![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 139. Go back in thread:
Posted by Phillipa on April 6, 2006, at 20:56:24
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by linkadge on April 6, 2006, at 17:37:33
Link l0 years and I'm worse than before meds. I did well on a benzo and beer nightly. Sometimes more or less but I divorced raised my three kids on my own, had my own business, went to nursing school, graduated magna cum laude and had scholarships the last year that paid my way. Worked as a nurse . Move to VABeach on my own with my kids bought my own house, boat, swimming pool. Never an ad. Hummmm Love Phillipa ps I told the neurosurgeon today when he said that percocet was addicting what about what happened with vioxx and zyprexa, and aren't ad's addictive too. There is a withdrawl. I told him I've wasted l0years of my life listening to pdocs. I said I would rather have l0 years of quality life and drink and have fun and be able to work again. Not be some zombie scared to leave my home.
Posted by Phillipa on April 6, 2006, at 21:04:40
In reply to Re: Drugs versus Psychotherapy - Backlash? » linkadge, posted by SLS on April 6, 2006, at 17:38:29
Scott what you say I believe but where do you find a good pdoc? l0minute appointments. And oh I found out none of the ones in NC at least do psychoanalycist at the same time . Meaning talk to you at least for 20minutes or so. Love Phillipa
Posted by FredPotter on April 6, 2006, at 23:31:02
In reply to Re: Drugs versus Psychotherapy - Backlash? » SLS, posted by Phillipa on April 6, 2006, at 21:04:40
Hi Phillipa I'm in NZ and I can't even get CBT unless I also have an alcohol or drug problem, which I don't. I had to give up drink as in the long term it made my anxiety and depression worse. It was the only thing that ever worked for anxiety though - in the short term Fondly Fred
Posted by Phillipa on April 7, 2006, at 0:18:59
In reply to Re: Drugs versus Psychotherapy - Backlash? » Phillipa, posted by FredPotter on April 6, 2006, at 23:31:02
Another one from so far away. your babblelight is off. Mine is one babblemail me and I'll send you my E-mail That way we can talk in private. Love Phillipa
Posted by SLS on April 7, 2006, at 7:42:21
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by linkadge on April 6, 2006, at 18:17:23
> > I went from therapist to therapist >without success until I properly identified >myself as having an affective disorder.
> But have you found the right drug either?
Yes. On several occasions. Parnate + desipramine produced a dramatic remission that lasted for 6 months before mania began to emerge. Unfortunately, my doctor at the time chose to avoid this treatment upon my relapse into depression. I have also had tricyclics bring me into a state of euthymia. Unfortunately, this response lasts for less than a week. I have had similar, although less robust responses to several SSRIs, memantine, and a few other drugs that I can't now remember. I also experience partial responses to MAOI monotherapy. Unfortunately, the Parnate + TCA combination no longer works.
> There are others who have found the right therapist after a few trials, and some who give up right away, so results vary just like with drugs.
Yes. I think this is an important point.
> >It was when one did work that I became convinced >of the biological nature of my particular case. >Actually, I was convinced prior to that because >I was an ultra-rapid cycler. Once I read "Mood >Swing" by Ronald Fieve, MD, I was able to >observe and interpret my cycling; 3 days up, 8 >days down. The switch from one state to the >other took place within the time period of 30-45 >minutes. It was quite dramatic and regular. I >learned that I could keep a social calendar >based upon the 11-day cycle.
> Not really trying to dismiss the biological nature of the illness.
I am convinced that a huge number of people who complain of depression do not have a biological illness.
> >What is fair is to be able to identify in >advance who will respond to biological >interventions and who will respond to >psychological interventions. Of course, to >combine the two offers an enhanced chance of >successful treatment and prophylaxis.
> Another thing to consider is exercise.
Been there. No dice. Not for me. Not for many others either.
> >Perhaps the reason we don't agree here is that >we see depression from the perspectives of >dissimilar illnesses. My depression is the >result of bipolar disorder. Perhaps there is a >bipolar spectrum affective disorder that is >driven by biological perterbations, one that is >most treatable using biological interventions; >depressions that do not belong to this spectrum >are treatable using psychotherapy. The problem >would then lie in the inability to tell the >difference. I think a good psychiatrist can, >though.
> I see what you are saying. But I think that it is not really fair to restrict certain diseases to certain treatments.I don't think that is what I wrote. What do you mean?
> Thats not to say that the disease isn't biological, it just says that biology can be altered in ways other than drugs.
I used the term "biological interventions" on purpose. Drugs are only one type of somatic treatment.
I think you will find that when psychomotor retardation is used as a gauge of the severity of depressive illness, drugs work much better than psychotherapy. I believe that there should be more focus on improving diagnostics. Not all people complaining of depression have MDD or BD. Not all people complaining of depression should be treated with drugs.
- Scott
Posted by SLS on April 7, 2006, at 7:49:02
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 7, 2006, at 7:42:21
I though that I had posted the link to the following submission somewhere along this thread. I can't find it so...
A repost from April 2000
--------------------------------
BIOLOGY OR PSYCHOLOGY?
The best answer to this question may be “either and both”.Many of us here have been diagnosed as having a mental illness. “Mental illness” is NOT “mental weakness”. The diagnoses that we are most familiar with include:
1. Major Depression (Unipolar Depression)
2. Bipolar Disorder (Manic Depression)
3. Dysthymia (Minor Depression)
4. Seasonal Affective Disorder (SAD)
5. Schizophrenia
6. Schizo-Affective Disorder
7. Obsessive-Compulsive Disorder (OCD)
8. Post-Traumatic Stress Disorder (PTSD)All of these disorders have one thing in common. They are not our fault. Each has both biological and psychological components. We all begin our lives with a brain that is built using the blueprints contained within the genes we inherit from our parents. Later, hormones change the brain to prepare it for adulthood. The brain can be changed in negative ways by things such as drugs, alcohol, and injury. The brain is also changed by the things we experience.
How we think and feel are influenced by our environment. Probably the most important environment is the family, with the most important time being our childhood. We all have both positive and negative experiences as we travel through life. How we are as adults is in large part determined by these positive and negative experiences. They affect our psychology, our emotions, and our behaviors. All of us can be hurt by unhealthy negative experiences.
Some of us are also hurt by unhealthy brains. Medical science has long recognized that many mental illnesses are biological illnesses. Even Sigmund Freud, who we know for his development of psychoanalysis, proposed a role for biology in mental illness. The first solid evidence for this concept in modern times came with the discovery of lithium in 1947. Lithium was found to cause the symptoms of bipolar disorder (manic-depression) to disappear completely, allowing people to lead normal lives. Lithium helps to correct for the abnormal biology that is the cause of bipolar disorder. Later biological discoveries included the observations that Thorazine (an antipsychotic) successfully treated schizophrenia, and that Tofranil (an antidepressant) successfully treated depression. Again, these drugs help to correct for the abnormal biology of the brain that accompanies these illnesses.
What about psychology? This can be a two-way street. The abnormal biology that occurs with some mental illnesses affects our psychology – how we think, feel, and behave. On the other hand, our psychology can also affect our biology. Often, the emotional stresses and traumas we experience change the way our brains operate. This is especially true of things we experience during childhood. These stresses can trigger the start of major depression, bipolar disorder, schizophrenia, and other mental illnesses. In order for this to happen, however, there must be a biological weakness to begin with. Not all doctors agree with all of this, but the vast majority of our top researchers in psychiatry do.
It is important to understand that not all psychological and emotional troubles are biological in origin. Again, we are all products of our environments – family, friends, enemies, school, work, culture, climate, war, etc. Environments that are unhealthy often produce unhealthy people. This, too, is not our fault.
In conclusion, regardless of the cause of our illness, it is important that we treat both the biological and the psychological. We will all benefit if we do.
- Scott
Posted by Sobriquet Style on April 7, 2006, at 9:24:53
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 7, 2006, at 7:42:21
> Another thing to consider is exercise.
>Been there. No dice. Not for me. Not for many others either.
From what I understand, exercise acts as a biological intervention for improving mood, depression and overall general health and well being - for depression which is thought to be of a biological cause, studies have shown it can be equally and sometimes more effective than both psychotherapy and medication. Mixing the treatments, if needed medication + exercise, or psychotherapy + exercise, can produce even more positive remission outcomes, as can using all 3 depending on the individual.
On the other hand people with chronic fatigue syndrome, do not benefit from exercise and it can actually make them feel worse in the long run, including their depression.
~
Posted by naughtypuppy on April 7, 2006, at 10:02:07
In reply to Re: reality check, posted by linkadge on April 6, 2006, at 18:34:08
> We've got SSRI's and we've got tianeptine. Both clinically effective, yet they do the opposite biologically. Every time science tries to categorize, we discover a counterexample to the rule.
>It just goes to show how complex and adaptive the brain is. Two different people can exibit similar symptoms, but the problem is caused by an entirely different mechanism. I guess that's why certain meds work for some people but not others.
> I don't even think there is enough evidence to suggest that antidepressants have made a big impact on the rates of depression and suicide.
>
> Linkadge
>
Posted by SLS on April 7, 2006, at 10:43:56
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by Sobriquet Style on April 7, 2006, at 9:24:53
> > > Another thing to consider is exercise.
> > Been there. No dice. Not for me. Not for many others either.> From what I understand, exercise acts as a biological intervention for improving mood, depression and overall general health and well being - for depression which is thought to be of a biological cause, studies have shown it can be equally and sometimes more effective than both psychotherapy and medication.
Let me state things in another way. Exercise does nothing to improve my depressed affective state. To my detriment, the homunculus operating my brain stubbornly refuses to acknowledge the studies you and I have read.
To tell someone with bipolar disorder (BD) or a severe recurrent major depressive disorder (MDD) that exercise will relieve them of their depression is to sabotage their treatment and possibly bring them closer to reaching a point of hopelessness.
I don't begrudge anyone who can relieve themselves of depression by using exercise. I just wish they wouldn't tell me that it must certainly do the same for me. It doesn't. They are not me. I am not them. Studies of exercise do not demonstrate a 100% success rate. I don't think the exercise treatment failures should be ignored or be given the message that they themselves are failures at performing exercise.
As with healthy people, exercise can affect some people with BD or MDD by giving them a transient boost in activation, mental energy, or animation. This is not, however, an antidepressant response.
Depends on the person, I guess.
- Scott
Posted by Caedmon on April 7, 2006, at 11:08:10
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 7, 2006, at 7:42:21
> I think you will find that when psychomotor retardation is used as a gauge of the severity of depressive illness, drugs work much better than psychotherapy.
Yes.
And this is where exercise takes a backseat to pharmacology. When you're REALLY REALLY depressed, you literally do not even have the energy to exercise.
I've had moments during my darkest depressions in which I would be exhausted just walking about 20 yards/meters or so, and have to sit and catch my breath.
Mind you, I normally include powerlifting as one of my hobbies. (During my phases of not being depressed. Ah, the joys of atypical depression and BP-II!) I am not very out of shape. When I am feeling like absolute, total horsesh*t, the prospect of using exercise to come around is a joke.
- C
Posted by Sobriquet Style on April 7, 2006, at 11:51:00
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 7, 2006, at 10:43:56
>To tell someone with bipolar disorder (BD) or a severe recurrent major depressive disorder (MDD) that exercise will relieve them of their depression is to sabotage their treatment and possibly bring them closer to reaching a point of hopelessness.
http://www.psycheducation.org/depression/03_treatment_app.html#Anchor-What-50896
http://www.mcmanweb.com/article-39.htm
http://www.mhsanctuary.com/bipolar/selfcare.htm
They're just random links. I don't think I've ever come across any information that doesn't suggest exercise as an anjucnt treatment when relating to mental illness. Of course this doesn't suggest that everyone must do exercise. Neither are people forced to have therapy or medication if they wish not too.
Its my belief that medication and therapy is the main treatment for bipolar disorder. However, I believe that a healthy diet, good sleep hygine and exercise plays an important role too in treatment. Relying on exercise alone, well thats not a risk I'd get myself involved with as a sole treatment, I don't know of any information that would suggest, or a psychiatrist recommend that psysical exercise be used 'alone.'
>I don't begrudge anyone who can relieve themselves of depression by using exercise. I just wish they wouldn't tell me that it must certainly do the same for me. It doesn't. They are not me. I am not them.
I'd agree. Thats similar to suggesting to someone, I like eating a particular food, so they must to!
>Studies of exercise do not demonstrate a 100% success rate.
Do any?
>As with healthy people, exercise can affect some people with BD or MDD by giving them a transient boost in activation, mental energy, or animation. This is not, however, an antidepressant response.
Nope, its not marketed as one.
>Depends on the person, I guess.
Without a doubt! :-)
I will add, for me personally, when faced with the depths of manic depression, exercise has never happened, laying in bed close to 24 hours has. In no way am I going to be exercising when feeling that way, period. On the flip side, when I've felt well, not hypomanic etc my physical energy is good, and usually i'm getting adaqute exercise. I'm working at present to mantain myself with a healthy exercise programme of weight lifting and cardiac training. Just hope I can stick to it, if the illness gets the better of me with depression, based on my previous experience it will be halted.
~
Posted by greywolf on April 7, 2006, at 12:34:05
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by Sobriquet Style on April 7, 2006, at 11:51:00
The concept of using exercise to improve minor or moderate depression makes sense to me. But it's a joke to suggest that exercise can be anything more than a generally healthy thing to do for those with severe/treatment resistant depression or bipolar.
Posted by Sobriquet Style on April 7, 2006, at 12:49:36
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by greywolf on April 7, 2006, at 12:34:05
>But it's a joke to suggest that exercise can be anything more than a generally healthy thing to do for those with severe/treatment resistant depression or bipolar.
I guess thats my point, its a generally healthy thing to do, if and when you can do it.
:-)
~
Posted by greywolf on April 7, 2006, at 13:05:49
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by Sobriquet Style on April 7, 2006, at 12:49:36
> >But it's a joke to suggest that exercise can be anything more than a generally healthy thing to do for those with severe/treatment resistant depression or bipolar.
>
> I guess thats my point, its a generally healthy thing to do, if and when you can do it.
>
> :-)--Absolutely, Sobriquet. My comment wasn't directed toward you. It refers to the multitude of "get out and enjoy the fresh air" and "mind over matter" folks who think simple lifestyle changes will cure serious mental illnesses.
Posted by linkadge on April 7, 2006, at 15:03:45
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 7, 2006, at 7:42:21
>Been there. No dice. Not for me. Not for many >others either
I know we've been down this road too, but I don't believe there is a case of depression out there that cannot benifit in some way shape or form, from a moderate amount of regular aerobic exercise. Exercise doesn't have the initial umph that an antidepressant does.
Linkadge
Posted by linkadge on April 7, 2006, at 15:11:47
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by SLS on April 7, 2006, at 10:43:56
Not to say that I don't believe you, but in order for me to believe that a long term aerobic exercise program has (and would always have) zero impact on every domain of your illness is hard for me to believe.
My mother too clamis that exercise never helped her. But the whole family can see a difference when she hasn't been swimming for a few weeks.
Don't take that as an insult, thats just me.
Linkadge
Posted by linkadge on April 7, 2006, at 15:16:29
In reply to Re: Drugs versus Psychotherapy - Backlash? » SLS, posted by Caedmon on April 7, 2006, at 11:08:10
I realize that exercise can not be directly applied to illnesses of all states, but I would recomend that after an antidepressant has worked sufficiantly enough to give an individual energy, then exercise should be encouraged.
Linkadge
Posted by linkadge on April 7, 2006, at 15:22:33
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by Sobriquet Style on April 7, 2006, at 11:51:00
>To tell someone with bipolar disorder (BD) or a severe recurrent major depressive disorder (MDD) that exercise will relieve them of their depression is to sabotage their treatment and possibly bring them closer to reaching a point of hopelessness.
I don't know what you would consider recurrent major depressive disorder. Perhaps I don't fit your critera. I suppose repeated suicide attempts might be sufficiant, maybe not. To tell an individual that exercise will be their cure might be misguided, but to take exercise out of the equation, and to throw that tool out of the chest, would be a mistake in my opinion.
Linkadge
Posted by linkadge on April 7, 2006, at 15:32:16
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by greywolf on April 7, 2006, at 12:34:05
I think thats where people misunderstand. Exercise has been used in major depressive disorder. Exercise has been shown (not always) to be effective in major depressive disorder. Then again, no antidepressant drug has been show to be always effective in major depressive disorder.
So you've got drugs (partially effective) and exercise (partially effective), I don't see how it is fair to say that exercise should be taken out of the equation.
There are plenty of reasons that it might be effective.
Enhanced BDNF expression, enhanced NGF expression, enhanced NT-3 expression, enhanced GDNF expression, enhaced GAP-43 epression, ehnaced IGF-1 release, ehanced 5-ht1a recetor expression, activation of the endocannabanoid system, ehnaced anandamide activity, hpa axis downregulation, increased release of phenyethylamine PEA, neurotransmitter system downregulation, 5-ht1b autorecetor downregulation, enhanced dentage gyrus neurogenesis, the list goes on.
I think it is a mistake to take it out of the equation.
Linkadge
Posted by greywolf on April 7, 2006, at 15:58:44
In reply to Re: Drugs versus Psychotherapy - Backlash? » greywolf, posted by linkadge on April 7, 2006, at 15:32:16
> I think thats where people misunderstand. Exercise has been used in major depressive disorder. Exercise has been shown (not always) to be effective in major depressive disorder. Then again, no antidepressant drug has been show to be always effective in major depressive disorder.
>
> So you've got drugs (partially effective) and exercise (partially effective), I don't see how it is fair to say that exercise should be taken out of the equation.
>
> There are plenty of reasons that it might be effective.
>
> Enhanced BDNF expression, enhanced NGF expression, enhanced NT-3 expression, enhanced GDNF expression, enhaced GAP-43 epression, ehnaced IGF-1 release, ehanced 5-ht1a recetor expression, activation of the endocannabanoid system, ehnaced anandamide activity, hpa axis downregulation, increased release of phenyethylamine PEA, neurotransmitter system downregulation, 5-ht1b autorecetor downregulation, enhanced dentage gyrus neurogenesis, the list goes on.
>
> I think it is a mistake to take it out of the equation.
>
> Linkadge--I certainly would never say to take exercise out of the equation. Health benefits from any safe source--especially one that gets you out and active--must be generally helpful and, therefore, advisable.
But even my GP, who's a world-class runner (Olympic trials level), recognizes that exercise can do a lot, but has distinct limits when it comes to severe depression and bipolar. Sure, he will encourage me to drop a few pounds and generally get into better condition [I regularly hover at 25-30 lbs above my recommended weight, but I look damn good doing it ;) ], but it's more of a bit of good advice for everyone regardless of physical or mental malady.
But I think your advice is sound, Link. Exercise if and when you can and you will usually feel a benefit, and sometimes it will be significant enough to warrant doing more of it.
Posted by SLS on April 7, 2006, at 16:09:08
In reply to Re: Drugs versus Psychotherapy - Backlash? » SLS, posted by linkadge on April 7, 2006, at 15:11:47
> Not to say that I don't believe you, but in order for me to believe that a long term aerobic exercise program has (and would always have) zero impact on every domain of your illness is hard for me to believe.
I have a problem with those claims made that exercise is as effective as pharmacotherapy for treating bipolar and endogenous depressive disorders. If it were, I doubt we would see so many people visiting this website looking for advice and support. I also doubt that we would have so many people visiting psychiatrists and taking antidepressants. It's not like exercise is the best kept secret in psychiatry.
- Scott
Posted by linkadge on April 7, 2006, at 16:56:49
In reply to Re: Drugs versus Psychotherapy - Backlash?, posted by greywolf on April 7, 2006, at 15:58:44
I don't think that limits to its effectivenes have ever been clearly estabished.
I don't think when it can and cannot help has been clearly established either. I would like to see one clinical trial that shows that exercise has no effect on major depression. We do have clinical trials showing that major depression can beneifit from exercise though. I personally know of a guy who failed ECT, and is having success with exercise and CBT so go figure.
Doctors will always favor pills. My father's doctor prescribed high blood pressure pills and cholesterol pills without ever mentioning that diet and exercise changes can significantly reduce the need for these medications.
I agree with the doctors statements insofar as to not make the patient feel guilty for his or her own condition, but I don't agree with the doctors claims that severe depression cannot benifit from exercise.
Again, western medicine like magic bullits, wheras a wholistic approach may yeild superior results.
Linkadge
Posted by ed_uk on April 7, 2006, at 17:24:29
In reply to Re: Drugs versus Psychotherapy - Backlash? » linkadge, posted by SLS on April 7, 2006, at 16:09:08
Hi Scott
>I have a problem with those claims made that exercise is as effective as pharmacotherapy for treating bipolar and endogenous depressive disorders. If it were, I doubt we would see so many people visiting this website looking for advice and support. I also doubt that we would have so many people visiting psychiatrists and taking antidepressants.
It seems that exercise is an effective AD for some people, but by no means all. No one is claiming that it's a cure-all for depression!
Regards
Ed
Posted by linkadge on April 7, 2006, at 17:27:15
In reply to Re: Drugs versus Psychotherapy - Backlash? » linkadge, posted by SLS on April 7, 2006, at 16:09:08
>I have a problem with those claims made that >exercise is as effective as pharmacotherapy for >treating bipolar and endogenous depressive >disorders. If it were, I doubt we would see so >many people visiting this website looking for >advice and support. I also doubt that we would >have so many people visiting psychiatrists and >taking antidepressants. It's not like exercise >is the best kept secret in psychiatry.
Why is obesity on the rise? Clearly the use of exercise is declining. I don't believe that everybody on this site has given what proponents would consider a fair trial for exercise.
*As effective* is also hard to quantify. For instance, in the zoloft vs. exercise clinical trial in MDD, zoloft produced vastly superior results in the first few weeks. However, the margin decreased slowly over a month or two. Shortly after this, the exercise group was winning on almost every parameter. This continued for the duration of the trial. So while medications may seem to be ahead at first, we need to look at the longer term picture. Antidepressant poop out for a lot of people with major depressive disorder. When the drug solution is as hazy as it is, then a closer look at alternitives may seem to be benificial.For some, exercise will not be as effective as medications, but for others it will be. But in terms of sevaritly, I don't think that exercise just stops at a certain level. The same thing goes for SJW. I think a lot of drug companies wanted us to believe that it was only effective in mild to moderate depression. Over in Europe there are a lot of trials showing it is helpfull in severe depression.
Bipolar disorder is a different story. Exercise is not an antimanic agent. Bipolar depression can (not always) respond to exercise, just like it can (not always) respond to drugs.
Linkadge
Posted by SLS on April 7, 2006, at 17:30:11
In reply to Re: Drugs versus Psychotherapy - Backlash? » greywolf, posted by linkadge on April 7, 2006, at 16:56:49
> I don't think when it can and cannot help has been clearly established either. I would like to see one clinical trial that shows that exercise has no effect on major depression. We do have clinical trials showing that major depression can beneifit from exercise though. I personally know of a guy who failed ECT, and is having success with exercise and CBT so go figure.
Was he depressed or was he depressed?
I still think we have a problem in the identification of what we are trying to treat. ECT and antidepressants will probably fail every time when treating someone whose depression is entirely psychogenic.
I experienced a brief depression during the time my depression was in remission.
Better said:
I expererienced a brief psychogenic depression during the time my endogenous bipolar depression was in remission. Yes. A girl dumped me. I got depressed. It felt entirely different than the depression that was in remission. Not only that, but it resolved completely once I processed the event psychologically.
A depression is not a depression is not a depression.
What exactly are we talking about when we use the word "depression"?
- Scott
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.