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If you look at that one variant and how it is stored, you will notice that a technical name has been assigned to it, as shown in the following illustration The system automatically assigns this technical name, and it s more of an encrypted number than a true technical name Also notice that the values of the variant are stored in an XHTML string rather than an ABAP field This allows the creation of these variants on the Web as well So, during the migration process, the older version variants are switched from an ABAP format into an XHTML format

Figure 31-22 Coronal FLAIR MRI from a woman with paraneoplastic limbic encephalitis associated with lung cancer and a mild pleocytosis but no detectable autoantibodies The hippocampi and adjacent regions are involved Pathologically there proved to be gliosis and a minimal in ammatory in ltrate in these regions

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changes and may overlap Most cases are subacute, meaning speci cally a progression over a few weeks or months, but often the main symptoms in mild form become apparent in a matter of days Rare instances of remission have been reported Anxiety and depression, a confusional-agitated state, hallucinations, retentive memory defect (Korsakoff syndrome), and dementia singly or in various combinations are the principal manifestations of so-called limbic encephalitis (Gultekin et al) Vertigo, nystagmus, ataxia, nausea and vomiting, and a variety of ocular and gaze palsies re ect the presence of paraneoplastic brainstem encephalitis As indicated above, these symptoms may be joined with cerebellar ataxia, and another group has a sensory neuropathy We have seen instances of this condition involving only the midbrain and others involving the medulla, the latter with unusual breathing patterns including gasping, inspiratory breathholding, and vocal-respiratory incoordination, and yet others with chorea and additional basal ganglionic features The great variety of clinical presentations can be appreciated from the series by Graus and colleagues of 200 patients: sensory neuropathy, 54 percent; cerebellar ataxia, 10 percent; limbic encephalitis, 9 percent; and others including multiple sites in 11 percent In most of these cases, MRI shows T2 signal changes in affected regions; in severe cases, zones of focal necrosis may be seen Odd seizures, including epilepsia partialis continua, have been observed with this disorder, but they must be rare Sensory symptoms may be related to neuronal loss in the posterior horns, traced to the commonly associated loss of neurons in the dorsal root ganglia (sensory neuronopathy and sensory neuropathy) as mentioned above and discussed further on All attempts to isolate a virus in these cases have failed There may be a slowly progressive, symmetrical or asymmetrical amyotrophy of the arms and less often of the legs, traced in two of our patients to poliomyelitic lesions in the anterior horns of the spinal gray matter (see further on) A form characterized mainly by corticospinal degeneration is also reported but has not been found in our clinical material Pathologic studies have not entirely clari ed these forms of paraneoplastic disorder In some cases, no changes were demonstrable in the brain, even though there had been a prominent dementia during life Contrariwise, widespread in ammatory changes may be found without clinical abnormalities having been recorded during life We believe that these seemingly paradoxical ndings may have to do with the thoroughness of the clinical and pathologic examinations Most patients with small-cell lung cancer and any of the types of paraneoplastic encephalomyelitis have circulating polyclonal IgG antibodies (anti-Hu, or antineuronal antibody, type 1) that bind to the nuclei of neurons in many regions of the brain and spinal cord, dorsal root ganglion cells, and peripheral autonomic neurons The antibodies are reactive with certain nuclear RNA-binding proteins Cancers of the prostate and breast and neuroblastoma may rarely produce a similar antibody The antibody titer is higher in the CSF than in the serum (as it is for anti-Yo with cerebellar degeneration), indicating production of antibody within the nervous system Low titers of anti-Hu are found in many patients with small-cell cancer who are neurologically normal, probably because these tumors have expressed only low levels of antigens that are recognized by anti-Hu Recently, antibodies to voltage-gated potassium channels have been identi ed in patients with limbic encephalitis without cancer (Vincent et al) Despite a few reports of improvement with plasma exchange or intravenous gamma globulin, the results of treatment have been.

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disappointing However, those few patients who did improve had treatment from the onset of symptoms, and this is possibly a way of limiting the neuronal loss

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