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Floppy Drives Floppy drives are installed and removed in a fashion similar to hard drives To remove the floppy drive, disconnect the power and ribbon cables, unfasten the retaining screws, and then slide the drive out of the bay Like a hard drive ribbon, a floppy drive ribbon works only one way Attach the first floppy drive to the end of the ribbon, and, if necessary, attach the second floppy drive to the middle of the ribbon The red stripe on a drive Also, ensure that the red stripe on the ribbon cable cable indicates pin 1 is lined up with pin 1 on the floppy drive CD-ROM and DVD Drives The physical removal and installation of a CD-ROM or DVD drive is the same as that for hard and floppy drives However, the CD drive could require the connection of a sound cable to the sound card Additionally DVD players will usually be connected using separate cables to a decoder card The BIOS of the computer needs to be configured to allow the operation of the CD-ROM or DVD Normally this will happen automatically, but it may be necessary to enable the device in the BIOS settings If the computer doesn t recognize or can t communicate with the new drive, you need to load a driver for it Insert the floppy disk that came with the CD and run the Setup or Install program This will load the CD driver and allow the computer to recognize the drive

acute necrotizing encephalopthy), or even more unusual conditions such as fatal familial insomnia Neuroserpinopathy In recent years, there have been case reports of dominantly inherited, adult-onset dementia with a fulminant evolution suggestive of encephalopathy and the special feature of seizures As distinctive as this combination of dementia and seizures has been the presence at autopsy of large eosinophilic, PASpositive intraneuronal inclusions that contain aggregates of neuroserpin, thus the initial description under familial encephalopathy with neuronal inclusion bodies The serpins are a family of protease inhibitors that include neuroserpine, a protein expressed exclusively in neurons The neuronal inclusions are densest in the deep layers of the cortex and in the substantia nigra Missense mutations in the gene encoding neuroserpin have been identi ed as the cause This newly described disease is reviewed by Lomas and Carrell Vascular Dementia Finally, a comment is required regarding the group of diseases popularly called vascular dementia and listed in many classi cations as among the most common causes of chronic mental deterioration, second only to Alzheimer disease One might remember that in past decades, much of senile dementia was incorrectly attributed to cerebral atherosclerosis Without doubt, as discussed in Chap 34, multiple cerebral strokes may cause increasing de cits that cumulatively qualify as a dementia, but at least some of the focal lesions that contribute to the cognitive worsening in the clinical syndrome can be identi ed, and there is a corresponding stepwise decline Admittedly, this type of vascular dementia may be more dif cult to recognize when a number of the infarcts are of the relatively silent lacunar type The mental capacities of such patients may then appear to fail in a gradual and continuous fashion Memory is relatively spared in the early stages and, usually, a pseudobulbar state or severe deterioration in gait accompany the dementia The subcortical white matter change of Binswanger disease causes similar diagnostic problems, as discussed on pages 373 and 707 Beyond these vascular diseases and the familial disease CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, page 707), which is of uncertain cause, the authors have doubts about the entire category of vascular dementia and certainly of the frequency with which it is assumed to occur Most cases turn out to be Alzheimer disease with one or more visible infarctions We are inclined toward the point of view expressed in Chap 21 and summarized in the commentary by Jagust, speci cally that while there may be an unde ned but perhaps synergistic interaction between strokes and progressive mental decline in patients with Alzheimer disease, the relationship is unproven Most often it is the degenerative condition of Alzheimer that explains the dementia Dementia Due to Metabolic Diseases (See Chap 37) In the diagnosis of this large category of chronic dementias, one must consider several nondegenerative disorders in which dementia may predominate and focal neurologic abnormalities may be minimal Several of the treatable ones were listed earlier in the discussion of Alzheimer disease above, and a larger group is reviewed in Chap 21 and Table 21-3 Also to be considered, particularly among dementias with onset at an early age, are the inherited metabolic diseases discussed in Chap 37, chief among which are the leukodystrophies metachromatic, adrenal, globoid body (Krabbe disease) and the poliodystrophies neuronal ceroid lipofuscinosis.

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