MikeLigalig.com

Special Forces Soldiers graduate qualification training Aug. 9

Class 270 graduates from Special Forces Qualification Course in Fayetteville, N.C. Fort Bragg's John F. Kennedy Special Warfare Center and School held a graduation ceremony at Crown Coliseum complex on Aug. 9, 2012.

Source: Special Forces Soldiers graduate qualification training Aug. 9

Special Forces qualification students graduate course, don green berets

More than 110 Soldiers were officially welcomed into the U.S. Army's Special Forces regiment during a ceremony Aug. 9 marking their graduation from the Special Forces Qualification Course.

Source: Special Forces qualification students graduate course, don green berets

Reeder assumes command of Special Warfare Center and School

One day after relinquishing command of the U.S. Army Special Forces Command (Airborne), Maj. Gen. Edward M. Reeder, Jr. assumed command of the U.S. Army John F. Kennedy Special Warfare Center and School in an outdoor ceremony Aug. 16 on Fort Bragg, N.C.

Source: Reeder assumes command of Special Warfare Center and School

Reeder to take command of Special Warfare Center and School

Maj. Gen. Edward M. Reeder will assume command of the U.S. Army John F. Kennedy Special Warfare Center and School during a change of command ceremony at 9 a.m. Aug. 16 on Fort Bragg's John F. Kennedy plaza.

Source: Reeder to take command of Special Warfare Center and School

U.S. Army Special Forces Soldiers to graduate qualification training Aug. 9

Media representatives and members of the public are invited to attend the graduation ceremony for more than 100 Soldiers from the 270th Special Forces Qualification Course at 3:30 p.m., Aug. 9 at the Crown Coliseum in Fayetteville.

Source: U.S. Army Special Forces Soldiers to graduate qualification training Aug. 9

PSYOP Soldiers graduate qualification training, join Army special-operations force

More than 60 service members were recognized as the newest members of the Army's Psychological Operations regiment during a Psychological Operations Qualification Course graduation ceremony July 20 on Fort Bragg.

Source: PSYOP Soldiers graduate qualification training, join Army special-operations force

Special Forces Students and Families Share Qualification Course Survival Skills

To clarify Family members' understanding and expectations for the course, women with husbands attending the SFQC held their first "SFQC Survival Skills" orientation meeting May 15 on Fort Bragg, N.C.

Source: Special Forces Students and Families Share Qualification Course Survival Skills

Camp Mackall dedicates facility to long-time range official, Vietnam veteran

The Master Sgt. Lowell Stevens Cadre Professional Development Center was formally named and dedicated during a ceremony May 10 on Camp Mackall's Rowe Training Facility in Hoffman, N.C.

Source: Camp Mackall dedicates facility to long-time range official, Vietnam veteran

Robin Sage exercise to run in North Carolina counties July 21 through Aug. 1

This summer, Special Forces candidates will participate in the Robin Sage training exercise, held within 15 North Carolina counties as the final test of their Special Forces Qualification Course training.

Source: Robin Sage exercise to run in North Carolina counties July 21 through Aug. 1

Special Forces Advanced Mountain Operations School announces course dates

The Special Forces Advanced Mountain Operations School, based out of Fort Carson, Colo., is filling its classes of the Special Forces Senior Mountaineering Course throughout the summer of 2012. The school trains special-operations personnel to survive in and move through mountainous terrain during military operations.

Source: Special Forces Advanced Mountain Operations School announces course dates

Special-operations Soldiers share history, experience with local cadets

Young cadets from a local high school made an after-school visit to Fort Bragg, N.C. the afternoon of April 27 for a behind-the-scenes look at the Soldiers and history of the Army's special-operations force.

Source: Special-operations Soldiers share history, experience with local cadets

Special Forces Soldiers graduate qualification training; honor green beret with Soldier's Medal

The U.S. Army Special Forces regiment welcomed more than 120 men into its brotherhood during a Special Forces Qualification Course graduation ceremony May 17 in Fayetteville, N.C.

Source: Special Forces Soldiers graduate qualification training; honor green beret with Soldier's Medal

Strategic-studies symposium for graduate students to be held on Fort Bragg

Members of the public, academia, media and military community are invited to attend an academic symposium for graduate students studying national defense, security studies and related fields at 8:45 a.m., May 17 on Fort Bragg, N.C.

Source: Strategic-studies symposium for graduate students to be held on Fort Bragg

Army CID Releases Statement on Captain Bruce Clark Death

Quantico, Va., May 7, 2012 -- The U.S. Army Criminal Investigation Command, commonly referred to as CID, released the following statement today in regard to the May 1, 2012 death of Capt. Bruce Clark:

Source: Army CID Releases Statement on Captain Bruce Clark Death

Special Forces training facility to be named after Vietnam War veteran, long-time Camp Mackall offic

The U.S. Army John F. Kennedy Special Warfare Center and School will formally name its cadre professional development center after a Special Forces hero during a dedication ceremony at 10 a.m. May 10 on Camp Mackall in Hoffman, N.C.

Source: Special Forces training facility to be named after Vietnam War veteran, long-time Camp Mackall offic

Army announces Reeder as next SWCS Commanding General

The Chief of Staff of the U.S. Army has announced that Brig. Gen. Edward M. Reeder, Jr. will be the next commanding general of the U.S. Army John F. Kennedy Special Warfare Center and School, based out of Fort Bragg, N.C., according to a May 4 Department of Defense press release.

Source: Army announces Reeder as next SWCS Commanding General

U.S. Army Special Forces Soldiers to graduate qualification training May 17

Media representatives and members of the public are invited to attend the graduation ceremony for more than 100 Soldiers from the 268th Special Forces Qualification Course at 3 p.m., May 17 at the Crown Coliseum in Fayetteville.

Source: U.S. Army Special Forces Soldiers to graduate qualification training May 17

Special Warfare Education Group (Airborne) activates headquarters company

The newly established Special Warfare Education Group (Airborne) formally activated its Headquarters and Headquarters Company during a ceremony May 1 on Fort Bragg, N.C., taking another step toward building a fully manned and equipped organization dedicated to educating U.S. Army special-operations Soldiers.

Source: Special Warfare Education Group (Airborne) activates headquarters company

Special-operations instructors forge occupational therapy

Instructors from the U.S. Army John F. Kennedy Special Warfare Center and School were introduced to the art of blacksmithing, Feb. 25, 2012, at Fort Bragg, N.C.

Source: Special-operations instructors forge occupational therapy

Continuous improvement and accountability drive SWCS training development

The U.S. Army John F. Kennedy Special Warfare Center and School relies on a formal process to keep course-development on track, and measured evaluations and data points for pre-defined course requirements to gauge their designs' strengths and weaknesses. They use a cyclical process of analyzing force requirements and student performance so courses are appropriately designed, developed and implemented, and throughout each phase, internal and external evaluations occurr to ensure nothing is overlooked.

Source: Continuous improvement and accountability drive SWCS training development

Family volunteers recognized for lending helping hands to special-operations students and spouses

Spouses who donated significant time in 2011 and 2012 to support Families connected with the U.S. Army John F. Kennedy Special Warfare Center and School were honored during a ceremony April 12 in Kennedy Auditorium on Fort Bragg, N.C.

Source: Family volunteers recognized for lending helping hands to special-operations students and spouses

Army launches annual Off-Duty Safety Awareness Presentation

FORT RUCKER, Ala. (April 11, 2012) -- In a continued effort to make Soldiers and their Family Members aware of hazards they may face while participating in off-duty activities, the U.S. Army Combat Readiness/Safety Center launched its annual Off-Duty Safety Awareness Presentation.

Source: Army launches annual Off-Duty Safety Awareness Presentation

21st TSC wins five Army legal service awards

Four 21st Theater Sustainment Command legal service centers won five Army level awards for excellence in claims and legal assistance for fiscal 2011.

Source: 21st TSC wins five Army legal service awards

21st TSC hosts Sergeant Audie Murphy, Sergeant Morales Club induction ceremony

Soldiers from throughout the Kaiserslautern Military Community were inducted into the Sergeant Audie Murphy Club and Sergeant Morales Club during a ceremony hosted by the 21st Theater Sustainment Command at the Galaxy Theater on the Vogelweh Military Complex, Feb. 1.

Source: 21st TSC hosts Sergeant Audie Murphy, Sergeant Morales Club induction ceremony

USAREUR CSM stresses fitness, discipline and training

United States Army Europe's top noncommissioned officer expects all Soldiers to be fit, disciplined and well trained and expects leaders to enforce those standards.

Source: USAREUR CSM stresses fitness, discipline and training

Four 7th CSC units change command

New leaders assumed command of four 7th Civil Support Command, 21st Theater Sustainment Command, units during separate ceremonies in January.

Source: Four 7th CSC units change command

Dr. Jill Biden visits Grafenwoehr

Dr. Jill Biden, wife of U.S. Vice President Joe Biden, talks with teachers at the Grafenwoehr (Germany) Elementary School during a visit to the training center Feb. 2, joined by U.S. Army Europe deputy commander Maj. Gen. James C. Boozer (left) and Command Sgt. Maj. David Davenport Sr. (center).

Source: Dr. Jill Biden visits Grafenwoehr

Italian parachute regiment trains at home of Sky Soldiers

Italian paratroopers of the 186th Regiment, Folgore Brigade, stationed in Pisa and Livorno, traveled to Caserma Ederle in Vicenza this month to conduct a regimental level Command Post Exercise, or CPX, at the Vicenza Mission Training Complex. The rotation was the latest in an ongoing series of joint trainings and exchanges with their airborne partners, the Sky Soldiers of the 173rd Airborne Brigade Combat Team.

Source: Italian parachute regiment trains at home of Sky Soldiers

3-58 Aviation Operations Battalion wins Air Traffic Control Unit of the Year

The Army Aviation Association of America awarded the Air Traffic Control unit of the year award Tuesday January 29, 2013 to 3-58th Airfield Operations Battalion for their outstanding performance in 2012.

Source: 3-58 Aviation Operations Battalion wins Air Traffic Control Unit of the Year

U.S. Army Europe commander visits 'Sky Soldiers' in Italy

U.S. Army Europe commander Lt. Gen. Donald M. Campbell Jr. recently visited with Soldiers of the 173rd Airborne Brigade Combat Team at Caserma Ederle in Vicenza, Italy, thanking them for their contributions to USAREUR's partnerships with Italy and Europe and applauding the brigade's successful completion of its most recent combat tour.

Source: U.S. Army Europe commander visits 'Sky Soldiers' in Italy

Owners bringing pets into Germany will pay new fee starting Feb. 1

Members of the U.S. forces community who bring their pets along when they arrive in Germany for assignment will be charged a fee by German authorities, beginning Feb. 1, 2013.

Source: Owners bringing pets into Germany will pay new fee starting Feb. 1

21st  TSC assists helicopter offload at Belgian port

Elements of the 21st Theater Sustainment Command assisted the 838th Transportation Battalion, Kleber Kaserne, Kaiserslautern, Germany, with the offload of nearly 50 Army helicopters and associated components from a cargo ship at the port here, Jan. 17.

Source: 21st  TSC assists helicopter offload at Belgian port

18th Military Police Brigade welcomes new command team

The 21st Theater Sustainment Command's 18th Military Police Brigade held a change of command and responsibility ceremony on Rhine Ordnance Barracks, Jan. 17, to welcome a new command team and farewell the outgoing team.

Source: 18th Military Police Brigade welcomes new command team

21st TSC Soldiers provide full-spectrum support, training for Patriots to Turkey

The 21st Theater Sustainment Command is providing logistical support as part of NATO's commitment to Turkey's security. Key elements of that support include setting up a staging base and arranging for living quarters, meals, training and fuel for those in Turkey as part of the Patriots to Turkey mission.

Source: 21st TSC Soldiers provide full-spectrum support, training for Patriots to Turkey

One-of-a-kind Wounded Heroes Service Center officially opens



Source: One-of-a-kind Wounded Heroes Service Center officially opens

Secretary of Defense visits Soldiers of U.S. Army Europe's 173rd Airborne Brigade

VICENZA, Italy - Secretary of Defense Leon Panetta visited with Soldiers of U.S. Army Europe's 173rd Airborne Brigade Combat Team at Caserma Ederle here, Jan. 17.

Source: Secretary of Defense visits Soldiers of U.S. Army Europe's 173rd Airborne Brigade

U.S. Army Europe, European Command lead first Balkans senior NCO conference

PRISTINA, Kosovo - Senior noncommissioned officers from the Balkans region are meeting here this week with U.S. Army Europe and U.S. European Command senior enlisted leaders during the first Regional Senior NCO Conference for the Land Forces Senior NCO and Senior Enlisted Leader.

Source: U.S. Army Europe, European Command lead first Balkans senior NCO conference

Afghan academy graduates first female sergeants major



Source: Afghan academy graduates first female sergeants major

21st TSC receives LSS awards at Pentagon ceremony



Source: 21st TSC receives LSS awards at Pentagon ceremony

U.S. Army Europe forces support NATO missile defense

RAMSTEIN AIR BASE, Germany -- Soldiers from U.S. Army Europe's 10th Army Air and Missile Defense Command and 44th Expeditionary Signal Battalion, along with members of the 32nd AAMDC from Fort Bliss, Texas, are deploying to Turkey in support of NATO missile defense operations.

Source: U.S. Army Europe forces support NATO missile defense

Wounded Heroes Service Center opens on Kleber Kaserne

A 21st Theater Sustainment Command initiative has resulted in a one-of-a-kind Soldier clothing sales facility that caters specifically to wounded Soldiers, enhancing their ability to obtain new and replacement uniform items in an easily accessible and discreet environment.

Source: Wounded Heroes Service Center opens on Kleber Kaserne

Campbell assumes command of U.S. Army Europe in Wiesbaden ceremony

Lt. Gen. Donald Campbell Jr. formally assumed command of U.S. Army Europe in a ceremony on Clay Kaserne, Germany, Jan. 9, 2013.

Source: Campbell assumes command of U.S. Army Europe in Wiesbaden ceremony

21st TSC wins DA LSS awards for 3rd year straight

The 21st Theater Sustainment Command's Lean Six Sigma program again received Department of the Army accolades for saving the Army and the American tax payers millions of dollars and discovering methods of conducting operations more efficiently.

Source: 21st TSC wins DA LSS awards for 3rd year straight

21st TSC selected to participate in DA sponsorship pilot program

The 21st Theater Sustainment Command is one of five units selected by the Department of the Army's personnel division to participate in a 180-day sponsorship test pilot program aimed at enhancing the effectiveness of the Total Army Sponsorship Program. The objective of the test pilot program is to develop a process that will ensure the assignment of a sponsor prior to receiving permanent change of station orders for those in the ranks of colonel and below

Source: 21st TSC selected to participate in DA sponsorship pilot program

Unified Endeavor prepares U.S. and multinational Soldiers for ISAF missions and beyond

GRAFENWOEHR, Germany --- Just as ground troops must become proficient at weaponry and a myriad of warrior skills and tasks, there is also an expectation that commanders and their staff master the their mission of orchestrating movements on the ground.

Source: Unified Endeavor prepares U.S. and multinational Soldiers for ISAF missions and beyond

The Inspector General of the Army visits 21st Theater Sustainment Command

Lt. Gen. Peter M. Vangjel, The Inspector General of the U.S. Army, speaks to attendees at the 21st Theater Sustainment Command's Board of Directors meeting on Panzer Kaserne, Nov. 29.

Source: The Inspector General of the Army visits 21st Theater Sustainment Command

Army/ Air Force reignite football rivalry

Grid-iron supremacy was on the line, as the 435th Security Forces Squadron, 30th Medical Command and four teams from the 18th Military Police Brigade battled in the second annual inter-service Sembach Flag Football Championship, Nov 18.

Source: Army/ Air Force reignite football rivalry

MP Soldier named USAREUR career counselor of the year

A 21st Theater Sustainment Command Soldier has been named the U.S. Army Europe's career counselor of the year. Sgt. 1st Class James Ray, 95th Military Police Battalion, 18th MP Brigade, and native of Section, Ala., will now compete at the Secretary of the Army career counselor of the year competition.

Source: MP Soldier named USAREUR career counselor of the year

U.S., Bulgarian forces train together during Allied Force 12

Soldiers from U.S. Army Europe and their partners from the Bulgarian Land Forces are working together at Novo Selo, Bulgaria, from Oct. 29 to Nov. 10, 2012, to certify a Bulgarian battalion as part of exercise Allied Force 12.

Source: U.S., Bulgarian forces train together during Allied Force 12

12th Combat Aviation Brigade renames headquarters in honor of aviator who died in combat

KATTERBACH ARMY AIRFIELD, Germany -- U.S. Army Europe's 12th Combat Aviation Brigade honored late Chief Warrant Officer 5 John C. Pratt in a Nov. 2 ceremony renaming the brigade headquarters building here for CWO5 Pratt.

Source: 12th Combat Aviation Brigade renames headquarters in honor of aviator who died in combat

Six Army in Europe Soldiers have been named Army's best

Since Armywide competition began in 2002, these six Army in Europe Soldiers have earned the title of Army NCO of the Year and Army Soldier of the Year, representing nearly a third of the total number who have been named top troops.

Source: Six Army in Europe Soldiers have been named Army's best

feeling pud seguro sa mga tawo nga unlimited show ni nga movie.

maayo unta ug ang hibut-an kadtong nanglugos sa babaye nga nagparaspa sa davao hospital.

hehehe. basin pud ug naghisgot ug basic lessons on human anatomy with a on-the-spot hands-on demo.

mao diay tirada ning tawhana. mag-atang ug naay tabangunon sa hospital, unya pahimuslan. kapila na kaha ni niya buhata? ug pila na kaha ka mga angkan ang nabiktima sa iyang modus operandi?

niingon ang babaye nga walay nahitabo kay gaestorya lang sila. sayo ra pud ang alas kwatro (4) sa kadlawon nga magsugod ug estorya.

That's Why Mo Lang

M.I.B. No, Not Men in Black

Chinua Achebe is a world-renowned scholar recognized for his ability to write simply, yet eloquently, about life's universal qualities. His writing weaves together history and fiction to produce a literary broadcloth that offers visions of people enduring real life. Critics appreciate his just and realistic treatment of his topics.

Achebe writes primarily about his native Africa, where he was born Albert Chinualumogu Achebe in 1930. He grew up in Ogidi, Nigeria, one of the first centers of Anglican missionary work in eastern Nigeria. His father and mother, Isaiah and Janet Achebe, were missionary teachers. Achebe's life as a Christian and member of the Ibo tribe enables him to create realistic depictions of both contemporary and pre-colonized Africa. He blends his knowledge of Western political ideologies and Christian doctrine with folklore, proverbs, and idioms from his native tribe to produce stories of African culture that are intimate and authentic.

Achebe left the village of Ogidi to attend Government College in Umuahia, and later, University College in Ibadan. He received his Bachelor of Arts degree from University College in 1953. He worked first for the Nigerian Broadcasting Corporation as a writer and continued radio work in various capacities until 1966, when he resigned from his post as Director of External Broadcasting. Dissatisfied with the political climate that would later prompt the Biafran War, he began traveling abroad and lecturing as the appointed Senior Research Fellow for the University of Nigeria, Nsukka.

Continuing his teaching career, Achebe accepted a position with the University of Massachusetts, Amherst, in 1972. He was a visiting professor of English at that institution until 1976 and again in 1987-1988. He also spent a year as a visiting professor at the University of Connecticut. In the intervening years, Achebe returned to his native country to teach at the University of Nigeria, Nsukka.

Achebe has written extensively throughout his adult life. His numerous articles, novels, short stories, essays, and children's books have earned prestigious awards. For example, his book of poetry Christmas in Biafra was a winner of the first Commonwealth Poetry Prize. His novels Arrow of God and Anthills of the Savannah won, respectively, the New Statesman-Jock Campbell Award and finalist for the 1987 Booker Prize in England.

source: Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.

The story of Chinua Achebe's novel Things Fall Apart takes place in the Nigerian village of Umuofia in the late 1880s, before missionaries and other outsiders have arrived. The Ibo clan practices common tribal traditionsâ€"worship of gods, sacrifice, communal living, war, and magic. Leadership is based on a man's personal worth and his contribution to the good of the tribe. Okonkwo stands out as a great leader of the Ibo tribe. Tribesmen respect Okonkwo for his many achievements.

Even though the tribe reveres Okonkwo, he must be punished for his accidental shooting of a young tribesman. The Ibo ban Okonkwo from the clan for seven years. Upon his return to the village, Okonkwo finds a tribe divided by the influence of missionaries and English bureaucrats who have interrupted the routine of tradition. Only when Okonkwo commits the ultimate sin against the tribe does the tribe come back together to honor custom.

Critics appreciate Achebe's development of the conflict that arises when tradition clashes with change. He uses his characters and their unique language to portray the double tragedies that occur in the story. Readers identify not only with Okonkwo and his personal hardships but also with the Ibo culture and its disintegration. Chinua Achebe wrote Things Fall Apart not for his fellow Nigerians, but for people beyond his native country. He wanted to explain the truth about the effects of losing one's culture. Published in 1958, the book was not widely read by Nigerians or by Africans in general. When Nigeria became independent in 1960, however, Africans appreciated the novel for its important contribution to Nigerian history.

source: Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights reserved.

The Modified Response to Injury Hypothesis of Atherosclerosis Development

The modified response to injury hypothesis, as it pertains to the development of atherosclerosis, proposes the following tenets: (1) endothelial injury results in growth factor secretion; (2) the local hemodynamic environment (low shear and oscillating shear) facilitates local injury and particle transfer; (3) circulating monocytes attach to the damaged endothelium; (4) subendothelial migration of monocytes may lead to fatty streak formation and further release of growth factors such as PDGF; (5) fatty streaks may then be converted to fibrous plaques via release of growth factors from macrophages, endothelial cells, or both; (6) macrophages may stimulate or injure the overlying endothelium, thus endothelial cell loss leads to platelet deposition; (7) platelet deposition leads to the release of growth factors and mitogenic factors for smooth muscle cells; and ( 8
) some of the smooth muscle cells in the proliferative lesion itself may form and secrete growth factors.

Atherosclerosis and Hemodynamics

The effect of local hemodynamic factors on localization of plaque has been studied mainly in the carotid bifurcation, initially in glass models, but more recently it was validated with magnetic resonance angiographic (MRA) imaging and by computer modeling. 19,20 Intimal thickening develops largely in areas of low wall shear stress, in areas of flow separation, and areas with high particle residence time. The theory is that all of these factors facilitate particle (e.g., LDL) interaction with the arterial wall. Caro postulated that low wall shear stress results in slowed transport of circulating particles away from the wall, resulting in the increased intimal accumulation of lipids.

Oscillating shear stress, such as that which occurs in the carotid bulb with areas of transient flow reversal, has been implicated in early lesion formation.

Lipids and Atherosclerosis

Elevated plasma lipids have been reported in one third to one half of patients with peripheral vascular disease (PVD). 17 Low levels of high-density lipoprotein (HDL) cholesterol are associated with PVD. There are several apoprotein levels and apoprotein ratios which are predictive of PVD: A-I and A-II levels, and A-I:B and A-I:C-III ratios.

Lipoprotein (a) [Lp(a)], a cholesterol ester, is a low-density lipoproteinâ€"like particle associated with an increased risk of cardiovascular disease. Elevated Lp(a) may represent the most prevalent inherited risk factor for atherosclerosis. Lp(a) levels are insensitive to dietary and drug manipulations. 18

Elevated LDL and very low-density lipoprotein (VLDL) levels have long been associated with increased risk of atherosclerosis. Cells contain a specific receptor for LDL, and there is a correlation between LDL binding and control of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductaseâ€"the rate-limiting step for cholesterol synthesis. It is proposed that the number of receptors expressed by the cell varies, protecting the cell against excess cholesterol. However, as the number of expressed LDL receptors decreases, the rate of cholesterol clearance decreases and plasma levels rise. It is postulated that hypercholesterolemia may induce a subtle form of injury. Changes in the cholesterol:phospholipid cell membrane ratios may result in altered endothelial malleability.

Another possible mechanism of endothelial injury in hypercholesterolemia is via oxidization of LDLs. If LDLs are oxidized by macrophages, then toxic products may result in endothelial injury and explain the progression of fatty streaks to fibrous plaques.

Smooth Muscle and Endothelial Cells

Smooth muscle cells are found in variable amounts in fatty streaks, but are the main cell type in fibrous plaques. They contain receptors for PDGF and LDL. The phenotype of these intimal smooth muscle cells is altered from a contractile to a secretory type. Production of an extracellular matrix and further accumulation of lipid and foam cells enlarge these lesions until the core becomes ischemic and eventually necrotic. Following arterial injury, smooth muscle cell proliferation begins in the media. Cells then migrate into the intima where replication continues. The observation that smooth muscle cells may elaborate both PDGF and PDGF receptors heralds a new understanding in the complex, local hormonal environment in atherosclerotic plaque. 7â€"11 The fibrous plaque consists of multiple layers of smooth muscle cells, each of which lies in a panelled arrangement comprising alternating layers of basement membrane and proteoglycan. Deep to this cellular area is a region of cholesterol crystals, necrotic debris, and calcification. There is increasing interest in circulating stem cells as possible precursors of the transformed smooth muscle cells at sites of arterial injury.

Endothelial cells regulate which plasma constituents reach the subendothelial space. They bind LDLs through a specific receptor, transcytose, and modify it so it is recognized and ingested by cells such as macrophages. They further produce and release growth factors and inhibitors, which may have profound effects on smooth muscle cells and macrophages.

The Role of Platelet-Derived Growth Factor in Atherogenesis

Platelet-derived growth factor (PDGF) may be responsible for the intimal smooth muscle cell proliferation of atherosclerosis. 9 This concept originated from the observation that platelets contain a potent mitogen for smooth muscle cells, PDGF, and that platelets accumulate and degranulate at sites of endothelial disruption. Although PDGF remains of great interest, it is now apparent that many cells produce PDGF: macrophage, endothelial, and smooth muscle cells (at least in vitro).

Therefore, although the platelet may be important in early PDGF release, it now seems likely that endogenous PDGF may be of greater long-term importance. In 1991, Ross demonstrated that antibodies to PDGF prevented the myointimal proliferation observed following balloon angioplasty, raising the question, "Could this have important implications for smooth muscle cells in atherosclerotic plaques?" These PDGF-producing cells also occur in human atherosclerotic plaque. PDGF gene expression has now been clearly demonstrated within human carotid plaque (probably smooth muscle).

PDGF -chain and -chain messenger RNAs can be localized to mesenchymal-appearing intimal cells within the intima. PDGF receptor probes also localize to the intima. Smooth muscle cells (SMCs) in the media do not elaborate PDGF or receptor mRNA. Consequently, the PDGF hypothesis has been changed so that endogenous production of PDGF, locally produced within the plaque, may play an important role in smooth muscle cell proliferation.

Relationship Between the Fatty Streak and the Fibrous Plaque
The fatty streak is the earliest identifiable lesion of atherosclerosis. It has been detected in children as young as 10 years of age and consists of lipid-laden macrophages overlying lipid-laden smooth muscle cells. They occur at the same anatomic sites as subsequent fibrous plaques. McGill demonstrated that increased surface involvement of fatty streaks precedes development of fibrous plaques, further supporting a precursor role for the fatty streak.

Common Types of Strokes

Anterior Cerebral Artery Stroke

The ACA supplies the medial frontal and parietal lobes, including the motor strip, as it courses into the interhemispheric fissure. ACA stroke results in contralateral leg weakness.

Middle Cerebral Artery Stroke

The MCA supplies the lateral frontal and parietal lobes and the temporal lobe. MCA stroke results in contralateral face and arm weakness. Dominant-hemisphere MCA stroke causes language deficits. Proximal MCA occlusion causing ischemia and swelling in the entire MCA territory can lead to significant intracranial mass effect and midline shift (see Fig. 41-6).

Posterior Cerebral Artery Stroke

The PCA supplies the occipital lobe. PCA stroke results in a contralateral homonymous hemianopsia (see Fig. 41-6).

Posterior Inferior Cerebellar Artery Stroke

The PICA supplies the lateral medulla and the inferior half of the cerebellar hemispheres. PICA stroke results in nausea, vomiting, nystagmus, dysphagia, ipsilateral Horner's syndrome, and ipsilateral limb ataxia. The constellation of symptoms resulting from PICA occlusion is referred to as lateral medullary syndrome or Wallenberg's syndrome.

Embolic Disease
Emboli causing strokes may originate in the left atrium due to atrial fibrillation, on a hypokinetic left ventricular wall segment, or in valvular vegetations, an atheromatous aortic arch, or stenosed carotid bifurcations, or from the systemic venous system in the presence of a right-to-left shunt, such as a patent foramen ovale. The majority of emboli enter the anterior (carotid) circulation rather than the posterior (vertebrobasilar) circulation. Characteristic clinical syndromes result from embolic occlusion of the various vessels.

Management of Thrombotic Disease
Complete occlusion of the carotid artery without referable neurologic deficit requires no treatment. A patient with new neurologic deficit and an angiographically demonstrated complete carotid occlusion contralateral to the symptoms should be considered for emergency carotid endarterectomy. 11 Surgery should not be performed on obtunded or comatose patients, and should be done within 2 hours of symptom onset. This time restriction significantly reduces the number of candidates.

Thrombotic Disease
The most common area of neurologically significant vessel thrombosis is the carotid artery in the neck. Disease occurs at the carotid bifurcation. Thrombosis of a carotid artery chronically narrowed by atheroma can lead to acute carotid occlusion. As discussed above, this may or may not cause symptoms. The more common concern is thromboembolus. Intracranial arterial occlusion by local thrombus formation may occur, but is considered rare compared to embolic occlusion.

Ischemic Diseases - Ischemic stroke accounts for approximately 85% of acute cerebrovascular events. Symptoms of acute ischemic stroke vary based on the functions of the neural tissues supplied by the occluded vessel, and the presence or absence of collateral circulation. The circle of Willis provides extensive collateral circulation, as it connects the right and left carotid arteries to each other and each to the vertebrobasilar system. Patients with complete occlusion of the carotid artery proximal to the circle of Willis may be asymptomatic if the blood flow patterns can shift and provide sufficient circulation to the ipsilateral cerebral hemisphere from the contralateral carotid and the basilar artery. However, the anatomy of the circle of Willis is highly variable. Patients may have a hypoplastic or missing communicating artery, both anterior cerebral arteries supplied by one carotid, or the posterior cerebral artery supplied by the carotid rather than the basilar. Similarly, one vertebral artery is often dominant, and the other hypoplastic. These variations may make disease in a particular vessel more neurologically devastating than in a patient with full collateral circulation. Occlusion distal to the circle of Willis generally results in stroke in the territory supplied by the particular artery.

Neurologic deficit from occlusive disease may be temporary or permanent. A patient with sudden-onset focal neurologic deficit that resolves within 24 hours has had a transient ischemic attack (TIA). If the deficit resolves between 24 hours and 1 week, then the patient has had a reversible ischemic neurologic deficit (RIND). A patient with permanent deficits has had a cerebrovascular accident (CVA). CVA is a commonly used, but vague term. Some prefer the term completed stroke.

Cerebrovascular disease is the most frequent cause of new rapid-onset, nontraumatic neurologic deficit. It is a far more common etiology than seizures or tumors. Vascular structures are subject to a variety of chronic pathologic processes which compromise vessel wall integrity. Diabetes, high cholesterol, high blood pressure, and smoking are risk factors for vascular disease. These conditions can lead to vascular damage by such mechanisms as atheroma deposition causing luminal stenosis, endothelial damage promoting thrombogenesis, and weakening of the vessel wall resulting in aneurysm formation or dissection. These processes may coexist. For instance, a vessel may contain an atheromatous plaque that significantly decreases lumen diameter, and also have compromised endothelium over the plaque, providing the opportunity for thrombus formation, which can lead to acute total occlusion of the remaining lumen. Aneurysms and dissection often occur in atheromatous vessels. Specific patterns of disease relevant to the cerebrovascular system are atheromatous and thrombotic carotid occlusion, brain ischemia due to embolus from a proximal source, vessel wall breakage leading to hemorrhage, and rupture of abnormal, thin-walled structures, specifically aneurysms and arteriovenous malformations.

Management of Peripheral Nerve Injury

The sensory and motor deficits should be accurately documented. Deficits are usually immediate. Progressive deficit suggests a process such as an expanding hematoma, and may need early surgical exploration. Clean, sharp injuries may also benefit from early exploration and reanastomosis. Most other peripheral nerve injuries should be observed. Electromyography and nerve conduction studies (EMG/NCS) should be done 3 to 4 weeks postinjury if deficits persist. Axon segments distal to the site of injury conduct action potentials normally until wallerian degeneration occurs, so EMG/NCS before 3 weeks is not informative. Continue observation if function improves. Explore the nerve surgically if no functional improvement occurs over 3 months. If intraoperative electrical testing reveals conduction across the injury, continue observation. In the absence of conduction, the segment should be resected and end-to-end primary anastomosis attempted. Anastomoses under tension will not heal, so a nerve graft may be needed to bridge the gap between the proximal and distal nerve ends. The sural nerve is often harvested, as it carries only sensory fibers and leaves a minor deficit when harvested. The connective tissue structures of the nerve graft may provide a pathway for effective axonal regrowth across the injury.

Types of Nerve Injury

The traditional classification system for peripheral nerve injury is the Seddon classification. Seddon described three injury patterns: neurapraxia, axonotmesis, and neurotmesis, as defined below. The Seddon classification provides a simple, anatomically-based approach to peripheral nerve injury.

Neurapraxia
Neurapraxia is defined as the temporary failure of nerve function without physical axonal disruption. Axon degeneration does not occur. Return of normal axonal function occurs over hours to months, often in the 2- to 4-week range.

Axonotmesis
Axonotmesis is the disruption of axons and myelin. The surrounding connective tissues, including endoneurium, are intact. The axons degenerate proximally and distally from the area of injury. Distal degeneration is known as wallerian degeneration. Axon regeneration within the connective tissue pathways can occur, leading to restoration of function. Axons regenerate at a rate of 1 mm per day. Significant functional recovery may occur for up to 18 months. Scarring at the site of injury from connective tissue reaction can form a neuroma and interfere with regeneration.

Neurotmesis
Neurotmesis is the disruption of axons and endoneurial tubes. Peripheral collagenous components, such as the epineurium, may or may not be intact. Proximal and distal axonal degeneration occurs. The likelihood of effective axonal regeneration across the site of injury depends on the extent of neuroma formation and on the degree of persisting anatomic alignment of the connective tissue structures. For instance, an injury may damage axons, myelin, and endoneurium, but leave perineurium intact. In this case the fascicle sheath is intact, and appropriate axonal regeneration is more likely to occur than if the sheath is interrupted.

Spine Trauma
The spine is a complex biomechanic and neural structure. The spine provides structural support for the body as the principal component of the axial skeleton, while protecting the passing spinal cord and nerve roots. Trauma may fracture bones or cause ligamentous disruption. Often bone and ligament damage occur together. Damage to these elements reduces the strength of the spine and may cause the spine to be unstable. This compromises both its structural support function and its ability to protect neural elements. Spine trauma may occur with or without neurologic injury. Neurologic injury from spine trauma is classified as either incomplete, if there is some residual motor or sensory neurologic function below the level of the lesion, or complete, if there is no residual neurologic function below the level of the lesion, as assessed by clinical exam. 7 A patient with complete neurologic dysfunction persisting 24 hours after injury has a very low probability of return of function in the involved area.

Neurologic injury from spine trauma may occur immediately or in delayed fashion. Immediate neurologic injury may be due to direct damage to the spinal cord or nerve roots from penetrating injuries, especially from stab wounds or gunshots. Blunt trauma may transfer sufficient force to the spine to cause acute disruption of bone and ligament and lead to subluxation, which is shift of one vertebral element in relation to the adjacent level. Subluxation decreases the size of the spinal canal and neural foramina, and causes compression of the cord or roots. Such neural impingement can also result from propulsion of bone fragments into the canal during a fracture. Transection, crush injury, and cord compression impairing perfusion are mechanisms leading to spinal cord injury. Delayed neurologic injury may occur during transportation or examination of a patient who is not properly immobilized.

Carotid Dissection may result from neck extension combined with lateral bending to the opposite side, or trauma from an incorrectly placed shoulder belt tightening across the neck in a motor vehicle accident. Extension/bending stretches the carotid over the bony transverse processes of the cervical vertebrae, while seat belt injuries cause direct trauma. Symptoms of cervical carotid dissection include contralateral neurologic deficit from brain ischemia, headache, and ipsilateral Horner's syndrome from disruption of the sympathetic tracts ascending from the stellate ganglion into the head on the surface of the carotid artery. The patient may complain of hearing or feeling a bruit.

Traumatic vessel wall injury to the portion of the carotid artery running through the cavernous sinus may result in a carotid-cavernous fistula (CCF). This creates a high-pressure, high-flow pathophysiologic blood flow pattern. CCFs classically present with pulsatile proptosis (the globe pulses outward with arterial pulsation), retro-orbital pain, and decreased visual acuity or loss of normal eye movement (due to damage to cranial nerves III, IV, and VI as they pass through the cavernous sinus). Symptomatic CCFs should be treated to preserve eye function. Fistulae may be closed by balloon occlusion using interventional neuroradiology techniques. Fistulae with wide necks are difficult to treat and may require total occlusion of the parent carotid artery.

Brain Tissue Oxygen Sensors

The brain tissue oxygen sensor is a recent development. The device is screwed into the skull in the same manner as the bolt; however, the sensor catheter is an electrochemical oxygenâ€"tension sensitive membrane. A single bolt can be designed to accept a pressure sensor, oxygen sensor, and brain temperature sensor. Patients with severe brain injury due to trauma or aneurysmal hemorrhage may benefit from placement of these three sensors and a ventriculostomy to drain CSF for control of ICP. This requires two twist-drill holes, which may be adjacent or on opposite sides of the head.

by pna

A bank employee who had served his company for 29 long years has not enjoyed the fruit of his labor after he died before the Supreme Court (SC) had decided, in his favor, the labor case he lodged against the bank.

The SC’s Second Division ruled in favor of Eleazar Padillo, former savings account bookkeeper of Rural Bank of Nabunturan, Incorporated, who was separated from his employment due to health reasons on October 3, 2007.

The High Court awarded P75,000 as financial assistance to Padillo, excluding the P100,000 benefit he got from the insurance company Philam Life Plan.

Court records showed that Padillo was employed with Rural Bank in Nabunturan, Incorporated, Nabunturan, Compostela Valley Province on October 1, 1977.

But in 2003, the bank had experienced liquidity problems prompting the company to procure insurance plans from Philippine American Life and General Insurance Company or Philam Life for its employees amounting to P100,000. The plan would mature on July 11, 2009.

On October 14, 2004, the bank was taken over by Mark Oropeza who bought majority shares of stocks and became the president of the bank.

With Oropeza’s management, the bank’s finances had improved and regained its liquidity.

But in 2007, Padillo suffered a mild stroke and he was diagnosed having hypertension which already affected his work.

Padillo then wrote on September 10, 2007, a letter to Oropeza expressing his intention to avail of the bank’s early retirement package but despite several follow-ups, his letter “remained unheeded”.

Padillo was separated from his employment on October 3, 2007 without affording him any retirement benefits prompting him to file a labor case before the National Labor Relations Commission (NLRC) Regional Arbitration Branch XI in Davao City.

Answering the charges hurled by Padillo, the bank and Oropeza countered that Padillo’s claim of retirement benefits “was not favorably acted upon for lack of any basis to grant the same”.

In a decision on March 13, 2009, the labor arbitration office dismissed Padillo’s claim ruling that he was disqualified from demanding retirement benefits pursuant to Article 300 of the Labor Code of the Philippines as he was only 55 years of age, five years short of the law’s prescribed retirement age of 60 and 10 years short of compulsory requirement 65.

The labor arbitration office, however, ordered the bank to pay P100,000 as advance payment from the amount receivable from Philam Life.

Padillo elevated the labor arbiter’s findings before the NLRC, which reversed the decision and granted P164,903.70 on top of the P100,000 he would get from Philam Life.

The NLRC decision was later reversed by the Court of Appeals but with modification to pay Padillo the amount of P50,000 as financial assistance in addition to the P100,000 from Philam Life.

The CA awarded the amount to Padillo for consideration of his 29 years of service with no derogatory record in the company.

Not satisfied with the CA decision, Padillo raised the issue before the Supreme Court.

But before the Supreme Court could hand down its decision, Padillo died on February 24, 2012 and the case was pursued by his heirs.

In a decision promulgated on January 21, 2013, the SC agreed with the CA ruling that Padillo could not get retirement benefits pursuant to law but the High Court increased the amount awarded to Padillo from P50,000 to P75,000 in addition to the P100,000 from Philam Life.

by pna

Tropical depression “Crising” has slowed down and is still expected to make a landfall in the southern tip of Palawan on Thursday, according to the Philippine Atmospheric Geophysical and Astronomical Services Administration (PAGASA).

Weather Forecaster Chris Perez said from 19 kph on Wednesday afternoon, Crising decelerated to 15 kph as it continues to move west northwest closer to Southern Palawan.

Perez said as of 5 a.m. Thursday, Crising was located at 460 km northwest of Zamboanga City (07.8°N, 117.7°E) packed with maximum winds of 45 kph near center.

He added that Crising is expected to make a landfall in the southern tip of Palawan on Thursday afternoon or evening.

With its slow movement, Crising is expected to be out of the Philippine Area of Responsibility by Friday morning or evening, Perez said.

Perez said storm warning signal number 1 remain hoisted over Southern Palawan.

PAGASA said residents living in low lying and mountainous areas under public storm warning signal 1 are alerted against possible flashfloods and landslides.

He said they expect the weather to improve â€" with less rainsâ€" in most parts of Mindanao, once Crising exits the country.

However, he noted that Eastern Visayas and parts of Southern Luzon will continue to have cloudy skies with occasional moderate to heavy rains due to the wind convergence and extended trough of cloudiness of Crising.

He said the rest of the Visayas and Luzon including Metro Manila will have partly cloudy to cloudy skies with passing light rains.

In its advisory, PAGASA said Southern Palawan will experience rains and gusty winds with moderate to rough seas.

Mimaropa (Mindoro, Marinduque, Romblon and Palawan), Bicol region, Eastern Visayas, Caraga and Northern Mindanao will have cloudy skies with moderate to occasionally heavy rainshowers and thunderstorms which may trigger flashfloods and landslides.

Calabarzon (Cavite, Laguna, Batangas, Rizal and Quezon), the rest of the Visayas and Mindanao will be cloudy with light to moderate rainshowers and thunderstorms.

Metro Manila and the rest of Luzon will be cloudy with light rains.

Moderate to strong winds blowing from the southeast to east will prevail over Mindanao and from the northeast over the rest of the country with moderate to rough seas.

Cebu to General Santos City: Air Philippines Promo

Manila to Cotabato, Cagayan de Oro: Air Philippines Promo

without the wheelchair, this creature might be transformed into a crispy bacon.

Air Phil Promo 2013: Boracay via Cebu Flight

AirPhil Promo 2013 Manila to Visayas Flights

Air Philippines Promo 2013 Davao to Iloilo, Zamboanga, Cebu

Cebu Pacific Promo 2013 Flights P199 Pesos

Out of the Ashes

During hardship and trouble, tough questions often arise: Where is God? How do I respond to difficulties? Is God both good and all-powerful? In the Discovery Series booklet Out of the Ashes by Bill Crowder, you?ll explore Job?s struggle with the problem of suffering. Through Job?s story, discover how you can trust God despite unanswered...

Source: Out of the Ashes

Change: Following God Through Life?s Crossroads

No matter how you view change, it?s an inevitable part of life?you can?t experience anything new without it. In Change: Following God through Life?s Crossroads, Bill Crowder examines the life of the apostle Paul and offers insights to help you overcome fears, doubts, and resistance to change. Discover how you can draw closer to God...

Source: Change: Following God Through Life?s Crossroads

Transformed in His Image

In a society that has seemingly dismissed the issues of the heart, outward appearances have become the source of determining beauty and self-worth. This excerpt from Regina Franklin?s book Who Calls Me Beautiful? offers insights to help you recognize the value of your identity in God. Discover how you can get your heart in the...

Source: Transformed in His Image

How Should Christians Respond to Government

Understanding how to balance earthly and heavenly citizenship without compromising accountability to God has been an issue for many Christians since the beginning of human government. In the booklet How Should Christians Respond to Government? author Mart DeHaan shares historical perspectives and wisdom from the Word to help you recognize what belongs to God and...

Source: How Should Christians Respond to Government

Hope for the World

No matter what you face in life, the decisions you make determine the course of your journey. Where can you find clear direction to help you make wise choices? In Hope for the World, author Alice Mathews examines the decisions made by Eve and Mary that continue to impact the world from generation to generation....

Source: Hope for the World

Discipled by Jesus: Mary Magdalene?s Walk of Faith

Gain insights from Mary Magdalene?s encounter with Jesus to help you strengthen your faith and align your priorities with God?s will.

Source: Discipled by Jesus: Mary Magdalene?s Walk of Faith

Finding Hope in a Hopeless World

Discover how you can strengthen your faith and trust in God, even in the midst of challenging times.

Source: Finding Hope in a Hopeless World

When God Isn?t Answering Your Prayer: Psalm 77

Gain insights from Psalm 77 to help you better understand God?s times of silence.

Source: When God Isn?t Answering Your Prayer: Psalm 77

Living an Authentic Christian Life

Discover how you can live in total dependence on God and truly display His glory to others.

Source: Living an Authentic Christian Life

Taking the Initiative Against Depression

Arise and eat?1 Kings 19:5The angel in this passage did not give Elijah a vision, or explain the Scriptures to him, or do anything remarkable. He simply told Elijah …

Source: Taking the Initiative Against Depression

The Inspiration of Spiritual Initiative

Arise from the dead . . .?Ephesians 5:14Not all initiative, the willingness to take the first step, is inspired by God. Someone may say to you, “Get up and get going! Take …

Source: The Inspiration of Spiritual Initiative

?Am I My Brother?s Keeper??

None of us lives to himself . . . ?Romans 14:7Has it ever dawned on you that you are responsible spiritually to God for other people? For instance, if I allow any turning away from …

Source: ?Am I My Brother?s Keeper??

The Discipline of Hearing

Whatever I tell you in the dark, speak in the light; and what you hear in the ear, preach on the housetops ?Matthew 10:27Sometimes God puts us through the experience and discipline of darkness to teach us to hear and obey Him. Song birds are taught to sing …

Source: The Discipline of Hearing

The Devotion of Hearing

Samuel answered, ?Speak, for Your servant hears? ?1 Samuel 3:10Just because I have listened carefully and intently to one thing from God does not mean that I will listen to everything He says. I …

Source: The Devotion of Hearing