FACTS AND FACTOIDS: An Information Sheet for Patients

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Today's Science Myths and Scams - FACTS AND FACTOIDS: An Information

Sheet for Patients

 

FACTS AND FACTOIDS: An Information Sheet for Patients

by i MD PhD FRCP©

 

Fact: Something that has really occurred or is the case: hence a

datum of experience, as distinct from conclusions. Loosely defined,

something that is alleged to be, or might be a " fact. "

 

Factoid: A factoid is a fact that never existed before it appeared in

print, but has been reprinted ever since. It is truly launched if it

first appears in a reputable medical journal like the Journal of the

American Medical Association and republished in the New York Times

which gives it international stature. A factoid, using simple Anglo

Saxon terminology, is a lie, and like many lies and misconceptions,

once it has been published develops a life of its own and is reprinted

over and over, from textbook to textbook. The best example is the lie

(factoid) that vitamin C causes kidney stones.

 

There is a close and intimate relationship between these

definitions and the battle between the former vitamins-as-prevention

and the current vitamins-as-treatment paradigms. A paradigm consists

of a system of beliefs which are generally accepted by the supporters

of the paradigm, usually a majority of the scientific establishment if

we are considering medicine and science. It is a combination of facts

and factoids, but the supporters of the paradigm will support both

facts and factoids with equal fervor. Pirsig wrote, " You are never

dedicated to something you have complete confidence in. No one is

fanatically shouting that the sun is going to rise tomorrow. They know

it's going to rise tomorrow. When people are fanatically dedicated to

political or religious faiths or any other kind of dogmas or goals,

it's always because these dogmas and goals are

in doubt " .

 

In most cases the facts and factoids comprising the paradigm are not

properly labeled, and factoids will be accepted as facts. The paradigm

is replaced in time by a new paradigm when enough of the factoids

present in the original paradigm are either destroyed by new evidence

or data or become facts by the accumulation of new data, new

observations. A factoid may become a fact, but a fact can never revert

to a factoid.

 

Factoids about vitamins are rampant on the internet because there is

no editorial control as there are in the journals. In journals

statements are expected to be derived from previous publications and

from data. On the internet they do not need any basis since they are

merely ideas put forward by the writers. The internet also contains

discussions of facts designed to explode the factoids. Other public

media use either facts or factoids, depending on the current public

opinion. If the opinion is positive for vitamins, facts are most often

published. If the public opinion is judged to be negative, factoids

receive easy publication.

 

Evidence Required to Establish Facts in Clinical Medicine

Clinical facts are based on clinical observations made by a clinician

who can draw careful and honest conclusions from clinical data. These

are one-to-one observations, patient and doctor. These kind of

observations have fallen into disfavor with the medical establishment

and are labeled anecdotal. These clinical trials are basic to the

whole field of medicine because no therapeutic trials will ever be

undertaken until one or more physicians find that the treatment has

some value, even even if only for a few patients.

 

The clinical observations are reinforced by special ways of

collecting the data called controlled clinical trials.

 

1) Historical controls - A number of patients are given the treatment

and the outcome of treatment over the follow-up period is compared

with the expected outcome based upon the history of that disease as

established by many observers. Thus if a disease kills every patient

and if a treatment saves half of them over the same follow-up period,

then one will conclude that the treatment had value. This is the

traditional way of running therapeutic trials. This is the least

expensive way of testing treatments but is no longer considered

scientific.

 

2) Controlled comparison therapeutic trials based on probability

theory and the need for equal samples of patients from the treatment

and the control (no treatment) group. This is similar to the first

method except that it uses current controls, not historical controls.

The decisions as to whether the patients will receive the control

treatment, i.e. no treatment, or the research treatment, is based on

random selection to remove bias.

 

3) Prospective single blind controlled therapeutic trials. With these

experiments the investigators and evaluators of the results of

treatment know whether the patients got the research treatment or the

control treatment but the patients are not told. That, of course, does

not mean that they do not know.

 

4) Prospective double blind randomized double blind therapeutic

trials. In these trials the treatment is allocated by random selection

and neither the patients nor the investigators know from which group

each patient is derived. Under my direction Psychiatric Services

Branch, Department of Public Health, Saskatchewan, conducted the first

psychiatric controlled trials of this type, completing six between

1952 and 1960. We compared the therapeutic effect of vitamin B-3

(niacin and niacinamide) against placebo in schizophrenic patients. In

this way I contributed to the development of a method which is now the

gold standard but which has never been calibrated, i.e. shown to do

what it is supposed to do. It is an awkward, very costly method best

suited for institutions with a lot of money and little imagination,

and meets the needs of the U.S. FDA and Health Protection Branch in

Canada, medical journals and granting agencies. It is a treatment

trial which probably is not as valuable as the direct clinical

examination which is so derided today as anecdotal. However, fewer

than one-quarter of the treatments commonly used in medicine and

surgery have been tested in this way.

 

Evidence Required to Establish Factoids in Clinical Medicine

No evidence is required. When discussing side effects and toxicity a

whole new set of variables are introduced. For establishing toxicity

no controlled trials are needed. The originators of the factoids may

develop their factoid on the basis of a theoretical examination of the

literature, or it may arise from their own bias against a treatment.

It often arises out of faulty experiments which later can not be

confirmed. Thus critics of a new treatment demand that the proponents

provide airtight facts based upon a large number of double blind

controlled experiments, but they will also attack the use of the

treatment based upon toxicity for which there is no basis. One of the

best examples of this occurred when it was concluded that folic acid

would decrease the incidence of congenital abnormalities. The

publication of this fact, which it is now, was followed by a series of

irate letters in the medical journals written by physicians who

bemoaned the fact that these tiny amounts of folic acid would be

toxic. We hear no more of this now. The factoid about toxicity has

vanished and the fact of its efficacy remains.

 

A recent example is the statement by oncologists that antioxidants

(by which they usually mean vitamin C) will decrease the therapeutic

value of chemotherapy for treating cancer. In fact there are no

clinical series which show that the patients given vitamin C and

chemotherapy fare worse than those not given this vitamin. On the

contrary, all the published series show just the opposite. I have

treated over 1130 cases with large doses of vitamin C and most of them

had chemotherapy. I have examined the follow-up data and find that the

mean difference on prolongation of life was heavily in favor of the

use of the vitamins. Recently Prasad KN et al, after reviewing

seventy-one scientific papers found no evidence that antioxidants

interfered with the therapeutic effect of chemotherapy. Even earlier

Simone CB et al, on the basis of a large number of clinical studies

(he also examined seventy-one scientific papers) came to the same

conclusion. Not one subject reported a worsening of symptoms. He

concluded, " ...cancer patients should modify their lifestyles using

the Ten Point Plan, which included modifying nutritional factors and

taking certain vitamins and minerals especially if they are receiving

chemotherapy, and/or radiation. " (The emphasis of this last part of

the sentence is mine).

 

Labriola et al concluded that vitamin C may prevent the therapeutic

effect of chemotherapy if given concurrently and recommended that

antioxidants be withheld until after the chemotherapy is completed. He

based his conclusion on one case. His report elicited three rebuttals,

Reilly, Gignac, and Lamson and Brignall. I will not repeat the

arguments but it was evident that Dr. Labriola was not convinced by

the points put forward by Reilly and Gignac. I think the factoid

repeated by Dr. Labriola would have a much better chance of becoming a

fact if he had considered the following points:

 

(1) What is the therapeutic value of chemotherapy without any

antioxidants? Even within the field of standard oncology there is a

debate whether chemotherapy has any merit except for a small number of

cancers, Moss15. Before one can claim that a treatment has been

inhibited, surely there must be pretty good evidence that the

treatment has any merit to begin with. It is possible (we do not know

the probability for this) that chemotherapy interferes with the

therapeutic value of the antioxidants. Almost all the studies testing

large doses of vitamin C yielded positive results while there is no

such unanimity with respect to chemotherapy.

 

(2) The difference between possibility and probability. Most people do

not distinguish between these two. Theoretically anything is possible,

and it is certainly possible that taking vitamin C might prevent the

toxic beneficial effect of chemotherapy. In the same way when one buys

a lottery ticket it is possible they may win. People confuse these two

terms, which is why lotteries are so popular. The relevant statistic

is the probability. What is the probability that patients receiving

vitamin C during their chemotherapy will not fare as well? The lottery

ticket may give one a probability of winning of one in a million and

the possibility that vitamin C may prevent the therapeutic effect of

chemotherapy may be equally low. We can only assume from the

literature reviewed by Simone, by Prasad, by Lamson and Brignall, and

more recently by Moss, that the real probability must be extremely

low. As I have pointed out earlier, I have seen no evidence that

adding vitamin C inhibited the therapeutic effect of chemotherapy.

Just the opposite. Patients on my orthomolecular program live

substantially longer and about 40 percent achieved over four year cure

rates.

 

(3) If he had not tried to bolster his argument by referring so

frequently to the peer reviewed journal in which his paper appeared.

This is certainly no guarantee of fact. The first factoid that vitamin

C caused kidney stones appeared in eminently peer-reviewed journals.

All the factoids regarding vitamins appeared first in peer reviewed

journals. I can assure you that articles attacking the use of vitamins

have very ready access to peer-reviewed journals. But they would not

have accepted the report had they tried to conclude from one patient

that vitamin C taken during chemotherapy was therapeutic. This would

not even be sent to the peer review committee because they do not

accept anecdotes - unless of course they consider them scientific

because they contain something adverse against vitamins.

 

(4) Moss points out that oncologists have no objection to using

xenobiotic antioxidants during chemotherapy. This includes Amifostine

which decreases the toxicity of radiation but is too toxic on its own

and is not used; Mesna, a drug used around the world to protect

against the toxic side effects of ifosfamide which damages the urinary

system; and Cardiozane, which counters Adriamycin's toxicity. There

are over 500 papers showing the safety of Cardiozane. In one clinical

trial using a drug similar to Adriamycin one-quarter of the patients

suffered damage to their hearts. When given Cardiozane concurrently

only 7% did. Thus it appears that only orthomolecular or natural

antioxidants are potentially dangerous. Synthetic antioxidants protect

against the toxic effect of drugs but do not increase their

therapeutic value. In sharp contrast, natural antioxidants not only

protect against the toxic effect of drugs but also increase their

efficacy in destroying cancer cells.

 

(5) Dr. Labroila emphasizes that long term studies must be used. I

agree and for this reason I have followed up my patients since 1977.

In my series, hardly any patients receiving chemotherapy but no

antioxidants survived very long. But chemotherapy is used by many

oncologists who know it will not extend life because there is nothing

else that they can do and they feel they have to do something.

 

In conclusion, as the proponents of the old paradigm see it, facts

are facts only after double blind controlled experiments conducted by

the right investigators from the correct school and published in the

correct medical journals. Factoids can be thought up by anyone and

immediately become facts in the profession if the factoid attacks the

evidence against the new paradigm.

 

Current Factoids:

 

About Megadose Vitamin C

These factoids are based upon hypotheses. There is no clinical data

to support any of them and almost all studies show that they are not

true or real. They are not supported by any studies.

 

- causes kidney stones,

- causes kidney damage,

- causes pernicious anemia,

- decreases fertility in women,

- causes liver damage,

- causes iron overload and toxicity,

- is dangerous for diabetics by interfering with

glucose tests,

- causes cancer,

- inhibits chemotherapy,

- prevents radiation from being effective

- prevented Linus Pauling from living longer

- prevents surgical scars from healing.

 

I should have used weasel terms - instead of " causes " by writing " may

cause. " Because using the word may allows the proponent of the

factoid to leave the suggestion that these factoids are true but

leaves an escape path in case they turn out not to be true. The author

can then claim, " well I did not say that these factors were true. I

merely suggested that they might be true. " There is the usual

confusion of probability and possibility. If a phenomenon occurs once

out of a million tries the probability is one out of a million, but

there is no value attached to the possibility. It is indeed possible.

Again, the enormous sale of lottery tickets depends upon confusing the

public in this way. Or looked at in another way, if the probability of

winning a lottery is one in ten million if one buys one ticket, and

the probability is zero if one does not buy the ticket, then one can

say that dividing the ratio one in ten million by zero yields the

enormous probability of infinity that one will win the lottery. Any

number divided by zero yields infinitesimal large values. Critics of

megavitamin therapy never give any probability values since they know

they are close to zero.

 

About Megadose Niacin

The factoid niacin causes liver damage is analyzed thoroughly by

William Parsons Jr, who shows that niacin will often increase liver

function tests but that these increases do not arise from liver

pathology. Since I began using megadoses of this vitamin in 1952 I

have seen a few cases of obstructive-type jaundice which cleared when

niacin was stopped, and in one case I had to resume the use of niacin

because the patient's schizophrenia recurred. He recovered and the

jaundice did not recur. I have seen so few cases of jaundice that

there is little evidence that the jaundice arose from the use of the

niacin. Jaundice has a natural occurrence rate and from any series of

patients a few will get jaundice from other factors. In rare cases too

much niacin causes nausea and vomiting, and if this persists because

the niacin is not decreased or stopped the dehydration might be a

factor. I have seen no cases in the past fifteen years. The main

danger from taking niacin is not jaundice, it is that people will live

longer.

 

Factoids in the Making

It is very interesting, even if frustrating, to witness the

manufacture of factoids. A new one may soon be born. It is that niacin

is dangerous because it increases the plasma homocysteine levels. Garg

et al reported that niacin increased homocysteine levels. Apparently

no other B vitamins were given. After a tough battle for acceptance

the homocysteine findings are recognized as playing a role in

atherosclerotic heart disease. But the reduction in the abnormal

cholesterol levels and the increase in HDL decreases the risk if heart

disease. The Coronary Drug Study, Canner et al, showed that over a

fifteen year follow up mortality was decreased by 11% by niacin and

longevity increased by two years. In this study niacin was used as a

drug which lowered elevated cholesterol levels. No other vitamins were

used. Garg et al are aware of this. They referred to the report by

Basu et al that the niacin induced increase in homocysteine levels did

not interfere with its normalizing effect on blood lipids. And they

pose the question whether it would be beneficial for patients on long

term niacin treatment to take other B vitamins such as folic acid. My

answer is that of course it would be beneficial, and since 1965 I have

routinely given my patients one of the B-complex formulations such as

B-complex 50's or 100's. These provide pyridoxine, folic acid and

vitamin B-12 as well as other vitamins. Adding these vitamins

inevitably will be beneficial since the other vitamins have

therapeutic properties of their own in addition to keeping

homocysteine levels from going too high. But even niacin alone was

beneficial, not harmful. And this confirms what I have seen since 1952

when Ibegan to used megadoses of niacin and niacinamide for

schizophrenia and for other conditions, including elevated cholesterol

levels and arthritis. The authors did not invent any factoid but it is

highly probable that some of the readers of that report will ignore

almost the whole report except that niacin elevates homocysteine and

therefore will increase the risk of heart disease. You will soon see

this factoid repeated endlessly.

 

Niacin is a methyl acceptor and this may be the mechanism which leads

to the elevation of homocysteine levels. Niacinamide is also a methyl

acceptor but it has no effect on blood lipid levels. Its effect on

homocysteine levels is not known but there is no evidence that it

reduces life expectancy. On the contrary, it has great value in the

treatment of senile states, both physical and mental, and in my

series, if anything, tended to prolong life.

 

Kaufman had studied the use of this vitamin for the arthritides

before 1950 and had published two books describing his remarkable

results. Since that time this vitamin has been a very important

component of the orthomolecular regimen for treating arthritis. Dr

William Kaufman, my long term friend, died a few days ago (August

2000) at age 89. His very important work remains mostly ignored even

after a double blind study showed him to be correct.

 

But Garg's report does raise very interesting questions which will

have to be studied. The first is whether the elevation of homocysteine

is an important factor but only in subjects who are not taking

adequate levels of the other B vitamins, i.e. are not well nourished

in orthomolecular terms. It is possible that in the presence of good

nutrition the increase in homocysteine levels is not pathological at

all and may even be beneficial.

 

Another potential factoid was trumped up by the press and received

wide attention in all the media. The press reported that Dr. James

Dwyer, University of San Diego Medical School, had found that the

carotid arterial walls had been thickened by 500 milligrams of vitamin

C daily. The press report cautioned against the use of vitamin C

because this showed that the arteries were depositing plaque. But

Professor Dwyer told Owen R. Fonorow they had used only one measure

and had not used two other measures which would have shown the degree

of focal plaque called the plaque index, nor the velocity ratio to

determine whether or not plaque interfered with blood flow. He did not

say that plaque had developed. Dr. Robert Cathcart with experience on

over 25,000 patients since 1969 has seen no cases of heart disease

developing in patients who did not have any when first seen. He added

that the thickening of the vessel walls, if true, indicates that the

thinning that occurs with age is reversed. I have used vitamin C in

megadoses since 1952 and have not seen any cases of heart disease

develop even after decades of use.

 

Recently Gokce, Keaney, Frei et al gave patients either a single dose

of 2000 milligrams of vitamin C and 500 milligrams daily for thirty

days and measured blood flow through the arteries. Blood flow

increased nearly fifty percent after the single dose and this was

sustained after the monthly treatment. They concluded that ascorbic

acid treatment may benefit patients with coronary artery disease. This

certainly effectively does not support the conclusion of Dwyer who did

not measure blood flow.

 

The Good News

The opposite of a factoid is a fact. The good news is that as none of

these factoids are true, the opposite is true. This summary statement

is based upon literally thousands of published papers in medical

literature and hundreds of books that have been published in the past

twenty years. I can not provide references to these numerous clinical

studies, but readers of the Journal of Orthomolecular Medicine have

ready access to the facts and also to the book reviews of over one

hundred of these books. The internet contains a large number of

excellent discussions of vitamins and, of course, the facts and

factoids which are current.

 

Vitamin C

Alleged Toxicity Factoid (Lies) Fact

Kidney Stones Decreases frequency

Kidney Damage No

Pernicious anemia Yes No

Fertility Impaired No

Liver damage Yes No

Iron overload Theoretical No clinical evidence

Glucose blood tests Interferes Not with modern tests

Cancer Causes cancer Therapeutic for cancer

Atherosclerosis Increases Prevents

Chemotherapy Decreases efficacy Increases efficacy

Radiation Decreases effect More effective

Surgery Prevents healing Increases healing rate and decreases scaring

Linus Pauling Shortened his life A ridiculous claim. He died age 94,

fully mentally alert.

 

Conclusion

The factoids about vitamins, used in optimum doses when needed, are

not true, are not based upon clinical evidence, do not have any

studies including double blind controlled clinical data to support

them, and are used primarily to attack the new paradigm, the

vitamins-as-treatment paradigm. Be wary of factoids whether they are

in print, on the internet, in the news media, on radio or on

television. If you hear of any new factoids, please let me know so I

can add to my collection.

 

The unfortunate result of these lies is that patients are made

fearful, some will stop taking their vitamins, medical costs will

increases since patients want to see their doctor again to discuss

these matters, and more patients will relapse. The harm done by these

factoids is immeasurable, but fortunately is slowly decreasing as the

population becomes more knowledgeable and sophisticated about

nutrition and nutrients. In the same way that drug companies are not

allowed to make false therapeutic claims about their products, we need

a system which will neutralize the factoids as they are proposed. And

above all we need the public media to become much more intelligent and

less subservient to major papers like the New York Times.

 

REFERENCES

1. The Oxford International Dictionary of the English Language.

Unabridged. Leland Publishing Company LTD, Toronto, 1957.

 

2. Mailer Norman: New York Times, January 9, 2000.

 

3. Pirsig R: Zen and the Art of Motorcyle Maintenance. Quoted in

Globe and Mail, Toronto, June 16, 2000, in Social Studies by M. Kesterton.

 

4. Hoffer A: A theoretical examination of double-blind design. Can

Med Ass J 97:123-127, 1967.

 

5. Hoffer A & Pauling L: Hardin Jones biostatistical analysis of

mortality data for cohorts of cancer patients with a large fraction

surviving at the termination of the study and a comparison of survival

times of cancer patients receiving large regular oral doses of vitamin

C and other nutrients with similar patients not receiving those doses.

J Orthomolecular Medicine 5:143-154, 1990. Reprinted in, Cancer and

Vitamin C, E. Cameron and L. Pauling, Camino Books, Inc. P.O. Box

59026, Phil. PA, 19102, 1993.

 

6. Hoffer A & Pauling L: Hardin Jones biostatistical analysis of

mortality data for a second set of cohorts of cancer patients with a

large fraction surviving at the termination of the study and a

comparison of survival times of cancer patients receiving large

regular oral doses of vitamin C and other nutrients with similar

patients not receiving these doses. J of Orthomolecular Medicine,

8:157-167,1993.

 

7. Hoffer A: Orthomolecular Oncology. In, Adjuvant Nutrition in Cancer

Treatment, Ed. P Quillin & RM Williams. 1992 Symposium Proceedings,

Sponsored by Cancer Treatment Research Foundation and American College

of Nutrition. Cancer Treatment Research Foundation, 3455 Salt Creek

Lane, Suite 200, Arlington Heights, IL 60005-1090, 331-362, 1994.

 

8. Hoffer A: One Patient's Recovery From Lymphoma. Townsend Letter for

Doctors and Patients #160, 50-51, 1996.

 

9. Prasad KN, Kumar A, Kochupillai V & Cole WC. High Doses of Multiple

Antioxidant Vitamins: Essential Ingredients in Improving the Efficacy

of Standard Cancer Therapy. Journal American College of Nutrition,

18:13-25, 1999.

 

10. Simone CB, Simone NL & Simone CB: Nutrients and Cancer Treatment.

International Journal of Integrative Medicine 1:20-24, 1999.

 

11. Labriola D & Livingston R: Possible Interactions Between Dietary

Antioxidants and Chemotherapy. Oncology 13:1003-1008, 1999, and

Editorial to Townsend Letter for Doctors and Patients, November 1999.

 

12. Reilly P: Dr. Labriola's Editorial on Antioxidants and

Chemotherapy, Townsend Letter for Doctors and Patients Feb/Mar 2000,

90-91.

 

13. Gignac MA: Antioxidants and Chemotherapy. What You Need to Know

Before Following Dr. Labriola's Advice. Townsend Letter for Doctors

and Patients Feb/March 2000, 88-89.

 

14. Lamson DW & Brignall MS: Antioxidants and Cancer Therapy II:

Quick Reference Guide. Alternative Medicine Review, 5:152-163, 2000.

 

15. Moss RW: Questioning Chemotherapy. Equinox Press, Brooklyn, New York.

 

16. Moss RW: Antioxidants Against Cancer. Equinox Presss Inc. Brooklyn

NY, 2000.

 

17. Hoffer A: Vitamin C and Cancer. Quarry Press, Kingston ON, 2000.

 

18. Herbert V, Canadian Broadcasting Corporation, National TV News.

Shortly after Dr Pauling died. He also said that if God wanted us to

take vitamin C tablets they would be growing on trees.

 

19. Parsons WB Jr: Cholesterol Control Without Diet: The Niacin

Solution. Lilac Press, Scotsdale, Arizona 1998. Reviewed in Journal of

Orthomolecular Medicine, Volume 14, 1999, 3rd quarter.

 

20. Garg R, Malinow MR, Pettinger M, Upson B & Hunninghake D: Niacin

Treatment Increases Plasma Homocysteine. Am Heart Journal,

138:1082-1087, 1999.

 

21. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ

& Friedewald W: Fifteen year mortality in coronary drug project

patients: Long term benefit with niacin. J. Amer College of Cardiology

8:1245-1255, 1986.

 

22. Basu TK & Mann S: Vitamin B-6 Normalizes the Altered Sulfur Acid

Status of Rats Fed Diets Containing Pharmacological Levels of Niacin

Without Reducing Niacin's Hypolipidemic

Effects. J Nutrition 127:117-121, 1997.

 

23. Kaufman W: Common Forms of Niacinamide Deficiency Disease:

Aniacin Amidosis. Yale University Press, New Haven CT, 1943.

 

24. Kaufman W: The Common Form of Joint Dysfunction: Its Incidence

and Treatment. E.L. Hildreth and Co. Brattelboro, VT, 1949.

 

25. Hoffer A: Orthomolecular Medicine For Physicians, Keats

Publishing, New Canaan CT, 1989.

 

26 Fonorow, O.R. http://www.vitamincfoundation.org

 

27. Cathart, R. Report to Fonorow http://www.vitamincfoundation.org

 

27. Gokce N, Keaney JF Jr, Frei B et al: Long-term ascorbic acid

administration reverses endothelial vasomotor dysfunction in patients

with coronary artery disease. Circulation 99:3234-3240, 1999.

 

28. Herbert. V. Canadian Broadcasting Corporation, National TV News.

Shortly after Dr Pauling died. He also said that if God wanted us to

take vitamin C tablets they would be growing on trees.

 

A. Hoffer MD, PhD, FRCP©

August 29, 2000

Posted by on May 10, 2004 01:47 PM

 

 

 

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