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third of patients with tumors smaller than 25 cm in diameter If no attempt is to be made to save hearing, small tumors can be removed safely by the translabyrinthine approach An alternative to surgery is focused gamma or proton radiation, which controls the growth of many of the smaller tumors In a large series of patients treated with radiosurgery, facial motor and sensory functions were preserved in three-quarters of cases and, after 28 months of observation, no new neurologic de cits were detected (Kondziolka et al) This approach is favored in older patients with few symptoms but is being adopted increasingly for others The rates of hearing loss and facial numbness and weakness are comparable or lower than with surgery but the follow-up period in most series is less than 5 years (Flickinger et al) Focused radiation with the gamma knife or linear accelerator also appears to be preferable to surgery in cases of recurrent tumor Other Tumors of the Cerebellopontine Angle Region Neurinoma or schwannoma of the trigeminal (gasserian) ganglion or neighboring cranial nerves and meningioma of the cerebellopontine angle may in some instances be indistinguishable from an acoustic neuroma Fifth nerve tumors should always be considered if deafness, tinnitus, and lack of response to caloric stimulation ( dead labyrinth ) are not the initial symptoms of a cerebellopontine angle syndrome A true cholesteatoma (epidermoid cyst) is a relatively rare tumor that is most often located in the cerebellopontine angle, where it may simulate an acoustic neuroma but usually causes more severe facial weakness Spillage of the contents of the cyst may produce an intense chemical meningitis Other disorders that enter into the differential diagnosis are glomus jugulare tumor (see below), metastatic cancer, syphilitic meningitis, arachnoid cyst, vascular malformations, and epidural plasmacytoma of the petrous bone All these disorders may produce a cerebellopontine angle syndrome, but they are more likely to cause only unilateral lower cranial nerve palsies and their temporal course tends to differ from that of acoustic neuroma Occasionally, a tumor that originates in the pons or in the fourth ventricle (ependymoma, astrocytoma, papilloma, medulloblastoma) or a nasopharyngeal carcinoma may present as a cerebellopontine angle syndrome Craniopharyngioma (Suprasellar Epidermoid Cyst, Rathke s Pouch or Hypophysial Duct Tumor, Adamantinoma) This is a histologically benign epithelioid tumor, generally assumed to originate from cell rests (remnants of Rathke s pouch) at the junction of the infundibular stem and pituitary By the time the tumor has attained a diameter of 3 to 4 cm, it is almost always cystic and partly calci ed Usually it lies above the sella turcica, depressing the optic chiasm and extending up into the third ventricle Less often it is subdiaphragmatic, ie, within the sella, where it compresses the pituitary body and erodes one part of the wall of the sella or a clinoid process; seldom does it balloon the sella like a pituitary adenoma Large tumors may obstruct the ow of CSF The tumor is oval, round, or lobulated and has a smooth surface The wall of the cyst and the solid parts of the tumor consist of cords and whorls of epithelial cells (often with intercellular bridges and keratohyalin) separated by a loose network of stellate cells If there are bridges between tumor cells, which have an epithelial origin, the tumor is classed as an adamantinoma The cyst contains dark albuminous uid, cholesterol crystals, and calcium deposits; the calcium can be seen in plain lms or CT scans of the suprasellar region in 70 to 80 percent of cases The sella beneath the tumor tends to be attened and enlarged The majority of the patients are.

The C# portion of the script is equally simple because the filter (WHERE) only specifies one value That value is whatever the user types in the TextBox in the ASPNET portion of the application

F i r s t - O r d eS p l i n e s r Problem Stotement Fit the data in Table 16I with first-ordersulinesEvaluate the functionotx:5 TABIE l6 l ix,f, I 2 3

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using System; using SystemDataSqlClient; public partial class Killer : SystemWebUIPage { private string strDelete; private SqlCommand sqlCmd; private SqlConnection hookUp;

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children, but the tumor is not infrequent in adults, and we have encountered patients up to 60 years of age The presenting syndrome may be one of increased intracranial pressure, but more often it takes the form of a combined pituitaryhypothalamic-chiasmal derangement The symptoms are often subtle and of long standing In children, visual loss and diabetes insipidus are the most frequent ndings, followed by adiposity, delayed physical and mental development (Froehlich or Lorain syndrome see page 486), headaches, and vomiting The visual disorder takes the form of dim vision, chiasmal eld defects, optic atrophy, or papilledema, as emphasized long ago by Kennedy and Smith In adults, waning libido, amenorrhea, slight spastic weakness of one or both legs, headache without papilledema, failing vision, and mental dullness and confusion are the usual manifestations One of the most remarkable cases in our experience was a middle-aged nurse who became distractible and ineffective at work and was thought for many months to be simply depressed Often it is observed that drowsiness, ocular palsies, diabetes insipidus, and disturbance of temperature regulation (indicating hypothalamic involvement) occur later Spontaneous rupture of the cystic lesion can incite a severe aseptic meningitis, at times with depressed glucose in the CSF In the differential diagnosis of the several craniopharyngioma syndromes, a careful clinical analysis is more informative than laboratory procedures Among the latter, MRI is likely to give the most useful information Often, because of the cholesterol content, the tumor gives an increased signal on T1-weighted images Usually, the cyst itself is isointense, like CSF, but occasionally it may give a decreased T2 signal Treatment Modern microsurgical techniques, reinforced by corticosteroid therapy before and after surgery and careful control of temperature and water balance postoperatively permit successful excision of all or part of the tumor in the majority of cases While smaller tumors can be removed by a transsphenoidal approach, attempts at total removal require craniotomy and remain a challenge because of frequent adherence of the mass to surrounding structures (Fahlsbusch et al) Partial removal practically assures recurrence of the tumor mass, usually within 3 years, and the surgical risks of reoperation are considerable (10 percent mortality in large series) In 21 of our 35 patients, only partial removal was possible; of these, 8 died, most in the rst postoperative year Stereotaxic aspiration is sometimes a useful palliative procedure, as are focused radiation therapy and ventricular shunting in patients with solid, nonresectable tumors Endocrine replacement is necessary for an inde nite time following tumor resection Glomus Jugulare Tumor This tumor is relatively rare but of particular interest nonetheless It is a purplish red, highly vascular tumor composed of large epithelioid cells, arranged in an alveolar pattern and possessing an abundant capillary network The tumor is thought to be derived from minute clusters of nonchromaf n paraganglioma cells (glomus bodies) found mainly in the adventitia of the dome of the jugular bulb (glomus jugulare) immediately below the oor of the middle ear but also in multiple other sites in and around the temporal bone These clusters of cells are part of the chemoreceptor system that also includes the carotid, vagal, ciliary, and aortic bodies The typical syndrome consists of partial deafness, facial palsy, dysphagia, and unilateral atrophy of the tongue combined with a vascular polyp in the external auditory meatus and a palpable mass below and anterior to the mastoid eminence, occasionally with a.

protected void DropIt(object sender, EventArgs e) { hookUp = new SqlConnection("Server=localhost\\SqlExpress;Database=VoteNow;" + "Integrated Security=True"); strDelete = "DELETE FROM Supporters WHERE LastName=@LName"; sqlCmd = new SqlCommand(strDelete, hookUp); sqlCmdParametersAdd("@LName", LNameText); hookUpOpen(); sqlCmdExecuteNonQuery(); hookUpClose(); Label1Text = LNameText +" was deleted"; } }

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When you test the program, you will see that whatever name you enter in the input window is repeated in a Label web control when you click the Delete Record button If no such record exists, it still shows the message because the label simply takes the entered text and echoes it in the label output Figure 12-23 shows what you can expect to see when you test the application