THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: April 17, 2013 08:00 AM Wednesday; Rod Welch

Dental examination and cleaning Graham Dental Offices.

1...Summary/Objective
2...Dental Care Leverages Patient History with Medical Chart
3...Findings No Remedial Work Performed Nor Recommended


..............
Click here to comment!

CONTACTS 

SUBJECTS
Dental Examination Cleaning Bleeding Gums Conflicts Patient History                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
5503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5503 -    ..
5504 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
5505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
550501 - Follow up ref SDS 35 0000. ref SDS 33 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
550502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550508 -  ..
5506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5507 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5508 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5509 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
550901 - On 101108, Lynn scheduled examination and cleaning for today, 110202,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
550902 - confirmed in letter. ref SDS 21 HG6P, and following up prior cleaning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
550903 - on 100325 0800. ref SDS 17 TL9F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
550905 -  ..
550906 - Background on prior work is listed on 100514 0730. ref SDS 19 VH5N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
550908 -  ..
550909 - On 110928 0800 dental examination, cleaning, ref SDS 27 8659, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
550910 - periodontal chart shows good oral hygeine has restored gum health.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
550911 - ref SDS 27 6Z3V                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
550913 -  ..
550914 - On 110929 2028 letter from Graham Dental received medical chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550915 - progress notes, ref SDS 28 VT5I, for work on 110928. ref SDS 27 534L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
550917 -  ..
550918 - On 110930 2246 letter to Graham Dental submits questions on issues in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
550919 - progress notes for work on 110928. ref SDS 29 VT5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
550921 -  ..
550922 - On 111022 1923 received and paid invoice for dental services performed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
550923 - today on 110928. ref SDS 30 004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
550925 -  ..
550926 - On 111025 1928 letter from Lynn at Graham Dental reports medical chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
550927 - progress notes for meeting on 110928 were submitted previously on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
550928 - 110929. ref SDS 31 VT5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
550930 -  ..
550931 - On 111026 1022 submit letter to Lynn at Graham Dental with questions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
550932 - and action items on medical chart and progress notes for meeting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
550933 - performing dental examination 110928. ref SDS 32 VT5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
550935 -  ..
550936 - On 120404 0800 dental examination, cleaning. ref SDS 33 004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
550938 -  ..
550939 - On 120507 1015 paid invoice for dental services on 120404.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
550940 - ref SDS 34 004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
550942 -  ..
550943 - On 121010 0800 dental examination, cleaning and xrays showing no                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
550944 - evident progression of decay. ref SDS 35 O75H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
550945 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
550947 -  ..
5510 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5511 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5512 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5513 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
551301 - Dental Care Leverages Patient History with Medical Chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551302 - 
551303 - Follow up ref SDS 35 004T, ref SDS 33 004T.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
551304 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551305 - Agenda for meeting today was submitted yesterday, on 130416 0143.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551306 - ref SDS 36 BY5G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551308 -  ..
551309 - Lynn scheduled the next meeting in October at 0800.  This will be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551310 - entered in the medical chart and submitted to the patient by email, as                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551311 - Mark did for the pior meeting, reported on 110202 0800. ref SDS 23                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
551312 - IA5M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551314 -             ..
551315 -            [On 131002 0850 received notice of next meeting on 131016                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
551316 -            0800. ref SDS 37 B77J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551318 -  ..
551319 - Sonia did the cleaning today.  Excellent work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
551321 -  ..
551322 - Xrays were considered today, as set out in the agenda, reported on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551323 - 130416 0143. ref SDS 36 4Z8F  Decided again not to take xrays, because                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
551324 - xrays were taken during the prior meeting on 121010 0800. ref SDS 35                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
551325 - SY5L also, did not want to spend the money because well over budget                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
551326 - already for this month.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
551328 -  ..
551329 - Sonia used a hand dentist pick, instead of the ultrasonic scaler.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551330 - This change avoided severe pain, experienced previously on 050518                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551331 - 1100, ref SDS 4 FB6L, and following Tanya's work cleaning teeth for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551332 - the prior meeting on 110202 0800. ref SDS 23 865J  Mark had used a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
551333 - conventional dental pick on request for the initial cleaning on 100325                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551334 - 0800. ref SDS 17 SW86                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551336 -  ..
551337 - After the meeting on 110928, considered trying the ultrasonic scaler                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551338 - for the work today, which is faster and so more economical, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551339 - perhaps more thorough.  Tanya tried the ultrasonic scaler for part of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551340 - the work on 110202, and this was easily tolerated. 110202 0800.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551341 - ref SDS 23 QH6F  Possibly gums are better able now for using this high                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
551342 - end technology.  Ultimately, however, did not make this suggestion                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551343 - today, due to continuing concern about avoiding pain.  Will consider                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551344 - this again in October.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551346 -  ..
551347 - As a result, the Ultasonic scaler was not used to remove plaque, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551348 - so numbing agent was not needed, discussed in the record on 110202                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551349 - 0800. ref SDS 23 QH6F  Hopefully, will remember to ask about trying                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551350 - numbing agent with ultrasonic scaler for work on next visit in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
551351 - October.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
551352 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551353 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551355 -  ..
551356 - Findings No Remedial Work Performed Nor Recommended                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551357 - 
551358 - Follow up ref SDS 35 8659, ref SDS 33 8659.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
551359 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551360 - Sonia reported finding...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551361 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551362 -    1.  Moderate to severe gum bleeding still occuring from back teeth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551363 -        on both left and right sides occurring when cleaning the teeth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551364 -        with a dental pick.  Mark showed gauze blotted with blood on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
551365 -        the right side.  Could also taste blood from the cleaning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551366 -        process.  Exact location was not clear during the meeting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551367 -        though Mark said back teeth on both sides are involved.  Mark                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551368 -        will list affected areas in the medical chart.  Report today of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551369 -        moderate to severe bleeding gums during teeth cleaning aligns                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551370 -        with Tanya's finding during the prior meeting on 110202 0800.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551371 -        ref SDS 23 8659   Mark further stated that the medical chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551372 -        for his work on 100325, also, shows findings of moderate to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551373 -        severe gum bleeding.  There is nothing in the record on 100325                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551374 -        indicating examination found bleeding gums at that time.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551375 -        ref SDS 17 SW86                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
551376 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551377 -            [...below letter to Graham Dental requests medical chart to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
551378 -            complete analysis of work today. ref SDS 27 TN5F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551380 -         ..
551381 -        Sonia advised that flossing can improve gum health to avoid                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551382 -        bleeding, also, noted by Tanya on 110202 0800. ref SDS 23 UD4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551383 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551384 -            [...below medical chart finding #10 says HS/POL/Floss                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551385 -            possible reference to guidance on flossing. ref SDS 27 H560                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
551387 -         ..
551388 -        Explained finding moderate and severe bleeding gums today                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551389 -        during cleaning with sharp metal dental pick aligns with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551390 -        patient history the past 25 years, showing no evidence of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551391 -        bleeding gums (by taste nor observation) from routine daily                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551392 -        activity, including eating and brushing, previously reported on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551393 -        110202 0800. ref SDS 23 UD5J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551394 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551395 -            [...below medical chart finding #9 reports mod+ gum                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551396 -            bleeding. ref SDS 27 H55L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
551398 -             ..
551399 -            [...below medical chart finding #3 Perio chart summary                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551400 -            lists bleeding teeth and sites = 0. ref SDS 27 XO5H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551402 -         ..
551403 -    2.  Tissue fraying from the inside the mouth was not found today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551404 -        which Tana previously attributed to tooth paste with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551405 -        ingredients harmful to some people, and reported during the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551406 -        prior meeting on 110202 0800. ref SDS 23 AW4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
551408 -         ..
551409 -        This aligns with recent change to toothpaste without whitening                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551410 -        agent, recommended on 110202 0800. ref SDS 23 AW4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551412 -            [...below medical chart finding #2 reports finding evidence                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
551413 -            of injury using harmful toothpaste, and work plan for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551414 -            switching to another brand. ref SDS 27 6Z3F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
551416 -         ..
551417 -    3.  Cavity forming on tooth #13, follow up from meeting on 121010                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551418 -        0800, ref SDS 35 DQ90, and previously in the meeting at Graham                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551419 -        Dental on 120404 0800. ref SDS 33 DQ90                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
551420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551421 -            [On 131016 0800 follow up examination found no evidence of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551422 -            decay for tooth #13, and so no treatment is required.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551423 -            ref SDS 38 ES7M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551425 -         ..
551426 -    4.  Cavity on tooth #9 identified for repair.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551427 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551428 -        Follows up medical chart #4 lists tooth 29 D for monitoring,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
551429 -        but does not identify scope of condition, reported 110928 0800,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551430 -        ref SDS 27 H54U                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
551432 -         ..
551433 -    5.  Mark quoted repair for these 2 teeth will be performed for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551434 -        price of $100 per tooth, $200 total.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551436 -         ..
551437 -        Today, decided to defer repairs until next meeting in 6 months.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551438 -        Can perform xrays to evaluate rate of decay progression on #13                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
551439 -        and #9.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
551440 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551441 -            [On 131016 0800 Graham Dental revised the price to repair                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
551442 -            tooth #9 to $40. ref SDS 38 ES7M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551444 -         ..
551445 -    6.  Several teeth identified today show procelain beginning to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551446 -        fail.  Mark will list in medical chart for continued                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551447 -        monitoring.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
551448 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551449 -            [...below medical chart #5, 6 & 7 lists tooth 25 needs                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
551450 -            mineralize lesion; 31, 30 and 13 for monitoring diminshed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
551451 -            porcelain. ref SDS 27 PD8O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551453 -         ..
551454 -    7.  No remedial care was performed nor recommended; issues noted                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
551455 -        during examination will be reviewed again in next April.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551456 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551457 -            [...below medical chart #8 and 9 find "OH fair, and "Gen                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
551458 -            mod calculus, plaque..." indicating effective oral hygeine.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551459 -            ref SDS 27 6Z5R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551461 -  ..
551462 - Mark will submit medical chart to cross check understandings from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
551463 - work today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
551464 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551465 -            [On 110929 2028 received medical chart, ref SDS 28 VT5I,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
551466 -            and entered in this record on patient history, shown below.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
551467 -            ref SDS 27 534L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
551468 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551469 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551470 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551471 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551472 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551473 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551474 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551475 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551476 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
551477 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5515 -