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site of natural narrowing of the lumen of an intracranial vessel, and ischemic infarction follows The infarction is pale, hemorrhagic, or mixed; hemorrhagic infarction nearly always indicates embolism, though most are pale Any region of the brain may be affected, the territory of the middle cerebral artery, particularly the superior division, being the most frequently involved The two cerebral hemispheres are approximately equally affected Large embolic clots can block large vessels (sometimes the carotids in the neck or at their termination intracranially), while tiny fragments may reach vessels as small as 02 mm in diameter usually with inconsequential effects The embolic material may remain arrested and plug the lumen solidly, but more often it breaks into fragments that enter smaller vessels and disappear, so that even careful pathologic examination fails to reveal their nal location In this instance, the clinical effects may clear in hours.

sh@AOS> desc customer Name Null Type ---------------------------------------- -------- --------------------CUST_ID NOT NULL NUMBER(6) CUST_FIRSTNAME VARCHAR2(20) CUST_LASTNAME VARCHAR2(20) CUST_ADDRESS VARCHAR2(40) CUST_CITY VARCHAR2(15) CUST_STATE VARCHAR2(2) CUST_ZIP VARCHAR2(10) CUST_CREDIT_CARD_NO VARCHAR2(19) CUST_CREDIT_CARD_EXP VARCHAR2(4) sh@AOS>

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The anatomic diagnosis must then be made by inference, eg, absence of a vascular occlusion at the proper site to explain the infarct; absence of atherosclerosis or other cause of occlusion in the offending cerebral vessel; presence of a source of emboli, atrial brillation, or infarcts in other organs such as the kidneys and spleen; the occurrence of hemorrhagic infarction; and nally the clinical history, which is characterized by an absolutely abrupt onset, as described below Because of the rapidity with which embolic occlusion develops, there is not much time for collateral in ux to become established Thus, sparing of the territory distal to the site of occlusion is not as evident as in thrombosis However, the vascular anatomy and ischemia-modifying factors mentioned above, under The Ischemic Stroke, are still operative and in uence the size and magnitude of the infarct.

Brain embolism is predominantly a manifestation of heart disease, and fully 75 percent of cardiogenic emboli lodge in the brain The commonest identi able cause is chronic or recent atrial brillation, the source of the embolus being a mural thrombus within the atrial appendage (Table 34-7) Patients with chronic atrial brillation are about six times more liable to stroke than an agematched population with normal cardiac rhythm (Wolf et al) and the risk is considerably higher if there is also rheumatic valvular disease as mentioned earlier Furthermore, the risk conferred by the presence of atrial brillation varies with age, being 1 percent per year in persons younger than 65, and as high as 8 percent per year in those over 75 with additional risk factors These levels of risk are of prime importance in determining the advisability of anticoagulation, as discussed below.

Embolism may also occur during paroxysmal atrial brillation or utter Mural thrombus deposited on the damaged endocardium overlying a myocardial infarct in the left ventricle, particularly if there is an aneurysmal sac, is an important source of cerebral emboli, as is a thrombus associated with severe mitral stenosis without atrial brillation Emboli tend to occur in the rst few weeks after an acute myocardial infarction, but Loh and colleagues found that a lesser degree of risk persists for up to 5 years Cardiac catheterization or surgery, especially valvuloplasty, may disseminate fragments from a thrombus or a calci ed valve Mitral and aortic valve prostheses are additional important sources of embolism Another source of embolism is the carotid or vertebral artery, where clot forming on an ulcerated atheromatous plaque may be detached and carried to an intracranial branch (artery-to-artery embolism).

A similar phenomenon may occur with arterial dissections and sometimes with bromuscular disease of the carotid or vertebral arteries Atheromatous plaques in the ascending aorta have been rec-.

To solve word problems involving geometric shapes, write down the formula or formulas referred to in the problem. For example, after reading The perimeter of a rectangular room . . . write P 2L 2W. Then ll in the information given about the formula. For example, after reading The perimeter of the room is 50 feet . . . write P 50 and 50 2L 2W. Its width is two-thirds its length. Write W 2 L and 50 2L 2W becomes 3 50 2L 2 2 L . 3 The formulas you will need in this section are listed below.

5. Enter ATTDISP and On. Each of the tools contains attributes, as shown in Fig. 37-1.

Now we need to have a table called DJ which contains the DJ names for us to list to the User when he decides to modify his preferences.

Notice how I used the align attribute of the <p> tag to get the logo in the center of the screen. The resulting output is shown here:

List of Commands for Web Templates (continued)

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