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Speaking generally, tumors of the central nervous system (CNS) constitute a bleak but vitally important chapter of neurologic medicine Their importance derives from the facts that they occur in great variety; produce numerous neurologic symptoms because of their size, location, and invasive qualities; usually destroy the tissues in which they are situated and displace those around them; are a frequent cause of increased intracranial pressure; and, most of all, are often lethal Slowly this dismal state of affairs is changing, as a result of advances in anesthesiology, stereotactic and microneurosurgical techniques, radiation therapy, and the use of chemotherapeutic agents For clinicians, it should be a matter of general knowledge that: 1 Many types of tumor, both primary and secondary, occur in the cranial cavity and spinal canal Certain ones are much more frequent than others and are prone to occur in particular age groups Some tumors such as craniopharyngioma, meningioma, and schwannoma have a disposition to grow consistently in particular parts of the cranial cavity, thereby producing highly characteristic neurologic syndromes The presence of certain diseases such as AIDS, inherited disorders such as neuro bromatosis, or some systemic cancers predisposes to the development of tumors of the nervous system The growth rates and invasiveness of tumors vary; some, like the glioblastoma, are highly malignant, invasive, and rapidly progressive and others, like the meningioma, are benign, slowly progressive, and compressive These pathologic peculiarities are important, for they have valuable clinical implications, frequently providing the explanation of slowly or rapidly evolving clinical states and determining a good or poor prognosis Systemic neoplasms, by poorly understood mechanisms, may have remote effects on the nervous system, quite apart from those due to their compressive, in ltrative, or metastatic actions Moreover, these remote effects, referred to as paraneoplastic, may constitute the initial or only clinical manifestation of the underlying neoplasm Metastatic neoplasms are a far more common cause than are primary tumors of brain and spinal cord, and certain cancers display this tendency more than others.

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Figure 1-14 shows beyond any doubt that what s doing all of the work is the serverside ASPNET combined with a C# program generated on the remote server Does this mean that you can develop applications on a Mac just as on your Windows PC Not exactly You can write your C# and ASPNET applications on a Mac using a simple text editor or something more sophisticated like Dreamweaver Then by transferring the code to an ASPNET host, you can see the same thing as you do in Figure 1-14 However, you cannot host the code on a Mac because ASPNET cannot be set up on a Mac Still, as you will see in the next section, you can work with any kind of system you want if you have an ASPNET hosting service

Incidence of CNS Tumors and Their Types Currently, in each year there are an estimated 540,000 deaths from cancer in the United States Of these, the number of patients who died of primary tumors of the brain seems comparatively small (about 18,000, half of them malignant gliomas), but in roughly another 130,000 patients the brain is affected at the time of death by metastases Thus, in approximately 25 percent of all the patients with cancer, the brain and its coverings are involved by neoplasm at some time in the 546

Figure 1-14

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One of the best options available is to develop your applications using either Visual Studio 2008 or your favorite web development tool, and to place the applications on a production server A production server is one where you place your applications for actual use on the Internet Several hosting companies provide ASPNET 35 along with the necessary server software you need to run ASPNET files Discount ASPNET has an offer that provides a 50 percent discount for a one-year contract Within the first 30 days, if you decide you do not want the service you can get a full refund After you re comfortable with developing some applications using either Visual Studio 2008 or on your own system with IIS7, you might want to give Discount ASPNET a try to see what development on a hosting service is like The advantage of using a production hosting service is that your application can be tested in the same environment in which you will eventually be placing the completed files Using a LAN is a close equivalent, and if you have multiple computers, it s the best alternative to a hosting service However, with big databases and other space-consuming elements, you can t beat a hosting service So while Visual Studio 2008 is the recommended development environment, the ultimate testing environment is a production server

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