Abdominoperineal Excision: Evolution of a Centenary Operation

During the last century, great improvements have been made in rectal cancer management regarding preoperative staging, pathologic assessment, surgical technique, and multimodal therapies. Surgically, there was a move from a strategy characterized by simple perineal excision to complex procedures performed by means of a laparoscopic approach, and more recently with the aid of robotic systems. Perhaps the most important advance is that rectal cancer is no longer a fatal disease as it was at the beginning of the 20th century. This achievement is definitely due in part to Ernest Mile's contribution regarding lymphatic spread of tumor cells, which helped clarify the natural history of the disease and the proper treatment alternatives. He advocated a combined approach with the rationale to clear "the zone of upward spread." The aim of the present paper is to present a brief review concerning the evolution of rectal cancer surgery, focusing attention on Miles' abdominoperineal excision of the rectum (APR) and its controversies and refinements over time. Although APR has currently been restricted to a small proportion of patients with low rectal cancer, recent propositions to excise the rectum performing a wider perineal and a proper pelvic floor resection have renewed interest on this procedure, confirming that Ernest Miles' original ideas still influence rectal cancer management after more than 100 years.

The Arctic prairies; a canoe-journey of 2,000 miles in search of the caribou; being the account of a voyage to the region north of Aylmer Lake,

Mode of access: Internet.

Stump puller in action four miles west of Gladwin, Michigan, September, 1914

description accompanying photograph: photos of stump puller made September 1914. Location: some four miles west of Gladwin, Mich. Undersigned was a member of this stumping crew at that time. signed: C. Ernest Robison 402 N. Broadway Spencerville, Ohio 45887

The arctic prairies; a canoe-journey of 2,000 miles in search of the caribou; being the account of a voyage to the region north of Aylmer lake,

"Copyright, 1911 ... New uniform edition ... 1917 ... Republication October 30, 1943."

Annual miles drive used car prices

This paper investigates whether the net benefits from owning a vehicle, proxied by annual miles driven, explain the price declines observed over a vehicle's life. We first model the household decision on how much to drive each of its vehicles. Then we empirically establish that variation in household annual miles across brands explains observed price declines. Furthermore, the effect of vehicle age on annual miles decisions (and consequently on market value) depends on household characteristics and the composition of the vehicle stock owned.

Three sides to every story; Ernesto Love + Eve Roleston + Ernest Olove = 3SUM/3DUM

This was another in the project of using my three pseudonyms to investigate the strategic potential of the fictocritical as an approach to making visual art. It was large scale single artwork that took place over 21 days and combined 2D, 3D, Time-based elements and performance in an attempt to construct a Gesamtkunstwerk. Over the course of the exhibition I critically and creatively engaged with political, social, economic and cultural issues thorugh opening up a range of rhetorical modes such as the lyrical, the elegiac, the rhapsodic, the humorous, the parodic and the satirical.

Ilse Goldschmidt nee Molling with her sons Ernest and Frank Goldschhmidt on her 80th birthday; Laguna Hills, California.

Left to Right: Ernest Goldschmidt, Ilse Goldschmidt born Molling, and Frank Goldschmidt. The picture was taken on the occasion of Ilse's 80th birthday party 22 Dec 1989 Laguna Hills, CA.

Ilse Goldschmidt nee Molling with her sons Ernest and Frank Goldschhmidt on her 80th birthday; Laguna Hills, California.

Left to Right: Ernest Goldschmidt, Ilse Goldschmidt born Molling, and Frank Goldschmidt. The picture was taken on the occasion of Ilse's 80th birthday party 22 Dec 1989 Laguna Hills, CA.

Ernest Krakauer outdoors.

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Portrait of Ernest Krakauer.

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Ernest Krakauer (left) with an unidentified man in front of a 1934 Plymouth; Germany.

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Ernest Krakauer outdoors; Germany.

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Ernest Krakauer with Claire "Mausi" Marum Krakauer; Andover, Massachusetts.

Ernest Krakauer is wearing a uniform; the picture is taken in front of a house.

Ilse Goldschmidt nee Molling with her sons Ernest and Frank Goldschhmidt on her 80th birthday; Laguna Hills, California.

Left to Right: Ernest Goldschmidt, Ilse Goldschmidt born Molling, and Frank Goldschmidt. The picture was taken on the occasion of Ilse's 80th birthday party 22 Dec 1989 Laguna Hills, CA.

Ilse Goldschmidt nee Molling with her sons Ernest and Frank Goldschhmidt on her 80th birthday; Laguna Hills, California.

Left to Right: Ernest Goldschmidt, Ilse Goldschmidt born Molling, and Frank Goldschmidt. The picture was taken on the occasion of Ilse's 80th birthday party 22 Dec 1989 Laguna Hills, CA.