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Encephalitis lethargica, or von Economo epidemic encephalitis, the remarkable illness that appeared on the medical horizon as a pandemic following World War I, provided some of the most dramatic instances of pathologic somnolence In fact, protracted sleep lasting for days to weeks was such a prominent symptom of this disease that it was called sleeping sickness The patient appeared to be in a state of continuous sleep, or somnosis, and could be kept awake only by constant stimulation Although the infective agent was never isolated, the pathologic anatomy was fully divulged by many excellent studies, all of which demonstrated a destruction of neurons in the midbrain, subthalamus, and hypothalamus Patients who survived the acute phase of the illness often had dif culty in re-establishing their normal sleep-wake rhythm As the somnolence disappeared, some patients exhibited a reversal of the normal pattern, tending to sleep by day and stay awake at night; many of them also developed a parkinsonian syndrome months or years later Possibly the hypersomnia was related to destruction or functional paralysis of dopamine-rich neurons in the substantia nigra, resulting in overactivity of the raphe (serotonergic) neurons Hypersomnia is also a manifestation of trypanosomiasis, the common cause of sleeping sickness in Africa, and of other diseases localized to the mesencephalon and the oor and walls of the third ventricle, as indicated earlier in this chapter Small tumors in this area have been associated with arterial hypotension, diabetes insipidus, hypo- or hyperthermia, and protracted somnolence lasting many weeks Such patients can be aroused; but if left alone, they immediately fall asleep Traumatic and vascular lesions and other diseases affecting the mesencephalon may have a similar effect Sleep drunkenness is the name given to a special form of hypersomnia, characterized by a failure of the patient to attain full alertness for a protracted period after awakening Unsteadiness, drowsiness, disorientation, and automatic behavior are the main features This disorder is usually associated with sleep apnea or other forms of sleep deprivation, but sometimes no such connection can be discerned, in which case a motivational factor should be suspected. asp.net c# pdf viewer Display ( Show ) PDF file embedded in View in ASP . Net MVC Razor
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Syncfusion PDF viewer for ASP . NET MVC is a lightweight HTML5 component that can be used for viewing, reviewing, and printing PDF documents within web ... Kleine-Levin Syndrome Kleine in 1925 and Levin in 1936 described an episodic disorder characterized by somnolence and overeating For days or weeks, the patients, mostly adolescent boys, sleep 18 h or more a day, awakening only long enough to eat and attend to toilet needs They appeared dull, often confused, and restless and were sometimes troubled by hallucinations In the series of 18 cases collected by Critchley, the age range was from puberty to 45 years There may be a brief prodromal period of inertia and drowsiness The duration of nocturnal sleep may be greatly prolonged, or, as in our patients referred to below, they may sleep for days on end Food intake during and around the period of hypersomnia may exceed three times the normal (bulimia) and occurs almost compulsively during brief periods of semiwakefulness; to a variable extent, there are other behavioral changes such as social withdrawal, negativism, slowness of thinking, incoherence, inattentiveness, and disturbances of memory The somnolence has been well studied by modern laboratory methods; except for the total duration of sleep, the individual components of the NREM and REM cycles are normal Between episodes these patients are behaviorally and cognitively normal The basis of this condition has never been elucidated A psychogenic mechanism has been proposed, but without foundation in our opinion The condition usually disappears during adulthood, and there is limited pathologic material (see page 488) We have cared for a sibling pair who had the illness into young adulthood (Katz and Ropper) The hyperphagia has suggested a hypothalamic disorder, but anatomic veri cation is lacking The case reported by Carpenter and coworkers, in which an acute and chronic in ammation in the medial thalamus but not the hypothalamus was found, must be questioned as representative of the idiopathic adolescent condition Their patient was a man 39 years of age who had episodes of diurnal drowsiness, hyperphagia (intermittently relieved by methylphenidate), and hypersexuality over a period of months In some patients with this disorder, schizophrenic and sociopathic symptoms have been recorded between attacks, raising doubt as to whether all the reported cases are of the same type In most instances, the disease is self-limited and disappears by early adult life, as mentioned We have seen variants of this syndrome manifesting themselves in drowsiness and extreme inactivity lasting for a few weeks, then with a complete return to normalcy In two of our patients, the use of serotonergic antidepressants lengthened the interval between episodes No consistent change in the level of hypocretin (orexin) has been found in the spinal uid, as occurs in narcolepsy (see further on), and the two disorders are distinct In one typical case there was pronounced hypoperfusion of the left medial temporal lobe both during and between attacks, but the intepretation of this nding is unclear (Portilla et al) No treatment has been consistently effective (eg, antidepressant drugs), but some of the stimulants that are used for the treatment of narcolepsy may be useful (see further on) Finally, it should be mentioned that sleep laboratories now recognize a form of idiopathic hypersomnia in which there are repeated episodes of drowsiness throughout the day This condition is discussed further on, in relation to the diagnosis of narcolepsy, with which it is most often confused. how to open a pdf file in asp.net using c# Asp.Net MVC how to get view to generate PDF - Stack Overflow
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ASP . NET MVC PDF Viewer : Easy Solution to View and Print PDF Files. ... The ASP . NET MVC PDF Viewer control is a lightweight, modular control for viewing and printing PDF files in your web applications. ... The PDF Viewer supports printing the loaded PDF file. 9 Which of the following most accurately describes the CSMA/CD network access method A An electronic signal is constantly passed around the network, and no computer can transmit until it receives the signal B A central device polls each computer in order, asking if the computer has any data to transmit C When a computer wants to transmit, it interrupts the network s central device and is given a transmission priority D When a computer wants to transmit, it first listens for traffic If a data collision occurs, each transmitting computer waits a random amount of time, then retransmits 10 A customer has set up a twisted-pair star topology and wants to implement a Token Ring standard What do you tell the customer A They must first change the topology to a ring B They must first change the cable type to fiber-optic Copyright 2005, 2001, 1997, 1993, 1989, 1985, 1981, 1977, by The McGraw-Hill Companies, Inc Click here for terms of use . FIGURE 9-5 asp.net pdf viewer control Q528425 - How to open a pdf file using javascript? | DevExpress ...
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