SERVICES FOR THE ELDERLY: MEMORY CLINICS

Comapre online pharmacy prices

HOW TO SURVIVE YOUR DOCTOR: IMODIUM, IMPETIGO AND INDERAL

Prescription meds without a prescription

COMMON IFECTIONS OF CHILDHOOD: EAR INFECTIONS (OTITIS MEDIA)

Ear infections (otitis media) are among the commonest of childhood illnesses, and occur most frequently in babies and young toddlers, and then peak again around the age of school entry. They are less common beyond 8 years of age. Like colds and influenza, they occur most frequently in the winter months. Although they may cause fever and pain in the short-term, they usually resolve with treatment and there are no long-term consequences.

Some children do have recurrent ear infections, for reasons that are not clear, and these may lead to ‘glue ear’ and hearing loss. ‘Glue ear’ is the term often used to describe the presence of thick, glue like secretions in the middle ear, which are sometimes the consequence of repeated ear infections. It very often affects the child’s hearing, which in turn may affect the child’s language and general development. Ear infections in young children must be treated promptly and followed up to make sure that a chronic or recurrent situation does not develop.

*218\90\8*

COMPLICATIONS OF PREGNANCY: HYPERTENSIVE DISEASE OF PREGNANCY

Cause

The cause of hypertensive disease of pregnancy is not well understood although it affects 5% of pregnant women.

Clinical features

It is usually diagnosed during the latter stages of pregnancy, and is characterised by the presence of high blood pressure together with fluid retention. If the condition is left untreated protein will appear in the urine. The danger of hypertensive disease of pregnancy is that it can lead to rapid degeneration of the placenta. As the placenta supplies all nutrients to the baby, this leads to a risk of the baby being born prematurely. If the baby is still immature it may not be able to survive outside the womb. The other risk is the progression of the condition to eclampsia, which affects the mother. Eclampsia is characterised by convulsions and in the worst case may lead to coma.

Treatment

The treatment of hypertensive disease of pregnancy is primarily bed rest. If you have markedly high blood pressure, your doctor may advise a short stay in hospital where close monitoring can continue until the condition is brought under control. Where mothers have hypertensive disease of pregnancy, labour is often induced. Those mothers who have full-blown eclampsia usually have a Caesarian section to end the pregnancy for their own and their baby’s safety.

*51\90\8*

YOUR MARITAL HEALTH/THE MOST OFTEN ASKED QUESTION: ISN’T THERE SOMETHING I CAN DO TO HOLD BACK?

    »I can’t hold back. No matter what, I come. Isn’t there something I can do to hold back until she finishes at least?»

ANSWER: Concepts such as «hold back,» «finish,» and «coming» are leftovers from old ideas about sex that emphasized the mechanical, reflex parts of sexual response. If you mean by «coming» ejaculating, then there is much you can do to ejaculate when you want to. Making sure your bladder is empty before sexual activity will help, and learning to thrust with your whole pelvis instead of squeezing the muscles of the buttocks together and tensing the area between your legs is another idea. Most important, however, are two rules of super marital sex. First, since ejaculation is the body’s reflex to arousal, your whole life-style affects that body response. If you live fast and pressured, you are setting the stage for all body processes to accelerate. Slowing down in living is as important as slowing down in loving. Second, a posture in which your most sensitive area of the penis, the F area, is contacting your partner’s most sensitive area, the Ñ area, is less likely to throw off the timing of this reflex. The posture of the future will help in this regard. And don’t forget, orgasm and psychasm are different. Focusing on coming or not coming only leads to more focus and less c. since psychasm is emotional and mental, it is impossible to think or feel too soon.

*242\97\8*

HYSTERIA – DESCRIPTION

Hysteria is a not uncommon emotional disorder, yet its true nature is often poorly understood.

It is usually thought to be only an outburst of crying or laughing, the result of sudden severe emotional shock and to be controlled by firm, forceful handling.

But hysteria is a complex emotional disorder where symptoms of illness appear and represent to the patient some advantage, even if he may not be aware of his own motives. It is more common in women.

The term «conversion hysteria» is often used. This means that painful and unacceptable happenings or ideas are repressed from conscious thought and translated or converted into physical terms which are tolerable or even prized.

It is different from malingering, where the person puts on symptoms to gain advantage but is aware all the time of his own deceit.

A malingerer may claim that part of his body has no feeling, yet, if a pin is stuck into this area, he will feel pain, although he may try not to show it.

*447/71/1*

ALTERNATIVE MEDICINE – INTRODUCTION

The Great Pyramid in Egypt is said to be more than just an elaborate tomb.

Studies reveal that the builders of the pyramid had advanced mathematical skills. Reproduction of the exact scale of measurements of the pyramid are believed to harness some electro-magnetic forces which may be beneficial for health.

Other claims that it makes your hair grow, improves the taste of food and enhances plant growth, have met with more scepticism.

No one knows how this pyramid power is supposed to work but it is said that certain electromagnetic waves are concentrated and condensed by the particular configuration of the building.

Whether you accept this as fact or just so much hocus pocus, pyramid healing, along with other forms of alternative medicine, is attracting attention.

Alternative medicine is a system of primary health care involved in diagnosis as well as treatment and in opposition to, or parallel with, orthodox Western medicine.

*191/71/1*

VIRUSES

Not really a complete cell but simple nucleic acid (DNA or RNA) encased in protein, a virus must make use of other cells to function and reproduce as a lifeform. Thus it invades cell tissue and interferes with its normal function and genetic behaviour.

Often viruses will kill the host cell and move quickly to invade others. Sometimes they do not kill the cell but live on within it, manipulating its genetic codes in order to reproduce. Such viruses are known as retroviruses and include HIV, which causes AIDS.

Other illnesses and ailments arising from viral infection include the commom cold, chicken pox, measles, warts, influenza, cold sores and genital herpes. The body reacts to their presence by producing special kinds of blood proteins called antibodies. These antibodies remain in the blood after the virus has been beaten and reinfection by the same virus is not possible. Unfortunately, many viruses quickly mutate, rendering the antibodies useless. An example of a rapidly mutating virus is influenza which a person could catch every year. Non-mutating viruses such as mumps are rarely caught twice in a lifetime.

*74\69\2*

CALCIUM AND OSTEOPOROSIS

Nowadays, with so much emphasis being put on the need to reduce the fat in our food and to increase our dietary intake of fiber and bulk-producing vegetables, care must be taken to avoid a deficiency of calcium.

Fat-containing dairy products, especially milk and ice cream, used to provide us with most of our calcium, whereas the vegetables and cereals, which we are now taking in their place, bind with calcium in the intestines and thus interfere with its absorption, Medical World News (25#12:41) reports. The net result, if we are not careful, is a calcium deficiency that leaves our bones weaker and more brittle than usual and unusually prone to be fractured, even in response to minor trauma.

While no one denies that low fat and high fiber diets benefit us by greatly reducing our liability to heart disease and stroke, we must take care to compensate for the decreased availability of calcium they bring about. We can help ourselves by taking, in addition to our one vitamin-mineral pill a day, half a gram (500 mg) tablet of calcium carbonate three times daily (or four times if one is big) as well.

It is important to note that it matters when we take these tablets. Since the calcium in pills can only be absorbed if there is a normal amount of acid in the stomach, the Journal of the American Medical Association (257:541) reports that older people, whose stomachs no longer produce much acid, cannot benefit from taking calcium between meals. Taken with food, however, calcium is absorbed, regardless of the lack of gastric acid.

Another article in the Journal of the American Medical Association (247:1106) emphasizes that taking calcium alone is not enough and, even in optimal amounts, can do nothing to prevent the bones from becoming osteoporotic in people who are inactive. Both exercise and calcium are needed to restore osteoporotic bones. Because exercise (e.g., walking two miles every day) can be difficult or impossible for those who have already become disabled by osteoporosis, prevention is truly better than cure.

Also, according to the Mayo Clinic Proceedings (61:116), it has been discovered that the density and amount of calcium in an older woman’s spinal bones correlates very closely with the strength of her back muscles. Thus, it is believed, older women may be able to protect themselves against collapse of the spinal bones by regularly performing exercises that increase the tone of the back muscles. Although it will take many years to obtain final proof that this works, it is reasonable for women to perform daily back exercises (sit-ups or with a rowing machine), so long as they do not overexert or hurt themselves.

*177\143\2*

HEADACHES IN CHILDREN

Symptoms: Pain, ache, or throbbing in any area of the head.

Home care:

Give aspirin or paracetamol to relieve pain.

Apply cold compresses to the forehead.

Have the child lie down in a dark room.

If the headache is accompanied by nasal congestion, antihistamines or nose drops may ease both conditions. Warm compresses may also help.

Try to identify any source of stress that may be causing headaches. Comfort and cuddle the child whose headache may be due to emotional factors.

See the doctor if the headaches persist.

Precautions

-    Get medical help immediately if the child has a sudden, severe headache, especially if it is accompanied by any of the following: fever, extreme weakness or collapse, severe vomiting, stiff neck, or confusion.

-    If the child has recurring headaches that become more frequent or severe, consult the doctor.

-    Your information about the child’s headaches will be important to the doctor. Note where the pain is located, when it occurs, what circumstances seem to provoke it, how long it lasts, if there are also other symptoms, and whether or not the headache responds to pain-relieving medication.

Headaches are probably as common in children as in adults and have as many or more causes. Fever and strong emotions (anxiety, fear, excitement, sadness, and worry) account for about 95 percent of all headaches in children. Less common causes of childhood headaches are high blood pressure, head injuries and concussions, tumours and inflammation of the brain (such as meningitis, encephalitis), bleeding inside the skull, sinusitis, eye strain, and psychiatric problems.

*94/84/5*

REDUCING RISKS OF ACCIDENTS: FOLLOWING SAFETY ADVICES

Drive yourself sober

If you’re thinking of driving after drinking, think first of this sobering fact: More than 40 percent of fatal crashes involve a driver or pedestrian who had been drinking. «It doesn’t make any sense to gamble and hope that you’re not the one affected. Don’t be so cocky to ignore the risks,» says Kennedy. You’re also forcing everyone who crosses your path to take the same risk. Nearly half of the people killed in crashes are innocent victims killed by drivers who had a few – or less than a few.

So try heeding the following advice from safety experts to help reduce your risk of being involved in an alcohol-related accident.

Use common sense. Some people stick to the guideline of having one drink an hour, followed by a nonalcoholic drink in the second hour, to monitor their blood alcohol level, says James Fell, chief of research and evaluation at the National Highway Traffic Safety Administration in Washington, D.C. «But we really can’t say what a safe ÂÀÑ is because everyone is affected differently, considering their age, weight, fat, food intake, and experience. The motto, plain and simple,» Fell adds, «is that if you have to drive, don’t drink. If you have to drink, don’t drive.»

Act like it’s New Year’s Eve. People have a heightened awareness of how dangerous the roads and highways are when everyone’s out ringing in the New Year, says Kennedy. «Well, any time you’re on the road late at night, especially on the weekends, you are driving among a lot of people who have been drinking,» he says.

Be aware of your surroundings. Keep yourself safe by leaving plenty of room between you and the cars around you. And by all means, don’t challenge anyone’s reaction time by making a quick turn in front of another car or cutting into traffic, Kennedy says. «Just being mindfully aware of the potential danger can keep you safer,» he advises.

A Need to Heed Speed

When engineers make roads, they take a lot of factors into consideration before telling you how fast you can go, Kennedy says. «Those numbers you see indicating the speed limit aren’t arbitrary. Road engineers consider the population of the neighborhood, the angle of the curves, the volume of traffic, and numerous other factors to figure the maximum speed you can safely travel,» he says.

The problem is that lots of folks choose to ignore the limits. Going faster than the posted speed limit contributes to more than 68 percent of fatal car crashes, according to the National Safety Council.

You don’t have to have your foot through the floorboards to get killed in a speed-related crash either. Only about 13 percent of speeding-related deaths occur on high-speed interstate highways. The rest happen as folks are flying around their familiar stomping grounds, generally after they’ve been drinking.

The take-home message here is to slow the heck down. You risk killing not just yourself but also some innocent mom, dad, or child who crosses your path, says Kennedy.

*103/36/5*

A TYPICAL STRESS PHOBIC

Steve is a typical stress phobic. He came to see me suffering from ulcerative colitis, with rectal bleeding and general abdominal discomfort. This young man, who ran a retail clothing outlet for a major manufacturer, was frustrated by company regulations. «The damn rules get in the way. I could sell more if they let me run the place my way,» he complained.

When I asked him if he had explained this to upper management, he mumbled something about their not understanding. Then he admitted he was too inhibited to «make waves.» Instead, he turned his anger and frustration inward, becoming depressed. He felt useless, nothing more than a cog in the company machinery.

Now he had no goals, nothing to look forward to. He told me that what he really wanted was to work in the company’s publicity department. He took no steps to achieve that goal, however, because he felt he wasn’t good enough to make it. That only increased his frustration and sense of worthlessness. Those unhappy thoughts were converted into chemical messages inside his head. From there, it’s a very short journey to the immune system.

An 18-year-old named Fred was another stress phobic I treated. He was in the hospital with marked anemia and weakness due to severe intestinal bleeding, diarrhea, abdominal pain and gas.

I met Fred’s father in the hospital one day. A very strong-willed man who ran a rubbish collecting company, he wanted Fred to take over the business. Fred wanted to be a poet, but couldn’t tell that to his father. Every time Fred went to work at the rubbish company, he developed increasing symptoms of bleeding. Feeling weak and lost, he unknowingly turned the feelings he couldn’t express into a painful and dangerous illness.

Feelings that had no outlet turned on Steve and Fred, making them sick. Again, it was their interpretation of the facts that mattered. A stress seeker in their shoes would have geared up his body for a fight, not retreated inward. In either case, of course, the result is disease.

Stress Phobics invite Cancer

If you talk to cancer patients, you’ll find that 70 to 75 percent of them experienced severe feelings of hopelessness, helplessness, frustration and/or inability to cope one to two years before their cancer was diagnosed. These feelings released the powerful immune-suppressing chemicals that allow cancer to flourish.

It’s well known that after the death of a spouse, the widow or widower’s immune system often weakens and falls, hitting rock bottom in about six months. Another six months pass, on the average, before the immune system returns to normal. What cripples the immune system? Not the fact that a spouse has died, but inconsolable grief, the guilt and the feelings of helplessness and hopelessness we sometimes feel in the wake of a death.

*136\80\8*

EXERCISING YOUR IMMUNE: WHY EXERCISE?

Let’s begin with the psychological benefits. My experience with patients, confirmed by other studies, is that regular exercisers tend to have a more positive outlook on life. Regular exercise improves your health, and healthy people are generally happier people. People who exercise have the great satisfaction of knowing that they’re working hard to strengthen their health; they have the discipline, energy and motivation to stick to their exercise program.

As we’ve seen, these positive feelings are mirrored by health-giving changes in body chemistry. Thus the pride, self-esteem and satisfaction that one derives from exercise goes a long way toward boosting one’s «doctor within.»

«I go out there and walk 30 minutes every day!» a patient will proudly announce.» Or, «For the first time since I was a kid, I can easily touch my toes!» Some tell me that they can finally see their toes again now that they’ve lost a lot of weight. I’ve seen many poor self-images go way up as people prove to themselves that they can accomplish something worthwhile. This is especially true for the unhappy and depressed among us.

Unfortunately, millions of Americans are unhappy, with symptoms ranging from a simple indifference to enjoyment all the way to full-blown depression. Many studies have shown that one of the best, and simplest, treatments for depression is regular exercise.

*92\80\8*

SUPER FOODS FOR IMMUNE

FRUITS

Apples Figs *Peaches

Apricots Grapes Pears

Bananas Guavas Persimmons

Berries Mangoes Pineapples

*Cantaloupes Melons Plums

Cherries Oranges Pomegranates

Citrus Fruits *Papayas Tomatoes

• Fruits are low in fat and sodium and contain no cholesterol. Fruits provide vitamins, minerals and sweetness.

• Uncooked, unprocessed, fresh fruit should be your first choice, rather than canned, cooked or frozen.

WHOLE GRAINS

*Barley *Millet *Whole-Grain Rye

*Brown Rice *Oat Bran *Whole-Grain Wheat

*Buckwheat *Whole-Grain Oats *Wild Rice

• Whole grains are low in fat, sugar and sodium, and contain no cholesterol. Whole grains give you complex carbohydrates, fiber, B vitamins, minerals and low-fat protein.

• Make sure to eat unprocessed whole grains rather than processed grains such as white rice and white bread.

• Oat bran is not a whole grain. I’ve listed it with the whole grains because of its cholesterol-lowering effects, plus its high fiber content.

*Black Beans * English Peas *Garbanzo Beans

(Chick Peas) *Green Beans

LEGUMES

*Kidney Beans *Lentils *Lima Beans *Navy Beans *Peas

*Pinto Beans *Red Beans *Snow Peas *White Beans

• Legumes are low in fat, sugar and sodium, and contain no cholesterol. Legumes provide you complex carbohydrates, fiber, low-fat protein, vitamin B1( vitamin B6, calcium, iron, plus other vitamins and minerals.

Abalone Brook Trout Cod

Flounder Haddock

*51\80\8*

THE IMMUNE SYSTEM: YOUR BUILT-IN DEPARTMENT OF DEFENSE

The immune system is one of the major components of your «doctor within.» To be immune is to be protected, to have resistance, to be exempt. That’s what your immune system is designed to do—protect you and give you resistance against disease. Your immune system is responsible for fighting off bacteria, viruses, fungi, cancer cells and other antigens (anything that challenges the immune system). It’s genetically programmed to swing into action as soon as disease rears its ugly head.

Germs are all around us, on us and in us. They’re on our clothes, in our food, in the air we breathe. If all it took to make us sick was for a germ to land on us, we’d all have died years ago. But we live, we thrive, because that part of our «doctor within» called the immune system maintains a constant vigil inside our body, always ready to destroy diseases before they harm us.

There are many parts to your immune system. You may have heard these names: T-cells, B-cells, phagocytes, complements, interferon, antibodies, interleukin. These are just some of the «immune warriors» your «doctor within» uses to fight disease. You can spend years studying the many fascinating details of the immune system, and I’ll tell you more about it in Part Three (page 215). But for now, the important thing to remember is that there is a powerful disease-fighting system within your body.

Many years ago, as a resident in Internal Medicine at Los Angeles County Hospital, I was in charge of the adult infectious-disease ward. For 10 to 15 hours a day, I was exposed to just about every infectious illness you can imagine. These patients had tuberculosis, meningitis, the very deadly septicemia and other dangerous diseases. They coughed and sneezed on me; I got their blood, sweat and even feces on my hands. But I didn’t «catch» any of their diseases. My «doctor within» kept me in perfect health.

Some time later, I was rotated out of the infectious-disease ward and into surgery. Months later I came down with meningitis, a potentially deadly infection of the covering of the brain. Why? None of the people I was treating had meningitis. I wasn’t near anyone with meningitis who could have «given» me the disease. What happened was that I was working double shifts, going to every class and lecture offered and moonlighting besides. In other words, I ran my immune system into the ground. Without immune-system protection I was «easy pickings» for any disease. If not meningitis, I would have «caught» something else.

*7\80\8*

PREMATURE EJACULATION: HOW TO END IT

According to many leading sex therapists, premature ejaculation is the most common sexual difficulty in men. It is not, however, an insurmountable problem. There are several proven techniques that are helpful in correcting and preventing the problem of premature ejaculation.

Perhaps the most common technique taught by sex therapists is the «squeeze technique». This technique involves squeezing the tip or base of the penis for a few seconds just prior to ejaculation. The squeeze technique can be applied by you or your partner whenever you want to delay ejaculation.

A second technique often recommended by sex therapists, requires that both partners stop thrusting just before ejaculation. Once the man regains control of the ejaculatory reflex, sexual activity resumes.

A third technique recommended by sex therapists is deep breathing. This technique is based on the theory that deliberate deep breathing helps to delay ejaculation by «diffusing» feelings of arousal throughout the entire body.

*192\27\8*

THE POPULAR HOUSEHOLD SPRAY YOU SHOULD NEVER USE IN YOUR HOME

Some common antistatic sprays you may use on your clothes so they won’t cling to you often contain/ammonium chloride, plus a fragrance, and potentially harmful propellants. Such sprays can irritate your skin and eyes. If you inhale the fine mist from the spray, it may also cause irritation to your respiratory tract. If overheated or punctured, the spray can may explode, and the propellant gases in the spray may be flammable.

You may be able to avoid such products by using a fabric softener in your wash. Not only is fabric softener safer, it may also be a good bit cheaper per application. If you continue to use a spray, read the label carefully, and take every precaution to ensure safe use.

Household insecticide sprays all contain specific insect poisons. It makes sense that something which is fatal to an insect also has the potential of having harmful effects on humans. The seriousness of the effect depends on the particular poison being used. Some insecticides contain arsenates which are compounds containing arsenic. If swallowed, these mixtures can be fatal. Aliphatic thiocynates (such as Lethane 384) are chemicals which release cyanide when swallowed or inhaled.

There are a whole host of other toxic chemicals in various insecticides which all pose a potential danger to humans if improperly handled. Some studies have even linked some of the chemicals used to cancer if excessive exposure is involved.

One alternative to the potentially dangerous insecticides is silica gel which is virtually nontoxic to humans. If you use insect sprays, be sure you wear a mask to cover your mouth and nose. Also cover your skin and protect your eyes by wearing goggles. Spray only in well-ventilated areas. Perhaps the safest way to get rid of insects is to hire a professional pest control.

*153\27\8*

STRESS, ANGER AND HEART ATTACKS

Two recent scientific studies have uncovered evidence showing how stress and anger may cause heart attacks.

In one study, at Brigham and Women’s Hospital and Harvard Medical School in Boston, 26 people with coronary artery disease were asked to perform certain «stress tasks», such as counting backwards by sevens while under the pressure of being timed. As the subjects counted, researchers monitored their coronary arteries.

The researchers focused on two randomly chosen artery segments for the participants. The segments were classified as «healthy», «mildly diseased» and «severely blocked». The results of the test showed that stress had no harmful effect on the healthy segments, but that it further constricted segments already constricted by coronary heart disease— almost 9 percent more constricted for segments which were mildly diseased and 24 percent for those that were severely blocked. And while blood flow in healthy arteries increased by about 10 percent, it decreased 27 percent in those that were diseased.

In another study, conducted at the Veterans Affairs Medical Center in Palo Alto, California, researchers studied the responses of 27 men in relation to anger and possible heart attacks. The subjects included 18 men with mild heart disease and 9 healthy men. All of the men were asked to talk about a recent event that had made them very angry. Researchers measured changes in the left ventricles of each subject.

Describing the disturbing incident had no ill effect on healthy ventricles, but in men with heart disease it reduced the pumping efficiency by up to 4 percent. The small reduction, although significant, caused no chest pain or other warning sign.

Researchers speculate that in the «real world» more intense, spontaneous anger may have a far more damaging effect on the heart’s pumping capabilities. These experts think that anger may send diseased coronary arteries into spasm, thereby cutting off necessary oxygen to the left ventricle. When that happens the risk of a serious heart attack is likely to increase.

*113\27\8*

HOW TO AVOID SWEETS IN FOOD

Excessive sugar intake is a problem for many people who are trying to control their weight. While an occasional «sweet binge» will not disrupt a serious weight management program, a regular high intake of sweets can be self- defeating. Here are several ways to cut down on, or avoid altogether, sweets in foods:

1) If you must have dessert, develop the habit of serving fruit. Fresh fruit is best, but if you must rely on canned and/or frozen fruit, purchase brands that are packaged in water rather than sweetened syrup.

2) Always read food labels to get an idea of the sugar content. One good clue as to sugar content is if the words sugar, sucrose, glucose, maltose, dextrose, lactose, fructose, or syrup appears first on the label, then the product most likely contains more sugar than any other ingredients.

3) Choose plain, unsweetened cereals and add sliced fruit or raisins instead of sugar. While raisins contain some sugar, they also supply vitamins, minerals and fiber.

4) Make your own cookies, pies or cakes and cut the sugar in the recipe by a third or even as much as a half.

*72\27\8*

LABELING RULES

Until now, high-fat foods seldom carried nutrition information, and labels that did include such information based it on varied serving sizes, and words used to describe food had no uniform meaning. The new labeling requirements will not only supply the federally imposed definitions for such terms, they will also require that servings sizes be uniform.

Raw meat and poultry are not included in the new labeling rules but products containing meat and processed meat, such as bologna, are covered by the new guidelines. The labeling rules will also not apply to restaurant menus, but any restaurant posting a sign advertising a «low-fat» food must be sure the food complies with the federal government’s definition.

According to nutrition experts, the point of the new labeling rules is to enable consumers to have better control of their diets. Such control would be protection against chronic diseases such as heart disease and some cancers.

While food companies are not required to have the new labels on their products until May 1994, many are expected to begin placing the new labels on their foods by the spring of 1993.

*33\27\8*