da Vinci Surgeons in Denver, CO

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stevef999
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Date Joined Feb 2007
Total Posts : 11
   Posted 2/5/2007 8:48 PM (GMT -7)   
Can anyone give me references/experiences with da Vinci surgery in the Denver, CO area?  Have talked to Dr. Stephen Ruyle.  Seems good.  Thanks in advance.

bluebird
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Date Joined May 2006
Total Posts : 2542
   Posted 2/6/2007 11:52 AM (GMT -7)   

Stevef999 &  Family,

  

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mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

June 29th ~ PSA Less than 0.1 Non-detectable


bluebird
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Date Joined May 2006
Total Posts : 2542
   Posted 2/6/2007 11:56 AM (GMT -7)   

Hi Stevef999,

Can’t help on the reference/experience with Denver… but we are sure glad you found us. yeah

We have family living in Evergreen and IzzyBlizzy *Tanya & Ken/members are in Genessee.

 

So ~ Welcome to your new forum family!!

 

Let us know if you need anything else…. Because we are “all” here with Helping Hands.  You just have to reach out and we are there!!

 

Keeping you close in thoughts and prayers…

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

June 29th ~ PSA Less than 0.1 Non-detectable

Post Edited (bluebird) : 2/7/2007 1:26:16 PM (GMT-7)


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 2/6/2007 10:59 PM (GMT -7)   
Hi steve,
 
Nice to see someone from around here!  We are up in Genessee CO, and having the davinci with Dr. Stephen Ruyle on April 03, 2007. 
 
Would love to stay in touch!  and if you don't mind where are you at in the process?
 
Tanya and Ken
 
 
 
 
 
 


Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment: DaVinci.  Sheduled April 3, 2007


stevef999
New Member


Date Joined Feb 2007
Total Posts : 11
   Posted 2/7/2007 7:40 PM (GMT -7)   

Hi Tanya and Ken,

I was set to use Ruyle until yesterday.  Went to Dr. David Schreiber to discuss radiation options.  Since I have cancerous cells in both lobes, he told me that I had a 50% chance of impotence with RP - either traditional or daVinci - because they cannot take any chances by taking less tissue on one side.  I am Gleason 3 + 3 with a PSA of 5.1 and T1c.  Cancerous cells in one of 13 biopsy samples on one side (< 5%) and one of 10 cores on the other side (<5%).  I am now seriously considering seeds as the probablility of cure is the same and the probability of negative side effects is probably much less.  Because mine is early stage I will not have to take hormones or EBT.  Schreiber says he does 400 a year in his clinic and is one of the top 5 Brachytherapists in the country.  As well, this is outpatient surgery with almost no down time.  I am still researching side effects of seeds.   Some of the posts on this site and others report more side effects than the Doc told me.  He dispelled most of the myths that others report as negatives of radiation.  If my chances of impotence are much lower, I see no reason to have surgery.  The other myth that you can't have the other options - RP, EBT, etc. - after seeds are wrong per Schreiber.  He uses new palladium seeds that are easier on the body than the old iodine seeds.  Best of all is that I will be able to get it done in about two weeks from the time I schedule.  Best of luck in your approach.  Thanks for writing.  Thoughts?

Steve


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/7/2007 8:22 PM (GMT -7)   
Steve, I responded to your question on your radiation thread, however forgot to mention that my husbands is also on both sides. Dr's here have not mentioned chances of ED dropping to 50%. He is a t2c with 20% on both sides, geason 3+3=6 and psa of 4.1. (11 samples on 1 side and 10 on the other.) Both docs still believe good chance of recovery........
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


stevef999
New Member


Date Joined Feb 2007
Total Posts : 11
   Posted 2/7/2007 8:30 PM (GMT -7)   
Thanks again.  He said that they have to be sure not to leave any cancer so they get really close to the nerves on both sides.  Can't avoid shocking/damaging them.  Don't know if he is hyping his procedure or if thais is a realistic issue.  I am still in the scheduling process for daVinci, so will ask my daVinci doc why he did not mention that.  Take care.  Steve

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 2/7/2007 10:12 PM (GMT -7)   
Steve,

You have to go with what makes you comfortable among the different treatment possibilities available to you. If seeds is what your choice turns out to be and you are comfortable with that decision, it's the right decision for you. My very best wishes with what ever you choose.

The Doc gave you a realistic 50/50 chance of ED with surgery. No matter how skilled the surgeon there is not a way to prevent some amount of damage although a highly skilled surgeon can limit it. Better and better results are becoming reality as you can see from just reading the stories of others...albiet YMMV. So much is up to anatomy, preoperative function, tumor extent and comorbid conditions (diabetes, HTN and so on). Nothing is a guarentee.

I don't see your stats as being an unusually high risk for ED compared to the average man unless the location is what he's referring to. Probably 80% of prostate cancers are bilateral. location of the tumor could be a reason. Something like 80-85% of tumors arise at the apex which is close to where the nerves course so yeah, it takes a very skilled hand to seperate the prostate away while removing enough tissue to get those good clear margins a surgeon always strives for. Picture peeling wet tissue off an orange without tearing it and you have a picture of what it's like to seperate all the tiny nerve branches away from the prostate. Picture the apex as a ragged sort of valentine. You know it's a heart by the shape but the bottom is a little ragged looking. It would take a good eye and a lot of skill to leave behind good tissue while removing the organ. Something is going to get at least bruised along the way.

Paul had 1 positive core and 3 suspicious cores among the biopsy cores taken. 3 were on left side and 1 on the right. 2 were at the apex. Oddly, it was the right side that stuck a little, not the left and intraoperative biopsies of the apex cleared the way for the Doc to spare the nerves.
It's taken a while but his function has returned to a level that has him feeling like he's in a good place now. The was no urinary incontinence at all. Bottom line...he made the right decision for him.

swim

stevef999
New Member


Date Joined Feb 2007
Total Posts : 11
   Posted 2/7/2007 11:26 PM (GMT -7)   
Thanks Swim for sharing your knowledge.  My biopsy results sheet does not say where in the gland the cancer was found.  Maybe I don't know how to read it??  I'm feeling good with my thought process at this point.  Hope I get more great input like yours.  Best of luck in the future. Steve

_____________________________
Age 58
Diagnosed 1-9-07
Gleason 6 (3 + 3)
Both lobes  - 2 of 23 ccores (<5% each)
PSA 5.1
T1c - Negative DRE
Considering Brachytherapy vs daVinci


kziz
Regular Member


Date Joined Feb 2007
Total Posts : 242
   Posted 2/8/2007 7:05 PM (GMT -7)   
Steve, Have you thought about talking to someone like an onocologist? We talked to my dad's old doc today. He gave us very good advice today regarding radiation vs. surgery. I trust this doc with all I have. He gave my dad more years to live than anyone one, including docs at MD Anderson thought remotely possible. He told us that if it were him, he would opt for the da Vinci with a good surgeon, like, Dr. F.a.g.i.n (word police will omit his name) in Austin. He said that he has done the most in this part of the country. He did say that if we wanted seeds, find the MOST qualified doc for the procedure, however if we wanted to go radiation, Proton therapy at Loma Linda was the only way to go.... Hope this helps. Courtney
Kurt & Courtney
47 year old
Great Health prior to dx
Dx on 1/29/07
PSA 4.1
Gleason 3+3=6, both lobes
Stage T2c, I believe
Tumor involves 20% of cores, both lobes
Looking for Surgeon with lots of da Vinci experience
Live in OK, willing to travel


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 2/8/2007 9:17 PM (GMT -7)   
Hi Steve,

Not familiar with Dr. Shreiber. We had a consult regarding various radiation treatments with Dr. Westmacott. He is a double-certified urology surgeon and radiologist (at TUCC, same place as Dr. Ruyle since they have all joined up there). He seemed to point us towards surgery too, in our situtation.

Although your situation is definitely different with it on both sides. Since ours is only on one side, although up by the apex, so near the right nerve. Dr. Ruyle seemed more positive than our primary urologist (Dr. Lawrence Karsh ... who does open surgeries), about sparing the nerve, although with no promises, of course.

Best wishes with your decision and keep in touch!
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment: DaVinci.  Sheduled April 3, 2007


MichaelM
New Member


Date Joined Jul 2006
Total Posts : 15
   Posted 2/9/2007 9:44 AM (GMT -7)   

Steve,

Michael here from Boulder. I had Davinci surgery with Dr's Ruyle and Montoya. They perform Davinci's as a team and when I had mine done last June, they had performed 240(I am sure alot more by now). They are the most experienced Davinci surgeons in Colorado and I highly recommend them. If you have any more questions about them, or anything else, let me know. I will be glad to share anything about my experiences with you.

 


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 2/9/2007 12:24 PM (GMT -7)   
Hi Michael,

Tanya (and Ken) here from Denver area. We have ours scheduled with Ruyle on April 3, 2007.

Just curious as to your stats going in (PSA, biopsy results, age etc). And what results did you have re: incontinence, ED, etc. afterwards. Were both nerves spared? How long did the surgery take for you and did you get out the next day, as expected? Any complications with recovery or anything?

Thanks for any input you can offer,

Tanya
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment: DaVinci.  Sheduled April 3, 2007


MichaelM
New Member


Date Joined Jul 2006
Total Posts : 15
   Posted 2/9/2007 2:06 PM (GMT -7)   

Tanya and Ken,

I just included my stats in my signature profile. Hopefully, it will attach.

Incontinence: My catheter was removed 8 days post surgical. I never leaked at night in bed but leaked a lot during the day for 30 days. Leakage diminished and I stopped wearing pads at 90 days. I still had some stress incontinence and wore light pads occasionally for another 30 days. I did begin to see a physical therapist at 90 days who I believed helped me to strengthen my pelvic floor muscles and improve my general continence. I saw her for eight sessions. 

ED: Ruyle/Montoya were aggressive with my ED therapy. I immediately started 25mg Viagra daily after catheter removal. I also injected myself twice a week with Trimix. Now at a little over 6 months, I still have a lot of recovering to do, but can get an erection using Viagra that is enough for penetration. This has been the case since about 6 weeks post surgical when my wife and I first had sex. Both of my nerves were spared. The docs are confident that ED will continue to improve. At my 6 month visit, Montoya told me that statistics are revealing that robotic patients could see improvement through 1 1/2 to 2 years post surgery; the nerves contiue to heal and regenerate. So, I am hopeful for further recovery.

Surgery: The surgery lasted I believe 3 hours(not sure)and I went home the next day, no complications. Surgery was at Pres/St. Lukes. I didn't have a great hospital experience; inattentive and not very compassionate nurses. Stay with Ken as much as you can if you can. My wife left in the evening assuming I would be well taken care of and I wasn't, my experience. There was one complication at my 30 day visit. The incision above my belly button opened up when the sutures were removed. It was partially healed but left a gapping hole that required frequent attention until it granulated in and healed, an inconvenience but not a big deal in the scheme of what I went through. 

Anything else, just ask, I'll be glad to share.

This is a wonderful forum. I continue to learn from others experiences. Thank you.


57 years old
Dx on 4/1/06
PSA 5.3
12 cores taken, 2% of 2 cores positive for adenocarcinoma
Gleason 2+3=5, right lobe, 2+2=4 left lobe
Stage T1c
DaVinci surgery on 6/27/06
Post-surgical Gleason 3+3=6
40% of right lobe and 50% of left involved in Gleason 6 tumor
Tumor close to margin in the left lobe.
30 day psa 0.1, 45 day psa <0.1, 90 day psa <0.1, 6 mo. psa<0.1


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 2/9/2007 3:38 PM (GMT -7)   
Hi Michael,

Thank you so much for your response, and all the information.

Good to know about Presbyterian/St. Lukes. I have checked out their website and they don't seem very patient friendly even from their website, e.g. no visiting hours posted, visitor info, etc. How long are their visiting hours. Do you know if you can stay overnight in the room with a patient? I need to check up on these things before surgery.

Did you have any problems with Dr. Ruyle's scheduling staff? We just got pushed out again this afternoon and are frustrated. It is a long story, but it seems like our surgery keeps going back and back. And that various people in his staff aren't communicating well. I don't know if this is the new move to the The Urology Center of Colorado, or what. I am starting another thread on the whole story, just because Ken is furious after he made a phone call this afternoon and is about to say "screw-it" going to find somewhere else.

I am sure I will have more questions later! Again thanks for your experiences.

Tanya
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment: DaVinci.  Sheduled April 3, 2007


MichaelM
New Member


Date Joined Jul 2006
Total Posts : 15
   Posted 2/10/2007 9:15 AM (GMT -7)   

Tanya,

I read your new post/thread and am sorry to hear of your difficulties.

I did not have problems scheduling and was not re-scheduled. I did have to wait 8-10 weeks for my surgery and that was hard enough. I did have good access post surgically to my Dr and staff for questions. I was frustrared several times by lack of follow up by the office staff, but I was very presistent when I needed to be in getting what I needed. I have had several of my post op visits rescheduled by phone calls before my visit. I attributed that to the Dr's changing schedule due to more urgent demands. My pre-operative appointment with the dr that scheduled by the surgical scheduler, never made it to the dr's schedule and our appearence was a surprise to the dr, good thing he was there. Overall, I would give the practice a C- in their quality of operations based on their operations last spring. THey may have deteriorated from there with the move. I do belive though, that the new practice and facility will evolve to be the premier urolical center in this region.

I do not have answers regarding Pres/St Lukes. You will have to look into that.

Before choosing Ruyle/Montoya, I looked into ***elson/Eisner. At the time of my surgery they had done less than half of the number of DaVincis and that drove me to Ruyle/Montoya. In the end, the experience of the surgeons was paramount to me.

If you guys are interested, you are welcome to call me or we can meet in Denver for coffee and you can pick my brain on more details. Or, just ask and I will post.

Michael


57 years old
Dx on 4/1/06
PSA 5.3
12 cores taken, 2% of 2 cores positive for adenocarcinoma
Gleason 2+3=5, right lobe, 2+2=4 left lobe
Stage T1c
DaVinci surgery on 6/27/06
Post-surgical Gleason 3+3=6
40% of right lobe and 50% of left involved in Gleason 6 tumor
Tumor close to margin in the left lobe.
30 day psa 0.1, 45 day psa <0.1, 90 day psa <0.1, 6 mo. psa<0.1


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 2/10/2007 1:52 PM (GMT -7)   
Thanks Michael,

We are confident in Dr. Ruyle from the recommendations we have had, and our meetings, and he clearly is the most experienced around here. So we are probably going to stick with it, despite our extreme frustration yesterday. Guess we will just have to stay on top and keep calling to confirm appointments, etc. and make sure that everything is down on the calendar, every step of the way.

Ken has asked Dr. Ruyle to call him on Monday, just to discuss these issues.

Have you been to the new urology center for any appointments yet? It is a beautiful facility.
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment: DaVinci.  Sheduled April 3, 2007


MichaelM
New Member


Date Joined Jul 2006
Total Posts : 15
   Posted 2/10/2007 2:10 PM (GMT -7)   
I was there for my 6 month exam in January. It is a very impressive facility with alot of resources under one roof.
I believe that the move there has caused a lot of problems. After they get settled, I believe that it will be a very good facility.
57 years old
Dx on 4/1/06
PSA 5.3
12 cores taken, 2% of 2 cores positive for adenocarcinoma
Gleason 2+3=5, right lobe, 2+2=4 left lobe
Stage T1c
DaVinci surgery on 6/27/06
Post-surgical Gleason 3+3=6
40% of right lobe and 50% of left involved in Gleason 6 tumor
Tumor close to margin in the left lobe.
30 day psa 0.1, 45 day psa <0.1, 90 day psa <0.1, 6 mo. psa<0.1


Izzyblizzy
Regular Member


Date Joined Oct 2006
Total Posts : 411
   Posted 2/10/2007 2:21 PM (GMT -7)   
Yeah, i think they are going through some "growing pains" throughout the facility. Just unlucky to be right in the middle of them. Guess you can't choose when you get prostate cancer :)

BTW,

Ken said he would be interested in talking on phone or perhaps meeting for a cup of coffee, he goes up to Boulder on business occasionally, so that might work out too.

Anyway, his email is KcKucera@earthlink.net

Drop him an e-mail if you are interested, and he can give you a call or whatever works out.
Signficant Other diagnosed: 10/30/06 (age 63)
PSA: 3.7 (up from 3.4 prior year)
Gleason: 3+3
Biopsy: 1/10 positive, 5% cancerous, right apex.
Treatment: DaVinci.  Sheduled April 3, 2007


Shamrock Leary
New Member


Date Joined Feb 2007
Total Posts : 1
   Posted 2/13/2007 4:22 AM (GMT -7)   
Is there an expert scientist who would comment on the path, which the palladium seed implant (brachytherapy) physician's instrument passes from the skin as it travels toward the desired destination? Which anatomical structures may be severed as the seed holder passes to its' intended target?

Post Edited (Shamrock Leary) : 2/14/2007 7:21:25 AM (GMT-7)


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 2/13/2007 9:11 PM (GMT -7)   

 

 

Hey Dave

I am four weeks past surgery today.  My urologist sent me to a physical therapist to help train the proper muscles and control incontinence.  It was very helpful.  I had my catheter out after 8 days and went to PT the next day.  I wore pads for 5 days.  I still leak lightly  at times and often have the feeling that I need to go, but I can control myself fine.  today I sat in the car for three hours feeling I had to go, but had no trouble holding it in.

The exercise is the key.  My Physical therapist suggests that you palpate the spot (just past the scrotum) to feel where you need to clinch your muscle.  (palpate is just a fancy word for apply a little pressure with your finger).

Good luck...


 
Da Vinci surgery 1/16/07
 
History
11/05 psa 2.9
6/06   psa 5.8
7/06   psa 6.7
 
biopsy 10/16/06
gleason 4+4=8
grade T2A
 
scans and post op confirm biopsy results
 
scans and post op pathology show clear for spread
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/15/2007 1:25 PM (GMT -7)   

Re: Posting above…     Hi ~ Shamrock Leary,

Look for  JustJulie's Brachytherapy Journey in the Helpful Hint's Page... Links are listed on 2nd posting...

Please consider starting your own personal thread with statistics... so we can all welcome you to the forum.  It's truly a great place to be... Helping Hands ~ Helping Each Other...

J Lee & Buddy

 

(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there)

Helpful Hints for New Members... Hope this helps you! :) Updated 02-05-2007


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/15/2007 1:31 PM (GMT -7)   

Hi Steve, 

 

                 Just touching base to see how you’re doing….   :-)  

                                         Let us know ~ okay!!!

 

 

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


stevef999
New Member


Date Joined Feb 2007
Total Posts : 11
   Posted 2/15/2007 3:54 PM (GMT -7)   

Hi Bluebird, I have ruled surgery out in favor of seeds.  Mine should be just about as easy as it gets as I do not have to have hormone therapy or EBR.  I just go in for the seeds and then wait on my next PSA.  Seems like a no-brainer to me.  Am in the process of scheduling.  Thanks for checking.  You do a great job.  What a service to the readers on this forum!!  Thanks for your work.

Steve


 
Diagnosed 1-9-07 at Age 58
Gleason 6 (3 + 3)
Both lobes  - 2 of 23 cores (<5% each)
PSA 5.1
T1c - Negative DRE
Considering Brachytherapy vs daVinci
 


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/16/2007 1:58 PM (GMT -7)   

Hi Steve,

 

Thank you ~ for your kind words…. This forum is a part of our lives now and as long as we can touch at least “1” individual… this is part of our continued journey with having had prostate cancer.

 

We are interested in knowing ~ is it the radiated seeds that you will have implanted and then you go on your way?  This is what my former boss had.  We see him on Tuesdays and Thursdays at the Y!  I’ll ask him for a little more details if you like!  I know he’s commented several time about “fatigue”.  But he’s doing great!!!!!  Mind you he had this procedure done, then a few months later…open heart surgery, and then gall bladder surgery all within a one year period so I’m sure it all grouped together to knock him for a loop.  He’s doing much better now and “getting a little dog” pulled him out of depression!!!  His PSA numbers are staying in a nice comfortable range that they are happy with.

 

Take care and hope to hear back from you!

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

Link to our personal journey…>>>     Our Journey ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

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