In-house Preparation of Examination Papers using troff, tbl, and eqn.

Starting in December 1982 the University of Nottingham decided to phototypeset almost all of its examination papers `in house' using the troff, tbl and eqn programs running under UNIX. This tutorial lecture highlights the features of the three programs with particular reference to their strengths and weaknesses in a production environment. The following issues are particularly addressed: Standards -- all three software packages require the embedding of commands and the invocation of pre-written macros, rather than `what you see is what you get'. This can help to enforce standards, in the absence of traditional compositor skills. Hardware and Software -- the requirements are analysed for an inexpensive preview facility and a low-level interface to the phototypesetter. Mathematical and Technical papers -- the fine-tuning of eqn to impose a standard house style. Staff skills and training -- systems of this kind do not require the operators to have had previous experience of phototypesetting. Of much greater importance is willingness and flexibility in learning how to use computer systems.

Cerebral misery perfusion diagnosed using hypercapnic blood-oxygenation-level-dependent contrast functional magnetic resonance imaging: a case report

Introduction Cerebral misery perfusion represents a failure of cerebral autoregulation. It is animportant differential diagnosis in post-stroke patients presenting with collapses in the presence of haemodynamically significant cerebrovascular stenosis. This is particularly the case when cortical or internal watershed infarcts are present. When this condition occurs, further investigation should be done immediately. Case presentation A 50-year-old Caucasian man presented with a stroke secondary to complete occlusion of his left internal carotid artery. He went on to suffer recurrent seizures. Neuroimaging demonstrated numerous new watershed-territory cerebral infarcts. No source of arterial thromboembolism was demonstrable. Hypercapnic blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging was used to measure his cerebrovascular reserve capacity. The findings were suggestive of cerebral misery perfusion. Conclusions Blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging allows the inference of cerebral misery perfusion. This procedure is cheaper and more readily available than positron emission tomography imaging, which is the current gold standard diagnostic test. The most evaluated treatment for cerebral misery perfusion is extracranial-intracranial bypass. Although previous trials of this have been unfavourable, the results of new studies involving extracranial-intracranial bypass in high-risk patients identified during cerebral perfusion imaging are awaited. Cerebral misery perfusion is an important and under-recognized condition in which emerging imaging and treatment modalities present the possibility of practical and evidence-based management in the near future. Physicians should thus be aware of this disorder and of recent developments in diagnostic tests that allow its detection.