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is a bias also toward large fatal lesions (usually hemorrhages) Table 34-4 summarizes the ndings of the Harvard Cooperative Stroke Registry, tabulated in 1978 and comprising 756 successive patients, each of whom was examined by a physician knowledgeable about strokes and subjected when necessary to appropriate ancillary examinations (four-vessel arteriography, CT scan, lumbar puncture, but before the days of MRI) For comparison, we have included an autopsy series of 740 cases, examined during the year 1949 by Fisher and Adams; of these, 179 (nearly 25 percent) had some form of cerebrovascular disease Interestingly, in both series the ratio of infarcts to hemorrhages was 4:1 and embolism accounted for approximately one-third of all strokes The above studies correspond reasonably well with more recent data collated in the Stroke Data Bank of the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) (Sacco et al, 1989) and other modern series which have had the advantage of MRI

(t (1) , t (length(r) ) ) ; za=n/ cd*1og (cosh (sqrt (qr*cd/m) *t,a) ) ; >> ploL (La, za,t, z,' a' ) >> >> >> >> ra=linspace >> xlabel title('Distance t-1me') versus ('t (s) ') ,ylabel ('x (m) ') 'numerical Legend ( 'analyticaL' , t

$db{ contact-1 } = "Martin;Brown;1,3,4"; $db{ contact-2 } = "Bob;Smith;2,5";

Most cerebrovascular disease can be attributed to atherosclerosis and chronic hypertension; until ways are found to prevent or control them, vascular disease of the brain will continue to be a major cause of morbidity Hypertension and atherosclerosis interact in a variety of ways Atherosclerosis, by reducing the resilience of large arteries, induces systolic hypertension In turn, sustained hypertension worsens atherosclerosis, seemingly driving it into the walls of small branch arteries (05 mm or less) All the coats of the vessel become impregnated with a hyaline-lipid material, a process that Fisher has called lipohyalinosis The segment so affected may also weaken and allow the formation of a small dissecting aneurysm (Charcot-Bouchard aneurysm), which most neuropathologists hold responsible for the hypertensive brain hemorrhage The atheromatous process in brain arteries is identical to that in the aorta, coronary, and other large arteries In general the process in the cerebral arteries runs parallel to but is somewhat less severe than that in the aorta, coronary, and lower limb vessels There are many exceptions to this rule, however, and not infreTable 34-4 Major types of cerebrovascular diseases and their frequency

The key is made up of the table name and a unique ID within that table The information is stored using delimited text fields in the value portion of the key/value pair Note that semicolons separate the individual fields, but commas separate the link data in the third field The numbers table could be populated with the following information:

,ly,

(756

$db{ numbers-1 } $db{ numbers-2 } $db{ numbers-3 } $db{ numbers-4 } $db{ numbers-5 } = = = = = "Email;mc@mcwordscom"; "Email;bsmith@foobarcom"; "Fax;01234 456789"; "Phone;09876 543210"; "Mobile;0789 123456";

F I G U R E7 1 5 1 Ploi distonce of time line versus The woscompufed theonolyticol with rne solufion, wnereos

SUCCESSIVE CASES)

To access the complete contact information for Martin Brown, you need to access record number one of the contact table and then access the related information listed in field three of that record In this case, this is records 1, 3, and 4 from the numbers table To dump the information from the database in a formatted formation, you might use a script like this:

(179 CASES) 21 (12%) 34 (185%) 57 (32%) 28 (155%) 8 (45%) 17 (95%) 14 (8%)

Newton-Cotes open integrotion formu/os formulos presenied the formotof Eq{17 The l3) ore in so thottheweighting the doto points estimote overogeheightis opporent siep to of the The size i s g i v e nb y h : ( b - u ) l n

use Fcntl; use GDBM_File;

Atherosclerotic thrombosis Lacunae Embolism Hypertensive hemorrhage Ruptured aneurysms and vascular malformations Indeterminate Otherc

Segmenls (n\

13:

244 (32%) 129 (18%) 244 (32%) 84 (11%) 55 (7%)

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Compiled by J Mohr, L Caplan, D Pessin, P Kistler, and G Duncan at Massachusetts General Hospital and Beth Israel Hospital, Boston Compiled by C M Fisher and R D Adams in an examination of 740 brains during the year 1949 at Mallory Institute of Pathology, Boston City Hospital Hypertensive encephalopathy, cerebral vein thrombosis, meningovascular syphilis, and polyarteritis nodosa

tie %db, 'GDBM_File', 'Test_Rel', O_CREAT|O_RDWR, 0644 || die "Can't open DB File, $!";; foreach $id (sort grep(/^contact-[0-9]+/,keys %db)) { ($lastname, $firstname, $relations) = split(/;/,$db{$id}); print "$firstname $lastname\n"; foreach $subid (sort split(/,/,$relations)) { ($type,$num) = $db{"numbers-$subid"} if (exists($db{"numbers-$subid"})); print " $type: $num\n"; } } untie %db || die "Can't close DB File, $!";

.

| /3V13 f"G) t,314)h3 f"G)

The method is basically very similar to the tricks you saw in the previous section for modeling complex data structures within a DBM database When run on the database above, it produces the following results: