managerial accounting Not only had Wai Lung come through for Spin Master Toys, but it went on to produce a high-quality toy and increased production more steeply than Harary had thought possible. Perez expressed his thoughts: Wai Lung is highly committed and has put us at the top of its priority list. During our early experience with Finger Bikes, they returned calls promptly and answered all questions during the critical production period. Wai Lung's performance with Finger Bikes allowed us to beat a major competitor to the market. This prompted our competitor to drop the project in mid-design. We should look at Wai Lung as a supplier for E-Chargers because of our positive experience with them. However, its engineering workforce is fairly small and it hasn't produced toys with electronic components. It has focused on die-casting and plastic action figures. E-Chargers have to be designed and produced to much more stringent tolerances than die-cast or plastic toys. To put it bluntly, flying toys would take a paradigm shift in Wai Lung's engineering expertise. We did plan to use a vendor survey report, but we don't have any engineering expertise at our Hong Kong office. And, in Canada, our manufacturing team includes me and Ronnenwith this in mind, I wonder if we can gather this information for Wai Lung and Wah Shing in time. We are already behind schedule as it stands.

61 I want to ask something about cerebrovascular accident (CVA). Can you please tell me how we can rapidly pinpoint the exact anatomical site of the neurological deficit using physical findings in the emergency room?

62 Why do you treat dissection of the carotid artery with an anticoagulant in the acute management of stroke secondary to dissection? To me this seems paradoxical as it would increase the severity of dissection.

63 Last week, in a neurology viva, I was asked about the indications for heparinization in patients with a stroke. I want to know when I can stop heparin and what test I should use for assessing its therapeutic range.

64 Has heparin a role in the management of acute ischaemic stroke not accompanied by atrial fibrillation?

65 1. In the treatment of a stroke, does low-molecular-weight heparin (LMWH) have an advantage over heparin? 2. In an ischaemic stroke in evolution, for how long should heparin be administered?

66 Can streptokinase be used in acute cerebral infarction and, if so, what is the dose?

67 There seems now to be a consensus about starting aspirin therapy in acute ischaemic strokes as early as possible. Why has this changed from past recommendations to avoid aspirin early (during the first 48 hours) during the ischaemic stroke on the pretext that it could convert an ischaemic infarct into a haemorrhagic one, thus increasing the dangers of complications like cerebral oedema and raised intracranial pressure? If both opinions are based on clinical trials, what is the significance of the much hyped 'evidence-based medicine'?

68 I understand that a loading dose of clopidogrel 600-900 mg can be given to ischaemic stroke in evolution and can stop the evolving deficit. Would you agree?

69 Is there any rationale for giving patients with recurrent strokes a combination of aspirin and anticoagulant?

70 1. Does a dipyridamol-aspirin combination have any superiority over aspirin alone in the secondary prevention of a stroke? 2. Is an aspirin plus anticoagulant combination superior to a dipyridamol aspirin combination in the treatment of recurrent ischaemic stroke not controlled by aspirin alone?