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Unlike the situation in most of the paraneoplastic neurologic disorders, there are no diagnostic markers by way of antineural antibodies In particular, this myelopathy does not seem to be a component of the anti-Hu associated encephalitisneuropathy spectrum In some cases of paraneoplastic myelopathy, the degenerative changes are more chronic, con ned to the posterior and lateral funiculi and they are often associated with a diffuse loss of cerebellar Purkinje cells This latter syndrome has a disproportionately high association with ovarian carcinoma but has been observed with carcinoma of other types and with Hodgkin disease All of the reported cases of these types have ended fatally Steroids and plasmapheresis were of no clear value A special but rare variety of anterior horn cell destruction resembling motor neuron diseases is known to occur rarely with certain lymphomas; it is discussed with the paraneoplastic syndromes in Chap 31.

Subacute Spinal Neuronitis Whitely and colleagues have drawn attention to a rare but distinctive form of encephalomyelitis of unknown cause, characterized clinically by tonic rigidity and intermittent myoclonic jerking of the trunk and limb muscles and by painful spasms of these muscles evoked by sensory or emotional stimuli In the late stages of the disease, signs of brainstem involvement may appear which are usually progressive over a period of several weeks, months, or a year or longer; consciousness is preserved However, the cases we have observed remained con ned to several contiguous spinal segments, usually the upper abdomen and lower thorax The CSF may be normal or show a mild lymphocytosis and increase in protein content This is probably the same disorder that had been described earlier by Campbell and Garland under the title of subacute myoclonic spinal neuronitis and.

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Involving older siblings, grandparents, aunts and uncles, family friends, and caregivers not only helps your baby communicate with these important people, it also gives her many more opportunities for learning. And while dads and

2 where wk is a zero mean, white Gaussian process with variance w . The parameter a = exp( 1/ ) where is the correlation time in seconds. The 2 positive parameters w and a are related by w = 1 a2 .

Another educational area in computer careers is user training. Hundreds of training companies have found training to be a lucrative business, especially in the personal computer market. Computer educators can offer training and seminars as freelancers or be employed by computer stores, educational and training institutions, computer vendors, and user companies. Many companies today are joining forces to fill training classes for their employees, flying in instructors. Microsoft is now customizing online training courses. The current emphasis on computers in elementary and secondary schools assures opportunities for trainers and educators to work at that level and other educators to train them to do it. In fact, every elementary student is receiving some hands-on computer experience today.

FIGURE 14-18

Pressing the TAB key cycles through all of the running snap modes associated with an object. This is useful when an area is densely covered with objects, making it dif cult to snap to a particular point. 1. Rest the crosshairs on the rear wheel. 2. Press the TAB key. 3. Press TAB several more times, stopping for a moment between each. As you can see, AutoCAD moves from one object snap to the next. 4. Press ESC to cancel the LINE command. 5. Pick the Osnap Settings... button on the Object Snap toolbar. 6. Pick the Clear All button, check Endpoint, Center, Intersection, and Extension, and pick OK.

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movements ( dancing eyes of an opsoclonic type) The child is irritable and speech may cease All laboratory tests are normal Treatment Adrenocorticotropic hormone and dexamethasone, the latter in doses of 15 to 40 mg/day, suppress the myoclonus and permit developmental progress Some patients have recovered from the myoclonus but have been left mentally slow and mildly ataxic Others have required corticosteroid therapy for 5 to 10 years, with relapse whenever it was discontinued Ordinary anticonvulsants seem to have no effect The pathology has not been determined A similar syndrome has been observed in conjunction with neuroblastoma in children and as a transient illness of unknown cause (probably viral or postinfectious) in young adults (Baringer et al; see page 641).

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The elimination of unknownsby combiningequations an algebraicapproach is that can be illustrated a setof two equations: for

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