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both the nuclei and cytoplasm The nature of these diverse changes is obscure The tubulo lamentous inclusions have suggested a viral origin, but one has never been isolated and serologic studies have failed to substantiate a viral causation except perhaps for one patient in whom adenovirus type 2 was isolated from a biopsy specimen (Mikol and Engel) No evidence has emerged to date to suggest an autoimmune mechanism, and the in ammatory component, although similar to PM, is thought to be possibly a secondary phenomenon as noted later Treatment Inclusion body myositis has not responded in any consistent fashion to treatment with corticosteroids or other immunosuppressive drugs Indeed, the disease should be suspected in recalcitrant cases of apparent PM Despite this, because a few patients improve slightly or cease worsening with steroids, a severalmonth trial is often recommended (Lotz et al) The level of CK and the degree of leukocyte in ltration of muscle often diminish with corticosteroid treatment despite a lack of clinical improvement On this basis, Barohn and coworkers have suggested, as alluded to earlier, that the in ammatory response is not a primary cause of muscle destruction Sayres and colleagues concluded in a review of 32 patients that low-dose methotrexate and corticosteroids may slow the progression of disease, but this regimen has not been widely adopted In a few cases there has been brief improvement in response to IVIG, especially in the weakened muscles involved in swallowing, but the gains have been unsustained and serial histopathologic examinations have detected no change Plasma exchange and leukocytopheresis have been tried, also with generally discouraging results The disease in most patients is relentlessly progressive over many years, sometimes very slowly, and no method of treatment has altered the long-term prognosis Sometimes, the process remains fairly restricted for up to a decade, thereby creating less disability than in cases that generalize.

Included under this heading are a large number of unrelated myositides and certain rare forms of focal myositis and relatively minor changes in muscle that occur in the course of in ammatory diseases of blood vessels or disseminated or systemic infections or curiously, with thymoma Most of them do not warrant extensive consideration here but are described in detail in monographs devoted to muscle disease (see Banker) We are uncertain how to place the newly described and undoubtedly rare entity of myositis with abundant macrophage in ltration and aluminum hydroxide crystalline deposits A type of fasciitis that is also characterized by pronounced in ltration of macrophages has been related to vaccinations that contain the aluminum compound, but the myositis is not related to this aforementioned entity (see Bassez et al) Three in ammatory myopathic diseases, however, are quite distinctive and of interest to neurologists; (1) the eosinophilic myositis, fasciitis and myalgia syndrome, (2) orbital myositis, and (3) sarcoidosis of muscle Eosinophilic Myositis and Fasciitis This term has been applied to four separate and probably overlapping clinical entities: (1) eosinophilic fasciitis, (2) eosinophilic monomyositis (sometimes multiplex), (3) eosinophilic PM, and (4) the eosinophilia-myalgia syndrome Eosinophilic Fasciitis This condition, mistakable for PM, was originally reported by Shulman in 1974 He described two men

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Experts in the field of AI have been disappointed in the past few decades Computers have been designed that can handle tasks no human could ever contend with, such as navigating a space probe Machines have been built that can play chess and checkers well enough to compete with human masters Modern machines can understand, as well as synthesize, much of any spoken language But these abilities, by themselves, don t count for much in the dreams of scientists who hope to create artificial life The human mind is incredibly complicated A circuit that would have occupied, and used all the electricity in, a whole city in 1940 can now be housed in a box the size of a vitamin pill and run by a battery Imagine this degree of miniaturization happening again, then again, and then again Would that begin to approach the level of sophistication in your body s nervous system Perhaps A human brain might be nothing more than a digital switching network, but no electronic device yet conceived has come anywhere near its level of intelligence Some experts think that a machine might someday be built that is smarter than a human But most concede that if it s ever done, it won t be for a very long time Other experts say that we humans cannot create a mind more powerful than our own, because that would violate the laws of nature

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