[Sympathetic skin potentials and neuroperineal disorders. Sixty-eight cases].

Sympathetic pathways can be assessed by using different electrophysiological tests. Sympathetic skin responses (SSR) are elicited with peripheral electrical stimulation of the median nerve. SSR are recorded from the skin of the hand and foot and from the genital skin.

[Complex cardiac lesion diagnosed more than 20 years after the causal injury].

Penetrating wounds of the heart, when not immediately fatal, may give rise to complex lesions associating valvular regurgitations and fistulous connections. The authors report the case of a patient with mitral and aortic regurgitation associated with an aorto-left atrial fistula of traumatic origin and causing invalidating cardiac failure. The interest of this particular case lies in the duration of the interval between the causal trauma and the appearance of symptoms (over 20 years).

[Stretch neuropathy of the internal pudendal nerve. Its relationship to urinary incontinence, anorectal, and genito-sexual disorders in women].

The progressive denervation of the striated pelvic sphincter musculature is due to repeated stretch injury of the innervation of these muscles when the pelvic floor diaphragm is weak. Electromyography examination, evoked potentials and perineal nerve motor latency confirmed perineal neurogenic abnormalities. This real "perineal stretch neuropathy" can be determine stress urinary incontinence, fecal incontinence and sexual disorders.

[Disorders of the bladder sphincter. Etiopathogenic approach].

Disorders of the vesico-sphincteral system are due to multiple causes (urological, gynaecological, neurological, psycho-behavioural, iatrogenic) which may be associated. By providing information on the type and evolution of these disorders and on the circumstances in which they developed, questioning is fundamental for the diagnosis. Completed by physical examination, it must precede all exploratory methods, including urodynamic, electrophysiological and radiological examinations.

[Evaluation and treatment of neurogenic vesico-sphincter dysfunction].

The evaluation of neurogenic vesicosphincteric disorders is based on clinical examination and instrumental assessment, composed of urodynamic and perineal electrophysiological studies allowing a better understanding of the pathophysiology, aetiopathogenesis and course of the symptoms. The treatment of urinary symptoms, whether medical, surgical, mixed or involving various rehabilitation techniques, must satisfy a dual objective of individual and psychosocial comfort and preservation of the patient's uronephrological future.

[Cardiology in general hospitals. A cooperative survey on medical teams, technical means and activity].

A national enquiry carried out in 1990 in the departments of cardiology of general and private non-profit making hospitals established the status of these departments and the evolution of their personnel and equipment since their creation. The enquiry involved two thirds of the cardiology departments of the general hospitals (119/180) and showed that most (66%) were established between 1974 and 1988. Implanted in fairly important cities with catchment areas of 100,000 to 400,000 people, they have an average of 32 beds (range 11 to 100) and 7.

Kinetics of action of salbutamol inhaled from a metered dose inhaler (MDI) and a "Diskhaler".

In a double-blind cross-over study, 12 patients with reversible airways obstruction were treated with 200 micrograms salbutamol base in aerosol or 400 micrograms of powder following methacholine-induced bronchoconstriction. Salbutamol was inhaled either from a conventional metered dose inhaler (MDI) or from an inhaler (Diskhaler) utilizing the powdered form of the drug. The efficacy of both forms was identical whether assessed in terms of FEV1 or vital capacity.

Watershed cerebral infarcts: retrospective study of 24 cases.

Twenty-four patients presenting an acute stroke with watershed cerebral infarct on CT scan or MRI were included in this retrospective study. Age was 63 +/- 14 years (mean +/- SD), and sex ratio was 2 men for 1 woman. Main clinical features were: in anterior location, lower limb weakness and frontal syndrome with transcortical motor aphasia in left lesions or spatial dyscalculia in right ones; in posterior location, brachiofacial weakness with constant quadranopsia and hypoesthesia, and Gerstmann syndrome in left lesion.

[Comparative results of flowmeter studies before and after urodynamic exploration].

Results of flowmeter studies in 145 patients before and then immediately after urodynamic exploration were unchanged in 80% of women and 72% of men. Abnormal results on flowmetric examination, detected in 18% of cases prior to urodynamic studies, were assessed as normal during follow-up urodynamic tests. These findings raise the question of the validity of flowmeter parameters determined during urethrocystometric exploration.

[Lesion of the dorsal nerve of the penis in Peyronie's disease].

Twelve patients with La Peyronie disease underwent complete neurophysiological investigation of the perineum including evaluation of the nerve conduction velocity of the dorsal nerve of the penis. A significant reduction was observed in this velocity with a reduction in the amplitude of the sensory potential in patients with associated disorders of erection or sensory disturbances (paraestesiae of the glans). A compressive lesion of the dorsal nerve by hard nodules buried in the dermis of the dorsal surface of the penis was suspected.

[Investigation of the vesical sphincter and genital-sexual autonomic pathways. Techniques, normal values, and application to pathology].

Parasympathetic and sympathetic pathways may be assessed by using different electrophysiologic tests. Sympathetic skin potentials (SSP) are elicited with peripheral electrical stimulation (e.g.

[Congenital syphilitic meningomyelitis manifested in the adult].

We report a case of neurosyphilis of the spinal cord in a 38-year-old-man presenting with urinary incontinence and Argyll-Robertson sign. Anamnesis revealed the congenital origin of the disease. Urodynamics findings were consistent with a conus medullaris involvement and CSF study revealed a specific lymphocytic meningitis.

[Delays in hospital admissions of myocardial infarction].

Analysis of the delays in hospital admission to the coronary care unit of 100 patients with recent myocardial infarctions showed an average delay time of 9 hr 50 with early hospital admission within 4 hours in 38% of cases. The number of early hospital admissions increased to: 51% when the infarct was preceded by unstable angina (35 cases, p less than 0.05); 65% when the patient himself diagnosed a coronary thrombosis (34 cases, p less than 0.

[Vesico-sphincter disorders in neurosyphilis].

The authors report 8 cases of disorders of the bladder and sphincter in neurosyphylis. Urodynamic study suggested preponderant damage to the sensory pathways and in particularly the posterior roots. The most common clinical manifestation was dysuria or chronic retention, these occasionally being signs of neurological disease.

[Isolation of Chlamydia trachomatis from the endometrium and endometritis. Apropos of a series of 42 patients].

Most studies have been concerned with recovering Chlamydia trachomatis (CT) from the endocervix on the one hand and from the adnexae on the other hand and consider its relationship to infection of the upper genital tract. Our work is concerned with the endometrium. 42 women were examined: 22 of them had salpingitis (group I), 14 were considered possibly to have endometritis with a risk of infection with CT, or had cervicitis (group II), and 6 were in the control group (group III).

[Determination of 3-methoxy-4-hydroxyphenyethylene-glycol and its urinary conjugates. Value in the diagnosis and therapeutic follow-up of depression].

In psychiatric illness like depression, difference is essential between noradrenergic and serotoninergic sources. Therefore the measurement of urinary excretion of MHPG (3-methoxy-4-hydroxy-phenylethylene-glycol) is interesting, because MHPG seems to be the best reflect of central noradrenergic activity. Analytical assay of MHPG includes an enzymatic hydrolysis and an extraction by ethyl acetate.

[Supernumerary liver. A case with a particular location in an omphalocele].

The authors report one case of a supernumerary liver lobe contained in the omphalocele of a new born. An accessory hepatic lobe was attached to the liver by a pedicle. Its histological structure was that of an immature liver.