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mal for 48 h The distribution of spinal paralysis is quite variable; rarely there may be an acute symmetrical paralysis of the muscles of the trunk and limbs as occurs in the Guillain-Barre syndrome Excessive physical activity and local injections during the period of asymptomatic infection were thought to favor the development of paralysis of the exercised muscles or injected limbs Coarse fasciculations are seen frequently as the muscles weaken; they are transient as a rule, but occasionally they persist Tendon re exes are diminished and lost as the weakness evolves and paralyzed muscles become accid Patients frequently complain of paresthesias in the affected limbs, but objective sensory loss is seldom demonstrable Retention of urine is a common occurrence during the early phase in adult patients, but it does not persist Atrophy of muscle can be detected within 3 weeks of onset of paralysis, is maximal at 12 to 15 weeks, and is permanent Bulbar paralysis is more common in young adults, but usually such patients have spinal involvement as well The most frequently involved cranial muscles are those of deglutition, re ecting involvement of the nucleus ambiguus The other great hazards of bulbar disease are disturbances of respiration and vasomotor control hiccough, shallowness and progressive slowing of respiration, cyanosis, restlessness and anxiety (air hunger), hypertension, and ultimately hypotension and circulatory collapse When these disturbances are added to paralysis of diaphragmatic and intercostal musculature, the patient s survival is threatened and the institution of respiratory assistance and intensive care becomes urgent Pathologic Changes and Clinicopathologic Correlations In fatal infections, lesions are found in the precentral (motor) gyrus of the brain (usually of insuf cient severity to cause symptoms), brainstem, and spinal cord The brunt of the disease is borne by the hypothalamus, thalamus, motor nuclei of the brainstem and surrounding reticular formation, vestibular nuclei and roof nuclei of the cerebellum, and mainly, giving the illness its name, the neurons of the anterior and intermediate gray matter of the spinal cord In these areas, nerve cells are destroyed and phagocytosed by microgliacytes (neuronophagia) A leukocytic reaction is present for only a few days, but mononuclear cells persist as perivascular accumulations for many months Nuclear or cytoplasmic inclusion bodies are not seen The earliest histopathologic changes are central chromatolysis of the nerve cells, along with an in ammatory reaction These changes correlate with a multiplication of virus in the CNS and, in the infected monkey, precede the onset of paralysis by one or several days In Bodian s experimental material, the infected motor neurons continued to function until a stage of severe chromatolysis was reached Moreover, if damage to the cell had attained only the stage of central chromatolysis, complete morphologic recovery could be expected a process that took a month or longer After this time, the degrees of paralysis and atrophy were closely correlated with the number of motor nerve cells that had been destroyed; where limbs remain atrophic and paralyzed, less than 10 percent of neurons survived in corresponding cord segments Lesions in the motor nuclei of the brainstem are associated with paralysis in corresponding muscles, but only if severe in degree The disturbances of swallowing, respiration, and vasomotor control are related to neuronal lesions in the medullary reticular formation, centered in the region of the nucleus ambiguus Atrophic, are exic paralysis of muscles of the trunk and limbs relates, of course, to destruction of neurons in the anterior and intermediate horns of the corresponding segments of the spinal cord.

The first thing to understand about C# is that unlike some languages C# is case sensitive That means whenever you reference a variable or class instances in C#, you need to be sure that the reference names take into account the case of the name For example, the following three variables are all different:

As would be expected this resulthasa relativelyhigh true enor of 1867o obtaina more To accurate result,we can use a very fine approximationbasedon 10,000segments: > > t r a p ( r r ,O , 3 , 1 0 t 1 0 0 ) 4!948049999r1528 which is very closeto the true value

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The MSG argument is the data string that you want to send Since Perl automatically knows the length of a string, you do not need to supply this information The FLAGS specify particular operations to be configured for this transmission Only two are generally supported MSG_OOB and MSG_DONTROUTE MSG_OOB allows you to send the MSG as out-of-band data This is generally only supported on Internet streams The MSG_DONTROUTE flag switches on the SO_DONTROUTE option for the duration of the transfer (see the previous Socket Options section) The TO argument, if specified, should be a suitable sockaddr_in structure to send the data to if the socket has not already been connected to a remote socket The recv function accepts information from SOCKET, placing it into SCALAR: