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It has long been appreciated that the process formerly known as Erdheim s medionecrosis aortica cystica, the main cause of aortic dissection, may extend into the common carotid arteries, occluding them and causing massive infarction of the cerebral hemispheres Examples of such an occurrence were cited by Weisman and Adams in 1944 in their study of the neurology of dissecting aneurysms of the aorta In more recent years, attention has been drawn to the occurrence of spontaneous dissection of the internal carotid artery and the fact that it is an important cause of hemiplegia in young adults Several large series of such cases have been reported in separate studies by Ojemann, Mokri, and Bogousslavsky and their colleagues Traumatic or apparently spontaneous carotid dissection is a not uncommon cause of stroke, particularly in younger individuals Bogousslavsky and colleagues found 30 instances (comprising both genders) in 1200 consecutive patients with a rst stroke (25 percent) It should be suspected in young adult women (typically in their late thirties or early forties), who seem especially susceptible to the condition, either as a spontaneous event or in relation to a whiplash injury, bouts of violent coughing, or direct trauma to the head or neck, which need not be severe eg, being struck in the neck by a golf or tennis ball We have also encountered cases that occurred during pregnancy and immediately after delivery Indeed, it is questionable if many cervical arterial dissections are truly spontaneous, since most can be connected to some strenuous event Three of our patients over the years had a carotid dissection that was manifest as a hemiplegia days after blunt head injury A small number of patients have bromuscular disease, as discussed above; the Ehlers-Danlos and Marfan syndromes, osteogenesis imperfecta, and alpha-1-antitrypsin de ciency are also associated with an increased risk of vascular dissection One of these conditions should be suspected if multiple extracranial vessels are involved in spontaneous dissections (neck and thoracic trauma are more common causes of this con guration) It is of interest that a few patients with carotid dissection have had warning attacks of unilateral cranial or facial pain, followed, within minutes to days, by signs of ischemia in the territory of the internal carotid artery The pain is nonthrobbing and centered most.

$db = new Win32::ODBC("Acronym"); if ($db->GetInfo($db->SQL_LIKE_ESCAPE_CLAUSE()) eq 'Y') { print "ODBC Driver supports wildcard escapes\n"; $char = $db->GetInfo($db->SQL_SEARCH_PATTERN_ESCAPE()); print "Escape Character is: $char\n"; } PROGRAMMING WITH PERL

The secondmethod is called Gcuss qundrnfureRecall that, in Chap 17, values of at /(x) for the Newton-Cotesformulas were determined specifiedvaluesof ,r For example, if we usedthe trapezoidal rule to determine integral,we were constrained takethe an to weightedaverageof /(x) at the endsof the intervalGauss-quadrature formulasemploy,r valuesthat arepositionedbetweenthe integrationlimits in sucha mannerthat a much more accurate integralestimateresults The third approachis called adaptivequadratureThis techniques appliescomposite Simpson's I /3 rule to subintervals the integrationrangein a way that allows error estiof mates to be computedThese error estimatesare then used to determinewhether more refined estimatesare required for a subintervalIn this way, more refined segmentation is only usedwhereit is necessary Two built-in MATLAB functionsthat useadaptivequadratureare illustrated

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SQL accepts single quotes as delimiters to text strings The single quotes tell SQL to treat anything between them as text, rather than as a keyword For most queries within Perl, it s best to use the double quotes to specify the query, so that you can use single quotes within the string: