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It can be surprising to realize that an organ as high-powered and sophisticated as the brain also has a plumbing system. And, as the case with a house's plumbing, the drainage side of the system can get gummed up. But the symptoms are different. When a home's drainage backs up, well...I won't go there. When the brain's drainage system backs up, the brain's owner can become confused, incontinent of urine and unsteady on his or her feet. The plumbing system in question is that which produces and drains the cerebrospinal fluid (CSF). Normal CSF looks the same as water from a faucet, but is created from the bloodstream in the choroid plexus tissue within three of the brain's four inner chambers -- the right and left "lateral" ventricles and the midline "fourth" ventricle, but not the interposed, midline "third" ventricle. The CSF percolates through passageways from one ventricle to another, finally emerging through openings at the base of the brain to bathe the outer surfaces of the brain and spinal cord before getting reabsorbed into the bloodstream again. This re-absorption occurs in special collection-nodes in the membranes surrounding the brain. The entire CSF volume of about 150 milliliters or five ounces (about as much as a glass of wine) is produced and reabsorbed four times a day, so the fluid is constantly turning over. But blockages along the way can interfere with the normal flow of the CSF. For example, when the passageway between the third and fourth ventricles becomes narrowed or choked with sludge, the CSF backs into the lateral and third ventricles. Those ventricles react to the increased pressure by becoming physically dilated or enlarged. In this case, a CT or MRI scan could reveal the location of the blockage by showing expansion of the two lateral and the single third ventricles, but a normal-sized fourth ventricle. Another example of a blockage and its consequences is when the collection-nodes responsible for CSF re-absorption in the brain's overlying membranes (meninges) become clogged. In this case, all four ventricles are upstream from the blockage, and all four of them expand. This, too, is visible on brain scans. Both cases are examples of hydrocephalus, or water on the brain. The first case is one of "internal" or high-pressure hydrocephalus. The second is called "external" or normal-pressure hydrocephalus (NPH). In NPH the pressure is inexplicably normal much of the time, but the term is somewhat misleading because prolonged recordings with pressure-monitors do show intermittent periods of increased pressure. Hydrocephalus of one kind or another is especially prevalent at the two extremes of the life cycle -- in the very young and the very old -- but can occur at any age. In infancy, hydrocephalus can be caused by malformed brain-tissue. In contrast, adults with hydrocephalus were usually born with normal brain anatomy, but acquired a blockage due to a tumor, injury, bleed or infection. However, many cases of hydrocephalus in adults occur without a history of these preceding illnesses. CT and MRI scans are sensitive tools in detecting hydrocephalus, particularly when it's striking enough not be confused with ventricular enlargement due to gradual loss of surrounding brain tissue from aging. The main treatment of hydrocephalus is for a surgeon to insert a tube (shunt) into one of the swollen lateral ventricles and provide an alternative pathway for the backed-up CSF to drain. Once the shunt equipment is in place, a piece of hardware about the size of a large button sits outside the hole made in the skull (but inside the skin of the scalp) and redirects the excess CSF through another tube into either a jugular vein in the neck or into the abdominal cavity (peritoneum). Thus, the patient can receive either a "VJ" shunt or a "VP" shunt, with the letters designating the locations of the two ends of the shunt. The success or failure of shunting depends not just on the skill of the surgeon, but also on the selection of appropriate patients. Sometimes hydrocephalus turns up unexpectedly on scans when doctors are looking for something else entirely. Although an unexpected finding like this should always cause the doctors to re-think the case, the point is that hydrocephalus doesn't always cause problems. Sometimes the hydrocephalus has been there for years and the brain has adjusted to it in a way that produces no symptoms. This is an example of a case that should not be shunted, though it would still be appropriate to monitor the patient and his or her scans over subsequent months and years. Who, then, should receive a shunt? The answer, in short, is people for whom the benefits of the operation exceed its risks. Identifying them, however, is the tough part. And the task is made even more difficult by the lack of randomized, controlled trials in which a group of patients receiving treatment is compared to an equivalent group of patients not receiving treatment. Although similar reasoning applies to adults thought to have internal (high-pressure) hydrocephalus, I'll lay out the decision-tree as it applies to external (normal-pressure) hydrocephalus. Published observations imply that shunts are most likely to help NPH patients who have the following features:substantial enlargement of all four ventricles a full "triad" of symptoms, including confusion, urinary incontinence and altered walking poor walking as the first of the three symptoms temporary improvement of symptoms after drainage of 50-60 milliliters (2 ounces) of CSF by lumbar puncture (spinal tap) The elderly patients most at risk for NPH are also at increased risk for other diseases, and the shunting operation doesn't help symptoms produced by other causes. For example, confusion can be caused by Alzheimer's disease and strokes. Urinary incontinence can be due to prostate disease in men and sagging pelvic tissue in women. Walking can be disrupted by arthritis, fractured bones, low vision, inner-ear disease, Parkinson's disease and many other unrelated processes. So it's important for the doctor to determine if other diseases might be to blame for the very symptoms that seem, at first glance, to be from NPH. Assuming that NPH still seems likely, the next round of decision-making concerns the possibility that an operation will cause harm. Even a patient whose brain scan and symptoms are classic for NPH can develop serious complications from the operation. A particularly feared complication is bleeding into the space outside the brain, called a subdural hematoma. Older patients are also more likely to have other medical conditions that could compromise the safety of an operation, like coronary artery disease or emphysema. Cases in which expected benefits of the operation are much greater than risks, or in which the risks are much greater than the expected benefits, are easy to make decisions about. 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The Forest As we drove farther into the outskirts of Augsburg, looking out placidly across the top of cars, houses, and at the dogs running about, I got thinking, thinking how I felt being with Chris, about Chris. It was like I was cast into a spell, an enchantment, or perhaps a curse; very seldom did I ever feel like this. Normally I would feel like this only if I was in the presence of a great person, like my karate instructor in San Francisco, Gosei Yamauchi, or his father ‘The Cat’ Gogan, who was one of the few 10th degree black belts in the world. Normally I’d be high the whole next day. With Chris I felt the same way I knew tomorrow I’d be high all day, it was a natural high. Once—I can’t remember when—I had read something about the poet Emily Dickinson, she was something like a recluse, but she made a poem indicating nature was her high, and I always remember that. How true this can be, grabbing the moment and cherishing it, absorbing it as if there was no tomorrow, and at the same time absorbing nature: the sounds and the heart beat mother earth, and sky; others humans, and the dogs and birds, all such things that at that moment surround you; they are all somewhat magical. I was learning, how to be a listener if anything and it entailed all things within your presence. Chris was fully alive now, as I turned my head towards her delectation her steering wheel facing me, at which made the moment a little more interesting, as she felt good about me checking her out; a weary kind of sense, not defeat, just a good profile look; I thought dimly in my mind as she drove mile after mile: how could she afford to look so prim and proper all the time. Do her hair in a unique style, not a hair out of place, so it seemed. I guess in our own way we are all unique, I heard that someone say that someplace, not sure where. An hour and a half had passed on by and she was still driving, and it was getting dark. She pulled into a wooded area; she said it was the outer rim of the Black Forest (otherwise known as the Eyebrow of the Woods), I think I heard of that forest in a fairytale book or at least that is where my mind said I got it from. An enchanting name, I must had said it my second self, that little person inside of all of us that we talk to: Black Forest, Black Forest…! “So you see,” said Chris “…here we are!” She added her conclusive little smile to her face as she said that; as we entered the dark huge green forest, parking the car a little off to the side of a dirt road that lead into the deeper and more distant part of the forest, partly covered by trees and bushes now. There was a chill in the air so I rolled up the window, as she turned on the radio for some music. Very quickly and carefully she moved her thin reserved neck and shoulders into my area, she just starred at me, as if she was going to eat me up; as her left arm was lowered, it pulled out a bottle of Mosel-Saar-Ruwer wine, 1965 wine, -- I looked the bottle over 9.5% volume; I knew they had been making wine around this intriguing river and hilly area for close to 1700-years. It was good wine I had tasted it before, not sweat or dry, flowerily white wine to be exact. “Now,” said Chris indignantly, but with the air of a certain point, “…let’s see what we can do with this battle. We started to drink and laugh. “Ah, yes,” I said to her, “you have a lovely profile.” She smiled and threw her head back. “Well,” I thought out loud “… this is a good way to pass the night away, and begin romantic indecencies”-- she leaned over the center-divider of the bucket seats to kiss me. She opened her mouth, sunk her lips on mine, as she pulled her long legs to the under-part of the dash, she then started to unzip her zipper to her boots. “This,” commented Chris “passes everything…I never did it in a car before.” She had drunk down 1/5 of the wine like a person drinking water. “Chick,” said Chris, ”…come over here.” I moved my body closer to hers. Everything seemed to be in the way. I could not back out of whatever was going to happen; and I knew what was in the makings. She was starting to stretch her hands out: --her blouse went over her head, I just kept looking as she started to strip, I was growing, getting as hard as a pencil. “Oh, damn Chick,” said Chris heartily as she touched my item. Just her saying that aroused me; then pulling off her bra, and her skirt up I seemed to become tranquilized somehow, my mind slipped to King Solomon, of all things, as he once defined the beauty of a woman’s body and how it was to measured for one’s pleasure by enjoying it fully, and this was all I wanted to do now—enjoy it, and I think Chris was feeling the same way for even though we were both a bit on the tipsy side we were fully aware of our responses, I had lost complete focus of the uncomfortable situation, as she did… ◊…now that she was almost completely stripped only her panties on, she curled up in a fetus position holding her legs and leaning back, then opened up her legs slowly… I thought what every on earth possessed her, yet who can predict women I told myself, and started to take off my cloths, quickly…getting out of this spill of sorts. I guess it is true, men like to observe, and women like to touch. I liked both. This was not dirty sex, this was pure sex, at its height, one might even say, it was like a painting; she painted the picture, she taught me how to enjoy what she had to offer. “I’m going to get it all off in a minute,” I said, it was difficult working in this cramped space… she chuckled, “Slowly please, I can wait…”she softly said as she rested her head back and I caught my breath, that is what she wanted, that is, for me to calm down, yet remain hard and possessed with her offering: I think we both had multiorgasms “I feel fine now –“ I said, adding, “cramped but fine…☺” Chris opened up her arms I couldn’t back away after that, could I? I told myself: I have a private room at the barracks…. Then said it out loud to her: “Of course, -- next time…” said she, and we continued to make love for the third orgasm for me, for her, perhaps five or six. We seemed to flop around the front seat finding the right position…’she‘s looking at me eeeeeeeee’, I told myself, I’m cramped, nothing to grab a hold of, her head leaning against the glass of the window. Without a word we continued: --my body heavy onto hers, my heart beating two-hundred ticks a minute, we both were hot, enmeshed in the moment, a lustful, and burning moment; I wanted to open the door, but feared the light going on and someone would see us, plus the air was cool, too cool. I had no escape we met each other’s eyes as I penetrated her. She looked again deep into my eyes as she tried to catch her breath, to make sure I was still alive I think. It was seemingly unfair for me to put her through this I thought, but the thought only lasted a half second, I found myself exploding … as my heart dropped to my feet, and again, and again, I exploded and burned as if I had opened myself up to a volcano; I had learned at that moment, the difference between happiness and pressure: happiness was listening to her talk before, and then came her smile, now the pleasure, sex; I hurt, this had never happened before. “Nice evening, isn’t it?” I said as I started pulling her body closer to me. “I hope you are not offended I am taking the lead?” said Chris. “Not at all,” I said, adding, “I’ll catch up.” “There are times,” said Chris, “when rules are made to be broken like now, them...mmm damn silly rules…” she pulled herself up a bit, “I stopped believing in those rules… this is one of those moments I want to remember…remember for a long time, even after I am dead.” As we tried to untwist our bodies, we caught ourselves laughing at our odd situation. We had made love, and became a little more sensitive with each other…a little more possessive of each other, I guess that is the nature of things in a relationship, they are made to progress, or stop, one or the other, and it was never to take place again in the front seat of a Mustang I knew…. She laid her cheek against my hand. “Chick.” “Yes?” “You realize don’t you, this can’t end here?” “There’s no reason for it to end, is there?” “No.” She spoke some German words I didn’t understand, German mingled with English I should say: then somehow, she went silent…maybe she was taking time to remember the moment, digesting it; I didn’t know, nor did I want to try to guess, I just looked at her, her smile it seemed to promise something, grace; instinct was in it also, around her small enclosed eyes, as they opened and shut slowly they were weaving a web I do believe, “It won’t end here, I promise.” Pleasant and agreeable-like a well-cultured woman she was, maybe too much for me, she opened the door, and dressed quickly, then got back in. “Want a cigarette?” I asked, sitting up straight. “No and neither do you. We are both restless it seems. Come over to me,” she started kissing me. As she released her lips from mine, she sat upright now, pulled out a cigarette, lit it and started blowing smoke rings into the air. “You know perfectly well, I’m very much attracted to you…yoouuuu… right?” “I hope so, I feel the some way.” “Luckily the wine deadens the bruises (discoloration).” I commented, she laughed and kind of stretched her back to put it back in place…”Me to,” she replied. “I wish all relationships could start like ours, it is like saying let’s drop all the game playing and pretend we are on the fifth date, and cut the crap; I like you Chick, I like you very much…” “The bruises will show up tomorrow,” I told Chris. Kind of saying maybe we should go, but neither one of us seemed to be all that bothered with that so we simply started kissing again after her cigarette brake…it was a long and needed pause for me, for a second breathe, a refractory period I needed [from uninterrupted sex]; that is, having multiple orgasms drains a man. I’ve learned also, women don’t need this rest period; so in time I’d learn how to last longer, and perhaps stretch the orgasms thinner but again, longer (three hours at the most; and I did). I thought in my head, she was having sex with me, and then that rich boyfriend she had; she was getting her multiorgasmic pleasures indeed, perhaps a secret to some women, for once they discover this, it is hard for any man to keep up with them, lest he be a superman of sorts. I did not even at that young age have the capacity to pass six organisms; five was my limit I learned. I was limp now; my penis had been as pointed as a scorpions tail a while ago. As scary as it started out for me I thought my reactions afterwards was cool, I seemed to be letting things take their natural course. It was a dark and colorless evening. Grossly romanticized in such an unimpressive way (so I thought in the back of my mind), yet Miss Chris was perfect. I thought to myself: maybe she might be annoyed with my lovemaking… I guess every man wants to please the woman, wife, girlfriend, the one he is making love to, or should want to please her, but most don’t; how can they, they pop too quickly. This is a fact, I’ve talked to men, and when they say they go so quick, no woman could get it on in that time period. A woman taught me how to hold myself from climaxing too early, thus allowing the woman to catch up—and therefore, allowing my female mate to get it on and enjoy. I know this evening went a little fast, but Chris was modest about it, like that other woman who had taught me, helped me, to help her, so we both could enjoy each other more; as my slowing down kept my penis hard longer, allowing her pleasure zone to become wider. This was something of the case in hand, but not completely. Most men think they make love better drinking, but it’s far from the truth. Most men do not know how to make love, no one taught them, so all they do is f*ck, and that is not love, that is, if anything, a quick climax, like eating a big fat burger, and wiping your mouth in its enjoyment and then leaving the café only to find out: you got indigestion, and had you went to a nicer restaurant, ate slower, you’d never forget the meal. I have experimented with that theory, and it is nine-minutes verse four-hours, I say four hours, but I knew in my head it was only one time I lasted four hours, two and a half was the norm. I was thinking now—as Chris kissed me—how I owe some women a bit of gratitude for allowing me to have my pleasure and not returning it to them; that’s the caretaker in a woman I think. But women just don’t know men can learn. And men are too bull-headed to let women teach them what pleases them. I had learned a good lover was worth his weight in gold and even maybe a little more: sometimes they can be irresistible. One could hardly tell her it wasn’t hastily done, our sex (to me it was) for it was, but she seemed to understand the circumstances, and we need not prove anything today, only allow our bodies to be sanctioned to the other. So I think we both felt. Lovemaking would improve as time went on. “I’m afraid my lover, we will have to find better accommodations next time,” Chris said, smiling at me. “Yes,” I hesitated, “absently,” I hesitated-- “I feel the same way.” “It’s a little hard in such a cramped car luckily we are both a little tipsy….” “I’m afraid I’m not, somehow I sobered up when you took your blouse off.” She smiled, with a grin. “Yes. I sense you have, do you really like me Chick?” “You are growing on me. And what is there not to like?” She was like a schoolgirl at times, needing to be encouraged, to grow up, and needed to be admired. But she didn’t need permission to live, she was taking that—but I’m learning to appreciate women more, I told myself, and it seems the more I show appreciation, the more they respect me, and to be quite frank with myself, I need respect. And why not … the world will give it, if you demand it, and if not, let that part of the world go; so my second self, my mind’s eye, told me. But then as I looked at her, if she really felt she was on death row, with cancer, maybe I was just a remedy for a while, and if so, so what, maybe I needed a remedy to make it through my time here in Germany; so seemed just to me. 8 The Spider and The Web A warm-wind had picked up it seemed, and April and May in Germany was a paradise of light-cool sunrays, it was a spring never to forget, Chris and I were growing on one another, like white on rice. More community drinking fairs were picking up and Chris and I tried to make a few, drink it up and eat and just go with the flow; it was a good time for living. Chris and I were known throughout the guardhouse-barracks as lovers and a heat wave at that. She seemed to have a charm with my soldier friends, and often drove her German boyfriend’s Mercedes car to the gate, and about, showing off kind of, not only to me, but it seemed at times going out of her way to show it to the other guards. Most of my friends thought she had two cars, I simply did not up date them, if they were not in my way of thinking or inner circle—why squander my time; and in most cases they didn’t have a need to know; but Ski and a few other of my friends knew the truth. I felt: plus, I felt: why not let Chris make an impression at the guard shacks, if it helps her ego so be it. I do not think I was envious, rather amused. I’m sure somewhere along the line I’d have to deal with envy, but who at my age is envious, for what, I have a lifetime to catch up. She flirted with the guards, and they all thought it cool. At night, if I had to work, she would bring me by a sandwich while on duty; in one way she got the guys a little jealous, or in lack of a better word, annoyed. And sometimes she would simply walk into barracks, which had about fifteen-guards some running around half naked from the shower room to their room, while others went visiting. She’d come knocking on my door. She’d spend the night with me, it was an improvement from the car, and for some reason we only went over to her house once in the following two months. I knew we were not fooling anyone at the guard-barracks, but we pretended to be secret about it anyway. penis enlarement picture penis enlagement pills safe pennis enlargement natural penis enlargment pills pennis enlargement pills product penis enlarement excercises buy pnis enlargement pills natural penis enlargment pills penis enlargment video

In previous articles, the importance of providing a variety of banner sizes and making banner content sharp and relevant were discussed. Here we will look at the secret weapon you should not ignore... Many merchants seem blissfully unaware of the potential of 'alt tags', as the little pale yellow rectangles with text in them, or 'tool tips' that come up when your mouse passes over a graphic are called. When a graphic fails to load, or the site visitor browses with the capacity to view images turned off, for speed or because a particular firewall is in use that refuses to show images, the 'alt' text appears in the space that should have been occupied by each image, assuming that someone has input some text... The same 'alt' text, as it appears when the cursor pauses over a graphic, is also commonly used by web surfers as an aid to deciding whether a 'thumbnail' image is worth clicking on to see the enlargement. Supplying banners without any 'alt tags' at all is a bad idea because it encourages affiliates to choose between leaving them that way and being penalized by some search engines as a result, or typing in whatever text seems expedient. Equally, it is a sloppy and unprofessional practice to supply banner links to affiliates that include alternative text content such as: "120x60-springcol-03" or "Banner56098347". Either the affiliate will leave it as it is and visitors who are about to click on the banner may be put off doing so by the appearance of what may be interpreted as sinister code, or the affiliate will replace the text with whatever he or she thinks is appropriate. If you are lucky and the affiliate has the time, can spell and write reasonably pertinent copy, all is well. If not...the fault lies more with the originator of the unmarked or badly marked banner than the end-user. When you think about it, the existence of the 'alt tag; is a huge opportunity to add a sales message that would never fit on the graphic itself. You can capitalize on this inbuilt resource, as some of your competitors are already doing, or risk having the message of the banner itself diluted by the contents, or lack thereof, of your alt text captions. Seasonal graphics are another important weapon and we are not just talking about the most obvious events either but, whilst we are mentioning them, there is no harm in having a seasonal banner that remains the same for years – provided there is nothing to identify the banner as specific to one year. Instead of trying to think up a new Valentine’s Day or Christmas banner every twelve months and creating something that is not particularly attractive, pick a design that works and stick with it, by all means. It is not every merchant who can afford to spend a fortune on such things and it isn’t strictly necessary either. At LWA Malls - http://www.linnetwoods.com/malls/ - for example, it is noticeable that a great many people like the traditional and comforting seasonal images best. People’s lives contain other seasons, apart from the universally-timed ones. Consider banners that catch the attention of people who have just been promoted or started their retirement or celebrated their tenth year in business or any one of a large number of milestones shared by a large number of people. Identify ‘seasons’ that bring people to your store and make banners that will help affiliates guide visitors enjoying those same seasons to your online presence. In conclusion: Make the effort to provide good-looking banners in a wide range of sizes to your affiliate partners; keep your website address off banners and the contents of text links and don't forget to make the most of the advertising oppportunity provided by those 'alt' tags. free penis elargement pills pnis enlargement excersizes enlarement manhattan penis surgeon penis enlagement before and after photo natural penis enlargement technique cheap vigrx pill herbal penis enlagement pills easy enhancement free penis surgery way penis enlargment video

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