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This has proven to be most typical of small-cell cancer of the lung In a large series of 71 patients with sensory neuronopathy reported by Dalmau and colleagues, more than half were associated with symptomatic in ammatory lesions in the temporal lobes (limbic encephalitis, page 586), the brainstem, and rarely the anterior horn neurons of the spinal cord Other distinctive paraneoplastic syndromes such as cerebellar degeneration and Lambert-Eaton myasthenic syndrome were combined with polyneuropathy in isolated cases, and there were signs of dysautonomia in 28 percent Our experience has been otherwise, with most cases of the myasthenic syndrome occurring in isolation The CSF protein is moderately elevated but acellular and shows high titers of the anti-Hu antibody Sensory potentials are usually absent in all nerves after a few weeks but may be spared early on.

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) Lesions of the lower cervical cord, even if complete, may show a sparing of sensation down to the nipple line because of the contribution of the C3 and C4 cutaneous branches of the cervical plexus, which variably innervate skin below the clavicle Or, a lesion that involves only the outermost bers of the spinothalamic pathways, sparing the innermost ones, results in a sensory.

Question 17-1

and external mail systems) are listed here, but their implementation is beyond the scope of this book.

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The localization of anti-Hu antibody to the several affected regions of the nervous system and to the tumor itself has led to speculation that the lung tumors are typically small or inevident because the antibody suppresses tumor growth Almost all cases of paraneoplastic sensory neuropathy and a proportion of the more nondescript sensory predominant or sensorimotor paraneoplastic polyneuropathies also demonstrate anti-Hu antibodies, making, serum anti-Hu testing useful in distinguishing paraneoplastic varieties of sensory neuropathy and neuronopathy from those due to postinfectious or immune disorders such as Sjogren syndrome and HIV infection The nding of high antibody titers should lead to.

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The goal of buying a call option is to gain the right to a long position in the underlying asset at a particular price with limited risk. This can be either an independent investment or an enhancement of risk control to another position. The advantage is that the call option is obtaining a long position with only the premium paid for the option at risk. Let s look at an example of a call purchase using an at-the-money call on Home Depot common stock and the breakeven scenario for the purchase. In Figure 4.1 we show the purchase of one May $20.00 call option for Home Depot, Inc. In the trade column, 1 represents the purchase quantity. This gives the buyer the right to purchase 100 shares of Home Depot common stock at $20.00 per share. The last column shows the purchase price of $2.33 per share. In the Acutals row at the top of the gure, you can see that the price of the underlying market at the time of this purchase was $20.71. With the call strike price at $20.00 and the underlying Home Depot stock at $20.71, the call option has an intrinsic value of $0.71.

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chart. This strong reduction in implied volatility is possible where volatility is high. Changes in implied volatility can work in favor of an options spread as well. In Figure 7.9 we demonstrate the same AA back spread with a 25-point increase in implied volatility. In this model we can see how the implied volatility change has bene ted the spread with the intermediate time-frame line crossing breakeven just over the 9.00 mark. The goal with a back spread is to buy at low volatility and have both price and volatility increase during the term of the option position. It is important to note that since a back spread is limited risk to the downside, traders frequently make the mistake of holding the spread too long. Time value is a signi cant problem to back spreads, and the best risk control for time value on this spread is early withdrawal. You can roll a back spread forward by liquidating options and applying a new spread so as to avoid the risk of time value.

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