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FIGURE 2-9

Table 31-1 Types of intracranial tumor in the combined series of Zulch, Cushing, and Olivecrona, expressed in percentage of total (approximately 15,000 cases)

8:

Gliomas Glioblastoma multiforme Astrocytoma Ependymoma Medulloblastoma Oligodendroglioma Meningioma Pituitary adenoma Neurinoma (schwannoma) Metastatic carcinoma Craniopharyngioma, dermoid, epidermoid, teratoma Angiomas Sarcomas Unclassi ed (mostly gliomas) Miscellaneous (pinealoma, chordoma, granuloma, lymphoma)b Total

20 10 6 4 5 15 7 7 6 4 4 4 5 3 100

growth potential (degree of nuclear atypia, cellularity, mitoses, and vascular changes) and prognosis The glioblastomas, which are largely de ned by the added features of necrosis and anaplasia of nonneural elements such as vascular proliferation, are set apart from anaplastic astrocytomas on the basis not only of their histology but also by a later age of onset than astrocytoma and a more rapid course Tumors formerly classi ed as grade I astrocytomas are rare and dif cult to distinguish from hamartomas; therefore they are currently omitted from most classi cations In the WHO system, grade I is reserved for the relatively benign pilocytic astrocytomas (well-differentiated tumors mostly of children and young adults) Similarly, the pleomorphic xanthoastrocytomas (with lipid- lled cells) and the subependymal giant-cell astrocytomas (usually associated with tuberous sclerosis) have been set apart because of their different growth patterns, pathologic features, and prognosis The ependymomas are subdivided into cellular, myxopapillary, clear-cell, and mixed types; the anaplastic ependymoma and the subependymoma are given separate status The pathologic criteria of malignant astrocytoma do not apply to oligodendroglioma,

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In children, the proportions differ: astrocytoma, 48 percent; medulloblastoma, 44 percent; ependymoma, 8 percent Seventy percent of gliomas in children are infratentorial; in adults, 70 percent are supratentorial Craniophrayngioma also occurs mainly in younger age groups The incidence of lymphoma was negligible when these series were collected, but it has increased markedly since then (see text)

16 Which of the following procedures should you use to compress a directory on your Windows XP Home Edition computer A Use the Backup utility and select the option to compress the files B Right-click the directory, select Properties | Advanced, and select the Compression option C Open the Disk Management utility and select the Compress Selected Files option D Use My Computer to move the appropriate files into the COMPRESSED folder

change an existing range-partitioned table into an intervalpartitioned table, as long as the ranges fall into a specific pattern, or you can extend an existing range partitioned table into an interval table in the future You can also merge partitions at the low end of an interval-partitioned table to create a single-range partition This last option is particularly useful for gaining the benefits of an interval partition while implementing an Information Lifecycle Management (ILM) strategy for reduced storage costs

Table 31-2 Age-speci c frequency of tumor types with age (adapted from the Central Brain Tumor Registry for the United States, 1995 1999; wwwcbtrusorg)

also appears to be increasing even in those with ostensibly normal immune function Classi cation and Grading of Nervous System Tumors Classi cations and grading systems of intracranial tumors abound and are often confusing to the general neurologist Most classi cations have been based on the presumed cell of origin of the neoplasm, while grading systems are meant to be an estimate of the rate of growth and clinical behavior, but the two are often concordant The most recent WHO classi cation represents a current view of tumor specialists but is unfortunately too unwieldy for most clinicians; a discussion of this system can be found in the article by Kleihues and colleagues In order to make this system comprehensible, what follows is an extracted synopsis of (1) modern re nements in the histopathologic study of gliomas, (2) the numerical grading system of Daumas-Duport and coworkers (also known as the St Anne Mayo system), (3) the three-tiered system of Ringertz (which correlates most closely with clinical survival), and (4) the aforementioned new third edition of the World Health Organization s classi cation (which incorporates the Ringertz system) These pathologic systems notwithstanding, it is becoming apparent that there are practical consequences to subclassifying tumors by additional molecular methods (see further on) The astrocytic tumors, the most common forms of glioma, have been subdivided into diffuse well-differentiated astrocytoma (grade II), anaplastic astrocytoma (grade III), and glioblastoma multiforme (grade IV) These represent a spectrum in terms of

Neuroepithelial tumors (glial origin) Pilocytic astrocytoma Glioblastoma Malignant glioma Diffuse astrocytoma Anaplastic astrocytoma Other astrocytoma Oligodendroglioma Anaplastic oligodendroglioma Ependymomas Mixed glioma Embryonal/primitive/ medulloblastoma Meningeal tumors Meningioma Hemangioblastoma Lymphoma Sellar tumors Pituitary adenoma Craniopharyngioma Cranial and spinal nerve tumors Germ cell tumors Local extension from regional tumors Unclassi ed Total

781 198 38 89 15 25 92 23 08 64 08 160 43 31 08 05 64 08 36 20 43 05 38 1000

17 An OS uses the NTFS 5 file system When you boot the computer with this OS, which other types of volumes will you be able to access A B C D A B C D A B C D FAT16 only FAT16 and FAT32 FAT16 and HPFS None FAT16 supports volumes up to 16MB, and FAT32 supports volumes up to 32MB FAT16 volumes typically have about half the amount of slack as FAT32 volumes Some versions of Windows 9x cannot access FAT16 FAT16 can be used by more versions of Windows than FAT32 FAT32, NTFS 4, and NTFS 5 NTFS 4 and NTFS 5 FAT32 and NTFS 5 NTFS 5

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