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His team lived up to the warranty and no one wanted his money back No one hollered for the Better Business Bureau I think my father s face would have been suffused with even more pride had the Packers prevailed that day, after making that.

Equations(PT6.3)and (PT6.4)can be substituted into Eq. (PT6.2)to convertit into a firstorder equation: du m7-tcu+kr:0

Similarly in monkeys as shown by Tower in 1940 and subsequently by Lawrence and Kuypers and by Gilman and Marco interruption of both pyramidal tracts results in a hypotonic paralysis; ultimately, these animals regain a wide range of movements, though slowness of all movements and loss of individual nger movements remain as permanent de cits Also, the cerebral peduncle has been sectioned in patients in an effort to abolish involuntary movements (Bucy et al); in some of these patients, a slight degree of weakness or only a Babinski sign was produced but no spasticity developed These observations and those in monkeys indicate that a pure pyramidal tract lesion does not result in spasticity and that control over a wide range of voluntary movements depends at least in part on nonpyramidal motor pathways.

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There are four equations in this chart. One of them will be the one you will use to solve for the unknown. Each horizontal line in the chart represents the equation Q rt for that particular line. The fourth equation comes from the sum of each worker s rate set equal to the together rate. Often, the fourth equation is the one you will need to solve. Remember, as in all word problems, that all units of measure must be consistent.

so that ber loss, brosis, and residual thin and large bers in haphazard arrangement may eventually impart a dystrophic aspect to the lesions For all these reasons the pathologic picture can be correctly interpreted only in relation to the clinical and other laboratory data Guidelines for the interpretation of the muscle biopsy re ecting these comments, a critical step in correct diagnosis of the in ammatory myopathies, are given in the review by Dalakas and Hohlfeld In DM, there are several additional and distinctive histopathologic changes In contrast to the evident necrosis of single- bers of PM, DM is characterized instead by perifascicular muscle ber atrophy (referring to changes at the periphery of a fascicle, for reasons noted below).

Moreover, the in ammatory in ltrates in DM predominate in the perimysial connective tissue, whereas in PM they are scattered throughout the muscle and are most prominent in relation to the muscle ber membrane and the endomysium The muscle lesions in dermatomyositis of childhood are similar to those of the adult form, only greatly accentuated In a biopsy sample, the diagnosis can be inferred from the perifascicular degeneration and atrophy of muscle bers Even more distinctive in DM are changes of a vasculitic nature in the small intramuscular blood vessels Endothelial alterations (tubular aggregates in the endothelial cytoplasm) and occlusion of vessels by brin thrombi are the main abnormalities Occlusion of small vessels also involves the intrafascicular nerves, so that the affected muscle may show both zones of infarction and denervation atrophy The same vascular changes underlie the lesions in the connective tissue of skin, subcutaneous tissue, and gastrointestinal tract.

This small vessel vasculitis is not seen in PM The perifascicular muscle ber atrophy is probably a result of an ischemic process set up by capillary occlusion Etiology and Pathogenesis The cause of idiopathic PM and DM, as the term indicates, is unknown All attempts to isolate an infective agent have been unsuccessful Several electron microscopists have observed virus-like particles in muscle bers, but their causative role has not been proved A polymyositic illness has not been induced in animals by injections of affected muscle Nevertheless, the notion that an autoimmune mechanism is operative in PM and DM is supported by the association of these disorders with a number of the more clearly established autoimmune diseases (myasthenia gravis, Hashimoto thyroiditis, scleroderma, Sjogren disease, rheumatoid ar thritis, Waldenstrom macroglobulinemia, agammaglobulinemia, and the other connective tissue diseases mentioned earlier).

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