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re exia ) is episodic and occurs in response to a certain stimuli, such as a distended bladder or rectum It has been ascribed to the re ex release of adrenalin from the adrenal medulla and of norepinephrine from the disinhibited sympathetic terminals caudal to the lesion Extensor re exes eventually develop in most cases (18 of 22 of Kuhn s patients who survived more than 2 years), but their appearance does not lead to the abolition of the exor re exes The overactivity of extensor muscles may appear as early as 6 months after the injury, but this only happens, as a rule, after the exor responses are fully developed Extensor responses are at rst manifest in certain muscles of the hip and thigh and later of the leg In a few patients extensor re exes are organized into support reactions suf cient to permit spinal standing Kuhn observed that extensor movements were at rst provoked most readily by a sudden shift from a sitting to a supine position and later by proprioceptive stimuli (squeezing of the thigh muscles) and tactile stimuli from wide areas Marshall, in a study of 44 patients with chronic spastic paraplegia of spinal origin, found all possible combinations of exor and extensor re exes; the type of re ex obtained was determined by the intensity and duration of the stimulus (a mild prolonged noxious stimulus evoked an ipsilateral extensor re ex; an intense brief stimulus, a exor response) From these observations one would suspect that the ultimate posture of the legs exion or extension does not depend solely on the completeness or incompleteness of the spinal cord lesion, as originally postulated by Riddoch The development of paraplegia in exion (extreme exion of the hips and knees, as in a fetal position) relates also to the level of the lesion, being seen most often with cervical lesions and progressively less often with more caudal ones Important also are repeated exor spasms, which are more frequent with higher lesions, and the ensuing contractures ultimately produce a xed exor posture Conversely, reduction of exor spasms by elimination of nociceptive stimuli (infected bladder, decubiti, etc) favors an extensor posture of the legs (paraplegia in extension) According to Guttmann, the positioning of the limbs during the early stages of paraplegia greatly in uences their ultimate posture Thus, prolonged xation of the paralyzed limbs in adduction and semi exion favors subsequent paraplegia in exion Placing the patient prone or placing the limbs in abduction and extension facilitates the development of predominantly extensor postures Nevertheless, strong and persistent extensor postures are usually observed only with partial lesions of the spinal cord Of some interest is the fact that many patients report sensory symptoms in segments of the body below the level of their transection Thus, a tactile stimulus above the level of the lesion may be felt below the transection (synesthesia) Patients describe a variety of paresthesias, the most common being a dull, burning pain in the lower back and abdomen, buttocks, and perineum We have encountered several patients in whom aching testicular or rectal pain was a distressing problem The pain may be intense and last for a year or longer, after which it gradually subsides It persists after rhizotomy but can be abolished by anesthetizing the stump of the proximal (upper) segment of the spinal cord, according to Pollock and his collaborators Transmission of sensation over splanchnic afferents to levels of the spinal cord above the lesion, the conventional explanation, is therefore not the most plausible one The overactivity of neurons in the isolated segments of the spinal cord has several explanations One assumes that suprasegmental inhibitory in uences have been removed by the transection, so that afferent sensory impulses evoke exaggerated nocifensive.

According to Nakano, a first-generation robot is a simple mechanical arm without AI Such machines have the ability to make precise motions at high speed, many times, for a long time They have found widespread industrial application and have been around for more than half a century These are the fast-moving systems that install rivets and screws in assembly lines, that solder connections on printed circuits, and that, in general, have taken over tedious, mind-numbing chores that used to be done by humans First-generation robots can work in groups if their actions are synchronized The operation of these machines must be constantly watched, because if they get out of alignment and are allowed to keep operating anyway, the result can be a series of bad production units At worst, a misaligned and unsupervised robot might create havoc of a sort that you can hardly begin to imagine even if you let your mind run wild

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