THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net
S U M M A R Y
DIARY: March 26, 2009 05:33 PM Thursday;
Rod Welch
Doctor Johnson plans to discuss treatments for expanding patient profile
and diagnostic tools to evaluate response to treatment at next meeting.
1...Summary/Objective
2...Dislocated Shoulder Recovering Extensive Brusing Subsides
..............
Click here to comment!
CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 91 0000. ref SDS 89 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - The letter today follows up patient history...
040902 -
040903 - 1. Examination at Kaiser found significant
040904 - recovery with sunitinib protocol
040905 - at UCSF........................... 081219, ref SDS 38 QW5J
040907 - ..
040908 - 2. Primary care physician calls about
040909 - Millie's fall and treatment in ER for
040910 - separated shoulder, and explains rise
040911 - in Millie's cancer marker signals
040912 - severe relapse for the 6th time,
040913 - and Millie needs immediate treatment
040914 - for her cancer as chronic
040915 - disease........................... 090123, ref SDS 48 RK6O
040917 - ..
040918 - 3. Sudden reversal with severe relapse
040919 - of IBC that requires immediate
040920 - change of treatment reported
040921 - from examination at
040922 - UCSF.............................. 090130, ref SDS 51 4S8O
040924 - ..
040925 - 4. Doctor Rugo prescribes immediate
040926 - treatment at UCSF in radiation
040927 - oncology department for
040928 - 7th relapse....................... 090130, ref SDS 51 TZ6H
040930 - ..
040931 - 5. Urgent treatment was delayed a week
040932 - due to communication problems
040933 - at UCSF........................... 090130, ref SDS 51 AY8Q
040935 - ..
040936 - 6. Approval for Kaiser referral to UCSF
040937 - was delayed by documentation
040938 - errors............................ 090202, ref SDS 53 SP6H
040940 - ..
040941 - 7. Kaiser expedites referral authorization
040942 - in order for UCSF to provide urgent
040943 - treatment quickly enough for
040944 - Millie to recover................. 090202, ref SDS 52 LC7H
040946 - ..
040947 - 8. UCSF proposes 3-week delay to begin
040948 - planning Millie's treatment for
040949 - recovering from 6th relapse of
040950 - of IBC............................ 090202, ref SDS 53 SP7M
040952 - ..
040953 - 9. Doctor Rugo notifies medical team
040954 - Millie needs urgent treatment quickly
040955 - in time to be effective recovering
040956 - from 6th relapse of
040957 - IBC............................... 090202, ref SDS 54 Y15J
040959 - ..
040960 - 10. Millie's letter to UCSF implements Doctor
040961 - Johnson's requests for UCSF strategy
040962 - to treat Millie's cancer as a
040963 - chronic disease................... 090203, ref SDS 55 278T
040965 - ..
040966 - 11. Doctor Rugo's letter explains planning
040967 - to evaluate response to hyperthermia
040968 - treatment and arrange continuing
040969 - care based on another
040970 - CT scan........................... 090204, ref SDS 57 278T
040972 - ..
040973 - 12. UCSF advances Millie's care in Radiation
040974 - Oncology Department 3 weeks; scope of
040975 - radiation and hyperthermia evaluated
040976 - by Dcotor Hsu and Doctor
040977 - Chang............................. 090205. ref SDS 59 0001
040979 - ..
040980 - 13. CT and xray tests taken, and layout
040981 - of treatment fields performed to
040982 - build molds for Millie's
040983 - radiation......................... 090209. ref SDS 63 9R61
040985 - ..
040986 - 14. Examination primary care physician
040987 - at Kaiser finds severe progression
040988 - of IBC in 6th
040989 - relapse........................... 090213, ref SDS 65 4W5I
040991 - ..
040992 - 15. Millie lucky to survive stage IV cancer
040993 - for 8 years because cancer mutates to
040994 - defeat treatments; and medical maladies
040995 - increase which makes recovery
040996 - more difficult to
040997 - achieve........................... 090213, ref SDS 65 NY7L
040999 - ..
041000 - 16. Complexity of case management grows
041001 - during long term survival prevents
041002 - keeping a well ordered record
041003 - essential for effective
041004 - care.............................. 090213, ref SDS 65 9L8O
041006 - ..
041007 - 17. Emotional trauma occurs from surprise
041008 - by medical professionals that Kaiser
041009 - and UCSF have enabled long term surivial
041010 - for a disease that normally is
041011 - difficult to control.............. 090213, ref SDS 65 ML4I
041013 - ..
041014 - 18. Communication leverages synergy
041015 - for Millie's care at Kaiser and UCSF
041016 - which helps prevent problems from
041017 - "falling through the cracks; fewer
041018 - mistakes, and timely response
041019 - helps the medical team
041020 - increase longevity,
041021 - also seems very
041022 - annoying.......................... 090213, ref SDS 65 FZ4H
041024 - ..
041025 - 19. Doctor urges proactive management to
041026 - plan Millie's next treatment because
041027 - there will be less time to recover
041028 - before cancer gets out of control
041029 - for Millie's next
041030 - relapse........................... 090213, ref SDS 65 UP6L
041032 - ..
041033 - 20. Millie's efforts the past 8 years to
041034 - combine medical treatment with vigorous
041035 - exercise was supported by research
041036 - showing exercise can be a strong
041037 - component of cancer
041038 - care.............................. 090213, ref SDS 65 GC40
041040 - ..
041041 - 21. Indian fable illustrates long-term survival
041042 - getting continuous treatment for cancer
041043 - becomes increasingly difficult to perform
041044 - complex clinical, logistical, and financial
041045 - case management; study of Millie's patient
041046 - history shows level of effort to maintain
041047 - well ordered record for effective
041048 - management increases exponentially
041049 - into a crushing burden
041050 - for patients and
041051 - providers......................... 090213, ref SDS 65 IG5O
041053 - ..
041054 - 22. Graph prepared by primary care physician
041055 - shows Millie's good fortune surviving a
041056 - very aggressive cancer with relatively
041057 - high quality of life into an 8th year
041058 - of continuous treatment that normally
041059 - causes early demise due to emotional
041060 - trauma and clincial failures from
041061 - complex case management........... 090213, ref SDS 65 4W72
041063 - ..
041064 - 23. Millie felt life was slipping away in
041065 - October when the 5th relapse was diagnosed
041066 - leading Millie to ask what was going to
041067 - happen to her; Doctor Rugo provided
041068 - encouragement saying "We're not
041069 - going to let anything happen
041070 - to you"........................... 090213, ref SDS 65 F148
041072 - ..
041073 - 24. Collaboration between Kaiser and UCSF
041074 - combines experience with research;
041075 - communication optimizes Millie's care
041076 - beating the odds for long-term survival
041077 - by integrating Kaiser's team care
041078 - practice with UCSF model
041079 - of comprehensive
041080 - care.............................. 090213, ref SDS 65 685I
041082 - ..
041083 - 25. Multiple relapse of cancer causes cells
041084 - to mutate into disease that resists
041085 - treatment; Millie surviving 6 relapses
041086 - needs highly specialized care and
041087 - so should ask Doctor Rugo to begin
041088 - planning for the next relapse
041089 - to treat Millie's cancer as
041090 - a chronic disease................. 090213, ref SDS 65 R75G
041092 - ..
041093 - 26. Doctor Rugo has responded by scheduling
041094 - a meeting with Millie at UCSF on
041095 - 090312............................ 090213, ref SDS 65 6P7G
041097 - ..
041098 - 27. Doctor Johnson underscored importance
041099 - timely care for Millie by offering
041100 - religious perspective on transition
041101 - from a vigorous life that may end
041102 - for Millie in less than a
041103 - year.............................. 090213, ref SDS 65 646L
041105 - ..
041106 - 28. Hospice care helps patients and families
041107 - cope with final days of life without
041108 - suffering significant physical
041109 - and emotional pain................ 090213, ref SDS 65 VW63
041111 - ..
041112 - 29. Life ending scenarios have been presented
041113 - to Millie many times the past 5 years;
041114 - case study reflects Millie's physical
041115 - resiliance and strength of character
041116 - that enables exceptional longevity
041117 - for her aggressive
041118 - cancer............................ 090213, ref SDS 65 L19H,
041120 - ..
041121 - 30. Collaboration on case management for
041122 - long-term survivors of cancer becomes
041123 - frustrating because everybody loses
041124 - control of increasingly
041125 - complex medical
041126 - records........................... 090213, ref SDS 65 JL9L
041128 - ..
041129 - 31. Lab and CT test reports illustrate
041130 - frustration, because providers do not
041131 - have enough time to enter results
041132 - from other doctorsrs in the medical
041133 - chart, because doctors prefer to
041134 - rely on local diagnostics
041135 - rather than referral
041136 - data.............................. 090213, ref SDS 65 NY4H
041138 - ..
041139 - 32. Cancer marker CA 15-3 wide disparities
041140 - between Kaiser and UCSF illustrates
041141 - why doctor's rely on local data
041142 - rather than referral
041143 - diagnostics....................... 090213, ref SDS 65 A46O
041145 - ..
041146 - 33. Case management takes a lot of will
041147 - power for due diligence to
041148 - maintain a well ordered
041149 - record............................ 090213, ref SDS 65 J27J
041151 - ..
041152 - 34. Meeting at Kaiser changed to 4 week
041153 - interval, rather than 8, as done the
041154 - past 2 years, provides effective support
041155 - for UCSF to start next treatment in
041156 - time to avoid losing control of
041157 - Millie's cancer................... 090213, ref SDS 65 QX5O
041159 - ..
041160 - 35. Millie requests explanation of treatment
041161 - plan. Doctor Rugo's letter to Kaiser on
041162 - 090129 discussed hyperthermia with Doxil,
041163 - reported on 090130. Has the plan changed
041164 - to use "lower dose" radiation rather
041165 - than Doxil. Will both be
041166 - used, or some other
041167 - agent............................. 090218, ref SDS 66 TH5W
041169 - ..
041170 - 36. Millie reports to medical team meeting
041171 - with Doctor Johnson at Kaiser on 090213
041172 - was optimistic Millie might have 3 - 6
041173 - months of recovery, but will need
041174 - treatment from Doctor Rugo for
041175 - cancer as a "chronic
041176 - disease".......................... 090218, ref SDS 66 TH6U
041178 - ..
041179 - 37. Millie requests reponse from UCSF to the
041180 - letter on 090209 requesting explanation
041181 - of treatments for side effects from
041182 - radiation and hyperthermia described by
041183 - Doctor Hsu during the meeting on
041184 - 090205. Does the treatment
041185 - plan address side effects
041186 - prospectively..................... 090218, ref SDS 66 TH7V
041188 - ..
041189 - 38. Radiation and hyperthermia begins
041190 - at UCSF for Millie to recover from
041191 - 6th relapse of
041192 - IBC............................... 090219, ref SDS 67 E57G
041194 - ..
041195 - 39. Millie's letter to UCSF requests
041196 - explanation of radiation and hyperthermia
041197 - treatments for recovering from
041198 - IBC............................... 090220, ref SDS 68 EA4Q
041200 - ..
041201 - 40. Hyperthermia treatment planning
041202 - on 090209 report received
041203 - from UCSF......................... 090220, ref SDS 69 PR4Y
041205 - ..
041206 - 41. Hyperthermia science, theraputic
041207 - rationale and applications with
041208 - other modalities presented in
041209 - BSD professional paper received
041210 - from UCSF......................... 090220, ref SDS 69 GK6F
041212 - ..
041213 - 42. Millie's letter to UCSF requests work
041214 - plan for radiation treatments to
041215 - recover from 6th relapse of
041216 - IBC............................... 090223, ref SDS 70 3N9J
041217 - and asks for scientific paper
041218 - using radiation to treat
041219 - IBC............................... 090223, ref SDS 70 T49U
041221 - ..
041222 - 43. Radiation combined with hyperthermia
041223 - treatment plan received from
041224 - UCSF.............................. 090226, ref SDS 71 D452
041226 - ..
041227 - 44. Blood test at Kaiser for meeting
041228 - at UCSF on 090312 to evaluate
041229 - effectiveness of radiation
041230 - and hyperthermia after
041231 - 3 weeks........................... 090309, ref SDS 73 6Z4F
041233 - ..
041234 - 45. Agenda submitted to medical team to
041235 - be prepared for productive meetings
041236 - at UCSF scheduled on 090312 to evaluate
041237 - response to treatment after getting
041238 - 3 weeks of radiation and hyperthermia
041239 - to recover from 6th relapse
041240 - of IBC............................ 090310, ref SDS 74 PR4Y
041242 - ..
041243 - 46. Called Kaiser to get results of blood
041244 - test on 090309 for submission to medical
041245 - team for being prepared to meet at
041246 - UCSF on 090312; Florida says results
041247 - pending from lab; says to call back
041248 - on 090311 to get the report
041249 - for distribution.................. 090310, ref SDS 75 JH4H
041251 - ..
041252 - 47. UCSF letter from Tara proposed canceling
041253 - meeting scheduled by Doctor Rugo for
041254 - 090312 to evaluate response to
041255 - treatment, and also Millie's
041256 - concern about growing
041257 - side effects...................... 090310, ref SDS 76 PR4Y
041259 - ..
041260 - 48. Millie letter to primary care physician
041261 - at Kaiser coordinates getting report
041262 - for blood test on 090309 for
041263 - meeting at UCSF on
041264 - 090312............................ 090311, ref SDS 77 S84F
041266 - ..
041267 - 49. Blood test report for Millie's lab on
041268 - 090209 was not submitted by Kaiser to
041269 - UCSF due to telephone and fax machine
041270 - problems; UCSF relied on backup
041271 - copy hand delivered by
041272 - Millie............................ 090312, ref SDS 80 XE3K
041274 - ..
041275 - 50. Examination at UCSF Breast Care Clinic
041276 - finds signs of recovery from 6th relapse
041277 - of IBC; Millie responding well after
041278 - 3 weeks of treatment with radiation
041279 - and hyperthermia; severe side
041280 - effects observed.................. 090312, ref SDS 80 YX9F
041282 - ..
041283 - 51. Cancer marker CA 15-3 missing from
041284 - blood test for Millie's lab at Kaiser
041285 - on 090309; missing diagnostic
041286 - complicates evaluating
041287 - response to treatment............. 090312, ref SDS 80 YX5F
041289 - ..
041290 - 52. Doctor Rugo planning to implement
041291 - request by Doctor Johnson at Kaiser
041292 - for UCSF to treat Millie's cancer
041293 - as a chronic disease.............. 090312, ref SDS 80 QQ9L
041295 - ..
041296 - 53. Examination at UCSF Radiation Oncology
041297 - department concurs Millie recovering
041298 - from 6th relapse of IBC by responding
041299 - to radiation and
041300 - hyperthermia...................... 090312, ref SDS 80 F88K
041301 - discloses side effects severely
041302 - blistering skin will worsen for a
041303 - month, and then gradually
041304 - recover........................... 090312, ref SDS 80 F860
041305 - that radiation and hyperthermia
041306 - will continue to destroy cancer cells
041307 - for weeks and even months after ending
041308 - treatments on
041309 - 090317............................ 090312, ref SDS 80 VL4O
041311 - ..
041312 - 54. After meeting with UCSF at 0800, called
041313 - Kaiser at 1437; was on "hold" for 90
041314 - minutes; Cisi in the Chemotherapy
041315 - Clinic came online and advised that
041316 - CA 15-3 was not listed in Kaiser's
041317 - for Millie's lab on
041318 - 090309............................ 090312, ref SDS 81 JO8O
041320 - ..
041321 - 55. Millie's letter to medical team reports
041322 - productive meetings at UCSF on 090312
041323 - with favorable findings that Millie
041324 - is recovering from 6th
041325 - relapse of
041326 - IBC............................... 090313, ref SDS 82 Q49L
041328 - ..
041329 - 56. Millie's final treatment at UCSF with
041330 - radiation and hyperthermia to
041331 - recover from 6th relapse
041332 - IBC............................... 090317, ref SDS 84 9L7K
041334 - ..
041335 - 57. Millie received at UCSF orientation and
041336 - medications for home care to treat severe
041337 - side effects from radiation treatments
041338 - that will get worse for a few weeks
041339 - before starting to get
041340 - better............................ 090317, ref SDS 84 M442
041342 - ..
041343 - 58. Arlette checked the computer and
041344 - concluded a mistake occurred at the
041345 - lab not testing for the cancer marker
041346 - on the blood test for 090309. Arlette
041347 - entered a supplemental order for
041348 - Millie to get another blood
041349 - draw at no charge
041350 - later today....................... 090317, ref SDS 85 Y04R
041352 - ..
041353 - 59. Kaiser reported CA 15-3 251 for blood
041354 - test on 090317 that corrected problems
041355 - with lab on 090309 which omitted cancer
041356 - marker needed for the meeting at UCSF
041357 - on 090312 to evaluate response to
041358 - treatment; results today indicate
041359 - strong recovery from 6th relapse
041360 - of IBC............................ 090323, ref SDS 86 Y077
041362 - ..
041363 - 60. Millie's letter notifies medical team
041364 - radiation and hyperthermia treatments
041365 - were completed on 090317; submits agenda
041366 - for meeting today evaluating response
041367 - to treatment with, and recovery from
041368 - side effects from radiation
041369 - and hyperthermia on
041370 - referral to
041371 - UCSF.............................. 090324, ref SDS 87 PR4Y
041373 - ..
041374 - 61. Meeting at Kaiser reveiw response to
041375 - treatment at UCSF for 6th relapse of
041376 - cancer, planning arrangements
041377 - for treating next
041378 - relapse........................... 090325, ref SDS 88 E54L
041380 - ..
041381 - 62. Shoulder injury recovering on schedule
041382 - following treatment in ER on 090122,
041383 - physical therapy; increased energy
041384 - after ending chemotherapy enables
041385 - faster recovery with
041386 - exercise.......................... 090325, ref SDS 88 YU6K
041388 - ..
041389 - 63. Examination finds strong response to
041390 - treatment with radiation and hyperthermia
041391 - at UCSF ended on 090317 aligns with
041392 - significant decline in cancer
041393 - marker reversing continuous
041394 - rising tread for the
041395 - past year......................... 090325, ref SDS 88 D452
041397 - ..
041398 - 64. Disease trajectory graph shows Millie
041399 - may be nearing a point of rapid
041400 - decline with next relapse
041401 - of cancer......................... 090325, ref SDS 88 P39M
041403 - ..
041404 - 65. Hospice care can be investigate in order
041405 - to be prepared for smooth transition
041406 - as patient enters decline phase
041407 - of cancer trajectory.............. 090325, ref SDS 88 JS5I
041409 - ..
041410 - 66. Streamlined referral procedures
041411 - delivering care required in order
041412 - for the medical team to be
041413 - prepared treating cancer
041414 - as a chronic
041415 - disease........................... 090325, ref SDS 88 P43G
041417 - ..
041418 - 67. Stress increases beyond capacity to cope
041419 - managing chronic disease with procedures
041420 - designed for routine cancer care;
041421 - doctor approves Millie for
041422 - vacation to get needed
041423 - rest.............................. 090325, ref SDS 88 M35H
041425 - ..
041426 - 68. Lab mistakes and delays hamper delivering
041427 - referral care in time to be effective
041428 - treating stage IV cancer; patient facing
041429 - 7th relapse at risk; providers under
041430 - stress angry that someone is
041431 - changing doctor's orders
041432 - for patient care.................. 090325, ref SDS 88 RB3G
041434 - ..
041435 - 69. Lab mistakes and delays chronic problems
041436 - prevent treating cancer as chronic
041437 - disease on referral to UCSF
041438 - case study........................ 090325, ref SDS 88 KZ6N
041440 - ..
041441 - 70. Cancer chronic disease timely treatment
041442 - essential for Millie's 7th relapse
041443 - stage IV IBC; Kaiser has no chemotherapy
041444 - agents for Millie's narrow patient profile
041445 - triple negative; prescribes care
041446 - on referral to UCSF;
041447 - case study........................ 090325, ref SDS 88 L15M
041449 - ..
041450 - 71. Pain relief medication prescribed by
041451 - Kaiser supplements treatment at UCSF
041452 - for severe radiation side
041453 - effects........................... 090325, ref SDS 88 P39I
041455 - ..
041456 - 72. Medical tests ordered at Kaiser for
041457 - examinations at UCSF on planning
041458 - Millie's treatment for the
041459 - next relapse of
041460 - IBC............................... 090325, ref SDS 88 P36O
041462 - ..
041463 - 73. Medical tests ordered 10 days prior to
041464 - meetings at UCSF allows enough time
041465 - for correcting mistakes and expediting
041466 - delays so that data is delivered
041467 - when needed....................... 090325, ref SDS 88 LX5I
041469 - ..
041470 - 74. Patient asked to coordinate on correcting
041471 - mistakes in CT Department by consolidating
041472 - findings in a single report, rather than
041473 - publising multiple reports for
041474 - each test......................... 090325, ref SDS 88 P53O
041476 - ..
041477 - 75. Letter to Kaiser confirms understandings
041478 - from meeting on 090325 that reported a
041479 - favorable response after completeing
041480 - treatment at UCSF on 090317 with
041481 - radiation and hyperthermia
041482 - protocol.......................... 090326, ref SDS 89 5V7O
041484 - ..
041485 - 76. Kaiser plans visual examination with
041486 - CT tests to evaluate response to treatment
041487 - at UCSF with hyperthermia and
041488 - radiation......................... 090326, ref SDS 90 1V4N
041490 - ..
041491 - 77. Millie submits patient history showing
041492 - Kaiser has had problems relying on visual
041493 - examination and CT tests to assess IBC;
041494 - she submits research showing enhanced
041495 - MRI is reported to be effective
041496 - supplementing visual and
041497 - CT test modalities................ 090326, ref SDS 91 5V7O
041499 - ..
041500 - 78. Millie's letter asks about progress
041501 - reviewing research to solve problem
041502 - of diminishing treatments for
041503 - Millie's expanding patient
041504 - profile........................... 090326, ref SDS 91 QM3V
041505 -
041506 -
041507 -
041508 -
041509 -
0416 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Dislocated Shoulder Recovering Extensive Brusing Subsides
050403 -
050404 - Follow up ref SDS 91 E54L, ref SDS 89 E54L.
050405 -
050406 - Millie met with the primary care physician at Kaiser yesterday on
050407 - 090325. The doctor found response to treatment after completing
050408 - radiation and hyperthermia on referral to UCSF, ref SDS 88 W13H The
050409 - doctor further approved UCSF to begin planning for Millie's next
050410 - treatment for the 7th relapse of IBC, ref SDS 88 G946, and requested a
050411 - copy of research to solve the problem of diminishing treatments for
050412 - Millie's patient profile. ref SDS 88 GO4O
050414 - ..
050415 - Late this evening, Millie issued a letter to the medical team and
050416 - asked about using CT and/or CT/PET technology to assess where IBC
050417 - still exists for evaluating response to treatment after skin recovers
050418 - from severe radiation burn. ref SDS 89 DW6X
050420 - ..
050421 - This morning, Millie received a letter from the primary care physician
050422 - at Kaiser responding to a question about using radiology diagnostic
050423 - tools for more thorough assessment on response to treatment, and in
050424 - which the doctor indicated Kaiser would rely on visual examination of
050425 - surface skin, and CTs. ref SDS 90 1V4N
050427 - ..
050428 - Millie sent a letter to Doctor Johnson explaining patient history
050429 - shows Kaiser has difficulty relying on visual and CT tests for
050430 - evaluating recovrey from IBC, ref SDS 91 QL6X; she submitted research
050431 - showing enhanced MRI can supplement visual and CT testing to assess
050432 - response to treatment for IBC. ref SDS 91 5V7O
050434 - ..
050435 - Millie also asked if the doctor has reviewed the research on
050436 - treatments that fit her complex patient profile. ref SDS 91 QM3V
050438 - ..
050439 - Doctor Johnson responded saying...
050440 -
050441 - 1. Subject: Re: Research on Possible Follow Up Treatments
050442 - Date: Thu, 26 Mar 2009 17:18:21 -0700
050449 - ..
050450 - Responding to your letter this morning asking about progress
050451 - reviewing 20 or so treatment options, ref SDS 91 QM3V, and also
050452 - submitting research on using enhanced MRI technology to
050453 - evaluate reponse to treatment for IBC, ref SDS 91 QM3S...]
050455 - ..
050456 - We'll talk about this at you next visit.
050457 -
050470 -
050471 -
050472 -
050473 -
050474 -
050475 -
050476 -
050477 -
050478 -
050479 -
0505 -