Eternal rest grant unto them, O Lord
And let perpetual light shine upon them,
May the souls of all the faithful departed,
through the mercy of God, rest in peace. Amen.
Photo credit: kadbucketcreations092-flickr.com
Sunday, November 2, 2008
Thursday, July 10, 2008
QUOTE OF THE DAY
Laughing is the sensation of feeling good all over and showing it
principally in one spot.
Josh Billings (1818 - 1885)
THANK YOU, DAD
SOURCE:
http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=109019
THANK YOU, DAD
Jun 4, 2004
By: Navreet Kallar, MD
Medical Economics
A review of her father's medical records 20 years after his death taught the author a lot about her father and about medicine.
It's funny how just as we begin to become complacent in our profession, something happens that rejuvenates us and reminds us of the privileges of being a physician. For me, that something was a review of my father's medical records from almost 20 years ago.
Dad was a physical medicine and rehabilitation specialist. He died of Takayasu's arteritis when I was 13 years old. Initially, I requested his records as an academic exercise, to learn more about the disease, which is rare and usually occurs in young Asian women. In the end, I learned more about my father—and myself—than I could have possibly imagined.
Getting the charts wasn't easy. Only my mother had the authority to release them, and she was reluctant to do so; she didn't want to relive the more painful memories of Dad's illness. I told her reviewing his charts would benefit my education, that he would have wanted me to learn more about medicine in any way possible. I don't know if she believed me, but she relented.
Details of a protracted illness come to light
Given the length of time that had passed since my father's death, it took months for the hospital to locate his records. In fact, I had forgotten about them by the time I was paged to come pick them up.
The records had been broken down to the bare essentials. The chart began with my father's medical history summary, written in 1984, a little more than two years before he died: "This patient is a 41-year-old physician whose current cardiovascular history started approximately eight years ago."
That would have made him 33 when he became symptomatic, only a year older than I am now. I couldn't help but wonder how I might have handled receiving a major diagnosis at such a young age. When he became ill, Dad's life, for all intents and purposes, was perfect. He had been married to my mother for nine years, had two healthy young children ages 8 (my brother) and 4 (me), and was enjoying a fulfilling career working at a local hospital.
After a hunting trip in 1976, he noticed a diminished right radial pulse. A later Doppler diagnosed this as right subclavian stenosis. As I read this in his chart, I recalled watching him periodically swing his arm in circles when I was a child. At the time, he told me he was trying to get his blood circulating. Now I realize he was trying to adapt to disruptive paresthesias.
"At age 37," the chart continued, "the patient began to develop symptoms of angina." That led to cardiac catheterization and subsequent coronary artery bypass surgery, both within the same year. Dad was eventually given corticosteroids. The debilitating myopathy, malaise, and fatigue he later developed finally explained the time when my father could no longer lift me or play outside with me. My mother later told me that he stopped taking the corticosteroids altogether, finding the side effects intolerable.
Once the Takayasu's arteritis took hold, my father developed coronary graft stenoses—which required six bypass operations—and aortic insufficiency, which led to three aortic valve replacements. Each time he recovered briefly, then the symptoms of dyspnea and fatigue would return. He had gone from an active, fit tennis player to a weak, tired patient. As time went on he began to walk more slowly and to tire more easily.
As a little girl, I didn't understand what was wrong with my father and it frustrated me. Now I realize how frustrated he must have been. To him dyspnea meant being unable to race his kids around the house. Myopathy meant debilitating muscle aches that kept him from working as a physician, a job he loved. And near the end of his life, intractable nausea and vomiting meant being unable to keep down even his favorite meals.
After the last surgery failed, Dad was told that the only option left was a heart transplant, which at the time was still an experimental procedure. Soon, I, too, began to feel the worry, sadness, and despair that showed on his face.
I still remember the night before he died. My mother and brother were puttering about in his bedroom, while I sat next to him on the edge of his bed. I sat to his right side, with my left arm draped lightly across his back, my hand resting on his shoulder. My arm couldn't have weighed more than five pounds, nor had it been there for more than two minutes when he asked me to move it because it was getting too heavy.
I responded with tears. The memory still stifles me, like a wool blanket worn in the heat of summer. That night, before I went to sleep, I asked myself, "What would happen if Dad died?" It was the first time I had allowed myself to consider such a thing. The next morning, he was gone.
A father's suffering gives valuable life lessons
When I look back on my decision to review Dad's medical records, I realize I did it because I wanted to get to know him from a new perspective. I now appreciate his bravery and how difficult it must have been for him, as a physician, to deal with his disease and face its implications. As time went on, he knew he would never live to see his retirement or to see his children grow up. But he never allowed the reality of his disease to taint his will to live.
I began to think of how often we get so caught up in worrying about the future that we lose the moment we're in. Even before he became sick, my father never took a second of his life for granted. He spent as much time as he could with my mother, my brother, and me, talking and making us laugh. He loved his family, his friends, and his profession.
I've since tried to emulate my father's approach to life. Whenever I feel stressed over something in the future—how I'll find time to attend a conference or pay for retirement, for instance—I remind myself of my father's lesson: Think only about now.
Even my patients have noticed how better focused and more attentive I've become. I listen more carefully and ask questions when they complain of a medication's side effects. Besides treating their current complaint, I ask how they're dealing with their chronic illnesses. Looking back at what my father faced has given me a sobering appreciation for what my chronically ill patients must go through each day. How often had I taken their medical conditions and emotions for granted? What I had seen as a self-preserving detachment was in some respects ignorance.
My medical training has taught me the science, but my father's illness has taught me the humanity and true essence of our noble profession. Just as I should never take my duty to treat patients lightly, I should remember my responsibility to become a more compassionate person both in and outside the office.
Thank you, Dad, with all of my heart.
NOTE: Dr. Navreet Kallar is an internist from Richmond, VA.
http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=109019
THANK YOU, DAD
Jun 4, 2004
By: Navreet Kallar, MD
Medical Economics
A review of her father's medical records 20 years after his death taught the author a lot about her father and about medicine.
It's funny how just as we begin to become complacent in our profession, something happens that rejuvenates us and reminds us of the privileges of being a physician. For me, that something was a review of my father's medical records from almost 20 years ago.
Dad was a physical medicine and rehabilitation specialist. He died of Takayasu's arteritis when I was 13 years old. Initially, I requested his records as an academic exercise, to learn more about the disease, which is rare and usually occurs in young Asian women. In the end, I learned more about my father—and myself—than I could have possibly imagined.
Getting the charts wasn't easy. Only my mother had the authority to release them, and she was reluctant to do so; she didn't want to relive the more painful memories of Dad's illness. I told her reviewing his charts would benefit my education, that he would have wanted me to learn more about medicine in any way possible. I don't know if she believed me, but she relented.
Details of a protracted illness come to light
Given the length of time that had passed since my father's death, it took months for the hospital to locate his records. In fact, I had forgotten about them by the time I was paged to come pick them up.
The records had been broken down to the bare essentials. The chart began with my father's medical history summary, written in 1984, a little more than two years before he died: "This patient is a 41-year-old physician whose current cardiovascular history started approximately eight years ago."
That would have made him 33 when he became symptomatic, only a year older than I am now. I couldn't help but wonder how I might have handled receiving a major diagnosis at such a young age. When he became ill, Dad's life, for all intents and purposes, was perfect. He had been married to my mother for nine years, had two healthy young children ages 8 (my brother) and 4 (me), and was enjoying a fulfilling career working at a local hospital.
After a hunting trip in 1976, he noticed a diminished right radial pulse. A later Doppler diagnosed this as right subclavian stenosis. As I read this in his chart, I recalled watching him periodically swing his arm in circles when I was a child. At the time, he told me he was trying to get his blood circulating. Now I realize he was trying to adapt to disruptive paresthesias.
"At age 37," the chart continued, "the patient began to develop symptoms of angina." That led to cardiac catheterization and subsequent coronary artery bypass surgery, both within the same year. Dad was eventually given corticosteroids. The debilitating myopathy, malaise, and fatigue he later developed finally explained the time when my father could no longer lift me or play outside with me. My mother later told me that he stopped taking the corticosteroids altogether, finding the side effects intolerable.
Once the Takayasu's arteritis took hold, my father developed coronary graft stenoses—which required six bypass operations—and aortic insufficiency, which led to three aortic valve replacements. Each time he recovered briefly, then the symptoms of dyspnea and fatigue would return. He had gone from an active, fit tennis player to a weak, tired patient. As time went on he began to walk more slowly and to tire more easily.
As a little girl, I didn't understand what was wrong with my father and it frustrated me. Now I realize how frustrated he must have been. To him dyspnea meant being unable to race his kids around the house. Myopathy meant debilitating muscle aches that kept him from working as a physician, a job he loved. And near the end of his life, intractable nausea and vomiting meant being unable to keep down even his favorite meals.
After the last surgery failed, Dad was told that the only option left was a heart transplant, which at the time was still an experimental procedure. Soon, I, too, began to feel the worry, sadness, and despair that showed on his face.
I still remember the night before he died. My mother and brother were puttering about in his bedroom, while I sat next to him on the edge of his bed. I sat to his right side, with my left arm draped lightly across his back, my hand resting on his shoulder. My arm couldn't have weighed more than five pounds, nor had it been there for more than two minutes when he asked me to move it because it was getting too heavy.
I responded with tears. The memory still stifles me, like a wool blanket worn in the heat of summer. That night, before I went to sleep, I asked myself, "What would happen if Dad died?" It was the first time I had allowed myself to consider such a thing. The next morning, he was gone.
A father's suffering gives valuable life lessons
When I look back on my decision to review Dad's medical records, I realize I did it because I wanted to get to know him from a new perspective. I now appreciate his bravery and how difficult it must have been for him, as a physician, to deal with his disease and face its implications. As time went on, he knew he would never live to see his retirement or to see his children grow up. But he never allowed the reality of his disease to taint his will to live.
I began to think of how often we get so caught up in worrying about the future that we lose the moment we're in. Even before he became sick, my father never took a second of his life for granted. He spent as much time as he could with my mother, my brother, and me, talking and making us laugh. He loved his family, his friends, and his profession.
I've since tried to emulate my father's approach to life. Whenever I feel stressed over something in the future—how I'll find time to attend a conference or pay for retirement, for instance—I remind myself of my father's lesson: Think only about now.
Even my patients have noticed how better focused and more attentive I've become. I listen more carefully and ask questions when they complain of a medication's side effects. Besides treating their current complaint, I ask how they're dealing with their chronic illnesses. Looking back at what my father faced has given me a sobering appreciation for what my chronically ill patients must go through each day. How often had I taken their medical conditions and emotions for granted? What I had seen as a self-preserving detachment was in some respects ignorance.
My medical training has taught me the science, but my father's illness has taught me the humanity and true essence of our noble profession. Just as I should never take my duty to treat patients lightly, I should remember my responsibility to become a more compassionate person both in and outside the office.
Thank you, Dad, with all of my heart.
NOTE: Dr. Navreet Kallar is an internist from Richmond, VA.
Wednesday, July 9, 2008
Tuesday, July 1, 2008
Tuesday, June 24, 2008
WORLD MUSIC VIDEO OF THE DAY
YOSHIDA BROTHERS ON SHAMISEN (Japanese 3-stringed instrument)
NEW AGE MUSIC TITLE: NIKATA (RENAISSANCE)
NEW AGE MUSIC TITLE: NIKATA (RENAISSANCE)
Monday, June 23, 2008
MINOCYCLINE IS EFFECTIVE FOR THE ACTIVE TAKAYASU ARTERITIS
SOURCES: www.cardiologyonline.com/wchd05/abstracts/1611Matsuyama.doc
http://www.annals.org/cgi/reprint/143/5/394.pdf
A Matsuyama1 , N Sakai2, M Ishigamai2, H Hiraoka2, S Yamashita2
1Osaka University Hospital, Suita, Osaka, Japan, 2Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Background: Takayasu arteritis (TA) is a chronic vasculitis of large elastic arteries. A number of patients are sometimes resistance to the treatment with glucocorticoids and/or immunosuppressive agents, and not a few of them suffer drug toxicity. To evaluate the effect of minocycline in patients with active Takayasu arteritis as a novel therapy, we treated active TA patient with minocycline. Results: A 3-month course of minocycline significantly improved disease activity score from 2.8 + 0.8 (mean + SD) to 0.7 + 1.0 (p<0.05)>
http://www.annals.org/cgi/reprint/143/5/394.pdf
MINOCYCLINE IS EFFECTIVE FOR THE ACTIVE TAKAYASU ARTERITIS
A Matsuyama1 , N Sakai2, M Ishigamai2, H Hiraoka2, S Yamashita2
1Osaka University Hospital, Suita, Osaka, Japan, 2Osaka University Graduate School of Medicine, Suita, Osaka, Japan
Background: Takayasu arteritis (TA) is a chronic vasculitis of large elastic arteries. A number of patients are sometimes resistance to the treatment with glucocorticoids and/or immunosuppressive agents, and not a few of them suffer drug toxicity. To evaluate the effect of minocycline in patients with active Takayasu arteritis as a novel therapy, we treated active TA patient with minocycline.
Methods: Eleven patients with active Takayasu arteritis referred to Osaka University Hospital from October 2001 to July 2004 were treated with minocycline orally (100 mg, b.i.d.) for 3 months without changing the dosage of prednisolone. Clinical evaluation based on NIH Criteria of Disease Activity and assessment of erythrocyte sedimentation rate (ESR) and serum levels of C-reactive protein (CRP) were performed at baseline and after treatment.
Conclusion: Minocycline could be an alternative to steroids and immunosuppressive agents in patients with active Takayasu arteritis. Before our results are confirmed in controlled clinical trials, minocycline should be considered only for patients who fail to respond or are difficult to stabilize with conventional therapy
Thursday, June 19, 2008
Thursday, May 29, 2008
Thursday, April 17, 2008
Friday, April 11, 2008
SERENITY PRAYER
God grant me the serenity to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world as it is, not as I would have it;
Trusting that He will make all things right if I surrender to His Will;
That I may be reasonably happy in this life and supremely happy with Him Forever in the next.
Amen.
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world as it is, not as I would have it;
Trusting that He will make all things right if I surrender to His Will;
That I may be reasonably happy in this life and supremely happy with Him Forever in the next.
Amen.
--Reinhold Niebuhr
Saturday, April 5, 2008
AFFIRMATION POSITIVE VIBE OF THE DAY
Here are some tips by Eckhart Tolle, author of the best selling novel A NEW EARTH, and featured on Oprah.
First, do not talk about your illness to other people, except when you visit your doctor.
The more you talk about it, the more you keep the process going.
Do not empower the disease.
If someone asks, say "I'm doing all I can to find healing in this. And I'm making good progress."
No more mentioning of illness. This will have a certain influence on your thought processes.
Gradually refrain from thinking of yourself as a sick person. Give less thought to your illness and focus attention more on well-being.
You may ask, well, but if I don't fell good, if I feel it, how can I give attention to well-being?
You can still do that.
One way is to see well-being around you in nature, because nature is just an embodiment of well being.
There's well-being even if certain parts of your body feel unwell or painful. Sense the body..there are always parts of your body where you can still find well-being, in your toes, wherever.
Take some attention into the body and see, where can I most strongly feel great, a sense of well-being in the body, and then take your attention there.
Choose to direct attention to well-being rather than dwelling on the idea of illness.
Thursday, April 3, 2008
ENVIRONMENTAL FACTORS LINK TO AUTOIMMUNE DISEASE
http://www.mrc.ac.uk/NewsViewsAndEvents/News/MRC004475
24 March 2008
Scientists working at the MRC National Institute for Medical Research have shown that environmental factors can influence the development of autoimmune diseases like multiple sclerosis.
A team led by Dr Brigitta Stockinger has identified a molecular mechanism that links a wide range of environmental factors to the autoimmune reactions in which immune system cells attack body tissue. The results are published online in Nature.
The research focused on a protein called the aryl hydrocarbon receptor (AhR). Activation of the AhR causes enzymes to be produced that are involved in reducing the toxic effect of a wide range of chemicals on the human body. Many of these, such as dioxin, are generated in industrial processes. The research found that stimulation of AhR by environmental factors could be involved in development of autoimmune disease.
The researchers looked at the effect that both AhR and environmental factors had on autoimmune disease in mice.
Dr Stockinger said: ‘‘Multiple factors can influence the development of autoimmune diseases, these include genetics, hormones, diet, the presence of infection or exposure to chemical and environmental irritants. Autoimmune diseases are becoming increasingly common in industrialised countries and it is likely that this is connected to environmental factors.’’
The AhR is present in a group of T helper cells called Th17 in both the mouse and human immune systems. T helper cells generate a response to infection by stimulating the immune cells that produce antibodies and those that destroy other infected cells.
Under normal circumstances, Th17 cells are important in mounting an immune reaction to fungal and bacterial infection. Th17 cell activity is also the cause of some autoimmune diseases including multiple sclerosis and rheumatoid arthritis.
The research found that if AhR is activated in mice while Th17 cells are developing, the proportion of Th17 cells present in the body increases and so the potential for the development of autoimmune disease is enhanced. The AhR is activated by environmental factors.
Dr Stockinger explains: ‘‘The AhR system can potentially react to an astounding range of factors, from environmental pollutants to particular foods or even hormone levels. So here we have identified a molecular mechanism that shows how such a wide range of environmental factors could be directly linked to the cells that cause autoimmune reactions.’’
In comparison, mice that lack AhR still develop Th17 cells and T helper cell responses but they don’t have enhanced numbers of these cells. This suggests that AhR interaction with environmental factors leads to an increase in the number of Th17 cells and may contribute to the onset or development of autoimmune diseases in genetically susceptible individuals. In addition, the research showed that stimulation of AhR resulted in faster development of autoimmunity with greater severity. This means that environmental factors are interacting with genetic factors to generate a detrimental autoimmune reaction.
Dr Stockinger concludes: ‘‘The discovery that the stimulation of AhR by environmental pollutants can accelerate the development of autoimmune reactions and the severity of symptoms raises intriguing possibilities and warrants closer examination of a possible role of AhR in human autoimmune diseases."
Original research paper: The Aryl hydrocarbon receptor links TH17-mediated autoimmunity to environmental toxins is published online in Nature.
Press contactPhone: 020 7637 6011press.office@headoffice.mrc.ac.uk
24 March 2008
Scientists working at the MRC National Institute for Medical Research have shown that environmental factors can influence the development of autoimmune diseases like multiple sclerosis.
A team led by Dr Brigitta Stockinger has identified a molecular mechanism that links a wide range of environmental factors to the autoimmune reactions in which immune system cells attack body tissue. The results are published online in Nature.
The research focused on a protein called the aryl hydrocarbon receptor (AhR). Activation of the AhR causes enzymes to be produced that are involved in reducing the toxic effect of a wide range of chemicals on the human body. Many of these, such as dioxin, are generated in industrial processes. The research found that stimulation of AhR by environmental factors could be involved in development of autoimmune disease.
The researchers looked at the effect that both AhR and environmental factors had on autoimmune disease in mice.
Dr Stockinger said: ‘‘Multiple factors can influence the development of autoimmune diseases, these include genetics, hormones, diet, the presence of infection or exposure to chemical and environmental irritants. Autoimmune diseases are becoming increasingly common in industrialised countries and it is likely that this is connected to environmental factors.’’
The AhR is present in a group of T helper cells called Th17 in both the mouse and human immune systems. T helper cells generate a response to infection by stimulating the immune cells that produce antibodies and those that destroy other infected cells.
Under normal circumstances, Th17 cells are important in mounting an immune reaction to fungal and bacterial infection. Th17 cell activity is also the cause of some autoimmune diseases including multiple sclerosis and rheumatoid arthritis.
The research found that if AhR is activated in mice while Th17 cells are developing, the proportion of Th17 cells present in the body increases and so the potential for the development of autoimmune disease is enhanced. The AhR is activated by environmental factors.
Dr Stockinger explains: ‘‘The AhR system can potentially react to an astounding range of factors, from environmental pollutants to particular foods or even hormone levels. So here we have identified a molecular mechanism that shows how such a wide range of environmental factors could be directly linked to the cells that cause autoimmune reactions.’’
In comparison, mice that lack AhR still develop Th17 cells and T helper cell responses but they don’t have enhanced numbers of these cells. This suggests that AhR interaction with environmental factors leads to an increase in the number of Th17 cells and may contribute to the onset or development of autoimmune diseases in genetically susceptible individuals. In addition, the research showed that stimulation of AhR resulted in faster development of autoimmunity with greater severity. This means that environmental factors are interacting with genetic factors to generate a detrimental autoimmune reaction.
Dr Stockinger concludes: ‘‘The discovery that the stimulation of AhR by environmental pollutants can accelerate the development of autoimmune reactions and the severity of symptoms raises intriguing possibilities and warrants closer examination of a possible role of AhR in human autoimmune diseases."
Original research paper: The Aryl hydrocarbon receptor links TH17-mediated autoimmunity to environmental toxins is published online in Nature.
Press contactPhone: 020 7637 6011press.office@headoffice.mrc.ac.uk
Saturday, March 22, 2008
LAUGHTER IS THE BEST MEDICINE
Medical studies show that by doing 15-20 minutes of simulated laughter every day, helps the blood vessels to open up and brings out the good endorphins.
SCIENTIFIC STUDIES & ARTICLES ON LAUGHTER:
http://www.laughteryoga.org/research.php
I AM HAPPY, I AM ALIVE!!!!
Tuesday, March 18, 2008
LAUGHTER BOOSTS THE IMMUNE SYSTEM
LAUGHTER YOGA
The theory behind it is that by doing 15-20 minutes of simulated laughter every day, helps the blood vessels to open up and brings out the good endorphins.
Scientific research write-ups about the benefits of laughter yoga:
http://www.laughteryoga.org/research.php
The theory behind it is that by doing 15-20 minutes of simulated laughter every day, helps the blood vessels to open up and brings out the good endorphins.
Scientific research write-ups about the benefits of laughter yoga:
http://www.laughteryoga.org/research.php
"What you repeatedly think and say is what you get."
WORDS ARE POWERFUL
http://www.successconsciousness.com/index_00000a.htm
The Power of Affirmations
By Remez Sasson
It is advisable to repeat affirmations that are not too long, as they are easier to remember. Repeat them anytime your mind is not engaged in something in particular, such as while traveling in a bus or a train, waiting in line, walking etc, but do not affirm while driving or crossing a street. You may also repeat them in special sessions of 5-10 minutes each, several times a day.
http://www.successconsciousness.com/index_00000a.htm
The Power of Affirmations
By Remez Sasson
Positive affirmations are positive sentences repeated many times in order to impress the subconscious mind and trigger it into action. These sentences describe a situation that we desire to happen, and are repeated many times, with conviction, attention and feelings.
Repeating positive affirmations a few minutes, and then thinking negatively, neutralizes the effects of the positive words. You have to refuse negative thoughts, otherwise you will not attain positive results. We often repeat affirmations, without even being aware of the process. We use them when we tell ourselves that we can't do something, that we are too lazy, or when we believe we are going to fail. The subconscious mind always accepts follows what we tell it.
It is the same principle at work when we say to ourselves that we can do it, or we cannot, when say we are going to succeed and when we keep saying that we are going to fail. It is the same power working both ways. Why not choose the better way?
How to Repeat Affirmations
It is advisable to repeat affirmations that are not too long, as they are easier to remember. Repeat them anytime your mind is not engaged in something in particular, such as while traveling in a bus or a train, waiting in line, walking etc, but do not affirm while driving or crossing a street. You may also repeat them in special sessions of 5-10 minutes each, several times a day.
Relax any physical, emotional or mental tension while affirming. The stronger the concentration, the more faith you have in what you are doing, the more feelings you put into the act, the stronger and faster will be the results.
Choose only positive words, describing what you really want. If you desire to lose weight, do not tell yourself "I am not fat" or "I am losing weight." These are negative statements, bringing into the mind mental images of what you do not want. Say instead, "I am getting slim" or "I have reached my right weight". Such words evoke positive images in the mind.
Always affirm in the present tense, not the future tense. Saying, "I will be rich", means that you intend to be rich one day, in the indefinite future, but not now. It is more effective to say, and also feel, "I am rich now", and the subconscious mind will work overtime to make this happen now, in the present.
The power of affirmations can help you to transform your life. By stating what you want to be true in your life, you mentally and emotionally see and feel it as true, irrespective of your current circumstances, and thereby attract it into your life.
Positive Affirmation: I am truly healthy.
THE POWER OF YOUR SUBCONSCIOUS MIND
PSYCHONEUROIMMUNOLOGY - Can We Control Our Immune Systems?
http://www.thefreelibrary.com/Psychoneuroimmunology+--+Can+We+Control+Our+Immune+Systems%3F-a074799726
Summary:
This article looks at the controversial issue of mind-body therapy. In particular it will examine the relatively new science of Psychoneuroimmunology, its formation and its relevance to the medical community in finding potential cures for disease through the immune system. This article will also look at some of the alternative therapies, which have proven to be successful, and for which Psychoneuroimmunology provides a potential scientific reason for their success.
For this is the great error of our day that the physicians separate the soul from the body. Hippocrates
Introduction:
A traditional view, still held by many scientists, is that the immune system is autonomous. That is to say that it is self-regulatory and functions separately and independently from the rest of the body. With the increasing focus on the relatively new science of Psychoneuroimmunology (PNI) these old views are becoming less legitimate.
The name Psychoneuroimmunology was provided in 1975, by Dr. Robert Ader, director of the division of behavioural and psychosocial medicine at New York's University of Rochester. Dr. Ader believes that there is a link between what we think (our state of mind) and our health and our ability to heal ourselves. In particular, this was borne out in a study conducted by Dr. Ader and his colleagues, which showed that it is possible to classically condition, the immune system(1). The experiment that caused this development consisted of feeding mice with saccharin while simultaneously injecting a drug that caused upset stomach. By association, the mice learned to avoid the saccharin. An additional side effect of the drug used was that it suppressed the immune system. When the experiment was repeated without the drug to reverse the aversion Dr. Ader found a high proportion of the mice formerly injected died when receiving saccharin alone.
Dr. Ader hypothesized that the conditioning had been so successful that saccharin alone suppressed the immune system enough to kill the mice.(2) It is possible then, that when there is stress on the organism, mental or physical, that there is a corresponding link between the two. That is to say, if a person has a mental state of depression, this state can be interpreted by the body to produce lethargy and other corresponding ailments. Conversely, if the body is diagnosed as ailing from a serious disease, i.e. cancer, a negative mental state may ensue. By conditioning the immune system through mental processes a connection in communication has been made. Providing patients with some feeling of control over their circumstances may create a positive outlook and attitude. Some believe that this may, Inoculate against disease and act as a valuable supplement to conventional medical care.(3)
Psychoneuroimmunology then is the scientific field of study investigating the link between bi-directional communications among the nervous system, the endocrine (hormone) system, and the immune system and the implications of these linkages for physical health.
This article will look at the history behind Psychoneuroimmunology, and the different sciences that make up Psychoneuroimmunology. It will also look at the research behind these sciences and the different therapies that compliment these studies. In addition, the notion that all non-allopathic medicine is placebo response will be discussed.
A Brief History of Mind-Body Medicine:
There is, and has always been, much controversy over the mind and body connection. It is interesting how the history affected medical philosophies causing the dichotomy between eastern and western medical cultures.
Looking at the ancients, one can see a strong connection in their beliefs that the mind and the body should be treated as the whole. Hippocrates, often referred to as the father of medicine, would caution against not including all of the possibilities in healing. In Chinese medicine the belief is held that certain organs of the body represent various mental or emotional conditions. In addition, a lot of connections are made to nature, through energy meridian lines and hands on manipulation (acupressure). The practitioner will take the time to look into the person's life and see what is happening that may cause a change in the `balance of the organism within the environment'. Knowing what psychological situations are going on in someone's life becomes important when deciding upon what course of treatment to follow.
In the present day western system, the doctor spends only as much time as needed to generally inquire about the symptoms of the ailment, and then to prescribe a particular medicine. This system is derived from the philosophies of Rene Descartes in the seventeenth century. Descartes believed `there are two distinct and separate substances in the world: matter, which behaved according to physical laws, and spirit, which was dimensionless and immaterial'.(4) A belief that these were the differences of spirit and body and that the two were totally unrelated became the philosophy of the day. And so it became that the western culture accepted that pathogens were the cause of all disease. This theory was substantiated in the late nineteenth century by a study of Robert Koch, a German doctor who injected the disease anthrax into healthy sheep and noticed they too contracted the disease and died. From this. `Koch theorised that every disease had a simple, specific cause: germs'.(5)
In the 1920's, Dr. Walter Cannon, a professor of physiology at Harvard University, looked at the need for mental and physical balance throughout the organism and coined the term, "Homeostasis", from the Greek word homoios, meaning similar, and stasis, meaning position. It was his studies into the relationship between the effects of emotions and perceptions on the autonomic nervous system, namely the sympathetic and parasympathetic responses that initiated the recognition of the `fight or flight response'.(6) Following on Cannon's work was that of Hans Selye. Selye experimented with animals putting them under different physical and mental adverse conditions and noted that under these conditions the body consistently adapted to heal and recover. He referred to this as the general adaptation syndrome. Selye also noticed during this adaptation the thymus and other major organs of the immune system shrank. In these studies it was found if the stress of the environment was continued then the immune system reduced and the animal would be overwhelmed and die. These studies validated the path for the connection between emotional states affecting physiological behaviour and states.
Current Research in the Field:
Research continued in the area of molecular communication between the mind and the body, this however was often seen as unwelcome by the existing science community. Research over the past twenty years has seen the development of Psychoneuroimmunology, which is based primarily upon the neuro sciences of the central nervous systems, the neuroendocrine system and the immune system and their inter-relationships. The central nervous system is a huge array of connections throughout the body incorporating sympathetic and parasympathetic systems. It allows the brain to send information throughout the body via chemicals generally referred to as information substances (IS). It was once thought that the brain sent out these information substances to respond to the various problems in the body and that the communication was that of a one way direction. What has become clear is that the central nervous system virtually controls the body's defense mechanisms. This being said, Every thought, emotion, idea or belief has a neurochemical consequence(7).
These natural chemical messengers, called Neuropeptides, were at one time thought to be found in the brain alone. Pioneering research by neuropharmacologist, Candice Pert, revealed that these neuropeptides are present on both the cell walls of the brain and in the immune system.(8) These information substances affect our emotions as well as our physiology. These cells of the body have their own receptors on the surface that act like satellite dishes. These receptors receive the chemical information substances being released by the brain and sometimes return messages at the appropriate times. Pert believes that peptides probably provide solutions to every medical problem.(9) As these complex messengers travel throughout the body they provide vital information and sometimes almost instant physical feedback. If you have ever encountered something unpleasant, possibly by surprise, you may have found yourself instantly shivering, then literally shaking off the feeling produced. This is a simple example of how fast the information can be transmitted from thought to physiology. The emotions we create are just that, created. This requires input from the brain. The centre for the brain that deals with emotional issues is the limbic system and in particular the hypothalamus. The discovery by Candice Pert, that neuropeptides and neurotransmitters are also on cell walls of the immune system shows a close association with emotions and suggests that emotions and health are deeply interdependent. Showing that the immune and endocrine systems are modulated not only by the brain but by the central nervous system itself has had an impact on how we see disease and how its created. For its part, the endocrine system is a series of hormone secreting glands that themselves moderate the function and balance of the body. Primarily the pituitary, thyroid and adrenal glands send these hormonal chemicals to regulate the function of other organs. Using this network of transmitters and receivers the body is in constant adjustment to ensure balance.
The balance is kept as long as the immune system is functioning optimally. The immune system is literally on patrol throughout the body and is a complex surveillance system. The immune cells, called Lymphocytes (white blood cells)
are the keys to the immune system. Produced initially in the bone marrow of long bones, some of these cells known as stem cells will migrate to the thymus where they multiply and are known as T cells. Those cells that remain in the bone marrow mature to become B cells. Each attacks the enemy in different ways. Circulating the body, when these antigens are discovered an army of appropriate cells (antibodies) is produced to attack the invader. To prevent this army of cells taking over, they in turn are suppressed and attacked. On this continuous patrol, natural killer (NK) cells attack and destroy cells that are produced by the organism which are mutated or abnormal. It is this action which prevents most people contracting cancers or other immune deficient problems such as A.I.D.S.
Research has indicated that an inextricable chemical link exists between our emotions, which includes all stress in our lives, both good and bad, and the regulatory systems of the endocrine and immune systems through the central nervous system. This research emphasizes the importance of expressing our emotions both verbally and physically in an appropriate way. When strong emotions generate fear, anger or rage and these are not expressed in a healthy way then the body's natural response is that of the sympathetic nervous system as demonstrated in Cannon's research on homeostasis and the fight or flight syndrome. At this point, inappropriate storing of these stressful emotions produces an excess of epinephrine. This excess of epinephrine causes a chemical breakdown, resulting in internal weakening of the immune system and an increased potential for disease.
For all of the research that has been conducted and continues to be conducted, this new research is not without its detractors. In 1985, Marcia Angell published an article in the New England Journal of Medicine on the new science of Psychoneuroimmunology in which she labelled the science "folklore". She stated that, No one had unequivocally shown a state of mind can cause or cure a disease.(10)
Imagination is more important than knowledge, for while knowledge points to all there is, imagination points to all there will be. Albert Einstein
Mind-Body Therapies:
The application of this field is truly cross-disciplinary and is readily available to the public. There are many techniques and they may be used by a variety of professionals. These professionals include: medical doctors, nurses, naturopaths, osteopaths, Chinese medicine and Chiropractors for the body model and psychiatrists, psychologists, psychotherapists, social workers, hypnotherapists and counsellors for the mind model. It now becomes a choice for the individual as to whether they attend these mind-body therapies used by a traditional medical person or a practitioner from one of the complimentary systems. While the systems purporting to deliver mind-body therapies are many, this article will restrict itself to a brief overview of some of the most popular of those with recorded successes.
To be continued in the next issue of Subconsciously Speaking
Endnotes:
(1) Kiecolt-Glaser J.K. &. Glaser R. "Psychoneuroimmunology: Past, Present & Future," Health Psychology 8(6): 1989,677-682
(2) Hall Stephen S. "A Molecular Code Links Emotions, Mind and Health," Smithsonian, June 1989
(3) Maranto Gina, "Emotions: How They Affect Your Body," Discover; November 1984, 35
(4) Hafen Brent Q, Karren Keith J., Frandsen Kathryn J., Lee Smith N., "The Effects of Attitudes, Emotions, & Relationships" 23 Allyn & Bacon Massachusetts
(5) Hafen Brent Q, Karren Keith J., Frandsen Kathryn J., Lee Smith N., "The Effects of Attitudes, Emotions, & Relationships" 23 Allyn & Bacon Massachusetts
(6) Gordon James S. M.D. "Testimony to the House Appropriations Committee Chairman" November 5th 1997 3-4
(7) Watkins Alan M.D. "Mind Body Medicine" Churchill Livingstone 1997 P.3
(8) Gordon James S. M.D. "Testimony to the House Appropriations Committee Chairman" November 5th 1997 5
(9) Hafen Brent Q, Karren Keith J., Frandsen Kathryn J., Lee Smith N., "The Effects of Attitudes, Emotions, & Relationships" 30 Allyn & Bacon Massachusetts
(10) Angell Marcia, "Disease as a Reflection of the Psyche," New England Journal of Medicine, 312: 1985, 1570-1572
Jay Quinlan owns and operates Global Learning Solutions Inc., a company that provides both individual and group therapeutic sessions within the Neuro Linguistic & Hypnotherapeutic processes. In addition, Jay provides training and seminars in related topics and communication skills. Jay is an approved school director with the International Medical & Dental Hypnotherapy Association[TM]. If you wish to contact Jay you can do so at (416) 523.9720/(519) 928.9624, Email jay.quinlan@sympatico.ca
Summary:
This article looks at the controversial issue of mind-body therapy. In particular it will examine the relatively new science of Psychoneuroimmunology, its formation and its relevance to the medical community in finding potential cures for disease through the immune system. This article will also look at some of the alternative therapies, which have proven to be successful, and for which Psychoneuroimmunology provides a potential scientific reason for their success.
For this is the great error of our day that the physicians separate the soul from the body. Hippocrates
Introduction:
A traditional view, still held by many scientists, is that the immune system is autonomous. That is to say that it is self-regulatory and functions separately and independently from the rest of the body. With the increasing focus on the relatively new science of Psychoneuroimmunology (PNI) these old views are becoming less legitimate.
The name Psychoneuroimmunology was provided in 1975, by Dr. Robert Ader, director of the division of behavioural and psychosocial medicine at New York's University of Rochester. Dr. Ader believes that there is a link between what we think (our state of mind) and our health and our ability to heal ourselves. In particular, this was borne out in a study conducted by Dr. Ader and his colleagues, which showed that it is possible to classically condition, the immune system(1). The experiment that caused this development consisted of feeding mice with saccharin while simultaneously injecting a drug that caused upset stomach. By association, the mice learned to avoid the saccharin. An additional side effect of the drug used was that it suppressed the immune system. When the experiment was repeated without the drug to reverse the aversion Dr. Ader found a high proportion of the mice formerly injected died when receiving saccharin alone.
Dr. Ader hypothesized that the conditioning had been so successful that saccharin alone suppressed the immune system enough to kill the mice.(2) It is possible then, that when there is stress on the organism, mental or physical, that there is a corresponding link between the two. That is to say, if a person has a mental state of depression, this state can be interpreted by the body to produce lethargy and other corresponding ailments. Conversely, if the body is diagnosed as ailing from a serious disease, i.e. cancer, a negative mental state may ensue. By conditioning the immune system through mental processes a connection in communication has been made. Providing patients with some feeling of control over their circumstances may create a positive outlook and attitude. Some believe that this may, Inoculate against disease and act as a valuable supplement to conventional medical care.(3)
Psychoneuroimmunology then is the scientific field of study investigating the link between bi-directional communications among the nervous system, the endocrine (hormone) system, and the immune system and the implications of these linkages for physical health.
This article will look at the history behind Psychoneuroimmunology, and the different sciences that make up Psychoneuroimmunology. It will also look at the research behind these sciences and the different therapies that compliment these studies. In addition, the notion that all non-allopathic medicine is placebo response will be discussed.
A Brief History of Mind-Body Medicine:
There is, and has always been, much controversy over the mind and body connection. It is interesting how the history affected medical philosophies causing the dichotomy between eastern and western medical cultures.
Looking at the ancients, one can see a strong connection in their beliefs that the mind and the body should be treated as the whole. Hippocrates, often referred to as the father of medicine, would caution against not including all of the possibilities in healing. In Chinese medicine the belief is held that certain organs of the body represent various mental or emotional conditions. In addition, a lot of connections are made to nature, through energy meridian lines and hands on manipulation (acupressure). The practitioner will take the time to look into the person's life and see what is happening that may cause a change in the `balance of the organism within the environment'. Knowing what psychological situations are going on in someone's life becomes important when deciding upon what course of treatment to follow.
In the present day western system, the doctor spends only as much time as needed to generally inquire about the symptoms of the ailment, and then to prescribe a particular medicine. This system is derived from the philosophies of Rene Descartes in the seventeenth century. Descartes believed `there are two distinct and separate substances in the world: matter, which behaved according to physical laws, and spirit, which was dimensionless and immaterial'.(4) A belief that these were the differences of spirit and body and that the two were totally unrelated became the philosophy of the day. And so it became that the western culture accepted that pathogens were the cause of all disease. This theory was substantiated in the late nineteenth century by a study of Robert Koch, a German doctor who injected the disease anthrax into healthy sheep and noticed they too contracted the disease and died. From this. `Koch theorised that every disease had a simple, specific cause: germs'.(5)
In the 1920's, Dr. Walter Cannon, a professor of physiology at Harvard University, looked at the need for mental and physical balance throughout the organism and coined the term, "Homeostasis", from the Greek word homoios, meaning similar, and stasis, meaning position. It was his studies into the relationship between the effects of emotions and perceptions on the autonomic nervous system, namely the sympathetic and parasympathetic responses that initiated the recognition of the `fight or flight response'.(6) Following on Cannon's work was that of Hans Selye. Selye experimented with animals putting them under different physical and mental adverse conditions and noted that under these conditions the body consistently adapted to heal and recover. He referred to this as the general adaptation syndrome. Selye also noticed during this adaptation the thymus and other major organs of the immune system shrank. In these studies it was found if the stress of the environment was continued then the immune system reduced and the animal would be overwhelmed and die. These studies validated the path for the connection between emotional states affecting physiological behaviour and states.
Current Research in the Field:
Research continued in the area of molecular communication between the mind and the body, this however was often seen as unwelcome by the existing science community. Research over the past twenty years has seen the development of Psychoneuroimmunology, which is based primarily upon the neuro sciences of the central nervous systems, the neuroendocrine system and the immune system and their inter-relationships. The central nervous system is a huge array of connections throughout the body incorporating sympathetic and parasympathetic systems. It allows the brain to send information throughout the body via chemicals generally referred to as information substances (IS). It was once thought that the brain sent out these information substances to respond to the various problems in the body and that the communication was that of a one way direction. What has become clear is that the central nervous system virtually controls the body's defense mechanisms. This being said, Every thought, emotion, idea or belief has a neurochemical consequence(7).
These natural chemical messengers, called Neuropeptides, were at one time thought to be found in the brain alone. Pioneering research by neuropharmacologist, Candice Pert, revealed that these neuropeptides are present on both the cell walls of the brain and in the immune system.(8) These information substances affect our emotions as well as our physiology. These cells of the body have their own receptors on the surface that act like satellite dishes. These receptors receive the chemical information substances being released by the brain and sometimes return messages at the appropriate times. Pert believes that peptides probably provide solutions to every medical problem.(9) As these complex messengers travel throughout the body they provide vital information and sometimes almost instant physical feedback. If you have ever encountered something unpleasant, possibly by surprise, you may have found yourself instantly shivering, then literally shaking off the feeling produced. This is a simple example of how fast the information can be transmitted from thought to physiology. The emotions we create are just that, created. This requires input from the brain. The centre for the brain that deals with emotional issues is the limbic system and in particular the hypothalamus. The discovery by Candice Pert, that neuropeptides and neurotransmitters are also on cell walls of the immune system shows a close association with emotions and suggests that emotions and health are deeply interdependent. Showing that the immune and endocrine systems are modulated not only by the brain but by the central nervous system itself has had an impact on how we see disease and how its created. For its part, the endocrine system is a series of hormone secreting glands that themselves moderate the function and balance of the body. Primarily the pituitary, thyroid and adrenal glands send these hormonal chemicals to regulate the function of other organs. Using this network of transmitters and receivers the body is in constant adjustment to ensure balance.
The balance is kept as long as the immune system is functioning optimally. The immune system is literally on patrol throughout the body and is a complex surveillance system. The immune cells, called Lymphocytes (white blood cells)
are the keys to the immune system. Produced initially in the bone marrow of long bones, some of these cells known as stem cells will migrate to the thymus where they multiply and are known as T cells. Those cells that remain in the bone marrow mature to become B cells. Each attacks the enemy in different ways. Circulating the body, when these antigens are discovered an army of appropriate cells (antibodies) is produced to attack the invader. To prevent this army of cells taking over, they in turn are suppressed and attacked. On this continuous patrol, natural killer (NK) cells attack and destroy cells that are produced by the organism which are mutated or abnormal. It is this action which prevents most people contracting cancers or other immune deficient problems such as A.I.D.S.
Research has indicated that an inextricable chemical link exists between our emotions, which includes all stress in our lives, both good and bad, and the regulatory systems of the endocrine and immune systems through the central nervous system. This research emphasizes the importance of expressing our emotions both verbally and physically in an appropriate way. When strong emotions generate fear, anger or rage and these are not expressed in a healthy way then the body's natural response is that of the sympathetic nervous system as demonstrated in Cannon's research on homeostasis and the fight or flight syndrome. At this point, inappropriate storing of these stressful emotions produces an excess of epinephrine. This excess of epinephrine causes a chemical breakdown, resulting in internal weakening of the immune system and an increased potential for disease.
For all of the research that has been conducted and continues to be conducted, this new research is not without its detractors. In 1985, Marcia Angell published an article in the New England Journal of Medicine on the new science of Psychoneuroimmunology in which she labelled the science "folklore". She stated that, No one had unequivocally shown a state of mind can cause or cure a disease.(10)
Imagination is more important than knowledge, for while knowledge points to all there is, imagination points to all there will be. Albert Einstein
Mind-Body Therapies:
The application of this field is truly cross-disciplinary and is readily available to the public. There are many techniques and they may be used by a variety of professionals. These professionals include: medical doctors, nurses, naturopaths, osteopaths, Chinese medicine and Chiropractors for the body model and psychiatrists, psychologists, psychotherapists, social workers, hypnotherapists and counsellors for the mind model. It now becomes a choice for the individual as to whether they attend these mind-body therapies used by a traditional medical person or a practitioner from one of the complimentary systems. While the systems purporting to deliver mind-body therapies are many, this article will restrict itself to a brief overview of some of the most popular of those with recorded successes.
To be continued in the next issue of Subconsciously Speaking
Endnotes:
(1) Kiecolt-Glaser J.K. &. Glaser R. "Psychoneuroimmunology: Past, Present & Future," Health Psychology 8(6): 1989,677-682
(2) Hall Stephen S. "A Molecular Code Links Emotions, Mind and Health," Smithsonian, June 1989
(3) Maranto Gina, "Emotions: How They Affect Your Body," Discover; November 1984, 35
(4) Hafen Brent Q, Karren Keith J., Frandsen Kathryn J., Lee Smith N., "The Effects of Attitudes, Emotions, & Relationships" 23 Allyn & Bacon Massachusetts
(5) Hafen Brent Q, Karren Keith J., Frandsen Kathryn J., Lee Smith N., "The Effects of Attitudes, Emotions, & Relationships" 23 Allyn & Bacon Massachusetts
(6) Gordon James S. M.D. "Testimony to the House Appropriations Committee Chairman" November 5th 1997 3-4
(7) Watkins Alan M.D. "Mind Body Medicine" Churchill Livingstone 1997 P.3
(8) Gordon James S. M.D. "Testimony to the House Appropriations Committee Chairman" November 5th 1997 5
(9) Hafen Brent Q, Karren Keith J., Frandsen Kathryn J., Lee Smith N., "The Effects of Attitudes, Emotions, & Relationships" 30 Allyn & Bacon Massachusetts
(10) Angell Marcia, "Disease as a Reflection of the Psyche," New England Journal of Medicine, 312: 1985, 1570-1572
Jay Quinlan owns and operates Global Learning Solutions Inc., a company that provides both individual and group therapeutic sessions within the Neuro Linguistic & Hypnotherapeutic processes. In addition, Jay provides training and seminars in related topics and communication skills. Jay is an approved school director with the International Medical & Dental Hypnotherapy Association[TM]. If you wish to contact Jay you can do so at (416) 523.9720/(519) 928.9624, Email jay.quinlan@sympatico.ca
Monday, December 31, 2007
HAPPY NEW YEAR!
Music can transcend anything. Happy New Year!
VIDEO: BACH, J.S.: St. Matthew Passion No.39 - Dresdner Kreuzchor
VIDEO: BACH, J.S.: St. Matthew Passion No.39 - Dresdner Kreuzchor
Thursday, December 27, 2007
A THOUSAND WINDS
SINGER: AKIKAWA MASAFUMI
(Translation)
A Thousand Winds
Do not stand at my grave and weep;
I am not there, I do not sleep.
I am a thousand winds that blow.
I am the diamond glints on snow.
I am the sunlight on ripened grain.
I am the gentle autumn's rain.
When you awaken in the morning's hush,
I am the swift uplifting rush
Of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry;
I am not there, I did not die.
(Translation)
A Thousand Winds
Do not stand at my grave and weep;
I am not there, I do not sleep.
I am a thousand winds that blow.
I am the diamond glints on snow.
I am the sunlight on ripened grain.
I am the gentle autumn's rain.
When you awaken in the morning's hush,
I am the swift uplifting rush
Of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry;
I am not there, I did not die.
Friday, December 7, 2007
Researchers Develop Powerful Tool to Study the Genetics of Inflammation
http://www.eurekalert.org/pub_releases/2007-11/wfub-rdp112907.php
Researchers develop powerful tool to study the genetics of inflammation
Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
WINSTON-SALEM, N.C. – Scientists have known which genes are linked to inflammation, but now researchers at Wake Forest University Baptist Medical Center have organized this information to develop a powerful tool to aid investigators in studying the genetics of inflammatory diseases.
Using complex web-based software called Ingenuity Pathway Analysis®, the researchers were able to systematically map out pathways, or chains of genes, and subpathways that contribute to various aspects of inflammation.
“We basically organized the inflammation-associated genes in a systematic way,” said Matthew Loza, Ph.D., of the Center for Human Genomics at Wake Forest University School of Medicine, and lead author of the study. “Before, a random list of genes involved in inflammation was all you had. We started with that same list, but then built these networks to bring all these different genes together.”
The study, which was recently published by the Public Library of Science in its online journal PLoS One, has also led to the development of two customized panels for analyzing genetic variations in the inflammation pathways -- one for European and one for African descent populations. In a laboratory, these panels are analyzed using special laboratory equipment and computer systems. Researchers can obtain the custom inflammation panel through Affymetrix Corporation.
“This is so significant because inflammation is a very hot topic, and many research groups want to study it,” said Bao-Li Chang, Ph.D., assistant professor of pediatrics at Wake Forest and senior author for the study. “We have provided researchers with the tool to effectively and efficiently accomplish their goals.”
###
Inflammation is the immune system’s response to pathogens and tissue damage. Chronic inflammation is linked to numerous diseases, including rheumatoid arthritis, cardiovascular disease, and many cancers.
This study is part of a larger study through the Women’s Health Initiative that explores the role of inflammation in colon, breast and lung cancer. It’s sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health.
Co-researchers were Charles McCall, M.D., and Jianfeng Xu, Dr. P.H., of Wake Forest, Liwu Li, Ph.D., of the Virginia Polytechnic Institute and State University, and William Isaacs, Ph.D., of Johns Hopkins University Medical Institutions.
Media contact: Karen Richardson, krchrdson@wfubmc.edu or Bonnie Davis, bdavis@wfubmc.edu; at (336) 716-4587.
Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university’s School of Medicine. The system comprises 1,238 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of “America’s Best Hospitals” by U.S. News & World Report.
Researchers develop powerful tool to study the genetics of inflammation
Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
WINSTON-SALEM, N.C. – Scientists have known which genes are linked to inflammation, but now researchers at Wake Forest University Baptist Medical Center have organized this information to develop a powerful tool to aid investigators in studying the genetics of inflammatory diseases.
Using complex web-based software called Ingenuity Pathway Analysis®, the researchers were able to systematically map out pathways, or chains of genes, and subpathways that contribute to various aspects of inflammation.
“We basically organized the inflammation-associated genes in a systematic way,” said Matthew Loza, Ph.D., of the Center for Human Genomics at Wake Forest University School of Medicine, and lead author of the study. “Before, a random list of genes involved in inflammation was all you had. We started with that same list, but then built these networks to bring all these different genes together.”
The study, which was recently published by the Public Library of Science in its online journal PLoS One, has also led to the development of two customized panels for analyzing genetic variations in the inflammation pathways -- one for European and one for African descent populations. In a laboratory, these panels are analyzed using special laboratory equipment and computer systems. Researchers can obtain the custom inflammation panel through Affymetrix Corporation.
“This is so significant because inflammation is a very hot topic, and many research groups want to study it,” said Bao-Li Chang, Ph.D., assistant professor of pediatrics at Wake Forest and senior author for the study. “We have provided researchers with the tool to effectively and efficiently accomplish their goals.”
###
Inflammation is the immune system’s response to pathogens and tissue damage. Chronic inflammation is linked to numerous diseases, including rheumatoid arthritis, cardiovascular disease, and many cancers.
This study is part of a larger study through the Women’s Health Initiative that explores the role of inflammation in colon, breast and lung cancer. It’s sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health.
Co-researchers were Charles McCall, M.D., and Jianfeng Xu, Dr. P.H., of Wake Forest, Liwu Li, Ph.D., of the Virginia Polytechnic Institute and State University, and William Isaacs, Ph.D., of Johns Hopkins University Medical Institutions.
Media contact: Karen Richardson, krchrdson@wfubmc.edu or Bonnie Davis, bdavis@wfubmc.edu; at (336) 716-4587.
Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university’s School of Medicine. The system comprises 1,238 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of “America’s Best Hospitals” by U.S. News & World Report.
Monday, December 3, 2007
THE JOURNEY - LEA SALONGA
Half the world is sleeping,
half the world's awake
half can hear their hearts beat
half just hear them break
I am but a traveler, in most every way
Ask me what you want...to know
What a journey it has been
And the end is not in sight
But the stars are out tonight
and they're bound to guide my way
When they're shining on my life
I can see a better day
I won't let the darkness in,
what a journey it has been.
I have been to sorrow
I have been to bliss
Where I'll be tomorrow,
I can only guess
Through the darkest desert
Through the deepest snow,
Forward always forward, I go..
What a journey it has been
and the end is not in sight
But the stars are out tonight
and they're bound to guide my way
When they're shining on my life
I can see a better day
I won't let the darkness in,
what a journey it has been...
Forward, always forward...
Onward, always up...
Catching every drop of hope
In my empty cup
What a journey it has been
And the end is not in sight
But the stars are out tonight
and they're bound to guide my way
When they're shining on my life
I can see a better day
I won't let the darkness in,
what a journey it has been...
What a journey it has been...
Friday, November 16, 2007
TODAY'S WORD
www.joelosteen.com
You Set the Limits
Today's Scripture
“What if they don’t believe? Will their lack of faith make the faith of God no effect?” (Romans 3:3)
Today's Word from Joel and Victoria
You Set the Limits
Today's Scripture
“What if they don’t believe? Will their lack of faith make the faith of God no effect?” (Romans 3:3)
Today's Word from Joel and Victoria
There will always be critics and naysayers in life. It’s not what’s said about you that affects your life, but what you say and believe about yourself. Has the opinions of other people caused you to water down your dreams? One of the most important things you can learn is that other people don’t have to believe in you in order for your dreams to come to pass. Other people don’t set the limits for your life—you do. In Romans 3:3, the Apostle Paul is saying, “It doesn’t matter if other people don’t believe. Their unbelief is not going to keep me from believing in my dreams.” When God puts a promise in your heart, it’s not up to other people to bring it to pass, it’s up to you! You don’t need everyone to validate you. You have to follow the voice of God for yourself and allow Him to order your steps. God sees the hidden treasures that you’ve had buried on the inside of you. He wants to bring those treasures out and make your dreams reality! As you get rid of old, defeated thoughts and replace them with what God says about you, you will remove the limits and live the abundant life God has in store for you!
A Prayer for Today
Heavenly Father, thank You for another day to see Your goodness in my life. Help me to see myself the way You see me. Help me to see the plans You have for me so that I can be empowered by You to fulfill my destiny. I love You and bless Your name today. In Jesus’ Name. Amen.
Thursday, November 15, 2007
LIVE ON A HIGHER LEVEL
When you're constantly on the lookout for limitations, you invite those limitations into your life.
Choose instead to allow more of the goodness and wholeness that make life so beautiful and miraculous.
Keep your focus on the positive possibilities, and put your energy into bringing those possibilities to life. When you're busy with creative accomplishment, fewer troubles will be able to find you.
Allow your thoughts and actions to be in harmony with your most cherished values. Fill your moments with sincere expressions of love, gratitude and creativity.
If you see yourself as struggling and striving, you give power to fear, pain and despair. Choose instead to see yourself as making a positive difference, and give your power to the very best things you can imagine.
You never have to live on the level at which everything is a problem or a conflict. You can decide to live on a higher level at which every situation is an opportunity to invoke and to express life's goodness.
In each moment, allow that goodness to stream into your world. With each day, lovingly bring to life the value that is yours to create.
Choose instead to allow more of the goodness and wholeness that make life so beautiful and miraculous.
Keep your focus on the positive possibilities, and put your energy into bringing those possibilities to life. When you're busy with creative accomplishment, fewer troubles will be able to find you.
Allow your thoughts and actions to be in harmony with your most cherished values. Fill your moments with sincere expressions of love, gratitude and creativity.
If you see yourself as struggling and striving, you give power to fear, pain and despair. Choose instead to see yourself as making a positive difference, and give your power to the very best things you can imagine.
You never have to live on the level at which everything is a problem or a conflict. You can decide to live on a higher level at which every situation is an opportunity to invoke and to express life's goodness.
In each moment, allow that goodness to stream into your world. With each day, lovingly bring to life the value that is yours to create.
Wednesday, November 14, 2007
TAKAYASU ARTERITIS STUDIES
TAKAYASU ARTERITIS AND ITS THERAPY
1: Annals of Internal Medicine. 1985 July;103(1):121-6
http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed&cmd=Retrieve&list_uids=2860834
Shelhamer JH, Volkman DJ, Parrillo JE, Lawley TJ, Johnston MR, Fauci AS.
PMID: 2860834 [PubMed - indexed for MEDLINE]
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TAKAYASU'S ARTERITIS -- COURSE, DIAGNOSIS AND LONG TERM RESULTS OF TREATMENT
2: Polish Archives of Medicine Wewn. 1994 Jun;91(6):451-60.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=PubMed&Cmd=ShowDetailView&TermToSearch=7971466&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1
[Article in Polish]
Cybulska I.
Kliniki Nadciśnienia Tetniczego Instytutu Kardiologii w Warszawie.
PMID: 7971466 [PubMed - indexed for MEDLINE]
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THE CLINICAL SPECTRUM OF TAKAYASU'S ARTERITIS
3: Surgery. 1988 November;104(5):905-10.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=PubMed&Cmd=ShowDetailView&TermToSearch=2903563&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1
Sise MJ, Counihan CM, Shackford SR, Rowley WR.
Department of Surgery, Naval Hospital, San Diego, Calif. 92134-5000.
PMID: 2903563 [PubMed - indexed for MEDLINE]
1: Annals of Internal Medicine. 1985 July;103(1):121-6
http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed&cmd=Retrieve&list_uids=2860834
Shelhamer JH, Volkman DJ, Parrillo JE, Lawley TJ, Johnston MR, Fauci AS.
Twenty patients with Takayasu's arteritis were followed prospectively for an average of 4.6 years. Sixteen patients with active inflammatory Takayasu's arteritis were treated with glucocorticosteroids; eight responded to therapy. Six patients had clinical or angiographic progression of their vasculitis on daily corticosteroid therapy. These patients were then given cyclophosphamide together with prednisone on alternate days. Four of these 6 patients had no progression of vascular lesions while receiving cyclophosphamide; two had progression of vascular lesions after 30 and 48 months of therapy. Vascular reconstructive surgery was successful in 7 patients who tolerated a total of 13 vascular surgical procedures without major complications. One bypass graft occluded after 13 months and was revised. With corticosteroid therapy, cytotoxic therapy, and surgery, no deaths due to Takayasu's arteritis or its treatment have occurred.
PMID: 2860834 [PubMed - indexed for MEDLINE]
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TAKAYASU'S ARTERITIS -- COURSE, DIAGNOSIS AND LONG TERM RESULTS OF TREATMENT
2: Polish Archives of Medicine Wewn. 1994 Jun;91(6):451-60.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=PubMed&Cmd=ShowDetailView&TermToSearch=7971466&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1
[Article in Polish]
Cybulska I.
Kliniki Nadciśnienia Tetniczego Instytutu Kardiologii w Warszawie.
Nonspecific aortoarteritis (Takayasu's arteritis) is a systemic disease of unknown cause. No characteristic symptoms may delay diagnosis and treatment as well as deteriorate prognosis.
The aim of the study was analysis of prevalence, course, diagnosis and treatment of Takayasu's arteritis. 10 patients (9 female, 1 male) with inflammatory phase of Takayasu's arteritis were seen at the Department of Hypertension of Institute of Cardiology between 1981 and 1992 (0.1% of all patients). The diagnosis was performed on the basis of typical arteriographic picture and laboratory investigations such as elevated of erythrocyte sedimentation rate and increase of immunoglobins, especially G fraction levels. Three patients were in poor general condition (fever, tachypnea, progressive weakness and severe arthralgia); in the remaining the symptoms were less severe, consisting mainly of weakness and arthralgia. All patients had multiple sites of arterial involvement (clinically and angiographically). Hypertension occurred in 9, aortic valve disease in 4, mitral valve disease in 2 and angina pectoris in 3 persons. All patients were treated with prednisone in initial dose of 1-1.5 mg/kg daily. After normalization of inflammatory indices (in average after 3 weeks therapy) this dose was gradually diminished to maintenance dose 5-15 mg daily. 4 patients were treated with prednisone in monotherapy, 6 received combined therapy--prednisone and cyclophosphamide or prednisone and azathioprine. Responses to immunosuppressive treatment were usually very good. In follow-up period (43.4 +/- 30.7 months) in 9 patients the regression of symptoms of inflammatory phase was observed (all patients were treated with maintenance dose of prednisone). Immunosuppressive therapy was ineffective in one woman, despite long term treatment with prednisone combined alternately with cyclophosphamide, azathioprine or methotrexate. She died of progressive heart and renal failure.
CONCLUSIONS: 1. Takayasu's arteritis is serious systemic disease with considerable risk of death. 2. Early and proper management of Takayasu's arteritis can improve prognosis of this disease. 3. In every case with multiple sites of arterial involvement, especially with associated symptoms of unidentified inflammatory disease it is necessary to consider diagnosis of Takayasu's arteritis, which prevalence seems to be underestimated.
PMID: 7971466 [PubMed - indexed for MEDLINE]
------------
THE CLINICAL SPECTRUM OF TAKAYASU'S ARTERITIS
3: Surgery. 1988 November;104(5):905-10.
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=PubMed&Cmd=ShowDetailView&TermToSearch=2903563&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1
Sise MJ, Counihan CM, Shackford SR, Rowley WR.
Department of Surgery, Naval Hospital, San Diego, Calif. 92134-5000.
Takayasu's arteritis is a rare inflammatory disease of the aorta, its major branches, and the pulmonary artery in which the varying anatomic involvement, the time course, and the periodicity of exacerbations give rise to a wide variety of signs and symptoms. We have recently encountered five patients with Takayasu's arteritis whose symptoms and findings demonstrate the clinical spectrum of this disease. All five patients are women, with a current mean age of 41 years. Although findings at initial evaluations included systemic manifestations and elevation of the erythrocyte sedimentation rate in four patients, the fifth patient had a normal erythrocyte sedimentation rate and signs of abdominal aortic occlusion. Two patients had a history of hypertension, and four patients complained of upper- or lower-extremity claudication. Arteriographic examination revealed aortic arch branch vessel involvement (type I) in two patients who also had aortic valvular insufficiency; three patients had combined arch vessel and distal aortic disease (type III). All patients have been maintained on steroid medications, and one patient has undergone a trial of cytotoxic agents. Three patients underwent surgical procedures: aortic valve replacement in two patients, and aortorenal bypass in one patient. Takayasu's arteritis gives rise to a variety of symptoms and findings resulting from the distribution and severity of the inflammatory process. With adequate immunosuppression and selective application of surgical therapy, there is a good prognosis for survival and a return to functional status.
PMID: 2903563 [PubMed - indexed for MEDLINE]
AFFIRMATION OF THE DAY
I am very blessed and lucky.
I have gratitude and appreciation for what I have and let go of coveting what others have.
I have gratitude and appreciation for what I have and let go of coveting what others have.
Tuesday, September 11, 2007
QUOTE OF THE DAY
I define joy as a sustained sense of well-being and internal peace - a connection to what matters. Oprah Winfrey
Monday, September 10, 2007
SLOW DOWN
AN INTERESTING REFLECTION: SLOW DOWN CULTURE
It has been 18 years since I joined Volvo, a Swedish company. Working for them has proven to be an interesting experience. Any project here takes 2 years to be finalized, even if the idea is simple and brilliant. It's a rule.Globalized processes have caused in us (all over the world) a general sense of searching for immediate results. Therefore, we have come to possess a need to see immediate results. Thiscontrasts greatly with the slow movements of the Swedish. They, on the other hand, debate, debate, debate, hold x quantity of meetings and work with a slowdown scheme. At the end, this always yields better results.
Said in other words:
1. Sweden is about the size of San Pablo, a state in Brazil
2. Sweden has 9 million inhabitants
3. Stockholm has 500,000 people
4. Volvo, Escania, Ericsson, Electrolux and Nokia are some of its owned companies.
The first time I was in Sweden, one of my colleagues picked me up at the hotel every morning. It was September, bit cold and snowy. We would arrive early at the company and he would park far away from the entrance (2000 employees drive their car to work). The first day, I didn't sayanything, either on the second or third.
One morning I asked, "Do you have a fixed parking space? I've noticed we park far from the entrance even when there are no other cars in the lot." To which he replied, "Since we're here early we'll have time to walk, and whoever gets in late will be late and need a place closer to the door, don't you think?” Imagine my face.
Nowadays, there's a movement in Europe named Slow Food. This movement establishes that people should eat and drink slowly, with enough time to taste their food, spend time with the family, friends, without rushing. Slow Food! is against its counterpart: the spirit of Fast Food and what it stands for as a lifestyle.
Slow Food is the basis for a bigger movement called Slow Europe, as mentioned by Business Week.Basically, the movement questions the sense of "hurry" and "craziness" generated by globalization, fueled by the desire of "having in quantity" (life status) versus "having with quality", "life quality" or the "quality of being". French people, even though they work 35 hoursper week, are more productive than Americans or British. Germans have established 28.8 hour workweeks and have seen their productivity driven up by 20%.
This slow attitude has brought forth the US's attention, pupils of the fast and the "do it now!"This no-rush attitude doesn't represent doing less or having a lower productivity. It means working and doing things with greater quality, productivity, perfection, with attention to detail and less stress. It means reestablishing family values, friends, free and leisure time.
Taking the "now", present and concrete, versus the "global", undefined and anonymous. It means taking humans' essential values, the simplicity of living.
It stands for a less coercive work environment, more happy, lighter and more productive where humans enjoy doing what they know best how to do. It's time to stop and think on how companies need to develop serious quality with no-rush that will increase productivity and the quality of products and services, without losing the essence of spirit.
In the movie, Scent of a Woman, there's a scene where Al Pacino asks a girl to dance and she replies, "I can't, my boyfriend will be here any minute now". To which Al responds, "A life is lived in an instant". Then they danced to a tango.
Many of us live our lives running behind time, but we only reach it when we die of a heart attack or in a car accident rushing to be on time. Others are so anxious of living the future that they forget to live the present, which is the only time that truly exists. We all have equal time throughout the world. No one has more or less. The difference lies in how each one of us does with our time.
We need to live each moment. As John Lennon said, "Life is what happens to you while you're busy making other plans".
Congratulations for reading till the end of this message. There are many who will have stopped in the middle so as not to waste time in this ‘rushed’ world.
TODAY'S WORD
www.joelosteen.com
The Land of Hope
Today's Scripture
“I’ve pitched my tent in the Land of Hope” (Acts 2:26 Message).
Today's Word from Joel and Victoria
Where have you pitched your tent today? What are you expecting to happen in your life? What kind of attitude do you have? If you’re focused on what’s wrong, or what’s not working, it’s time to dig up your tent stakes! It’s time to pack up your belongings and move out of the land of discouragement. Move out of the “Not-going-to-happen” sub-division. Move out of “Can’t-do-it-ville.” It’s time to leave “Self-pity Estates.” Get out of those areas and move into the land of hope, faith, and expectation. Maybe you don’t quite know how to get there, but now’s the time to start looking for that new place. Open your heart to the Lord and ask Him to direct your thoughts and expectations. The Bible says that those who hope in the Lord will never be put to shame. You can trust God to order your steps. You can trust Him to move you from the land of disappointment to the land of hope today!
A Prayer for Today
Heavenly Father, thank You for ordering and directing my steps. Thank You for taking me to the land of hope! I release all my past hurts and disappointments to You today and ask that You fill me with Your faith and expectancy for a bright future! In Jesus’ Name, Amen.
The Land of Hope
Today's Scripture
“I’ve pitched my tent in the Land of Hope” (Acts 2:26 Message).
Today's Word from Joel and Victoria
Where have you pitched your tent today? What are you expecting to happen in your life? What kind of attitude do you have? If you’re focused on what’s wrong, or what’s not working, it’s time to dig up your tent stakes! It’s time to pack up your belongings and move out of the land of discouragement. Move out of the “Not-going-to-happen” sub-division. Move out of “Can’t-do-it-ville.” It’s time to leave “Self-pity Estates.” Get out of those areas and move into the land of hope, faith, and expectation. Maybe you don’t quite know how to get there, but now’s the time to start looking for that new place. Open your heart to the Lord and ask Him to direct your thoughts and expectations. The Bible says that those who hope in the Lord will never be put to shame. You can trust God to order your steps. You can trust Him to move you from the land of disappointment to the land of hope today!
A Prayer for Today
Heavenly Father, thank You for ordering and directing my steps. Thank You for taking me to the land of hope! I release all my past hurts and disappointments to You today and ask that You fill me with Your faith and expectancy for a bright future! In Jesus’ Name, Amen.
Friday, August 31, 2007
Friday, August 3, 2007
TODAY'S WORD
Believe and Receive
Today's Scripture
“Therefore, I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours” (Mark 11:24, NIV).
Today's Word from Joel and Victoria
Has God spoken things to your heart that haven’t come to pass yet? Sometimes when we are believing for things, it’s easy to let circumstances and the pressures of life drag us down. But when you make the choice to receive your promise by picturing it in your mind’s eye, and declaring it with the words of your mouth, your faith becomes stronger. You begin to feel more confident. You begin to feel more settled. You begin to have joy and peace because you know God is working behind the scenes on your behalf. What are you believing for God to do in your life today? Can you see it in your mind’s eye? Can you see yourself healed? Can you see yourself paying off that last debt? Can you see yourself at your ideal weight? Can you see yourself sharing the gospel with a family member or coworker? Ask the Lord to give you the picture of what He sees when He looks at you. As you open your heart and allow God’s thoughts to become your thoughts, and your receive His promises by faith, just like it says in the above verse—whatever you ask for in prayer will be yours!
A Prayer for Today
Heavenly Father, thank You for another day to serve You. Thank You for the gift of faith. I ask that you search my heart and mind and remove anything that does not please you. Give me your thoughts of peace and joy today so that I can learn to receive all you have for me today. In Jesus’ Name. Amen.
Today's Scripture
“Therefore, I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours” (Mark 11:24, NIV).
Today's Word from Joel and Victoria
Has God spoken things to your heart that haven’t come to pass yet? Sometimes when we are believing for things, it’s easy to let circumstances and the pressures of life drag us down. But when you make the choice to receive your promise by picturing it in your mind’s eye, and declaring it with the words of your mouth, your faith becomes stronger. You begin to feel more confident. You begin to feel more settled. You begin to have joy and peace because you know God is working behind the scenes on your behalf. What are you believing for God to do in your life today? Can you see it in your mind’s eye? Can you see yourself healed? Can you see yourself paying off that last debt? Can you see yourself at your ideal weight? Can you see yourself sharing the gospel with a family member or coworker? Ask the Lord to give you the picture of what He sees when He looks at you. As you open your heart and allow God’s thoughts to become your thoughts, and your receive His promises by faith, just like it says in the above verse—whatever you ask for in prayer will be yours!
A Prayer for Today
Heavenly Father, thank You for another day to serve You. Thank You for the gift of faith. I ask that you search my heart and mind and remove anything that does not please you. Give me your thoughts of peace and joy today so that I can learn to receive all you have for me today. In Jesus’ Name. Amen.
Thursday, August 2, 2007
Tuesday, July 31, 2007
TA CLASSIFICATION TYPES & CRITERIA
Reference: Ball, G.V. and S. Louis Bridges JR (Eds) (2002) Vasculitis. Oxford University
In Chapter 19 by Sharma and Jain they provide a classification of TA on page 283
"A new 5-type classification proposed by an International Cooperative Study on Takayasu's Arteritis is based on the location of the disease (Moriwaki et al, 1997)".
The Roman Numerals refer to Type.
The statement refers to Site of Involvement.
Type I - Branches of the aortic arch.
Type IIa - Ascending aorta, aortic arch and its branches.
Type IIb - Ascending aorta, aortic arch and its branches and thoracic descending aorta.
Type III - Thoracic descending aorta, abdominal aorta and/or renal arteries.
Type IV - Abdominal aorta and/or renal arteries.
Type V - Combination of Types IIb and IV.
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From: http://www.rheumatology.org/publications/classification/takayasu.asp?aud=mem
1990 criteria for the classification of Takayasu arteritis
1. Age at disease onset < 40 years
Development of symptoms or findings related to Takayasu arteritis at age 40 years
2. Claudication of extremities
Development and worsening of fatigue and discomfort in muscles of 1 or more extremity while in use, especially the upper extremities
3. Decreased brachial artery pulse
Decreased pulsation of 1 or both brachial arteries
4. BP difference >10 mm Hg
Difference of >10 mm Hg in systolic blood pressure between arms
5. Bruit over subclavian arteries or aorta
Bruit audible on auscultation over 1 or both subclavian arteries or abdominal aorta
6. Arteriogram abnormality
Arteriographic narrowing or occlusion of the entire aorta, its primary branches, or large arteries in the proximal upper or lowe extremities, not due to arteriosclerosis, fibromuscular dysplasia, or similar causes; changes usually focal or segmental
In Chapter 19 by Sharma and Jain they provide a classification of TA on page 283
"A new 5-type classification proposed by an International Cooperative Study on Takayasu's Arteritis is based on the location of the disease (Moriwaki et al, 1997)".
The Roman Numerals refer to Type.
The statement refers to Site of Involvement.
Type I - Branches of the aortic arch.
Type IIa - Ascending aorta, aortic arch and its branches.
Type IIb - Ascending aorta, aortic arch and its branches and thoracic descending aorta.
Type III - Thoracic descending aorta, abdominal aorta and/or renal arteries.
Type IV - Abdominal aorta and/or renal arteries.
Type V - Combination of Types IIb and IV.
--------
From: http://www.rheumatology.org/publications/classification/takayasu.asp?aud=mem
1990 criteria for the classification of Takayasu arteritis
1. Age at disease onset < 40 years
Development of symptoms or findings related to Takayasu arteritis at age 40 years
2. Claudication of extremities
Development and worsening of fatigue and discomfort in muscles of 1 or more extremity while in use, especially the upper extremities
3. Decreased brachial artery pulse
Decreased pulsation of 1 or both brachial arteries
4. BP difference >10 mm Hg
Difference of >10 mm Hg in systolic blood pressure between arms
5. Bruit over subclavian arteries or aorta
Bruit audible on auscultation over 1 or both subclavian arteries or abdominal aorta
6. Arteriogram abnormality
Arteriographic narrowing or occlusion of the entire aorta, its primary branches, or large arteries in the proximal upper or lowe extremities, not due to arteriosclerosis, fibromuscular dysplasia, or similar causes; changes usually focal or segmental
Thursday, July 26, 2007
QUOTE OF THE DAY
One of the most tragic things I know about human nature is that all of us tend to put off living. We are all dreaming of some magical rose garden over the horizon instead of enjoying the roses that are blooming outside our windows today. ~ Dale CarnegieMonday, July 23, 2007
CASE REPORT: Descending Aorta to Carotid Bypass for Takayasu Arteritis as a Redo Operation
http://ats.ctsnetjournals.org/cgi/content/abstract/76/1/283
Descending aorta to carotid bypass for takayasu arteritis as a redo operation Norihiko Shiiya, MD, PhDa*, Kenji Matsuzaki, MDa, Tohru Watanabe, MDa, Satoshi Kuroda, MD, PhDb, Keishu Yasuda, MD, PhDa
a Department of Cardiovascular Surgery, Sapporo, Japan
Accepted for publication January 7, 2003.
* Address reprint requests to Dr Shiiya, Department of Cardiovascular Surgery, Hokkaido University Hospital, N14W5, Kita-ku, Sapporo 060-8648, Japane-mail: shiyanor@med.hokudai.ac.jp
'//-->
In Takayasu arteritis recurrent brain ischemia, due to bypass graft failure, is frequent. Redo bypass grafting from the ascending aorta may be at risk if a failing but patent graft that is critical for brain blood flow is present, because partial clamping the ascending aorta may disturb graft flow if the ascending aorta is short. We report such a patient who successfully underwent redo bypass grafting from the descending aorta. In type I Takayasu arteritis, this operation may be valuable because the descending aorta is usually disease free and brain blood flow is maintained during the operation.
Case report
Descending aorta to carotid bypass for takayasu arteritis as a redo operation Norihiko Shiiya, MD, PhDa*, Kenji Matsuzaki, MDa, Tohru Watanabe, MDa, Satoshi Kuroda, MD, PhDb, Keishu Yasuda, MD, PhDa
a Department of Cardiovascular Surgery, Sapporo, Japan
b Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Accepted for publication January 7, 2003.
* Address reprint requests to Dr Shiiya, Department of Cardiovascular Surgery, Hokkaido University Hospital, N14W5, Kita-ku, Sapporo 060-8648, Japane-mail: shiyanor@med.hokudai.ac.jp
'//-->
In Takayasu arteritis recurrent brain ischemia, due to bypass graft failure, is frequent. Redo bypass grafting from the ascending aorta may be at risk if a failing but patent graft that is critical for brain blood flow is present, because partial clamping the ascending aorta may disturb graft flow if the ascending aorta is short. We report such a patient who successfully underwent redo bypass grafting from the descending aorta. In type I Takayasu arteritis, this operation may be valuable because the descending aorta is usually disease free and brain blood flow is maintained during the operation.
Myocardial Thievery: The Coronary-Subclavian Steal Syndrome
http://ats.ctsnetjournals.org/cgi/content/abstract/81/1/386
Review
Myocardial Thievery: The Coronary-Subclavian Steal Syndrome
Thomas J. Takach, MD, George J. Reul, MD, Denton A. Cooley, MD * , J. Michael Duncan, MD, James J. Livesay, MD, David A. Ott, MD, Igor D. Gregoric, MD
Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas
* Address correspondence to Dr Cooley, Department of Cardiovascular Surgery, The Texas Heart Institute, PO Box 20345, Houston, TX 77225. (Email: dcooley@heart.thi.tmc.edu
'//-->).
Coronary-subclavian steal syndrome entails the reversal of blood flow in a previously constructed internal mammary artery coronary conduit, which produces myocardial ischemia. The most frequent cause of the syndrome is atherosclerotic disease in the ipsilateral, proximal subclavian artery. Although coronary-subclavian steal was initially reported to be rare, the increasing documentation of this phenomenon and its potentially catastrophic consequences in recent series suggests that the incidence of the problem has been underreported and that its clinical impact has been underestimated. We review the causes and background of coronary-subclavian steal; methods of preventing, diagnosing, and treating it; and the potential influence of various treatment regimens on long-term survival and the likelihood of late adverse events in patients with coronary-subclavian steal syndrome.
Review
Myocardial Thievery: The Coronary-Subclavian Steal Syndrome
Thomas J. Takach, MD, George J. Reul, MD, Denton A. Cooley, MD * , J. Michael Duncan, MD, James J. Livesay, MD, David A. Ott, MD, Igor D. Gregoric, MD
Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas
* Address correspondence to Dr Cooley, Department of Cardiovascular Surgery, The Texas Heart Institute, PO Box 20345, Houston, TX 77225. (Email: dcooley@heart.thi.tmc.edu
'//-->).
Coronary-subclavian steal syndrome entails the reversal of blood flow in a previously constructed internal mammary artery coronary conduit, which produces myocardial ischemia. The most frequent cause of the syndrome is atherosclerotic disease in the ipsilateral, proximal subclavian artery. Although coronary-subclavian steal was initially reported to be rare, the increasing documentation of this phenomenon and its potentially catastrophic consequences in recent series suggests that the incidence of the problem has been underreported and that its clinical impact has been underestimated. We review the causes and background of coronary-subclavian steal; methods of preventing, diagnosing, and treating it; and the potential influence of various treatment regimens on long-term survival and the likelihood of late adverse events in patients with coronary-subclavian steal syndrome.
TODAY'S WORD
From Joel & Victoria Osteen
Brighter Days Ahead
Today's Scripture
“The way of the righteous is like the first gleam of dawn, which shines ever brighter until the full light of day” (Proverbs 4:18, NLT).
Today's Word from Joel and Victoria
Are you facing a situation that seems dark today? As a believer, God promises that your path will shine brighter and brighter as you seek His Truth and righteousness in every situation. What is righteousness? Righteousness is simply being in "right standing" with God. Being in "right standing" with God is about submitting your life to Him. It's about obeying His commands and seeking His plan for your life on a daily basis. God wants to be involved in every detail of your life. It pleases Him when you come to Him. It pleases Him when you study your Bible and talk to Him in prayer. And just as the increasing light of the sun helps you see better in the natural, the increasing light of God's Word will guide you in every decision you have to make. No matter what you may be facing today, take time to ask the Lord to shine His light on your thoughts. Ask Him to confirm His plan for your today. Ask Him to shine the light of His Word in your heart so that you can clearly see the next step to take. As you continue pursing His Truth and Righteousness, you will experience more of His blessings and live the life of abundance that He has in store for you!
A Prayer for Today
God, I know that You have a wonderful plan and purpose for me. I want to be in "right standing" with You today. Show me your ways and teach me to walk righteously before you. Shine your light in my heart and give me strength and wisdom to pursue the path You have in-store for me. In Jesus' Name. Amen.
Brighter Days Ahead
Today's Scripture
“The way of the righteous is like the first gleam of dawn, which shines ever brighter until the full light of day” (Proverbs 4:18, NLT).
Today's Word from Joel and Victoria
Are you facing a situation that seems dark today? As a believer, God promises that your path will shine brighter and brighter as you seek His Truth and righteousness in every situation. What is righteousness? Righteousness is simply being in "right standing" with God. Being in "right standing" with God is about submitting your life to Him. It's about obeying His commands and seeking His plan for your life on a daily basis. God wants to be involved in every detail of your life. It pleases Him when you come to Him. It pleases Him when you study your Bible and talk to Him in prayer. And just as the increasing light of the sun helps you see better in the natural, the increasing light of God's Word will guide you in every decision you have to make. No matter what you may be facing today, take time to ask the Lord to shine His light on your thoughts. Ask Him to confirm His plan for your today. Ask Him to shine the light of His Word in your heart so that you can clearly see the next step to take. As you continue pursing His Truth and Righteousness, you will experience more of His blessings and live the life of abundance that He has in store for you!
A Prayer for Today
God, I know that You have a wonderful plan and purpose for me. I want to be in "right standing" with You today. Show me your ways and teach me to walk righteously before you. Shine your light in my heart and give me strength and wisdom to pursue the path You have in-store for me. In Jesus' Name. Amen.
Friday, July 20, 2007
THE POWER OF POSITIVE THINKING
From Dr. Val and the Voice of Reason Blog
http://www.revolutionhealth.com/blogs/valjonesmd?page=2
The Power of Positive Thinking
Posted on 07:49AM (EDT) on 2007-07-09
Norman Vincent Peale wrote a bestselling book in the 1950’s, “The Power of Positive Thinking.” I read it a few years ago and found it to be a tad simplistic but it had an undeniable point: a positive attitude is important in life.
In my last post I described the dangers of magical thinking – since it opens the door to pseudoscience-touting snake oil salesmen. But now we will turn our attention to positive thinking – a favorable psychological condition.
There is no doubt that there is a mind-body connection that affects health. “Type A personalities” are known to engage in behaviors that increase the risk for heart attack; anxiety and perceived stress can cause higher output of adrenaline and cortisol, and in turn contribute to inflammation, atherosclerosis, heart disease, sleep disturbances, and weight gain. Depressed individuals (for example) are more likely to suffer from pain syndromes, and may have impaired immune function.
Because our mind influences the health of our body, it is physically therapeutic to focus attention on peace of mind as a preventive health measure. And in so far as techniques are developed to reduce stress, decrease mental anguish, and improve psychological wellbeing – they are helpful in keeping the body in a healthier state.
Now, the temptation is to exaggerate the benefits of peace of mind – that one might be able to avoid cancer (for example) with the right attitude, which is blatantly false. So this is where positive thinking and magical thinking can be confused. Magical thinking ascribes excessive value to a treatment, while positive thinking understands the limitations of treatments and yet respects the reality of the mind-body connection.
Let’s consider back pain, for example. A magical thinker would look for the “secret cure” for their back pain, and turn over every stone – fully anticipating that he would discover a miracle solution that others don’t know about. He would read books promising the ultimate back treatment “that your doctor doesn’t want you to know about” and would spend a great deal of money on treatments that have been rumored to have some benefit in treating back pain (without any supporting evidence). The magical thinker is vulnerable to snake oil, and would rather risk thousands of dollars on experimental treatments than consider traditional modalities first.
A positive thinker, on the other hand, will realize that back pain is difficult to treat, has variable causes, and responds to different therapies based on an individual’s unique circumstances. A positive thinker would have a realistic view of recovery, would accept the limitations of therapeutic options, but would focus on his abilities rather than his disabilities and look for ways to make the best of his current circumstances. He would actively participate in physical activity, perhaps join a support group, get good rest and engage in a healthy lifestyle while working towards a brighter tomorrow one step at a time.
Definitions for clarity:
Snake oil is a treatment whose efficacy is knowingly exaggerated by those who wish to turn a profit on its sale. E.g. diet pills that will "miraculously correct morbid obesity in a matter of weeks."
A placebo is a treatment that has no known plausible mechanism for a physical effect - but may affect the individual through the mind-body connection. E.g. a sugar pill that is substituted for a pain killer may cause a patient to experience his pain differently, though there is no active ingredient in the pill.
An untested treatment is neither snake oil nor a placebo but could be used as either under certain circumstances. It is simply a proposed intervention of unclear clinical significance. There are many of these currently undergoing scientific review, and it takes patience to analyze their potential efficacy and safety.
A magical thinker is a person who is willing to accept snake oil as a valid treatment option for his condition despite a vast preponderance of evidence to the contrary. Magical thinking is belief-based, rather than evidence-based. Many very good and reasonable people are tempted to adopt magical thinking under duress.
A positive thinker is a person who choses to look for the positives in all circumstances, and approaches health with a can-do attitude. Realistic and yet optimistic, the positive thinker will focus on abilities rather than disabilities - and reach out for support as needed to optimize his psychological well being.
All of this is simply to say that a positive attitude, peace of mind, stress reduction techniques and a healthy lifestyle are an important foundation for good health. Placebos are most relevant for influencing psychological well being or pain perception (obviously they're not appropriate for treating infections, type 1 diabetes, and the like), and magical thinking and snake oil are dangerous hindrances to wellbeing. Stay positive and protect yourself from snake oil salesmen. Knowledge is power. There are voices of reason to guide you here at Revolution Health.
**Views expressed are my own and do not necessarily reflect the views of Revolution Health.**
The Power of Positive Thinking
Posted on 07:49AM (EDT) on 2007-07-09
Norman Vincent Peale wrote a bestselling book in the 1950’s, “The Power of Positive Thinking.” I read it a few years ago and found it to be a tad simplistic but it had an undeniable point: a positive attitude is important in life.
In my last post I described the dangers of magical thinking – since it opens the door to pseudoscience-touting snake oil salesmen. But now we will turn our attention to positive thinking – a favorable psychological condition.
There is no doubt that there is a mind-body connection that affects health. “Type A personalities” are known to engage in behaviors that increase the risk for heart attack; anxiety and perceived stress can cause higher output of adrenaline and cortisol, and in turn contribute to inflammation, atherosclerosis, heart disease, sleep disturbances, and weight gain. Depressed individuals (for example) are more likely to suffer from pain syndromes, and may have impaired immune function.
Because our mind influences the health of our body, it is physically therapeutic to focus attention on peace of mind as a preventive health measure. And in so far as techniques are developed to reduce stress, decrease mental anguish, and improve psychological wellbeing – they are helpful in keeping the body in a healthier state.
Now, the temptation is to exaggerate the benefits of peace of mind – that one might be able to avoid cancer (for example) with the right attitude, which is blatantly false. So this is where positive thinking and magical thinking can be confused. Magical thinking ascribes excessive value to a treatment, while positive thinking understands the limitations of treatments and yet respects the reality of the mind-body connection.
Let’s consider back pain, for example. A magical thinker would look for the “secret cure” for their back pain, and turn over every stone – fully anticipating that he would discover a miracle solution that others don’t know about. He would read books promising the ultimate back treatment “that your doctor doesn’t want you to know about” and would spend a great deal of money on treatments that have been rumored to have some benefit in treating back pain (without any supporting evidence). The magical thinker is vulnerable to snake oil, and would rather risk thousands of dollars on experimental treatments than consider traditional modalities first.
A positive thinker, on the other hand, will realize that back pain is difficult to treat, has variable causes, and responds to different therapies based on an individual’s unique circumstances. A positive thinker would have a realistic view of recovery, would accept the limitations of therapeutic options, but would focus on his abilities rather than his disabilities and look for ways to make the best of his current circumstances. He would actively participate in physical activity, perhaps join a support group, get good rest and engage in a healthy lifestyle while working towards a brighter tomorrow one step at a time.
Definitions for clarity:
Snake oil is a treatment whose efficacy is knowingly exaggerated by those who wish to turn a profit on its sale. E.g. diet pills that will "miraculously correct morbid obesity in a matter of weeks."
A placebo is a treatment that has no known plausible mechanism for a physical effect - but may affect the individual through the mind-body connection. E.g. a sugar pill that is substituted for a pain killer may cause a patient to experience his pain differently, though there is no active ingredient in the pill.
An untested treatment is neither snake oil nor a placebo but could be used as either under certain circumstances. It is simply a proposed intervention of unclear clinical significance. There are many of these currently undergoing scientific review, and it takes patience to analyze their potential efficacy and safety.
A magical thinker is a person who is willing to accept snake oil as a valid treatment option for his condition despite a vast preponderance of evidence to the contrary. Magical thinking is belief-based, rather than evidence-based. Many very good and reasonable people are tempted to adopt magical thinking under duress.
A positive thinker is a person who choses to look for the positives in all circumstances, and approaches health with a can-do attitude. Realistic and yet optimistic, the positive thinker will focus on abilities rather than disabilities - and reach out for support as needed to optimize his psychological well being.
All of this is simply to say that a positive attitude, peace of mind, stress reduction techniques and a healthy lifestyle are an important foundation for good health. Placebos are most relevant for influencing psychological well being or pain perception (obviously they're not appropriate for treating infections, type 1 diabetes, and the like), and magical thinking and snake oil are dangerous hindrances to wellbeing. Stay positive and protect yourself from snake oil salesmen. Knowledge is power. There are voices of reason to guide you here at Revolution Health.
**Views expressed are my own and do not necessarily reflect the views of Revolution Health.**
Monday, July 16, 2007
Durable Remission in Patients with Refractory Takayasu’s Arteritis Treated with Infliximab or Etanercept (Remicade)
Durable Remission in Patients with Refractory Takayasu’s Arteritis Treated with Infliximab or Etanercept
Eamonn S. Molloy, Carol A. Langford, Tiffany M. Clark, Carmen E. Gota, Leonard H. Calabrese, Gary S. Hoffman
While up to 20% of Takayasu’s arteritis (TAK) patients have a monophasic illness, most have a relapsing/remitting course, typically requiring prolonged treatment with glucocorticoids and additional immunosuppressive agents, such as methotrexate, azathioprine and, in severe cases, cyclophosphamide. More than one-third of patients are unable to achieve adequate disease control on these therapies. As tumor necrosis factor alpha (TNFa) is critical for granuloma homeostasis and granulomatous inflammation is the pathologic hallmark of TAK, TNFa is an attractive therapeutic target in TAK; anti-TNF therapy has been employed in TAK patients with encouraging results.
We sought to assess the efficacy of anti-TNF therapy in patients with TAK refractory to other therapies. Twenty-eight TAK patients were identified as having received anti-TNF therapy; 3 patients were excluded because of insufficient follow-up data. No patient was in remission at the time of initiation of anti-TNF therapy; 13 had not achieved remission at any time since initial diagnosis. Twenty-five patients were treated with anti-TNF therapy for up to 6.5 years. Twenty patients were treated with infliximab (INF) with a mean follow-up of 27 months (range 2-76). Nine patients were treated with etanercept (ETA) with a mean follow-up of 33 months (range 4-78). Four patients received both agents (all initially treated with ETA, later switched to INF). No patients were treated with adalimumab.
Of 25 patients, 22 were female; mean age was 35 years (range 15-63). Patients’ ethnicities were Caucasian, 20, Asian,3, Hispanic,1, and one unknown. Median disease duration was 108 months (range 31-336). All patients were previously treated with prednisone and a mean of 2 additional immunosuppressive agents (range 0-6) including 22 methotrexate, 10 cyclophosphamide, and 12 with a variety of other agents.
Overall, prednisone was discontinued in 15/25 patients (60%) and tapered below 10 mg/day in a further 7/25 (28%). Median prednisone dose before and after anti-TNF therapy was 19 mg (range 5-90) and 0 mg (range 0-30). Nine out of 18 patients were able to taper or discontinue additional immunosuppressive agents used concurrently with the anti-TNF agent. Six patients had definite new changes noted on MR imaging (3 INF, 3 ETA); 5 patients entered remission on higher dose anti-TNF therapy. Three patients who stopped ETA had disease flares within a median of 2 months (range 1-2); 6/7 patients that stopped INF had disease flare at a median interval of 6 months (range 2-12); 1 patient recommenced INF treatment and achieved sustained remission.
Conclusions
In this group of TAK patients refractory to other immunosuppressive therapies, anti-TNF therapy led to complete or partial remission in 79% of patients. Anti-TNF therapy allowed prednisone to be discontinued or tapered in 60% and 28%, respectively. Of those patients taking concurrent immunosuppressive drugs other than prednisone, anti-TNF therapy allowed reduction of the dose of these agents in 50%. These findings provide further support for the rationale for randomized controlled trials of anti-TNF therapy in TAK.
THINGS THAT I AM HAPPY ABOUT
1. Chilled Watermelon
2. Rubber inflatable swimming pools
3. Play n Bounce place
4. Good Book
5. Creative ideas
2. Rubber inflatable swimming pools
3. Play n Bounce place
4. Good Book
5. Creative ideas
UNWRITTEN VIDEO - NATASHA BEDINGFIELD
UNWRITTEN
By Natasha Bedingfield
I am unwritten,
Can't read my mind
im undefined
im just begining
the pen is in my hand
ending unplanned
Staring at the blank page before you
Open up the dirty window
Let the sun illuminate the words
That you could not find
Reaching for something in the distance
So close you can almost taste it
Release your inner visions
Feel the rain on your skin
No one else can feel it for you
Only you can let it in
No one else, no one else
Can speak the words on your lips
drench yourself in words unspoken
Live your life with arms wide open
Today is where your book begins
The rest is still unwritten ,yeah
Oh, oh
I break tradition
Sometimes my tries
Are outside the lines, oh yeah
Within condition
To not make mistakes
But I can't live that way oh, oh
Staring at the blank page before you
Open up the dirty window
Let the sun illuminate the words
That you could not find
Reaching for something in the distance
So close you can almost taste it
Release your inner visions
Feel the rain on your skin
No one else can feel it for you
Only you can let it in
No one else, no one else
Can speak the words on your lips
drench yourself in words unspoken
Live your life with arms wide open
Today is where your book begins
The rest is still unwritten
Staring at the blank page before you
Open up the dirty window
Let the sun illuminate the words
That you could not find
Reaching for something in the distance
So close you can almost taste it
Release your inner visionnnnnnnnnns
Feel the rain on your skin
No one else can feel it for you
Only you can let it in
No one else, no one else
Can speak the words on your lips
drench yourself in words unspoken
Live your life with arms wide open
Today is where your book begins
The rest is still unwritten
The rest is still unwritten
Friday, July 13, 2007
Tuesday, July 10, 2007
Thursday, July 5, 2007
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