A unique episode of REM sleep behavior disorder triggered during surgery for Parkinson's disease.

REM sleep behavior disorder (RBD) is characterized by vigorous movements during REM sleep. Here, the authors report the case of a patient who presented such a disorder immediately after the implantation of the definitive electrode for left subthalamic stimulation. Interestingly, this was and has remained a unique episode in his medical history.

Impaired cardiovascular autonomic control in newly and long-term-treated patients with Parkinson's disease: involvement of L-dopa therapy.

In idiopathic Parkinson's disease (PD), autonomic dysfunction is frequent, causing orthostatic hypotension. The respective roles of disease progression and dopaminergic treatment remain unclear. In this study, we investigated the autonomic control of cardiovascular functions and its relation to L-dopa therapy in both newly diagnosed (ND) and long-term-treated (LT) patients.

[A surgical approach to Holmes' tremor associated with high-frequency synchronous bursts].

Introduction: The effectiveness of thalamic stimulation is now clearly demonstrated for essential tremor, but remains to be demonstrated for other types of tremor.

Observation: A young woman presented Holmes' tremor resulting from a pontine tegmental hemorrhage related to an arteriovenous malformation. A surgical approach was considered when major functional impairment persisted at 2-year follow-up despite drug therapy.

Six-month cardiovascular changes in cyclosporine-treated recipients of corneal grafts: serial baroreflex responses.

Loss of autonomic cardiovascular homoeostasis is often suspected in hypertension that has developed after organ transplantation. We serially assessed autonomic cardiovascular control in eight patients in generally good condition who needed cyclosporine (CyA) treatment because of high risk of rejection in corneal transplantation. To this aim, we investigated the patients, before and while they were receiving CyA, for 1 week and at 1, 3 and 6 months.

Decrease in heart rate variability with overtraining: assessment by the Poincaré plot analysis.

Numerous symptoms have been associated with the overtraining syndrome (OT), including changes in autonomic function. Heart rate variability (HRV) provides non-invasive data about the autonomic regulation of heart rate in real-life conditions. The aims of the study were to: (i) characterize the HRV profile of seven athletes (OA) diagnosed as suffering of OT, compared with eight healthy sedentary (C) and eight trained (T) subjects during supine rest and 60 degrees upright, and (ii) compare the traditional time- and frequency-domain analysis assessment of HRV with the non-linear Poincaré plot analysis.

Graded vascular autonomic control versus discontinuous cardiac control during gradual upright tilt.

Indexes of heart rate variability (HRV) and the slope of cardiac baroreflex are extensively used for non invasive assessment of circulatory autonomic control in pathophysiology. We performed this study (1) to assess the sensitivity of these indexes towards small graded postural stimulations and (2) to delineate the informations provided about the settings of both vascular tone and cardiac activity. Twenty healthy subjects were randomly tilted for eight minutes at each of the six angles: -10 degrees, 0 degrees (supine), 10 degrees, 30 degrees, 45 degrees, and 60 degrees.

Abnormal autonomic cardiovascular control in ankylosing spondylitis.

Objective: This study was aimed at assessing the contribution of the autonomic nervous system to adjustments of cardiovascular function in patients with ankylosing spondylitis (AS).

Methods: In 18 AS patients (mean age: 34.9; mean disease duration: 6.

Active standing and passive tilting similarly reduce the slope of spontaneous baroreflex in healthy subjects.

Non-invasive assessment of the sensitivity of cardiac baroreflex was performed by recording each RR-interval and each blood pressure cycle (Finapres). In sequences of at least three cardiac cycles in which systolic blood pressure and RR-interval had changed in the same direction, the slope of linear regression of RR duration as a function of the change in systolic arterial pressure was taken for estimating the sensitivity of the spontaneous cardiac baroreflex. This technique was used in healthy humans to examine how a postural change from supine to upright by either active standing up or 60 degrees head-up tilting modified the sensitivity of the spontaneous baroreflex.

Effects of i.v. insulin bolus on urinary calcium and oxalate excretion in healthy subjects.

Oral glucose load increases urinary excretion of calcium (Ca) and oxalate. Although this increase in calciuria is commonly ascribed to insulin, the role of glucose on Ca excretion remains unclear. In order to assess the role of glucose changes on calciuric response to insulin and oxalate excretion, hypoglycemia induced by insulin (hypo) and hyperglycemia induced by oral glucose load (hyper) were studied in 7 healthy subjects on two separate days.

Aspartame ingestion increases urinary calcium, but not oxalate excretion, in healthy subjects.

Aspartame is the artificial sweetener most extensively used as a substitute for glucose or sucrose in the food industry, particularly in soft drinks. As glucose ingestion increases calciuria and oxaluria, the two main determinants of urinary calcium-oxalate saturation, we considered it worthwhile to determine whether aspartame ingestion also affects calcium-oxalate metabolism. Our study compares the effects of the ingestion of similarly sweet doses of aspartame (250 mg) and glucose (75 g) on calcium and oxalate metabolisms of seven healthy subjects.

Lack of increased urinary calcium-oxalate supersaturation in long-term kidney transplant recipients.

Nephrolithiasis is uncommon after kidney transplantation. However, calcium (Ca) supplementation, which has been proposed as a treatment of post-transplant osteopenia, might increase calciuria and bolster Ca stone formation. Therefore, in 24-hour urine of 82 normocalcemic long-term renal transplant recipients (RT) and in 82 healthy subjects (HS), we assessed some Ca nephrolithiasis risk factors and the Ca-salt saturation estimated by the ion-activity product index (AP) and relative supersaturation (RS).

Lack of evidence that cyclosporine treatment impairs calcium-phosphorus homeostasis and bone remodeling in normocalcemic long-term renal transplant recipients.

Since the effects of cyclosporine on mineral and bone metabolism are controversial, we studied calcium regulating hormones, calcium-phosphorus (Ca-P) metabolism, and bone remodeling, assessed by serum osteocalcin, in long-term renal transplant recipients (RT). Forty-seven normocalcemic patients with good renal function receiving cyclosporine (CT, n = 27) or not (NC, n = 20) were studied at baseline and after an oral Ca load. CT and NC had similar age, daily dose of steroids, GFR level, and duration of transplantation.

Surgical management of pelvic recurrence from resected rectal cancer: technical aspects.

Management of local-regional recurrences of primary rectal cancer (LRR) by a multi-disciplinary surgical team (GI, urological and plastic surgeons) is presented. Aggressive treatment involving surgical debulking and intra operative radiation can result in local control and long term survival in 10 to 20% of the patients with a low mortality and morbidity. Sequelae caused by the extended surgical resection are limited thanks to the fast healing following omentoplasty associated with musculo cutaneous flaps and to the fashioning of a continent stoma.

Increase in urinary calcium and oxalate after fructose infusion.

We have previously shown that an oral glucose load increased both calciuria and oxaluria while the ingestion of fructose induced a rise in calciuria and a decrease in oxaluria. This latter effect remains unclear and might be linked to the reduced intestinal oxalate absorption subsequent to digestive intolerance in some subjects. Such a hypothesis could be enlightened by the study of a parenteral fructose load.

Acute oral calcium load decreases parathyroid secretion and suppresses tubular phosphate loss in long-term renal transplant recipients.

Persistent hyperparathyroidism and impaired tubular reabsorption of phosphate (P) are common after kidney transplantation. In order to assess the suppressibility of these abnormalities, we studied the effects of a single oral calcium (Ca) load (1 g) in 7 healthy subjects (HS) and in 14 normocalcemic long-term renal transplant recipients with good renal function (RT). In HS and RT, serum and urinary Ca were similar at baseline, and increased (p < 0.

[Acute motor axonal neuropathy with favourable outcome after Salmonella Ohio infection].

We report one patient presenting an acute weakness following an infection with Salmonella Ohio. Diagnosis was Guillain-Barré syndrome (GBS). However, preservation of reflexes and electrophysiological study showing purely axonal pattern make this case different from typical GBS.

Increase in calciuria and oxaluria after a single chocolate bar load.

Chocolate, a foodstuff rich in sucrose, fat and oxalate, is considered unsuitable in cases of obesity, diabetes mellitus, urolithiasis and postprandial hypoglycemia. However the pathophysiological effects of chocolate are poorly documented. Therefore we investigated the effects of ingestion of 100 g dark chocolate bar (45 g cocoa and 55 g sucrose) on carbohydrate, calcium and oxalate metabolisms in 10 healthy subjects.

Carbohydrate metabolism and urinary excretion of calcium and oxalate after ingestion of polyol sweeteners.

Polyols are widely used instead of glucose and sucrose in sweets and dietary products because they are barely cariogenic, and their energy value is lower. In addition, it has been shown that calciuria and oxaluria increase after an oral glucose (Glu) load. We, therefore, investigated the effects of a single polyol ingestion on carbohydrate, calcium, phosphate, and oxalate metabolism in 10 healthy subjects.

[Reversible dementia and polyneuritis in an elderly woman: a case of late-onset disseminated lupus erythematosus].

Reversible dementia and polyneuropathy in an elderly woman: a case of late onset systemic lupus erythematosus. We report the case of a 76-year-old woman with undiagnosed systemic lupus erythematosus. She presented with severe dementia.

Met-enkephalin, beta-endorphin and cortisol responses to sub-maximal exercise after sleep disturbances.

The present study compared the effects of partial sleep deprivation and the effects of an intake of a hypnotic compound (zolpidem) prior to bedtime, on sleep and on hormonal and metabolic adaptations to subsequent exercise. Sleep deprivation consisted of a delayed bedtime and an early getting-up time. Eight young subjects, who slept well and were highly trained athletes, were enrolled in this study.

[Lambert-Eaton syndrome. Apropos of 2 cases].

Lambert-Eaton syndrome is a myasthenia-like syndrome of paraneoplastic origin which is often associated with anaplastic small-cell lung cancer. It seems to be an autoimmune disease responsible for a deficit of acetylcholine ejection in the motor end plate. On the occasion of two recent cases, we review the clinical, physiopathological and diagnostic aspects of this paraneoplastic syndrome.

Kock pouch procedures: continuing experience and evolution in 135 cases.

Between April 1985 and January 1989, 135 consecutive patients underwent construction of a Kock pouch (to the skin in 72 patients, a urethral pouch in 45, an ileorectal pouch in 10 and a hemi-Kock pouch augmentation cystoplasty in 8). The operative mortality (30 days) rate was 4.4%.

[Pelvectomy and continent diversion].

We owe to N.G. Kock and to M.

[Kock's ileal reservoir].

Since April, 1985, 167 patients have been operated: 85 continent external urinary bypasses to complement the bladder, 57 ileourethral anastomoses to replace the bladder, 14 ileorectoplasties, 9 ileocystoplasties and 2 ileoanal anastomoses. The mortality rate was 5.3% during the first 60 days.

[Opsoclonus associated with multisystemic sarcoidosis].

A 32 year old patient with unexplained cough developed an opsoclonus-ataxic-myoclonic syndrome. Chest X-ray film were normal at this onset but became pathologic, and the diagnosis of multisystemic sarcoidosis was made. The possibility of sarcoidosis being the cause of the opsoclonus is discussed.