study extends those results and demonstrates that, in individuals with obstructive sleep apnea, gradations of the awake CO2 even within the normal range, reflect events occurring during sleep, with elevation of nocturnal carbon dioxide as a possible intermediary step associated with shorter post-apnea duration, with lesser contributions from longer apnea duration, and increased age.
In contrast, we found that the apnea-hypopnea index was not a significant predictor of the integrated overnight CO2, and that the body mass index trended towards a poor correlation with the integrated overnight CO2, though both are important determinants of daytime hypercapnia in obese patients with obstructive sleep apnea.9 A potential explanation for those findings is that, beyond causing variations of awake CO2 within the normal range, inciting events to nocturnal hypercapnia (such as lower post-event ventilation, longer apnea duration, shorter post-apnea duration) require other factors (such as the apnea-hypopnea index or body mass index) for the transition to daytime hypercapnia. For instance, obese patients, and especially those with the metabolic syndrome, have a higher resting metabolic rate compared to non-obese patients21,22 but also have a decrease in metabolic rate during sleep in direct proportion to the body mass index.21 The resting to sleep differential in the metabolic rate based on body mass index, may explain the stronger contribution of the body mass index to the development of daytime as opposed to nocturnal hypercapnia.
Our findings do not establish whether an impairment of ventilation (as determined by apnea and post-apnea duration, or post-ventilation relative to pre-ventilation) determines ETCO2, or whether elevation in the ETCO2 impairs ventilation. However, progressive hypercapnia above a certain threshold improves upper airway stability in a linear fashion.23–25 This pharyngeal chemosensitivity parallels the control gain of central and peripheral chemoreceptors, with the net effect that increased CO2 protects and increases ventilation. Our findings are therefore more consistent with a ventilatory impairment in the balance between the accumulation of CO2 (longer apnea duration) and perhaps more importantly the unloading of CO2 (longer post-apnea duration) leading to nocturnal then daytime elevation of CO2.
Our study expands the indications of capnometry during polysomnography beyond its current contexts of apnea detection and quantification of the hypoventilation syndromes5 to its use as a reflection of the pathophysiology, severity, or ventila-tory burden of sleep apnea, which may not be fully captured by the apnea-hypopnea index. These findings may have both diagnostic and prognostic clinical implications, as exhaled CO2 may be a physiologic marker of disease severity that is independent of the apnea-hypopnea index, reflects the balance between event and inter-event duration, and may be an intermediary stage towards the development of daytime hypercapnia in some individuals. Advances in methods of exhaled breath analysis may broaden the role of exhaled CO2 as a diagnostic tool and therapeutic target in patients with sleep apnea.26
This was not an industry supported study. The authors have indicated no financial conflicts of interest.
mean apnea duration
mean post-apnea amplitude
mean pre-apnea amplitude
end-tidal CO2
mean hypopnea duration
mean post-hypopnea amplitude
mean pre-hypopnea amplitude
mean post-apnea duration
mean post-hypopnea duration
The authors gratefully acknowledge the contribution of Dr. Nancy Foldvary-Schaefer for her thoughtful review of the manuscript, and Nengah Hariadi and Jie Zeng for technical support. Work for this study was performed at the Cleveland Clinic, Cleveland, OH. Raed A. Dweik is supported by the following grants: HL081064, HL107147, HL095181, and RR026231 from the National Institutes of Health (NIH), and BRCP 08-049 Third Frontier Program grant from the Ohio Department of Development (ODOD).
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California's Board of Equalization released the numbers today. They include state, local and district taxes. 40 percent of the revenue, or just over 100 million dollars, has gone to the state's general fund. That largely matches projections from state budget analysts.
Some critics had predicted the tax would drive businesses to leave California. But Chas Alamo with the Legislative Analyst's Office says it's hard to tell if that's been the case.
"Business makes location decisions and decisions about where to expand or contract based on hundreds of different factors," he said, "the cost of living, the price of housing, the cost of labor."
Internet giant Amazon led the initial charge against the online sales tax pushed by Governor Jerry Brown in 2011. But it later came to an agreement with lawmakers. The company is now opening distribution centers around California - including one in San Bernardino, whose grand opening Tuesday was attended by the governor himself.


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National Lampoon's Vacation (BLU)
Harold Ramis
Everything is planned. Everything is packed. And everything is about to go hilariously wrong. The Griswolds are going on vacation. In the driver's seat, of course, is Clark Griswold (Chevy Chase), an Everyman eager to share the open road and the wonders of family togetherness with his wife and kids. Myriad mishaps, crude kin (Randy Quaid), encounters with a temptress (Christie Brinkley), financial woes, Aunt Edna (Imogene Coca) on the roof, one security guard (John Candy) and 2,460 miles later, it is indeed a wonder the Griswolds are together. There's never been a family vacation like it. Except perhaps for yours. And that helps explain why National Lampoon's Vacation remains so popular...and so very funny.
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- Language: English
- Aspect Ratio: 1.85.1
- Number of Discs: 1
- Rating: R
- Label: Warner Studios
- Run Time: 100 minutes
- Catalogue #: 3000031682
Special Features
- Griswold Family Commentary
- Introduction By Chase, Quaid And Simmons


text: Alan is looking for a new way to tell the story of climate change but what does that actually mean? This week the team gather to thrash out ideas. Some in the room believe a global problem needs a global political solution. But proposals of carbon taxes and auctions have proved hard to implement, international summits have fallen short of expectations and the fossil fuel companies are hugely powerful. Perhaps a people's movement might work better. Would a divestment campaign have more success?


text: The Big Pitch: In 1910, William Howard Taft became the first president to throw out the opening pitch for a professional baseball season. He was also the first president to have cars at the White House, and he helped start the "tradition" of federal income taxes. Taft, who once said, "politics makes me sick," fulfilled a lifelong ambition when he was named Supreme Court chief justice nine years after his presidency ended.


text:
The consumer electronics trend that had us shuffling out our perfectly good but perfectly bulky CRT televisions in favor of fancy-new flat screens appears to be ebbing. According to research firm IHS iSuppli, U.S. shipments of flat-panel TVs will actually decline for the first time since Fujitsu introduced the first 42-inch plasma display in 1997. And it doesn't appear as though the now mature product category is in line for returned growth anytime soon.
(LIST: The Top Ten Best Brand Extensions)
IHS forecasts the U.S. flat-panel TV market to decline to 37.1 million units in 2012, down 5 percent from 39.1 million units in 2011. By 2015, the research firm predicts that the American market for these TVs will drop to around 34 million shipments. The flat-panel category includes TVs built around the now-dominant liquid crystal display (LCD) technology, as well as older plasma and somewhat obsolete digital light projection (DLP) technologies.
Driving the forecast, IHS says, is the maturation of the market—most consumers who could afford to swap out their big, bulky TVs in favor of more elegant high-definition flat screens have already done so. That means that in the U.S., most of the purchasing is being conducted by consumers who are replacing an older flat screen.
(MORE: The End of Email? A New Social Network Built For Office Communication Says Yes.)
"The U.S. flat-panel television market has never declined on an annual basis, even at the height of the recession in 2008 and 2009," noted Lisa Hatamiya, TV research analyst for IHS. "The decline starting this year suggests that demand may have crested for the mature U.S. TV market. Sales in the United States now are being driven by consumers who are replacing their older flat-panel sets with new models boasting more advanced features. This contrasts with developing regions of the world where vibrant, untapped markets remain for buyers making their first-ever purchase of flat-panel sets."
Another factor cited by IHS: "irrational exuberance" on the part of TV manufacturers, who glutted the current market by over-projecting demand last year.
Republished with permission from paidContent, which writes about the transformation of the media-and-entertainment industries in the digital era, with a focus on emerging-business models and technologies.
Read More from paidContent.org:
The Cable Sports Bidding War Will Justify The Dodgers' $2.15B Sale Price


text:
Middle-class Americans are beginning to learn what Mitt Romney's tax plan would mean for them. The Wall Street Journal reports:
A new study released Wednesday suggests that Mitt Romney's tax plan would benefit the rich and hurt the poor and middle class, no matter how current blanks in the plan are filled in.
Mr. Romney's ambitious plan would extend current Bush-era tax rates, plus cut rates another 20 percent, eliminate investment taxes altogether for households making under $200,000, and abolish the dreaded alternative minimum tax. But it provides few details about what tax breaks would be pared to offset the budget hit.
The study basically concludes that eliminating tax breaks to offset the impact of Mr. Romney's rate cuts would inevitably hurt the middle class.
Want more details about Governor Romney's plan? Check out the full report.


text:
John Krasinski and Emily Blunt will soon be husband and wife.
The Office star, 29, and actress, 26, who have been dating since November 2008, are engaged, his rep confirms to PEOPLE.
"We can confirm that John and Emily are engaged," says the rep.
The couple have kept their relationship under wraps, arriving separately at the 2009 SAG Awards in January and enjoying low-key dates in Los Angeles including a double date with Blunt's The Devil Wears Prada costar Anne Hathaway and her beau Adam Shulman.
"It's not about celebrity or not," Krasinski told Glamour in August 2007 about what he looks for in a woman. "It's all about, do you have that 'girl in a cardigan' in you. You gotta have that."
Krasinski, named one of PEOPLE's Sexiest Men Alive, also said he looks for someone with a good sense of humor.
"Being able to laugh with someone is one of the best feelings," he told PEOPLE last year.
Krasinski previously dated his Office costar Rashida Jones. Blunt ended her relationship with Canadian singer Michael Bublé in July 2008 after three years of dating.


text:
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Topic Page: pneumonia
Inflammation of the lung tissue, most often caused by bacterial infection. Most at risk are the very young, the aged, and those whose immune systems have been undermined by disease or certain medical treatments. The most common form is pneumococcal pneumonia, caused by the bacterium Streptococcus pneumoniae. Symptoms include fever, chest pain, coughing and the production of rust-coloured sputum. Treatment is with antibiotics.
(nʊmōn'yӘ), acute infection of one or both lungs that can be caused by a bacterium, usually Streptococcus pneumoniae (also called pneumococcus; see streptococcus), or by a virus, fungus, or other organism. The causal organisms reach the lungs through the respiratory passages. Usually an upper respiratory infection precedes the disease. Alcoholism, extreme youth or age, debility, immunosuppressive disorders and therapy, and compromised consciousness are predisposing factors. When one or more entire lobes of the lung are involved, the infection is considered a lobar pneumonia. When the disease is confined to the air spaces adjacent to the bronchi, it is known as bronchopneumonia. Aspiration pneumonia is the pathological consequence of the abnormal entry of fluids, particulate matter, or secretions in the lower airways.
The symptoms of pneumonia are high fever, chills, pain in the chest, difficulty in breathing, cough, and sputum that is pinkish at first and becomes rust-colored as the infection progresses. The skin may turn bluish because the lungs are not sufficiently oxygenating the blood. Complete bed rest and good supportive care are important. Oxygen helps to relieve severe respiratory difficulty.
Immunization for pneumococcal pneumonia is recommended for children under two years old, adults 65 or older, and others at risk. Penicillin is most commonly used to treat pneumococcal pneumonia and other pneumonias caused by bacteria and, with the other antibiotic and sulfa drugs, is responsible for the marked decline since the mid-20th cent. in mortality figures. Nevertheless, pneumonia is still a serious disease, especially in elderly and debilitated persons (who usually acquire bronchopneumonia) or when complicated by bacterial invasion of the bloodstream, membranes of the heart, or the central nervous system.
Viral pneumonia, generally milder than the bacterial form, is the result of lower respiratory infection and has been the cause of more than 90% of deaths for individuals over 65. Pneumocystis carinii pneumonia, which is caused by an organism traditionally thought to be a parasitic protozoan but now suspected to be a fungus, generally only occurs in patients who have AIDS or leukemia or whose immune system is otherwise suppressed.
Related Articles
Full text Article Pneumonia
Pneumonia is an acute inflammatory condition of lung parenchyma (lung tissue excluding the airways) caused by a variety of infectious agents...
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The lungs are primarily responsible for gas exchange, removing carbon dioxide in exchange for oxygen. The lungs have significant surface area and...


text:
Teacher resources and professional development across the curriculum
Teacher professional development and classroom resources across the curriculum
A video instructional series on physics for college and high school classrooms and adult learners; 52 half-hour video programs and coordinated books
1. Introduction
This preview introduces revolutionary ideas and heroes from Copernicus to Newton, and links the
physics of the heavens and the earth.
2. The Law of Falling Bodies
Galileo's imaginative experiments proved that all bodies fall with the same constant acceleration.
3. Derivatives
The function of mathematics in physical science and the derivative as a practical tool.
4. Inertia
Galileo risks his favored status to answer the questions of the universe with his law of inertia.
5. Vectors
Physics must explain not only why and how much, but also where and which way.
6. Newton's Laws
Newton lays down the laws of force, mass, and acceleration.
7. Integration
Newton and Leibniz arrive at the conclusion that differentiation and integration are inverse
8. The Apple and the Moon
The first real steps toward space travel are made as Newton discovers that gravity describes the
force between any two particles in the universe.
9. Moving in Circles
A look at the Platonic theory of uniform circular motion.
10. Fundamental Forces
All physical phenomena of nature are explained by four forces: two nuclear forces, gravity, and
11. Gravity, Electricity, Magnetism
Shedding light on the mathematical form of the gravitational, electric, and magnetic forces.
12. The Millikan Experiment
A dramatic recreation of Millikan's classic oil-drop experiment to determine the charge of a single
13. Conservation of Energy
According to one of the major laws of physics, energy is neither created nor destroyed.
14. Potential Energy
Potential energy provides a powerful model for understanding why the world has worked the
same way since the beginning of time.
15. Conservation of Momentum
What keeps the universe ticking away until the end of time?
16. Harmonic Motion
The music and mathematics of periodic motion.
17. Resonance
Why a swaying bridge collapses with a high wind, and why a wine glass shatters with a higher
18. Waves
With an analysis of simple harmonic motion and a stroke of genius, Newton extended mechanics
to the propagation of sound.
19. Angular Momentum
An old momentum with a new twist.
20. Torques and Gyroscopes
From spinning tops to the precession of the equinoxes.
21. Kepler's Three Laws
The discovery of elliptical orbits helps describe the motion of heavenly bodies with
unprecedented accuracy.
22. The Kepler Problem
The deduction of Kepler's laws from Newton's universal law of gravitation is one of the
crowning achievements of Western thought.
23. Energy and Eccentricity
The precise orbit of a heavenly body — a planet, asteroid, or comet — is fixed by the laws of
conservation of energy and angular momentum.
24. Navigating in Space
Voyages to other planets use the same laws that guide planets around the solar system.
25. Kepler to Einstein
From Kepler's laws and the theory of tides, to Einstein's general theory of relativity, into black
holes, and beyond.
26. Harmony of the Spheres
A last lingering look back at mechanics to see new connections between old discoveries.
27. Beyond the Mechanical Universe
The world of electricity and magnetism, and 20th-century discoveries of relativity and quantum
28. Static Electricity
Eighteenth-century electricians knew how to spark the interest of an audience with the principles
of static electricity.
29. The Electric Field
Faraday's vision of lines of constant force in space laid the foundation for the modern force field
30. Potential and Capacitance
Franklin proposes a successful theory of the Leyden jar and invents the parallel plate capacitor.
31. Voltage, Energy, and Force
When is electricity dangerous or benign, spectacular or useful?
32. The Electric Battery
Volta invents the electric battery using the internal properties of different metals.
33. Electric Circuits
The work of Wheatstone, Ohm, and Kirchhoff leads to the design and analysis of how current
34. Magnetism
Gilbert discovered that the earth behaves like a giant magnet. Modern scientists have learned
even more.
35. The Magnetic Field
The law of Biot and Sarvart, the force between electric currents, and Ampère's law.
36. Vector Fields and Hydrodynamics
Force fields have definite properties of their own suitable for scientific study.
37. Electromagnetic Induction
The discovery of electromagnetic induction in 1831 creates an important technological
breakthrough in the generation of electric power.
38. Alternating Current
Electromagnetic induction makes it easy to generate alternating current while transformers make
it practical to distribute it over long distances.
39. Maxwell's Equations
Maxwell discovers that displacement current produces electromagnetic waves or light.
40. Optics
Many properties of light are properties of waves, including reflection, refraction, and diffraction.
41. The Michelson-Morley Experiment
In 1887, an exquisitely designed measurement of the earth's motion through the ether results in
the most brilliant failure in scientific history.
42. The Lorentz Transformation
If the speed of light is to be the same for all observers, then the length of a meter stick, or the rate
of a ticking clock, depends on who measures it.
43. Velocity and Time
Einstein is motivated to perfect the central ideas of physics, resulting in a new understanding of
the meaning of space and time.
44. Mass, Momentum, Energy
The new meaning of space and time make it necessary to formulate a new mechanics.
45. Temperature and Gas Laws
Hot discoveries about the behavior of gases make the connection between temperature and heat.
46. Engine of Nature
The Carnot engine, part one, beginning with simple steam engines.
47. Entropy
The Carnot engine, part two, with profound implications for the behavior of matter and the flow
of time through the universe.
48. Low Temperatures
With the quest for low temperatures came the discovery that all elements can exist in each of the
basic states of matter.
49. The Atom
A history of the atom, from the ancient Greeks to the early 20th century, and a new challenge for
the world of physics.
50. Particles and Waves
Evidence that light can sometimes act like a particle leads to quantum mechanics, the new
51. From Atoms to Quarks
Electron waves attracted to the nucleus of an atom help account for the periodic table of the
elements and ultimately lead to the search for quarks.
52. The Quantum Mechanical Universe
A last look at where we've been and a peek into the future.
© Annenberg Foundation 2017. All rights reserved. Legal Policy


text:
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Verify meat probe is securely inserted in the meat probe receptacle.
Location may vary.
Reset power to the product:
- Power unit down by turning off the circuit breaker(s) for one (1) minute.
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text:
Este vídeo es parte de las siguientes colecciones:
Suggest video details
Selecciona los siguientes detalles que mejor describan a este vídeo. Apreciamos tu ayuda y utilizaremos esta información para mejorar nuestro servicio.
¿Reconoces a una estrella porno en este vídeo? Ayúdanos a que las estrellas porno sean más fáciles de encontrar en YouPorn diciéndonos quién está en este vídeo.
Ayúdanos: ¿Estas estrellas porno aparecen en este vídeo?
if you listen her ass pops when he takes his dick out at 4;30
The girl was cute but the guy looks like a fucking perv it was a total turn off
love her patriotism!
She is soooooo sexy
ja pobre loko estaba biendo la TV ahhh rreeee1!!
damm i wouldent mind fukking that ass
i can try....
i am boy
Something tells me this isn't Victoria's first time perching her ass on top of a meat whistle...I'm just guessin' here.
to ketty, i agree with u. my british bf fucks me hardddd...u know i have a little pussy coz i am filipina...i ant walk after he fuck in my vagina and anal
pinay's have small pussy
oh my god i love it how old that girl i like her the way she move her body
fuck you! dats my girlfriend! fuuuuuuck!!!!!! fuck you!
That ain't no virgin asshole the way she spurts that cum out!!!
suck my cock fuck ass uhh uhhh (bouncy bed) xx (i)
i can't try?
Beautiful. I wish I could be young again.
Why do guys think it's okay to shove a girl's head up and down when she's giving him head? It's uncomfortable, and makes giving head harder to do - it's not that difficult to do, she can figure it out without you shoving her head roughly up and down.
virgin my ass!
Ella no esta viginano
i wanna fuck guy right now
HEY YOU! obama is ruining this nation. stop jacking off and do something about it!!!!!!!!!1
Yea..why does that weird looking dude get to fuck so much fine ass?!
Ilike to fuck a Girl anal...hard and fast!!!
Then fuck me
coralie jaimere bien defonse ton pti cul
ese culito es virgen ???????......
I want only to marry her............
fuck this girl its so cute and hot yummy
iam 21. 1st time i get very very hard anal fuck by my bf just.one month back. it was very painful but i love that very much it make me wit. & now i compled him to fuck my anal very deep & fastly. i love speedy fucking. my bf has a big thick penies near about 7.5". when he strocks me fast from behind, holding my shoulders very strongly, he says my loudely moaning & shouting makes him very hot, his cock becomes very long tite & strong & he fucks very violently 2 me. aaahhhh my god what a sex what a nice feeling what a pleasure wow!!!! my bf is a good fucker. he fuck me so hot, so harder, very deeper. when his cum jurking out very fourcely on my face in my mouth & on big round boobs. aaaahhhh god i become so mad. he rub that hot cum all over to my body & i suck his long fat penies with my sweet lips. ooohhh god iam so crazy aaaahhhh fuck me yar fuck me harder, deepar,and sosososososoooo faster ccccoooommmeeeoooonnnn fuck me
that was great
slammed shut quickly hasent been bourd out yet!
ke rico esta el tipo, yo me le monto y ya no me bajo. me gusta la escena donde la tiene boca abajo y el trepado en ella dandole por el culito. asi me gusta ke me pongan a mi, bien sumisa.
lindo Culito I love Panties XD
Fucking hot virgina
make dat pig squeal do you take black cock how about it tator tots malt liquor and chicken necks for supper at my house if intrested lets have some crack head babies together call me
no memen pero si es una bebe
sweet sex
Does anybody knows the name of the actress, would like to see her in other situations
Virgin ass, once upon a time.
¿Cuántos años tenía cuando hizo este vídeo?
Virgin anal? It's big ass hole buddy
ouhhh men
Love it
Beautiful booty but she doesn't look like a Tight end to me, more like a Wide receiver.
hallo i like
Very nice..
wow! nice.
fucking boots or shoes, sandals again
owww shit
Das habt ihr gut gemacht (Y)
Holy shit how young is she???XD
Not young enough.
I need a dick up my pussy hell I love it
holy shit i had multiple orgasms watching this video, wish i had my supertight asshole fucked hard
So sweet I like it baby oooooooooooooommmmmmmmhhhhhhhhh
hmmm... come on take my ass...
I will make her pussy suffer....
dis dude liv anal
nce ha
Can I?
Just something i love watching Anal and i got my wife the other night and i love to fill her with my hot cum in her anal it was fun
wow that amazin'
esta hermosura querra acer un video con migo tengo 22 añitos y me encanta el sexo
alguna chica para acer un video por ay
He is probably thinking dat ass
love Rocco!!
That girl is sweet.
fuck you
she has very hot butt
fuck me harder oh yeah
You were sweet, babygirl.
Dat ass
im wet
I like how he sucks her titties!!!
That was cum worthly
Hahaha...se isso e ser virgen imagina um arrombado!!!
its so nice 2 fuck victoria...i like 2 fuck you victoria
omg how old is she?
de todas maeras yosi me la cojo este como este es q esta vien mamacita
mini tits XD
she looks so innocent but im not sure she is... whats her real name?? she have more videos??
tangina libog na libog ako
i super like this vidro can hindot your pussy ang srap!!!!!!
masarap maki pag-kantutan
can i get your number u wanna sex me!!!!!!!!!!!!!
damn wish my girl let me do that to her perfect butthole
Download Full Video
No download links available now


text:
Hand-Eye Coordination
Monday, April 14, 2008
95 comments:
- Scar06 said...
That look just... Super!! :P
- April 14, 2008 at 11:29 PM
- Anonymous said...
This is what you get when Thing from the Adams family masturbates...
- April 14, 2008 at 11:31 PM
- Anonymous said...
scary and Creepy!
- April 15, 2008 at 12:15 AM
- cartoonjoe said...
- April 15, 2008 at 5:19 AM
- Justin said...
This kind of reminds me of Jason felix's stuff... in terms of mood/texture.
Can't wait for more! :D
- April 15, 2008 at 7:38 AM
- Carlão said...
Funny! That's something like an assassin hand (or 2?).
I'll click sometimes in the google ads as a reward of your work! Very good job!
- April 15, 2008 at 9:28 AM
- Eseseta said...
I love your work, but in this case I think its wrong. It doesn't seem "real" or "plausible". I think the wanderful of this art is that I can dude for a moment if this is plausible. In this case the image, specialy the mouth part, its very very plain. Excuses for my english!
- April 15, 2008 at 11:26 AM
- Nikki said...
Yes that is disturbing, but way awesome. All with Photoshop? It's an amazing program especially with a good driver! PS - eyeball in the tongue freaks me out even more.
- April 15, 2008 at 12:32 PM
- trepiccanti said...
the mouth was fine enough without that eye inside. that just makes it "too much".
but all in all is good.
keep on.
- April 15, 2008 at 12:41 PM
- Eseseta said...
Ah! We enjoyed the untooned homer... This could be a perfect mate! http://upload.wikimedia.org/wikipedia/en/thumb/1/1b/The_Homer_by_Carlos_Bisquertt.jpg/800px-The_Homer_by_Carlos_Bisquertt.jpg
- April 15, 2008 at 12:41 PM
- Anonymous said...
This is just a step away from agent orange mutants.
- April 15, 2008 at 9:14 PM
- Anonymous said...
Holy crap, this is way scary
- April 16, 2008 at 12:37 AM
- Anonymous said...
do you know the work by Jake & Dinos Chapman? (two british contemporary artists).
If not, you should definitely check it.
some links:
cheers !
- April 16, 2008 at 8:03 AM
- Anonymous said...
I just don't know about this one, I think the untooning is cooler.
- April 16, 2008 at 8:47 AM
- F1 Zap news said...
yep, I have to agree too, I like the untooning much more :)
but of course it is a great work
- April 16, 2008 at 10:31 AM
- Anonymous said...
Nice eerie pic. It's just awesome what you can cook up in PS. I would REALLY like some sort of tutorial on your work. Lastly I must point out that I too like the untooning more tho' 'cause of the extra wow-factor you get by knowing the character since before, but whatever keeps your spirit up and nice pics coming out :D
- April 16, 2008 at 11:37 AM
- Anonymous said...
Reminds me of Pan's Labryth
- April 16, 2008 at 4:38 PM
- Andrew Cunningham said...
This sort of is an untoon - quite a lot like some of the images in the manga Parasyte.
- April 16, 2008 at 7:21 PM
- Cari said...
Oh Dear LORD that thing gives me the jibblies! I hate the mouth eye thing in the wrist! It's making my wrist feel crawly!
- April 17, 2008 at 8:51 AM
- BronzeArmor said...
This looks awesome.....like something out of Silent Hill
- April 17, 2008 at 12:30 PM
- WJUK said...
Animate it!
- April 17, 2008 at 2:02 PM
- Skeith said...
This is really awesome.
Untooning or stuff like that, I don't care, they are just both so awesome :).
- April 17, 2008 at 2:56 PM
- Ulisses Adirt said...
Very cool...
- April 18, 2008 at 12:46 AM
- pippinTuk said...
Please... think of the kittens!
- April 18, 2008 at 11:32 AM
- Doppelbock said...
That is great, it definitely has a Lovecraft feel to it.
- April 19, 2008 at 4:04 PM
- Anonymous said...
- April 20, 2008 at 11:20 AM
- Anonymous said...
I really like ur work, and I still think it would be awesome if you could do one of Stewie "untooned."
- April 20, 2008 at 11:52 AM
- Anonymous said...
what program do you use to make these renders?
- April 20, 2008 at 12:28 PM
- Anonymous said...
Somebody's been staying up too late watching the Evil Dead movies.
- April 20, 2008 at 6:46 PM
- Peter said...
Your works are really good!
I love the untoons. Also this one is a masterpiece of photo editing. It reminds me to the works of a german artist, named "Heile Mania". Watch his works at http://www.fotocommunity.de/pc/pc/mypics/416206
- April 21, 2008 at 12:14 PM
- Ted said...
It reminds me of Makonde sculpture from Tanzania. If you've seen their abstract representations of demons, you know that they've been "untooning" in 3D since long before PhotoShop was created. Since before the computer was created, for that matter.
I own a sculpture that's somewhere in the freak zone between this "Hand-Eye" image and this elephant.
- April 21, 2008 at 3:33 PM
- skraggle said...
Well done! Even the name is clever...
- April 21, 2008 at 3:57 PM
- Anonymous said...
Wow. I wanna use that as my Christmas card this year.
- April 21, 2008 at 6:19 PM
- Henry Von Stifle said...
Fine work and looks frightfully like my Aunt, you haven't met her have you! She passed away sometime ago sadly. I say sadly because one has to say those kind of things, but in all honesty it was a relief to us all. For the last three years of her life he was convinced she was Bruce Willis, which sounds like fun but after a while the jumping around trying to defuse bombs became somewhat tiresome. Keep up the good work.
- April 22, 2008 at 7:29 AM
- Ronnie said...
We spent a lot of time sitting and staring, and all agree that it's yet another wonderful pixeloo work.
- April 22, 2008 at 4:09 PM
- LiveWire said...
Is there any chance we can use this image or borrow a copy of native psd? We would love to take a stab at a 3d model replicate into the animation
world. Our outside email address is email@example.com
- April 23, 2008 at 9:01 AM
- pockets said...
You are remarkably and quite notably CREATIVE! Engaging work.
- April 23, 2008 at 10:41 AM
- JimBoy said...
Ooooh, that's creepy!
It kinda gives a whole new perspective on the "don't bite the hand that feeds you" proverb. In this case, I'd be darn careful when feeding that thing.
- April 24, 2008 at 11:51 AM
- Anonymous said...
Definitely nightmare material.
- April 24, 2008 at 3:33 PM
- Portman said...
Do you take requests?
- April 24, 2008 at 5:45 PM
- JJ Michaels said...
That's not creepy at all... :-) You're amazing, dude. If I had half the artistic talent as you, my blog would be way better. Speaking of which, I just started one; my first blog, but not my first time doing something like this. You probably get a lot of requests like this, but could you read it? It's called (Insert Title Here). Thanks in advance.
- April 26, 2008 at 6:45 AM
- Anonymous said...
i've got one of those in my basement as well...
- April 26, 2008 at 8:35 AM
- Kate said...
- April 27, 2008 at 12:12 AM
- Riley said...
wow dude that is some pic. make him a little buddy!!!
- April 27, 2008 at 8:33 AM
- Kylie B said...
Wow very creative, love your work...
- April 29, 2008 at 11:33 PM
- Jenrosesegrest said...
lol, i have to say it is definitely creepy, but well executed, you are vey talented:)
- May 1, 2008 at 5:53 AM
- Abhishek said...
Really good job, I'm a bit of a photoshop fan, but that is way above my skill. Greate work
- May 2, 2008 at 2:01 PM
- Anonymous said...
- May 2, 2008 at 6:30 PM
- earvz said...
hi so coolie!!
check my blogs guys thanksie!! lab yah
- May 2, 2008 at 10:19 PM
- missylo said...
Look what i found in the basement" reminds me of my favorite book series as a kid: the goosebumps!
Though, this is definately MUCH scarier. it gives me the chills.
- May 3, 2008 at 10:25 AM
- VenomousNinja said...
That is severely messed up... In a good way, of course.
- May 3, 2008 at 12:55 PM
- Anonymous said...
It's like something out of silent hill! sick but cool!
- Poetry Book
- May 3, 2008 at 2:53 PM
- Stephen said...
wow! untooning is so cool! who else is untooned? Got more links?
- Poetry Book
- May 3, 2008 at 2:59 PM
- gamer said...
Very good work. Man I am your fan now!
- May 4, 2008 at 8:04 AM
- Young & Wealthy said...
I like your work. Keep it up.
- May 4, 2008 at 1:21 PM
- lynn dunham said...
Amazing the number of remarks on this work - love it!
- May 5, 2008 at 7:15 PM
- Rhiana said...
Truly disturbing.
- May 5, 2008 at 8:04 PM
- Suyash Pratap Singh said...
You can put your talent to some better creativity, this one is awaful.
- May 6, 2008 at 4:09 AM
- Naochan said...
- May 6, 2008 at 4:47 PM
- JHON said...
parcero las imagenes le quedaron muy bacanas, usted es un artista.
- May 7, 2008 at 8:47 PM
- JHON said...
partner images you were very Bacán, you are an artist, luck and success.
- May 7, 2008 at 8:50 PM
- Anonymous said...
USE THIS TO CREATE AN HONEST BUSINESS OF YOUR OWN interests
- May 7, 2008 at 10:09 PM
- Scheni said...
Really cool! Love your work! =)
- May 13, 2008 at 6:05 PM
- Anonymous said...
Ewwww rank rank rank
thats really disgusting and i know it isn't real but watever its still ewww...
Have you seen the teeth on it like Yuck.
- May 15, 2008 at 2:55 AM
- Anonymous said...
If you were to extend tentacles, just slightly, from the final knuckle of each finger, it would give an even more Lovecraftian feel. It would mean removing the fingernails but I think it would add a slight twist to the abstract of humanity.
Love Lynzi
- May 16, 2008 at 6:44 AM
- Anonymous said...
Most excellent! This image really reminded me of The Corinthian character from Neil Gaiman's Sandman comics. Instead of eyes, he has two mouth with sharp teeth. Personally, I think that would be an awesome addition if you did one.
- May 20, 2008 at 5:01 PM
- Anonymous said...
It's not a bad thing that it's disturbing. Some of the best art is horrifying.
- May 20, 2008 at 10:11 PM
- Ulysses said...
muy buenas imagenes
saludos desde Chiapas mexico
un abrazo!
good luck!!!
- May 21, 2008 at 10:21 PM
- scratch79nine said...
Oh my GOD, HOW DO YOU MAKE THESE THINGS? AWESOME!
- May 24, 2008 at 8:43 AM
- Inty Pakary said...
I like it very much. It has impress me!
- May 28, 2008 at 12:10 PM
- David said...
man, you're seriously awesome i've seen your video of jessica rabbit and it rocks...
btw, this image looks so great that it almost looks as if it was the cover of a movie or something like that...
just WOW!
- May 28, 2008 at 8:16 PM
- Anonymous said...
Looks kind of like Lefty from Parasyte to me.
- May 31, 2008 at 2:14 AM
- Anonymous said...
omg fantastic and scarry!!!! ever thought of making these into bedtime toys for kids!!!!! just brilliant
- June 6, 2008 at 8:38 AM
- Charles said...
If you offered this as a poster, I'd probably buy it. Has been my desktop wallpaper for at least a month now.
- June 16, 2008 at 10:27 AM
- richjerk said...
Great Job! Feels damn scary to me
- July 1, 2008 at 7:12 AM
- Anonymous said...
- August 11, 2008 at 5:10 PM
- snorre said...
wow - that's really amazing.
i love disturbing pics like these -
great job!
- September 26, 2008 at 12:44 PM
- Anonymous said...
WOW! it´s like the hand from IMPRINT of MASTERS OF HORROR
- October 29, 2008 at 1:05 AM
- Anonymous said...
Wohohohohoooo... THIS IS A INVENTION OF A EVIL GENIUS!!!O_O Anyway, it should've been a lot of work so *respect, master*
- November 4, 2008 at 1:41 PM
- Anonymous said...
- November 8, 2008 at 3:23 PM
- Anonymous said...
Kill it! Kill it with fire!
- January 18, 2009 at 6:41 PM
- Anonymous said...
fap fap fap fap fap!
- January 21, 2009 at 3:50 PM
- Ragni said...
Wow, you're really good at PhotoShop! Is it CS3? I've got it myself, but I can honestly say I'm not even close.. And I really thought I was good.. This just proves how much one can do using it! How about making other Family Guy caracters untooned? Or someone from South Park, that'd be great!
- February 3, 2009 at 8:26 AM
- Anonymous said...
Wow that is scary to me but not to my friend sitting next to me he has seen worse.
- February 5, 2009 at 9:03 AM
- The Justinator said...
as creepy as this is, it in no way scares me.
- February 26, 2009 at 4:05 PM
- Grograman said...
Very unique. Doesn't remind ME of anything. It DOES look like something that might be growing in the Monsanto corporations basement, though...
- May 5, 2009 at 6:33 AM
- Barney McGroo said...
That's great! The lighting's really consistent. Did you plan it out carefully before photographing all the bits or did you see how it fitted together after you'd taken all the images?
- July 9, 2009 at 9:38 PM
- CatherineL said...
I agree with Anonymous that it reminds me of Migi from Parasyte, the manga by Hitoshi Iwaaki. Parasyte is about a boy dealing with the alien parasite that's taken over his right arm. Migi, the parasite, is like putty and tends to grow eyes and a mouth and tendrils from wherever is convenient, not wherever is pretty.
The two of you artists would get along great.
- September 10, 2009 at 11:02 PM
- alex said...
Kind of looks like something that would be on a Mars Volta poster or album. Looks awesome btw.
- May 8, 2010 at 7:59 PM
- costa rica condos said...
great! valuable information, I've shared with my two children and liked, thanks for sharing information
- June 12, 2010 at 9:43 AM
- Alison said...
I feel sorry for the little mouth on the bottom for some reason... is that weird?
- August 29, 2010 at 7:55 PM
- Anonymous said...
what happens when you smash 2 hands, several eyes, an ear, and two mouths? THIS!
- January 16, 2011 at 10:43 AM
- Anonymous said...
...Are you cyriak?
- March 12, 2011 at 8:22 PM
- Anonymous said...
very cool. super creepy. you should do more of the griffin family or futurama or american dad characters
- March 20, 2011 at 2:22 PM
- Crotalus (Dont Tread on Me) said...
Is that what you get when Cthulhu mates with a human?
- April 26, 2011 at 8:03 AM