CENTS QUARTERLY NEWSLETTER President’s Message

Transcription

CENTS QUARTERLY
NEWSLETTER
Community Ear, Nose
& Throat Specialists
CENTS
Spring / Summer
Issue 2005
INSIDE THIS ISSUE
President’s Message
Dr. Myers, legendary in his field throughout the
world, founded the Department of Otolaryngology and the CENTS Network. He has brought
the Department of Otolaryngology into a position of scope and stature that surely ranks it
among the top three such departments worldwide as assessed by any appropriate metric. I would like to thank Dr. Myers for his service and dedication to the Department of Otolaryngology and CENTS Network and
look forward to him continuing as an active member of CENTS.
As the new Chair of the Department of Otolaryngology, in the School of
Medicine, I will also be assuming the role of President of the CENTS Net-
-President’s Message
1
-Officers & Board of Directors
-Member Accomplishments
2
-CENTS Member Spotlights:
-David H. Chi, M.D.
-Kirk W. Steehler, D.O.
3
-Clinical Studies Information 4-5
- Administrator’s Corner
6
- Endonasal Surgery Featured
- Coding Corner
- Welcome….Dr. Lai
7
-Websites of Interest
-Upcoming Courses/Events
8
work. I look forward to working closely with the members of the CENTS
Network. Should you have suggestions on how you would like to see the
CENTS Network move forward, please do not hesitate to contact me.
I have attached the announcement of my appointment for your review.
Attachments:
-Announcement of Chairman
-March 14, 2005
CENTS Meeting Minutes
Jonas T. Johnson, M.D.
President
Julie Truver, Editor
CENTS Officers
President
Jonas T. Johnson, M.D.
Vice President
Peter F. White, M.D.
Secretary
Murat Bankaci, M.D.
Treasurer
Barry E. Hirsch, M.D.
CENTS Board of Directors
Margaretha Casselbrant, M.D., Ph.D.
David DeMarino, M.D.
Suman Golla, M.D.
Marc Maslov, M.D.
Michael Orsini, M.D.
Carl Snyderman, M.D.
Elizabeth Toh, M.D.
Keith Welker, M.D.
CENTS Standing
Committees
• Executive
• Continuing Medical
Education
• Cost Reduction
• Membership
• Payor Relations
• Nominating
Board of Governors
Governor
Stephen Froman, M.D.
Public Relations
Marc Maslov, M.D.
Legislative
Sidney Lipman, M.D.
CENTS QUARTERLY NEWSLETTER
Page 2
MEMBER ACCOMPLISHMENTS
Isabelle Billig, PhD., Assistant Professor of
Otolaryngology at the University of Pittsburgh School of
Medicine, gave a lecture entitled, “Vestibulo-cerebellar
zones controlling principal and accessory eye muscles in
a canal plane using pseudorabies virus” at the
Association for Research in Otolaryngology meeting
that was held in New Orleans on February 22, 2005.
Dr. Billig was also invited to speak at the Pittsburgh
Supercomputing Center, Carnegie Mellon Institute, on
April 7, 2005 on a lecture entitled, “Computing through
the Gordian knot: Quantifying neuroanatomy".
Charles D. Bluestone, M.D., Professor of
Medicine, was selected by the Pittsburgh Business Times as
a Health Care Hero finalist for Life-Time Achievement at
their Annual dinner on March 10, 2005.
Ricardo L. Carrau, M.D., Professor of Otolaryngology
and Carl H. Snyderman, M.D., Associate Professor of
Medicine, and Amin Kassam, M.D., Department of
Neurosurgery, held a course on "Minimally Invasive
Endoscopic Surgery of the Cranial Base and Pituitary" on
January 7-8, 2005, that was attended by neurosurgeons and
otolaryngologists from the United States and Europe.
They presented new minimally invasive surgical techniques
for endoscopic surgery of the brain, cranial base, and spine
that were developed at the University of Pittsburgh
Medical Center. They will also be hosting a "World
Congress on Endoscopic Surgery of the Brain, Cranial
Base, and Spine" in Pittsburgh from September 30-October
2, 2005, to bring together the world's experts to advance
this new surgical specialty.
Berrylin J. Ferguson, MD, Associate Professor and
Director of the Division of Sinonasal Disorders, Department of Otolaryngology, University of Pittsburgh School
of Medicine, would like to announce the opening of the
Sino-nasal Disorders and Allergy Clinic on the second
floor of the Eye and Ear Institute. It incorporates state
of the art visualization and recording of patients sinonasal problems, including the first ENT electronic record, digital streaming archiving, and dual flat screens,
one for the physician to visualize and another for the
patient.
Barry E. Hirsch, M.D., Professor of Otolaryngology
at the University of Pittsburgh School of Medicine, was a
Visiting Professor at the University of Pennsylvania
Health System, Department of Otolaryngology, Philadelphia, PA, from February 9-10, 2005. He presented two
lectures entitled, “Noise Induced Hearing Loss” and
“Intratympanic Gentamicin”. Dr. Hirsch also attended
the 10th Symposium on Cochlear Implants in Children,
representing the American Academy of Otolaryngology,
Head and Neck Surgery, in Dallas, TX, on March 19-20,
2005. He participated as a panel member of the "Soft
Failures in Cochlear Implants Consensus Conference".
Eugene N. Myers, MD, Professor and Eye & Ear
Foundation Chair of the Department of Otolaryngology
at the University of Pittsburgh School of Medicine, presented the invited lectures: “Management of Tumors of
the Parapharyngeal Space” and “Management of the
Neck in Cancer of the Larynx” at the 43rd Annual Basic
Science Course in Otolaryngology-Head and Neck Surgery
held in Washington, DC on March 3, 2005. Dr. Myers
was the Distinguished Visiting Professor of the Department of Head and Neck Surgery at the University of
Texas MD Anderson Cancer Center in Houston on
March 29-30, 2005 and as such presented the following
lectures: “A Tale of Two Grants” and “Neck Dissection: An Operation in Evolution”.
Robert F. Yellon, M.D., Associate Professor of Otolaryngology at the University of Pittsburgh School of Medicine, was elected to Best Doctors in America ® 2005,
Who's Who in Medical Education 2005, and received the
Children’s Hospital Of Pittsburgh Outstanding Achievement in Patient Care - Highest Level of Patient Satisfaction - 2004.
Page 3
CENTS Member Spotlights
David H. Chi, M.D.
Kirk W. Steehler, D.O.
David H. Chi, MD, immigrated from South Korea with his parents at the age of 5 and was raised in Minnesota and Michigan.
He completed his undergraduate training and received his
medical degree from the University of Michigan in 1997. He
completed a surgical internship and his otolaryngology residency at the University of Virginia. From 2002 to 2004, Dr.
Chi was a pediatric otolaryngology fellow at the Children’s
Hospital of Pittsburgh / University of Pittsburgh. Dr. Chi became an Assistant Professor of Otolaryngology and a staff otolaryngologist at the Children’s Hospital of Pittsburgh in 2004.
He is also the Medical Director of the Hearing Center at Children’s Hospital.
Kirk W. Steehler, D.O., is a community-based general otolaryngologist with the ENT Specialists of Northwestern Pennsylvania, Erie, PA. He received a B.A. from Gannon University in 1973 and a D.O. from Kirksville College of Osteopathic Medicine, Kirksville, MO in 1977. He completed his
internship at Kirksville Osteopathic Hospital and his otolaryngology residency at the Doctors Hospital in Columbus, OH.
From 1981 to 1993, Dr. Steehler was an Assistant Clinical
Professor at Philadelphia College of Osteopathic Medicine
and since 1993 has been an Assistant Professor in Otolaryngology at Lake Erie College of Osteopathic Medicine.
Dr. Chi’s clinical interests include all aspects of pediatric otolaryngology with a focus on medical and surgical evaluation of
children with sensorineural hearing loss. He is currently the
Principal Investigator of several research grants entitled:
A Rat Model of Gastroesophageal Reflux and Otitis Media
Reduction of the Incidence of Postoperative
Hemorrhage in Children with Von Willebrand’s
Disease Undergoing Tonsillectomy with or without Adenoidectomy Using Epsilon-Aminocaproic
Acid (Amicar)
Speech Recognition Abilities in Noise for Children with Unilateral Sensorineural Hearing Impairment, a research grant from the Pennsylvania
Lions Hearing Research Foundation.
Dr. Chi is certified by the American Board of Otolaryngology
and is licensed in Pennsylvania and Virginia. He is a member of
the American Academy Otolaryngology – Head and Neck Surgery Foundation Inc. and The DePaul School for Hearing and
Speech, Board of Directors. Dr. Chi has published several articles, presented various abstracts, and participated in many
teaching and invited lectures. Most recently, Dr. Chi has contributed to book chapters in Advanced Therapy of Otitis Media and Pediatric Signs & Symptoms in a Page.
Dr. Chi resides in Pittsburgh. In his free time, Dr. Chi enjoys
spending time with his family- wife, Cathy, and his two sons,
Ethan age 4, and Connor age 1. When time permits, he digs
divots while attempting to play golf. Dr. Chi can be reached
via email at [email protected] or via phone at 412-692-5466.
Dr. Steehler is a certified member, fellow, and board certification examiner of the Osteopathic College of Otolaryngology, Head and Neck Surgery, Orofacial Plastic Surgery and a
certified member of the American Academy of Otolaryngology-Head and Neck Surgery. Dr. Steehler is also a member
of the American Medical Association, the Pennsylvania Medical Society, the Erie County Medical Society, the American
Osteopathic Association, the Pennsylvania Osteopathic Association, and the American Rhinologic Society.
Dr. Steehler is involved in several intern/extern and residency programs at health centers in the northwestern Pennsylvania area. At the Metro Health Center / Millcreek Community Hospital, Dr. Steehler has been involved in the intern
and extern training programs, monthly journal club, and instruction of plastic surgery techniques. He has served as the
Chairman and Residency Instructor for the Otolaryngology
Head and Neck Surgery Training Program of the Lake Erie
College of Osteopathic Medicine. At the Saint Vincent
Health Center, he is involved in the summer extern program.
Dr. Steehler is also involved in several community activities.
He is member of the Museum Trustee Association and the
Erie Art Museum. He has served as President of the Board
for the Erie Art Museum for 15 years. He is a member of
the Board of Trustees and was a past President of the Discovery Square project.
Dr. Steehler resides in the Erie, PA with his wife and six children, one girl and five boys. In his free time he enjoys Jazz
music, jogging and chasing after his children. Dr. Steehler can
be reached at 814-864-9994.
Page 4
Clinical Studies Information
* Project Title: Prospective Controlled Randomized Study to the
Effect of Immunotherapy on Recurrence of Allergic Fungal Sinusitis
and Specific Immunoglobulin Fungal Levels.
* Project Title:
A Randomized, Double-Blind, PlaceboControlled, Parallel_group, Multicenter Study to Evaluate the
Efficacy and Safety of Once-Daily, Intranasal Administration of
GW6856908X Aqueous Nasal Spray 100mcg for 4 Weeks in
Adult and Adolescent Subjects (12 years of age and older) with
Vasomotor/Idiopathic Rhinitis
Principal Investigator: Berrylin J. Ferguson, M.D.
Brief Description: The objective of this study is to compare
the efficacy and safety of GW685698X 100mcg one daily aqueous nasal spray with vehicle placebo nasal spray in adult and adolescent subjects with VMR/IR.
Subjects: Patients with a diagnosis of VMR-IR who meet inclusion criteria.
Contact: Berrylin Ferguson, M.D. or a research coordinator at
(412) 647-8783 for additional details.
Brief Description: This study seeks to enroll subjects who are
scheduled for surgery for a fungal sinus infection. Subjects are assigned to two groups: those receiving allergy shots for molds and
those not receiving allergy shots. Subjects can also choose which
group they would like to be in.
Subjects: Subjects must be between 18-80 years of age and have
been diagnosed with allergic fungal sinusitis as defined by the presence
of nasal polyps with green mucus or CT scan showing opacification.
Changes in serological data will be analyzed preoperatively and 6 and
12 months post-operatively.
Contact: Dr. Ferguson at (412) 647-0448 or a research coordinator
at (412) 647-8783 for additional details.
* Project Title: Pilot Study to Assess the Intranasal Deposition of
Zicam Cold Remedy
* Project Title: Multicenter Comparative Study of Endoscopically-Guided Middle Meatal and Direct Sinus Bacterial Cultures in
Subjects with Acute Bacterial Rhinosinusitis.
Brief Description: The purpose of this research study is to
survey the bacteria that are present in the nasal cavity, middle
meatus, and maxillary sinus of subjects with acute bacterial rhinosinusitis. Subjects who fit the inclusion criteria will be sent for
a sinus x-ray. Subjects whose x-rays show an air-fluid level or
partial or complete opacification of the maxillary sinus will have
the sinus endoscopy and maxillary sinus culture. Subjects will be
compensated for their participation.
Subjects: Subjects must present with acute bacterial rhinosinusitis. A diagnosis may be made if there are at least two major
factors or one major factor and two minor factors. Major factors include: nasal drainage, nasal congestion, facial pain/pressure,
postnasal drainage, and hyposmia/anosmia. Minor factors include: fever, cough, fatigue, maxillary dental pain, and ear fullness/
pressure.
Contact: Dr. Ferguson at (412) 647-0448 or a research coordinator at (412) 647-8783 for additional details.
Brief Description: This study seeks to examine how a nasal spray
deposits into the nose using correct and incorrect techniques.
Subjects: Subjects must be between 18 and 80 years of age (male
and female) and must have no sinonasal surgery or actively using nasal
steroid sprays or saline solutions. Subjects can be normal or have
nasal congestion.
* Project Title: A Multicenter, Randomized, Double Blind Crossover Pilot Study of the Efficacy of Immunotherapy in Prick Negative,
Intradermal Positive Patients with Allergic Rhinitis
Brief Description: The specific aim is to determine whether subjects whose allergies are not detectable by skin multiprick testing but
are evident on intradermal dilutional testing(IDT) have improvement
in allergy symptoms after six months of weekly allergy shots compared to a placebo control group
Subjects: 10 participating sites to provide 40 evaluable subjects.
Page 5
Clinical Studies Information (Continued)
* Project Title: Direct Measurement of Rates of Synthesis and
Turnover of T Lymphocytes in Head and Neck Cancer Subjects and
Healthy Controls.
Principal Investigator: Robert L. Ferris, M.D., Ph.D.
Brief Description: This pilot study will examine the production and
turnover of T cells in people with head and neck cancer as well as
healthy control subjects. This study will require an overnight stay in
the General Clinical Research Center for administration of the
deuterated water compound as well as several blood draws.
Subjects: Head and neck cancer subjects must have active disease
and may not have any prior oncology therapy for their HNC. In addition, subjects must have normal screening laboratory tests (CBC,
chemistry profile, liver function). Healthy controls will be age
matched. Subjects will be compensated for their participation.
Contact: Dr. Ferris at (412) 647-0954
* Project Title: Case-Control Study of High-Risk Sexual Behaviors,
Human Papillomavirus, and Oropharyngeal Squamous Cell Carcinoma
Principal Investigator: Robert L. Ferris, M.D., Ph.D.
Brief Description: This study will use information obtained from a
computerized questionnaire to compare high-risk sexual behavior
profiles between cancer cases and non-cancer controls; to compare
the high-risk sexual behavior profiles between HPV-positive cancer
cases, HPV-negative cancer cases, and non-cancer controls; and to
determine if orogenital sexual contacts are more common amongst
HPV-positive cancer cases compared to HPV-negative cases and noncancer controls. In addition, an oral specimen will be collected by
brush biopsy and a blood sample will be taken for HPV and STD serology.
Subjects: Subjects must be at least 18 years of age (male or female).
Cases must have a cytologically or histologically confirmed diagnosis
of squamous cell carcinoma of the oropharynx. Cases will have routine diagnostic biopsy or surgical resection as standard of care. Controls must be diagnosed with benign disease and may not currently or
historically have cancer.
Contact: Dr. Ferris at (412) 647-0954
* Project Title: SPORE (Specialized program of Research Excellence) In Head and Neck Cancer
Principal Investigator: Jennifer R. Grandis, M.D.
Brief Description: The purpose of this research study is to provide
tissue, blood, saliva, and/or sputum for the study of cancer of the
head and neck. The majority of patients are recruited after they have
scheduled for surgery, chemotherapy and/or radiation treatments.
Samples banked through this study supply numerous investigators
with regular biologic samples for examination, tissue culture, etc.
Subjects: Subjects must be at least 18 years of age (male or female).
Subjects with and without cancer are being recruited for this study.
Subjects recruited as controls must have no previous history of ANY
cancer.
Contact: Dr. Grandis at (412) 647-5979 or a research coordinator
* Project Title: Adjuvant DC-Based Therapy for Subjects with
Squamous Cell Cancer of the Head and Neck Using UV Irradiated
Autologous Tumors (A Pilot/Feasibility Study) (UPCI #00-046)
Principle Investigator: Jonas T. Johnson, M.D.
Brief Description: This research study seeks to enroll subjects
who have been diagnosed with squamous cell carcinoma of the head
and neck. Using cells from the tumor, researchers will prepare an
experimental vaccine. The study seeks to determine if there are
side effects associated with administration of the experimental vaccine and to evaluate the ability of the experimental vaccine to induce
immune responses against the subject’s own tumor or similar cancers.
Subjects: Subjects must be at least 18 years of age (male or female)
and have a diagnosis of T4 squamous cell carcinoma.
Contact: Dr. Johnson at (412) 647-2131 or a research coordinator
*
Project Title: The Sleep Study: Studying Live Effects and Effectiveness of Palatopharyngoplasty
Principal Investigator: Jonas T. Johnson, M.D.
Brief Description: UPPP improves symptoms: sleepiness, snoring,
morning headache frequency, and global improvement of sleep apnea.
Subjects: Patients 18 years or older with palatal obstruction felt to
be consistent with the presenting symptoms of sleep apnea as assessed by the treating surgeon.
Contact: Jonas T. Johnson, M.D. or a research coordinator at
(412) 647-8783 for additional details.
* Project Title: A Randomized Double Blind Study Comparing the
Effects of Resource Support® to a Standard Nutritional Supplement
on Immune Response in People with Head and Neck Cancer
Principal Investigator: Carl H. Snyderman, M.D.
Brief Description: The primary objective of this study is to investigate the effects of 3 weeks of supplementation with Resource Support®, a nutritional supplement, as compared with a standard nutritional supplement on the T cell mediated immune response in people with a history of head and neck cancer. This will be a singlecenter, randomized, double-blind parallel-group study enrolling 50
subjects to identify 40 who meet the eligibility criteria. Subjects will
be randomized in a 1:1 ratio to receive active (Resource Support®):
placebo (standard nutritional treatment).
Subjects: Patients with a history of head and neck cancer who
have completed their surgery and/or radiotherapy treatments.
Contact: Dr. Snyderman at (412) 647-2462 or a research coordinator at (412) 647-2209 for additional details.
Administrator’s Corner:
Coding Corner:
It was suggested at the March meeting that
residents attend the CENTS Quarterly meetings. Please send your residents’ name, address, phone, and email address to Julie Truver.
Fax: 412-647-8935 or Email: truverja@upmc.
edu
Diagnostic Laryngoscopes
Coverage Change
Endonasal Surgery Featured on NBC
Nightly News and UPMC Health Journal
Drs. Carl Snyderman, Department of Otolaryngology, and Amin Kassam, Department of Neurosurgery are co-directors of the Center for
Cranial Base Surgery. Their endoscopic transnasal brain surgery techniques and advancements were featured on NBC Nightly News on
June 21, 2005 and the UPMC Health Journal in
April 2005. Below are links to the articles:
http://www.msnbc.msn.com/id/8304870/
http://healthjournal.upmc.com/0405/
EndonasalSurg.htm
Page 6
Seeing an increase in your medical necessity
denials for Medicare?
If so, the reason could be an easy one.
Medicare created a new policy for Direct
Laryngoscopes (CPT Code 31515) and
Flexible Fiberoptic Laryngoscopes (CPT
code 31575). Policy M-71 went into effect
March 15, 2005. Indications for the use of
these two scopes is that a rigid or flex was
attempted, but do to gagging limits or upper airway anatomy, the other scopes were
needed. (These should be clearly documented in the chart notes.)
There are no carrier limits placed on frequency of Diagnostic Laryngoscope. Medicare will not cover the use of these scopes
if used for screening, in the absence of a
specific sign or symptoms. The new HGS
Administrator policy does put a large restriction on what the carrier determines to
be medical necessity in restricting what diagnosis codes will be covered. It may surprise you to know that 195.0, Head and
Neck Cancer, did not make the list for covered diagnosis. It is important that all Otolaryngologists and their office staff review
this policy. Often there may be signs and
symptoms that have been documented that
are on the covered list that will help your
claim process. Please do not hesitate to
contact your Medicare representative or
write to the director of Medicare to have
appropriate diagnosis added to this list.
Article submitted by Kathi Flaherty, CPC
Page 7
Welcome…Stephen Y. Lai, M.D., Ph.D.
Our Newest CENTS Member
Stephen Y. Lai, M.D., Ph.D. has joined the faculty as an Assistant
Professor of the Department of Otolaryngology – Head and
Neck Surgery at the University of Pittsburgh and is our newest
CENTS member. Dr. Lai attended Stanford University for his undergraduate studies. He received both his medical degree and
doctorate in biomedical sciences from the University of California, San Francisco in the NIH Medical Scientist Training Program.
He completed his internship with the Department of Surgery and
his residency with the Department of Otorhinolaryngology –
Head and Neck Surgery both at the University of Pennsylvania,
School of Medicine. In 2003, Dr. Lai came to the University of
Pittsburgh to complete a two-year Oncologic Head and Neck/Cranial Base Surgery fellowship
with the Department of Otolaryngology – Head and Neck Surgery.
Dr. Lai became a diplomate of the American Board of Otolaryngology in 2004. He is also a member of several professional and scientific societies. Dr. Lai has published numerous reviews, papers, book chapters, and abstracts and presented several invited lectures. His current research
focuses upon the influence of the tumor microenvironment on head and neck cancer invasion and
metastasis. Current research funding includes a grant entitled, “Erythropoietin Signaling in Head
and Neck Squamous Cell Carcinoma.”
Dr. Lai resides in Pittsburgh with his wife Teresa S. Lin, a lawyer at Cohen & Grigsby. In his free
time, he enjoys photography, tennis and jazz.
Dr. Lai can be reached via email at [email protected] or via phone at 412-647-5280.
Page 8
Websites of Interest
* CENTS *
http://otolaryngology.medicine.pitt.edu/cents/home.html
•
•
•
The CENTS website is now available.
Username = cents
Password = scuba
-ENT Teleconferences on the web
http://teleconference.upmc.edu/entpuh/
-MGMA
http://www.mgma.com
-Hearing/Balance Disorders
www.upmc.edu/healthmed/services/otolaryngology
-Hearing Loss
http://hearingloss.upmc.com/Default.htm
-Medical Resource (CME Credits, Searchable
Journal)
www.emedicine.com
- Centers for Medicare and Medicaid Services, Carriers
Manual Table of Contents
http://cms.hhs.gov/manuals/14_car/3btoc.asp
-Swallowing Center
www.upmc.edu/swallowingdisorders
Upcoming Courses/Events
9-13-05
CENTS Quarterly Meeting, 6:30-8:30,
S121 Biomedical Science Tower,
Pittsburgh, PA
9-25-05 to AAO-HNSF Annual Meeting & OTO EXPO
9-28-05
Los Angeles, CA
9-30-05 to World Congress for Endoscopic Surgery of
10-2-05
the Brain, Skull Base and Spine.
David L. Lawrence Convention Center,
Pittsburgh, PA
12-5-05
CENTS Quarterly Meeting, 6:30-8:30,
S121 Biomedical Science Tower,
Pittsburgh, PA
For more information on any of the courses, please call
412-243-5156 or email [email protected]
-Voice Center
www.upmc.edu/upmcvoice
-AAO-HNS
www.entnet.org
-AOA-Association of Otolaryngology
Administrators
www.oto-online.org
-HIPAA Related Sites
Site
www.hipaacomply.com
Comments
News, Information,
Discussions, & Forums
www.hipaabasics.com
Training Tools,
Resources, FAQ’s, & Links
www.ahima.org
Regulations, Standards,
Seminars & More
www.aha.org/
American Hospital Association
www.cms.hhs.gov/hipaa/hipaa2/
Medicare/Medicaid page Dealing
with HIPAA (has helpful forms and
summaries)
-Medicare Website
www.cms.hhs.gov
We still need digital photographs from the
following members:
David C. Armstrong
Murat Bankaci
Michael Bell
Kristin C. Brant
Howard R. Goldberg
Mark Klingensmith
Mariann McElwain
David R. Rogerson
George Schein
Stephen E. Schell
Paul Scolieri
Kirk W. Steehler
Stephen F. Wawrose
Keith B. Welker
C. Thomas Yost

CENTS QUARTERLY NEWSLETTER President’s Message

Transcription

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