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Compression was first introduced with Oracle 9 i This initial compression option is known as table compression With table compression, data was compressed with direct load inserts, which typically are only used with batch operations Oracle Database 11g Release 1 introduced a new form of compression referred to as OLTP compression This new compression differed from table compression in several ways First of all, Oracle Database 11 g can read data in compressed blocks directly, meaning that read operations would not be affected by OLTP compression OLTP compression comes as a part of the Advanced Compression option, which also includes a variety of other compression technologies used to compress SecureFiles (large objects), backup sets, and network traffic Most importantly, OLTP compression provides compression for data that is inserted after the initial load without affecting write performance The method used by OLTP compression to accomplish this is shown in Figure 2-16 Data is compressed within a block on the initial load of data Data added to a block is initially stored without compression, but when a block contains a sufficient amount of uncompressed data, the block is added to a compression queue, which performs compression as a background process With this method, data added or changed after an initial load is eventually compressed without affecting the real-time write operation for the data

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(Table 32-6 and page 1062) Schistosomiasis The ova of trematodes seldom involve the nervous system, but when they do, the infecting organism is usually Schistosoma japonicum and, less often, Schistosoma haematobium or Schistosoma mansoni It is said that Schistosoma japonicum has a tendency to localize in the cerebral hemispheres and S mansoni in the spinal cord, but there have been many exceptions The cerebral lesions form in relation to direct parasitic invasion of blood vessels and take the form of mixed necrotizing and ischemic parenchymal foci that are in ltrated by eosinophils and giant cells (Scrimgeour and Gajdusek) The lesions do not calcify Schistosomiasis is widespread in tropical regions, especially in the Nile Valley of Egypt; North American neurologists have little contact with it except in travelers who have bathed in lakes or rivers where the snail hosts of the parasite are plentiful The initial manifestation is often a local skin irritation at the site of entry of the parasite (swimmer s itch), but the patient frequently does not offer this information unless sought An estimated 3 to 5 percent of patients develop neurologic symptoms several months after exposure Headaches, convulsions (either focal or generalized), and other cerebral signs appear; with lesions of larger size, papilledema may develop, simulating a brain tumor Some types of Schistosoma infection (also called Bilharzia), mainly mansoni, tend to localize in the spinal cord, causing an acute or subacute myelitis that is concentrated in the conus medullaris The clinical picture is of a subacutely developing transverse cord lesion There is often preceding leg or radicular pain and bladder control is affected prominently This is one of the most frequent forms of myelitis in Brazil and other parts of South America We have observed a few cases in students returning from Africa; their lesions were in the conus Unless treated immediately, there may be permanent paralysis of the legs and bladder from in ammatory and microvascular destruction of the lower cord Examination of the CSF in the myelitic form discloses a pleocytosis, sometimes with an increase in eosinophils (more than half of patients), increased protein content, and sometimes increased pressure Biopsy of liver and rectal mucosa, skin tests, and complement xation tests con rm the diagnosis The role of serologic tests has not been clearly established The other major trematode, Paragonimus, has been known rarely to invade the brain, where it creates a solitary granulomatous nodule comparable to that seen in schistosomiasis Treatment This consists of praziquantel orally in a dosage of 20 mg/kg tid In one series, 8 of 9 patients with epilepsy due to cerebral schistosomiasis became seizure-free after treatment with praziquantel Surgical excision of spinal granulomatous tumors is sometimes indicated, but the results are unpredictable.

Figure 32-8 Cysticercosis on MRI Multiple small enhancing cysts and a large cerebellar cyst in a man whose presenting illness was the result of obstructive hydrocephalus The cysts are in the early stage of degeneration and have not yet calci ed

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