WWE 24/7 Notes
I can't believe I haven't seen this tidbit mentioned elsewhere.... February is "Midget Mania" month on WWE 24/7, and what DVD are they showing? Hard Knocks, the Chris Benoit story. Either that was a really odd coincidence or someone in programming there has a great sense of humor. Not sure.
I was watching the weekly ECW program last night, and noticed Matt Bourne as Bourne Again. Wow, was this a great gimmick! No, seriously, it was. He was wearing the Doink outfit with about half his facepaint on, doing a dead-on Rowdy Roddy Piper impersonation. He came across as someone you'd see on the street talking to himself and yelling at passersby. Just a really, really, creepy gimmick for the former Doink. Anyways, he had a match with 2 Cold Scorpio which resulted in a disqualification when Mr. Hughes interfered. I have no idea where this whole angle went, if anywhere. Some solid promos by Public Enemy as well, who had just lost the tag team titles to Cactus Jack and Mikey Whipwreck.
Also caught some of SuperBrawl III (Sting vs. Vader in a White Castle Hamburger Of Fear match and the WCW return of Ric Flair). Not a bad show, though some of the early matches dragged on forever. Speaking of Scorpio and Benoit, the two of them put on a helluva match, which ended literally one second before the time limit draw (I'm sure Gary Michael Capetta counting down the remaining seconds over the PA helped them work out the timing, though). Steve Austin and Brian Pillan as The Hollywood Blonds = gold. Too bad they had to work with Erik Watts (who was getting John Cena-like jeers) and - heh heh - Marcus Alexander Bagwell. Also, I was amazed that they kept Jesse Ventura's commentary on the entire show, given how often they edit him out their DVD's. It was HILARIOUS hearing him tear Tony a new Schiavone.
14 Comments:
Check out Kissmyassclub.com
i am loving 24/7. its funny cause i just got done watching the benoit/2 cold match for the third time this week and about 5 minutes later i read your post. hard knocks was pretty good too, though i can't bring myself to look at the tv during the sabu segment.
Static -- do yourself a favor and check out the ultra-lame "Biggest, Smallest, Strongest, Strangest" show on 24/7 if you have an hour to kill.
It's basically Jesse Ventura talking about random wrestlers in an obviously-scripted speech. I remember wanting to watch this one SO BADLY way back when -- so glad I didn't shell out the two dollars or whatever to rent it at the time.
have you watched the episode of TNT yet? too frickin' funny.
Nope, not yet.... was about to start watching some of the MSG show tonight, but I'm beginning to drift off to sleep. Will probably catch TNT over the weekend - thanks for the heads-up.
Check the game links on www.kissmyassclub.com
KissMyAssClub
Great Posting web site
KissMyAssClub.com
Bay Area Lawyers Bay Area Attorneys California Lawyers
Are you looking for a Bay Area lawyer or law firm? BayAreaLawyers.com is a free searchable directory of Bay Area Lawyers who provide free consultations to California residents in need of legal advice
Loan Modification
CaliforniaLoanRate.com
A Loan Modification is a permanent change in one or more of the terms of a mortgagor's loan, allows the loan to be reinstated, and results in a payment the mortgagor can afford.
Question 1: In utilizing the Loan Modification option to bring an asset current, can the mortgagee include all fees and corporate advances?
Answer: Mortgagee Letter 2008-21 states in part: Legal fees and related foreclosure costs for work actually completed and applicable to the current default episode may be capitalized into the modified principal balance.
Question 2: May a mortgagee perform an interior inspection of the property if they have concerns about property condition?
Answer: Yes, the mortgagee may conduct any review it deems necessary to verify that the property has no physical conditions which adversely impact the mortgagor's continued ability to support the modified mortgage payment.
Question 3: Can a mortgagee include late charges in the Loan Modification?
Answer: Mortgagee Letter 2008-21 states that accrued late charges should be waived by the mortgagee at the time of the Loan Modification.
Question 4: When utilizing a Loan Modification option, can a mortgagee capitalize an escrow advance for Homeowner's Association fees?
Answer: HUD Handbook 4330.1 REV-5, Paragraph 2-1, Section B, Escrow Obligations states: Mortgagees must also escrow funds for those items which, if not paid, would create liens on the property positioned ahead of the FHA-insured mortgage.
Question 5: Is there a new basis interest rate which mortgagees may assess when completing a Loan Modification?
Answer: Yes, Mortgagee Letter 2008-21 states that the new basis interest rate is 200 points above the monthly average yield on U.S. Treasury Securities, adjusted to a constant maturity of 10 years.
Question 6: Will HUD subordinate a Partial Claim, should a mortgagor subsequently default and qualify for a Loan Modification?
Answer: If a mortgagor subsequently defaults and qualifies for a Loan Modification, HUD will subordinate the Partial Claim.
Question 7: Are mortgagees required to perform an escrow analysis when completing a Loan Modification?
Answer: Yes, mortgagees are to perform a retroactive escrow analysis at the time the Loan Modification to ensure that the delinquent payments being capitalized reflect the actual escrow requirements required for those months capitalized.
Question 8: Is the mortgagor eligible for the upfront premium refund at payoff of a modified loan?
Answer: It depends upon when the closing date occurred. For assets closed:
After July 1, 1991 but before January 1, 2001, the 7-year unearned premium refund schedule shown in Mortgagee Letter 1994-1 remains in effect,
On or after January 1, 2001 that are subsequently refinanced, the 5-year refund schedule shown in the attachment of Mortgagee Letter 2000-46 applies, or
On or after December 8, 2004, refunds of upfront MIP are eliminated except, when the mortgagor refinances to another FHA insured mortgage. The refund schedule attached to Mortgagee Letter 2005-03 has been modified to a 3-year period.
Question 9: Can a mortgagee qualify an asset for the Loan Modification option when the mortgagor is unemployed, the spouse is employed, but the spouse name is not on the mortgage?
Answer: Based upon this scenario, the mortgagee should conduct a financial review of the household income and expenses to determine if surplus income is sufficient to meet the new modified mortgage payment, but insufficient to pay back the arrearage. Once this process has been completed the mortgagee should then consult with their legal counsel to determine if the asset is eligible for a Loan Modification since the spouse is not on the original mortgage.
CaliforniaLoanRate.com
tits pictures pics Better
masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation pictures big tits pictures
movies Better masterbation pics videos galleries movies thumbnails mpegs
mpgs clips better masterbation videos big tits pictures mpegs Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation clips big tits pictures mpgs Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation trailers
big tits pictures samples Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation blowjobs big tits pictures
cumshots Better masterbation pics videos galleries movies thumbnails mpegs
mpgs clips better masterbation big tits big tits pictures asian lesbian
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation teen mature big tits pictures anal masturbation Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation gay boys big tits pictures hardcore interracial Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation indian japanese big tits pictures interracial orgies Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation tits boobs pussy wet lips big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation facial internal female ejacualtion big tits pictures pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation bruntte blonde teen schoolgirls big tits pictures pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation milking tits female squirting big tits pictures pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation jizz on tits ass fucked big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation fucking hard big cock amateur big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation mature sluts intereacial threesome big tits pictures pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation public sex outdoor fucking big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation anime hentai sluts black ebony hardcore long movies download
big tits pictures pics Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation nudist springbreak naked
boobs nude teen ass cracks big tits pictures pics Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation
soiled panties white three plug dildos big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation wide open clits pussy licking tit sucking amature sluts big
tits pictures pics Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation mom son mother son dad
daughter incest sex big tits pictures pics Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation black
monster cocks office secreatory boss fuck big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation big tits pictures pics Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation pictures
big tits pictures movies Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation videos big tits pictures
mpegs Better masterbation pics videos galleries movies thumbnails mpegs mpgs
clips better masterbation clips big tits pictures mpgs Better masterbation
pics videos galleries movies thumbnails mpegs mpgs clips better masterbation
trailers big tits pictures samples Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation blowjobs big tits
pictures cumshots Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation big tits big tits pictures
asian lesbian Better masterbation pics videos galleries movies thumbnails
mpegs mpgs clips better masterbation teen mature big tits pictures anal
masturbation Better masterbation pics videos galleries movies thumbnails
mpegs mpgs clips better masterbation gay boys big tits pictures hardcore
interracial Better masterbation pics videos galleries movies thumbnails
mpegs mpgs clips better masterbation indian japanese big tits pictures
interracial orgies Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation tits boobs pussy wet lips
big tits pictures pics Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation facial internal female
ejacualtion big tits pictures pics Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation bruntte blonde teen
schoolgirls big tits pictures pics Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation milking tits female
squirting big tits pictures pics Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation jizz on tits ass
fucked big tits pictures pics Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation fucking hard big cock
amateur big tits pictures pics Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation mature sluts
intereacial threesome big tits pictures pics Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation public sex
outdoor fucking big tits pictures pics Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation anime
hentai sluts black ebony hardcore long movies download big tits pictures
pics Better masterbation pics videos galleries movies thumbnails mpegs mpgs
clips better masterbation nudist springbreak naked boobs nude teen ass
cracks big tits pictures pics Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation soiled panties white
three plug dildos big tits pictures pics Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation wide open
clits pussy licking tit sucking amature sluts big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation mom son mother son dad daughter incest sex big tits pictures
pics Better masterbation pics videos galleries movies thumbnails mpegs mpgs
clips better masterbation black monster cocks office secreatory boss fuck
big tits pictures pics Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation big tits pictures pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation pictures big tits pictures movies Better masterbation
pics videos galleries movies thumbnails mpegs mpgs clips better masterbation
videos big tits pictures mpegs Better masterbation pics videos galleries
movies thumbnails mpegs mpgs clips better masterbation clips big tits
pictures mpgs Better masterbation pics videos galleries movies thumbnails
mpegs mpgs clips better masterbation trailers big tits pictures samples
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation blowjobs big tits pictures cumshots Better masterbation
pics videos galleries movies thumbnails mpegs mpgs clips better masterbation
big tits big tits pictures asian lesbian Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation teen mature
big tits pictures anal masturbation Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation gay boys
big tits pictures hardcore interracial Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation indian
japanese big tits pictures interracial orgies Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation tits
boobs pussy wet lips big tits pictures pics Better masterbation pics videos
galleries movies thumbnails mpegs mpgs clips better masterbation facial
internal female ejacualtion big tits pictures pics Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation
bruntte blonde teen schoolgirls big tits pictures pics Better masterbation
pics videos galleries movies thumbnails mpegs mpgs clips better masterbation
milking tits female squirting big tits pictures pics Better masterbation
pics videos galleries movies thumbnails mpegs mpgs clips better masterbation
jizz on tits ass fucked big tits pictures pics Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation
fucking hard big cock amateur big tits pictures pics Better masterbation
pics videos galleries movies thumbnails mpegs mpgs clips better masterbation
mature sluts intereacial threesome big tits pictures Kiss My Ass Club pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation public sex outdoor fucking big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation anime hentai sluts black ebony hardcore long movies download
big tits pictures pics Better masterbation pics videos galleries movies
thumbnails mpegs mpgs clips better masterbation nudist springbreak naked
boobs nude teen ass cracks big tits pictures pics Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation
soiled panties white three plug dildos big tits pictures pics Better
masterbation pics videos galleries movies thumbnails mpegs mpgs clips better
masterbation wide open clits pussy licking tit sucking amature sluts big
tits pictures pics Better masterbation pics videos KissMyAssClub galleries
movies thumbnails mpegs mpgs clips better masterbation mom son mother son
dad daughter incest sex big tits pictures pics Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation
black monster cocks office secreatory boss fuck big tits pictures pics
Better masterbation pics videos galleries movies thumbnails mpegs mpgs clips
better masterbation thumbs thumbnails galleries Better masterbation pics
videos galleries movies thumbnails mpegs mpgs clips better masterbation
http://www.kissmyassclub.com
Mesothelioma is a form of cancer that is almost always caused by
previous exposure to asbestos. In this disease, malignant cells
develop in the mesothelium, a protective lining that covers most of
the body's internal organs. Its most common site is the pleura (outer
lining of the lungs and internal chest wall), but it may also occur in
the peritoneum (the lining of the abdominal cavity), the heart,[1] the
pericardium (a sac that surrounds the heart) or tunica vaginalis.
Most people who develop mesothelioma have worked on jobs where they
inhaled asbestos particles, or they have been exposed to asbestos dust
and fiber in other ways. Washing the clothes of a family member who
worked with asbestos can also put a person at risk for developing
mesothelioma.[2] Unlike lung cancer, there is no association between
mesothelioma and smoking.[3] Compensation via asbestos funds or
lawsuits is an important issue in mesothelioma (see asbestos and the
law).
The symptoms of mesothelioma include shortness of breath due to
pleural effusion (fluid between the lung and the chest wall) or chest
wall pain, and general symptoms such as weight loss. The diagnosis may
be suspected with chest X-ray and CT scan, and is confirmed with a
biopsy (tissue sample) and microscopic examination. A thoracoscopy
(inserting a tube with a camera into the chest) can be used to take
biopsies. It allows the introduction of substances such as talc to
obliterate the pleural space (called pleurodesis), which prevents more
fluid from accumulating and pressing on the lung. Despite treatment
with chemotherapy, radiation therapy or sometimes surgery, the disease
carries a poor prognosis. Research about screening tests for the early
detection of mesothelioma is ongoing.
Symptoms of mesothelioma may not appear until 20 to 50 years after
exposure to asbestos. Shortness of breath, cough, and pain in the
chest due to an accumulation of fluid in the pleural space are often
symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia,
abdominal swelling and pain due to ascites (a buildup of fluid in the
abdominal cavity). Other symptoms of peritoneal mesothelioma may
include bowel obstruction, blood clotting abnormalities, anemia, and
fever. If the cancer has spread beyond the mesothelium to other parts
of the body, symptoms may include pain, trouble swallowing, or
swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious
conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up (hemoptysis)
In severe cases, the person may have many tumor masses. The individual
may develop a pneumothorax, or collapse of the lung. The disease may
metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms
until they are at a late stage. Symptoms include:
abdominal pain
ascites, or an abnormal buildup of fluid in the abdomen
a mass in the abdomen
problems with bowel function
weight loss
In severe cases of the disease, the following signs and symptoms may be present:
blood clots in the veins, which may cause thrombophlebitis
disseminated intravascular coagulation, a disorder causing severe
bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pleural effusion
pulmonary emboli, or blood clots in the arteries of the lungs
severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal
glands. Pleural tumors are usually found only on one side of the
lungs.
Diagnosing mesothelioma is often difficult, because the symptoms are
similar to those of a number of other conditions. Diagnosis begins
with a review of the patient's medical history. A history of exposure
to asbestos may increase clinical suspicion for mesothelioma. A
physical examination is performed, followed by chest X-ray and often
lung function tests. The X-ray may reveal pleural thickening commonly
seen after asbestos exposure and increases suspicion of mesothelioma.
A CT (or CAT) scan or an MRI is usually performed. If a large amount
of fluid is present, abnormal cells may be detected by cytology if
this fluid is aspirated with a syringe. For pleural fluid this is done
by a pleural tap or chest drain, in ascites with an paracentesis or
ascitic drain and in a pericardial effusion with pericardiocentesis.
While absence of malignant cells on cytology does not completely
exclude mesothelioma, it makes it much more unlikely, especially if an
alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a
biopsy is needed to confirm a diagnosis of mesothelioma. A doctor
removes a sample of tissue for examination under a microscope by a
pathologist. A biopsy may be done in different ways, depending on
where the abnormal area is located. If the cancer is in the chest, the
doctor may perform a thoracoscopy. In this procedure, the doctor makes
a small cut through the chest wall and puts a thin, lighted tube
called a thoracoscope into the chest between two ribs. Thoracoscopy
allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy.
To obtain tissue for examination, the doctor makes a small incision in
the abdomen and inserts a special instrument into the abdominal
cavity. If these procedures do not yield enough tissue, more extensive
diagnostic surgery may be necessary
The mesothelium consists of a single layer of flattened to cuboidal
cells forming the epithelial lining of the serous cavities of the body
including the peritoneal, pericardial and pleural cavities. Deposition
of asbestos fibres in the parenchyma of the lung may result in the
penetration of the visceral pleura from where the fibre can then be
carried to the pleural surface, thus leading to the development of
malignant mesothelial plaques. The processes leading to the
development of peritoneal mesothelioma remain unresolved, although it
has been proposed that asbestos fibres from the lung are transported
to the abdomen and associated organs via the lymphatic system.
Additionally, asbestos fibres may be deposited in the gut after
ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been
shown to cause cancer. Long thin asbestos fibers (blue asbestos,
amphibole fibers) are more potent carcinogens than "feathery fibers"
(chrysotile or white asbestos fibers).[6] However, there is now
evidence that smaller particles may be more dangerous than the larger
fibers.[1][2] They remain suspended in the air where they can be
inhaled, and may penetrate more easily and deeper into the lungs. "We
probably will find out a lot more about the health aspects of asbestos
from [the World Trade Center attack], unfortunately," said Dr. Alan
Fein, chief of pulmonary and critical-care medicine at North
Shore-Long Island Jewish Health System. Dr. Fein has treated several
patients for "World Trade Center syndrome" or respiratory ailments
from brief exposures of only a day or two near the collapsed
buildings.[3]
Mesothelioma development in rats has been demonstrated following
intra-pleural inoculation of phosphorylated chrysotile fibres. It has
been suggested that in humans, transport of fibres to the pleura is
critical to the pathogenesis of mesothelioma. This is supported by the
observed recruitment of significant numbers of macrophages and other
cells of the immune system to localised lesions of accumulated
asbestos fibres in the pleural and peritoneal cavities of rats. These
lesions continued to attract and accumulate macrophages as the disease
progressed, and cellular changes within the lesion culminated in a
morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete
carcinogen with the development of mesothelioma occurring in
sequential stages of initiation and promotion. The molecular
mechanisms underlying the malignant transformation of normal
mesothelial cells by asbestos fibres remain unclear despite the
demonstration of its oncogenic capabilities. However, complete in
vitro transformation of normal human mesothelial cells to malignant
phenotype following exposure to asbestos fibres has not yet been
achieved. In general, asbestos fibres are thought to act through
direct physical interactions with the cells of the mesothelium in
conjunction with indirect effects following interaction with
inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown
that phagocytosed fibres are able to make contact with chromosomes,
often adhering to the chromatin fibres or becoming entangled within
the chromosome. This contact between the asbestos fibre and the
chromosomes or structural proteins of the spindle apparatus can induce
complex abnormalities. The most common abnormality is monosomy of
chromosome 22. Other frequent abnormalities include structural
rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion
of the tumor suppressor genes
Incidence
Although reported incidence rates have increased in the past 20 years,
mesothelioma is still a relatively rare cancer. The incidence rate is
approximately one per 1,000,000. The highest incidence is found in
Britain, Australia and Belgium: 30 per 1,000,000 per year.[7] For
comparison, populations with high levels of smoking can have a lung
cancer incidence of over 1,000 per 1,000,000. Incidence of malignant
mesothelioma currently ranges from about 7 to 40 per 1,000,000 in
industrialized Western nations, depending on the amount of asbestos
exposure of the populations during the past several decades.[8] It has
been estimated that incidence may have peaked at 15 per 1,000,000 in
the United States in 2004. Incidence is expected to continue
increasing in other parts of the world. Mesothelioma occurs more often
in men than in women and risk increases with age, but this disease can
appear in either men or women at any age. Approximately one fifth to
one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were
occupationally exposed to asbestos in the United States [4]. Between
1973 and 1984, there has been a threefold increase in the diagnosis of
pleural mesothelioma in Caucasian males. From 1980 to the late 1990s,
the death rate from mesothelioma in the USA increased from 2,000 per
year to 3,000, with men four times more likely to acquire it than
women. These rates may not be accurate, since it is possible that many
cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung,
which is difficult to differentiate from mesothelioma.
[edit] Risk factors
Working with asbestos is the major risk factor for mesothelioma.[9] A
history of asbestos exposure exists in almost all cases. However,
mesothelioma has been reported in some individuals without any known
exposure to asbestos. In rare cases, mesothelioma has also been
associated with irradiation, intrapleural thorium dioxide
(Thorotrast), and inhalation of other fibrous silicates, such as
erionite.
Asbestos is the name of a group of minerals that occur naturally as
masses of strong, flexible fibers that can be separated into thin
threads and woven. Asbestos has been widely used in many industrial
products, including cement, brake linings, roof shingles, flooring
products, textiles, and insulation. If tiny asbestos particles float
in the air, especially during the manufacturing process, they may be
inhaled or swallowed, and can cause serious health problems. In
addition to mesothelioma, exposure to asbestos increases the risk of
lung cancer, asbestosis (a noncancerous, chronic lung ailment), and
other cancers, such as those of the larynx and kidney.
The combination of smoking and asbestos exposure significantly
increases a person's risk of developing cancer of the airways (lung
cancer, bronchial carcinoma). The Kent brand of cigarettes used
asbestos in its filters for the first few years of production in the
1950s and some cases of mesothelioma have resulted. Smoking modern
cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 (SV40) may act as a cofactor
in the development of mesothelioma.[10]
[edit] Exposure
Asbestos was known in antiquity, but it wasn't mined and widely used
commercially until the late 1800s. Its use greatly increased during
World War II. Since the early 1940s, millions of American workers have
been exposed to asbestos dust. Initially, the risks associated with
asbestos exposure were not publicly known. However, an increased risk
of developing mesothelioma was later found among shipyard workers,
people who work in asbestos mines and mills, producers of asbestos
products, workers in the heating and construction industries, and
other tradespeople. Today, the U.S. Occupational Safety and Health
Administration (OSHA) sets limits for acceptable levels of asbestos
exposure in the workplace, and created guidelines for engineering
controls and respirators, protective clothing, exposure monitoring,
hygiene facilities and practices, warning signs, labeling,
recordkeeping, and medical exams. By contrast, the British
Government's Health and Safety Executive (HSE) states formally that
any threshold for mesothelioma must be at a very low level and it is
widely agreed that if any such threshold does exist at all, then it
cannot currently be quantified. For practical purposes, therefore, HSE
does not assume that any such threshold exists. People who work with
asbestos wear personal protective equipment to lower their risk of
exposure. Recent findings have shown that a mineral called erionite
has been known to cause genetically pre-dispositioned individuals to
have malignant mesothelioma rates much higher than those not
pre-dispositioned genetically. A study in Cappadocia, Turkey has shown
that 3 villiages in Turkey have death rates of 51% attributed to
erionite related mesothelioma.
[edit] Occupational
Exposure to asbestos fibres has been recognised as an occupational
health hazard since the early 1900s. Several epidemiological studies
have associated exposure to asbestos with the development of lesions
such as asbestos bodies in the sputum, pleural plaques, diffuse
pleural thickening, asbestosis, carcinoma of the lung and larynx,
gastrointestinal tumours, and diffuse mesothelioma of the pleura and
peritoneum.
The documented presence of asbestos fibres in water supplies and food
products has fostered concerns about the possible impact of long-term
and, as yet, unknown exposure of the general population to these
fibres. Although many authorities consider brief or transient exposure
to asbestos fibres as inconsequential and an unlikely risk factor,
some epidemiologists claim that there is no risk threshold. Cases of
mesothelioma have been found in people whose only exposure was
breathing the air through ventilation systems. Other cases had very
minimal (3 months or less) direct exposure.
Commercial asbestos mining at Wittenoom, Western Australia, occurred
between 1945 and 1966. A cohort study of miners employed at the mine
reported that while no deaths occurred within the first 10 years after
crocidolite exposure, 85 deaths attributable to mesothelioma had
occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had
been reported in Western Australia.
[edit] Paraoccupational secondary exposure
Family members and others living with asbestos workers have an
increased risk of developing mesothelioma, and possibly other asbestos
related diseases. This risk may be the result of exposure to asbestos
dust brought home on the clothing and hair of asbestos workers. To
reduce the chance of exposing family members to asbestos fibres,
asbestos workers are usually required to shower and change their
clothing before leaving the workplace.
[edit] Asbestos in buildings
Many building materials used in both public and domestic premises
prior to the banning of asbestos may contain asbestos. Those
performing renovation works or DIY activities may expose themselves to
asbestos dust. In the UK use of Chrysotile asbestos was banned at the
end of 1999. Brown and blue asbestos was banned in the UK around 1985.
Buildings built or renovated prior to these dates may contain asbestos
materials.
[edit] Environmental exposures
Incidence of mesothelioma had been found to be higher in populations
living near naturally occurring asbestos. For example, in Cappadocia,
Turkey, an unprecedented mesothelioma epidemic caused 50% of all
deaths in three small villages. Initially, this was attributed to
erionite, however, recently, it has been shown that erionite causes
mesothelioma mostly in families with a genetic predisposition[11].
[edit] Treatment
Treatment of malignant mesothelioma using conventional therapies in
combination with radiation and or chemotherapy on stage I or II
Mesothelioma have proved on average 74.6 percent successful in
extending the patients life span by five years or more [commonly known
as remission][this percentage may increases or decrease depending on
date of discovery / stage of malignant development] (Oncology Today,
2009). Treatment course is primarily determined by the staging or
development. This is unlike traditional treatment such as surgery by
itself which has proved only be 16.3 percent likely to extend a
patients life span by five years or more [commonly known as
remission]. Clinical behavior of the malignancy is affected by several
factors including the continuous mesothelial surface of the pleural
cavity which favors local metastasis via exfoliated cells, invasion to
underlying tissue and other organs within the pleural cavity, and the
extremely long latency period between asbestos exposure and
development of the disease.
[edit] Surgery
Surgery, by itself, has proved disappointing. However, research
indiates varied success when used in combination with radation and
cheemotherapy (Duke, 2008) A pleurectomy/decortication is the most
common surgery, in which the lining of the chest is removed. Less
common is an extrapleural pneumonectomy (EPP), in which the lung,
lining of the inside of the chest, the hemi-diaphragm and the
pericardium are removed.
[edit] Radiation
Wikibooks has a book on the topic of
Radiation Oncology/Lung/Mesothelioma
For patients with localized disease, and who can tolerate a radical
surgery, radiation is often given post-operatively as a consolidative
treatment. The entire hemi-thorax is treated with radiation therapy,
often given simultaneously with chemotherapy. This approach of using
surgery followed by radiation with chemotherapy has been pioneered by
the thoracic oncology team at Brigham & Women's Hospital in
Boston.[12] Delivering radiation and chemotherapy after a radical
surgery has led to extended life expectancy in selected patient
populations with some patients surviving more than 5 years. As part of
a curative approach to mesothelioma, radiotherapy is also commonly
applied to the sites of chest drain insertion, in order to prevent
growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment
with radiotherapy alone, palliative treatment regimens are sometimes
used to relieve symptoms arising from tumor growth, such as
obstruction of a major blood vessel. Radiation therapy when given
alone with curative intent has never been shown to improve survival
from mesothelioma. The necessary radiation dose to treat mesothelioma
that has not been surgically removed would be very toxic.
[edit] Chemotherapy
Chemotherapy is the only treatment for mesothelioma that has been
proven to improve survival in randomised and controlled trials. The
landmark study published in 2003 by Vogelzang and colleagues compared
cisplatin chemotherapy alone with a combination of cisplatin and
pemetrexed (brand name Alimta) chemotherapy) in patients who had not
received chemotherapy for malignant pleural mesothelioma previously
and were not candidates for more aggressive "curative" surgery.[13]
This trial was the first to report a survival advantage from
chemotherapy in malignant pleural mesothelioma, showing a
statistically significant improvement in median survival from 10
months in the patients treated with cisplatin alone to 13.3 months in
the combination pemetrexed group in patients who received
supplementation with folate and vitamin B12. Vitamin supplementation
was given to most patients in the trial and pemetrexed related side
effects were significantly less in patients receiving pemetrexed when
they also received daily oral folate 500mcg and intramuscular vitamin
B12 1000mcg every 9 weeks compared with patients receiving pemetrexed
without vitamin supplementation. The objective response rate increased
from 20% in the cisplatin group to 46% in the combination pemetrexed
group. Some side effects such as nausea and vomiting, stomatitis, and
diarrhoea were more common in the combination pemetrexed group but
only affected a minority of patients and overall the combination of
pemetrexed and cisplatin was well tolerated when patients received
vitamin supplementation; both quality of life and lung function tests
improved in the combination pemetrexed group. In February 2004, the
United States Food and Drug Administration approved pemetrexed for
treatment of malignant pleural mesothelioma. However, there are still
unanswered questions about the optimal use of chemotherapy, including
when to start treatment, and the optimal number of cycles to give.
Cisplatin in combination with raltitrexed has shown an improvement in
survival similar to that reported for pemetrexed in combination with
cisplatin, but raltitrexed is no longer commercially available for
this indication. For patients unable to tolerate pemetrexed, cisplatin
in combination with gemcitabine or vinorelbine is an alternative,
although a survival benefit has not been shown for these drugs. For
patients in whom cisplatin cannot be used, carboplatin can be
substituted but non-randomised data have shown lower response rates
and high rates of haematological toxicity for carboplatin-based
combinations, albeit with similar survival figures to patients
receiving cisplatin.[14]
In January 2009, the United States FDA approved using conventional
therapies such as surgery in combination with radiation and or
chemotherapy on stage I or II Mesothelioma after research conducted by
a nationwide study by Duke University concluded an almost 50 point
increase in remission rates.
[edit] Immunotherapy
Treatment regimens involving immunotherapy have yielded variable
results. For example, intrapleural inoculation of Bacillus
Calmette-Guérin (BCG) in an attempt to boost the immune response, was
found to be of no benefit to the patient (while it may benefit
patients with bladder cancer). Mesothelioma cells proved susceptible
to in vitro lysis by LAK cells following activation by interleukin-2
(IL-2), but patients undergoing this particular therapy experienced
major side effects. Indeed, this trial was suspended in view of the
unacceptably high levels of IL-2 toxicity and the severity of side
effects such as fever and cachexia. Nonetheless, other trials
involving interferon alpha have proved more encouraging with 20% of
patients experiencing a greater than 50% reduction in tumor mass
combined with minimal side effects.
[edit] Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal
chemotherapy was developed by Paul Sugarbaker at the Washington Cancer
Institute.[15] The surgeon removes as much of the tumor as possible
followed by the direct administration of a chemotherapy agent, heated
to between 40 and 48°C, in the abdomen. The fluid is perfused for 60
to 120 minutes and then drained.
This technique permits the administration of high concentrations of
selected drugs into the abdominal and pelvic surfaces. Heating the
chemotherapy treatment increases the penetration of the drugs into
tissues. Also, heating itself damages the malignant cells more than
the normal cells.
[edit] Notable people who died from mesothelioma
Mesothelioma, though rare, has had a number of notable patients.
Hamilton Jordan, Chief of Staff for President Jimmy Carter and life
long cancer activist, died in 2008. Australian anti-racism activist
Bob Bellear died in 2005. British science fiction writer Michael G.
Coney, responsible for nearly 100 works also died in 2005. American
film and television actor Paul Gleason, perhaps best known for his
portrayal of Principal Richard Vernon in the 1985 film The Breakfast
Club, died in 2006. Mickie Most, an English record producer, died of
mesothelioma in 2003. Paul Rudolph, an American architect known for
his cubist building designs, died in 1997.
Bernie Banton was an Australian workers' rights activist, who fought a
long battle for compensation from James Hardie after he contracted
mesothelioma after working for that company. He claimed James Hardie
knew of the dangers of asbestos before he began work with the
substance making insulation for power stations. Mesothelioma
eventually took his life along with his brothers and hundreds of James
Hardie workers. James Hardie made an undisclosed settlement with
Banton only when his mesothelioma had reached its final stages and he
was expected to have no more than 48hrs to live. Australian Prime
Minister Kevin Rudd mentioned Banton's extended struggle in his
acceptance speech after winning the 2007 Australian Federal Election.
Steve McQueen was diagnosed with peritoneal mesothelioma on December
22, 1979. He was not offered surgery or chemotherapy because doctors
felt the cancer was too advanced. McQueen sought alternative
treatments from clinics in Mexico. He died of a heart attack on
November 7, 1980, in Juárez, Mexico, following cancer surgery. He may
have been exposed to asbestos while serving with the U.S. Marines as a
young adult—asbestos was then commonly used to insulate ships'
piping—or from its use as an insulating material in car racing
suits.[16] (It is also reported that he worked in a shipyard during
World War II, where he might have been exposed to asbestos.[citation
needed])
United States Congressman Bruce Vento died of mesothelioma in 2000.
The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF
Symposium to persons or organizations who have done the most to
support mesothelioma research and advocacy.
After a long period of untreated illness and pain, rock and roll
musician and songwriter Warren Zevon was diagnosed with inoperable
mesothelioma in the fall of 2002. Refusing treatments he believed
might incapacitate him, Zevon focused his energies on recording his
final album The Wind including the song "Keep Me in Your Heart," which
speaks of his failing breath. Zevon died at his home in Los Angeles,
California, on September 7, 2003.
Christie Hennessy, the influential Irish singer-songwriter, died of
mesothelioma in 2007, and had stridently refused to accept the
prognosis in the weeks before his death.[17] His mesothelioma has been
attributed to his younger years spent working on building sites in
London.[18][19]
Bob Miner, one of the founders of Software Development Labs, the
forerunner of Oracle Corporation died of mesothelioma in 1994.
Scottish Labour MP John William MacDougall died of mesothelioma on
August 13th, 2008, after fighting the disease for two years.[20].
Canberra journalist and news presenter, Peter Leonard also succumbed
to the condition on 23 September 2008.
Terrence McCann Olympic gold medalist and longtime Executive Director
of Toastmasters, died of mesothelioma on June 7, 2006 at his home in
Dana Point, California.
[edit] Notable people who have lived for some time with mesothelioma
Although life expectancy with this disease is typically limited, there
are notable survivors. In July 1982, Stephen Jay Gould was diagnosed
with peritoneal mesothelioma. After his diagnosis, Gould wrote the
"The Median Isn't the Message"[21] for Discover magazine, in which he
argued that statistics such as median survival are just useful
abstractions, not destiny. Gould lived for another twenty years
eventually succumbing to metastatic adenocarcinoma of the lung, not
mesothelioma.
Author Paul Kraus was diagnosed with mesothelioma in June 1997
following an umbilical hernia operation. His prognosis was "a few
months." He continues to survive using a variety of integrative and
complementary modalities and has written a book about his experience.
Main article: asbestos and the law
The first lawsuits against asbestos manufacturers were in 1929. Since
then, many lawsuits have been filed against asbestos manufacturers and
employers, for neglecting to implement safety measures after the links
between asbestos, asbestosis, and mesothelioma became known (some
reports seem to place this as early as 1898). Today, you may see a
commercial stating something like, "Mesothelioma is a rare type of
cancer caused by asbestos particles. Asbestos particles can be found
in lumberyards, shipyards or any of the heating or automotive
industries." The liability resulting from the sheer number of lawsuits
and people affected has reached billions of dollars. [22] The amounts
and method of allocating compensation have been the source of many
court cases, reaching up to the United States Supreme Court, and
government attempts at resolution of existing and future cases.
However, to date, Congress has failed to enact significant asbestos
reforms. [23]
Legal History
The first lawsuit against asbestos manufacturers was brought in 1929.
The parties settled that lawsuit, and as part of the agreement, the
attorneys agreed not to pursue further cases. It was not until 1960
that an article published by Wagner et al first officially established
mesothelioma as a disease arising from exposure to crocidolite
asbestos.[24] The article referred to over 30 case studies of people
who had suffered from mesothelioma in South Africa. Some exposures
were transient and some were mine workers. In 1962 McNulty reported
the first diagnosed case of malignant mesothelioma in an Australian
asbestos worker.[25] The worker had worked in the mill at the asbestos
mine in Wittenoom from 1948 to 1950.
In the town of Wittenoom, asbestos-containing mine waste was used to
cover schoolyards and playgrounds. In 1965 an article in the British
Journal of Industrial Medicine established that people who lived in
the neighbourhoods of asbestos factories and mines, but did not work
in them, had contracted mesothelioma.
Despite proof that the dust associated with asbestos mining and
milling causes asbestos related disease, mining began at Wittenoom in
1943 and continued until 1966. In 1974 the first public warnings of
the dangers of blue asbestos were published in a cover story called
"Is this Killer in Your Home?" in Australia's Bulletin magazine. In
1978 the Western Australian Government decided to phase out the town
of Wittenoom, following the publication of a Health Dept. booklet,
"The Health Hazard at Wittenoom", containing the results of air
sampling and an appraisal of worldwide medical information.
By 1979 the first writs for negligence related to Wittenoom were
issued against CSR and its subsidiary ABA, and the Asbestos Diseases
Society was formed to represent the Wittenoom victims.
Are you looking for a bayarea Lawyer? BayAreaLawyers.com is a free searchable directory of California attorneys who provide free consultations to California residents in need of legal advice
Http://www.KissMyAssClub.com
Post a Comment
<< Home