Brain FDG-PET correlates of saccadic disorders in early PSP.

BACKGROUND: New diagnostic criteria of Progressive Supranuclear Palsy (PSP) have highlighted the interest of Eye Movement Records (EMR) at the early stage of the disease. OBJECTIVES: To investigate the metabolic brain correlates of ocular motor dysfunction using [18F] Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in early PSP. METHODS: Retrospective observational descriptive study on longitudinal data with patients who underwent EMR and FDG-PET at the stage of suggestive and possible PSP according to Movement Disorders Society criteria. Longitudinal follow-up enables to confirm diagnosis of probable PSP. Using the Statistical Parametric Mapping software, we performed whole-brain voxel-based correlations between oculomotor variables and FDG-PET metabolism. RESULTS: Thirty-seven patients with early PSP who fulfilled criteria of probable PSP during the follow-up were included. Decrease in the gain of vertical saccades correlated with reduced metabolism in Superior Colliculi (SC). We also found a positive correlation between mean velocity of horizontal saccades and SC metabolism as well as dorsal nuclei in the pons. Finally, increase in horizontal saccades latencies correlated with decrease of posterior parietal metabolism. CONCLUSIONS: These findings suggest the early involvement of SC in saccadic dysfunction in the course of PSP.

First cage-like pentanuclear Co(ii)-silsesquioxane.

A new pentanuclear "cylinder"-like cobalt(ii) phenylsilsesquioxane [(PhSiO1.5)10(CoO)5(NaOH)] exhibits a slow relaxation of the magnetization and a high catalytic activity and stereoselectivity in the oxidation of alkanes and alcohols.

Estudio sobre las propiedades térmicas, la toxicidad emitida y la reinhalación de CO2 en los colchones de bebés como factores estresores externos relacionados con el lactante. Recomendaciones de diseño / No disponible

No disponible

Consensus on drug treatment, definition and diagnosis for insomnia.

Thirty-four experts and a literature supervisor got together in order to reach a 'consensus' regarding the definition, diagnosis and pharmacological treatment of insomnia. Insomnia is a subjective perception of dissatisfaction with the amount and/or quality of sleep. It includes difficulty in initiating or maintaining sleep or early awakening with inability to fall asleep again. It is associated with complaints of non-restorative sleep and dysfunction of diurnal alertness, energy, cognitive function, behaviour or emotional state, with a decrease in quality of life. The diagnosis is based on clinical and sleep history, physical examination and additional tests, although polysomnography is not routinely indicated. Therapy should include treatment of the underlying causes, cognitive and behavioural measures and drug treatment. Hypnotic therapy can be prescribed from the onset of insomnia and non-benzodiazepine selective agonists of the GABA-A receptor complex are the drugs of first choice. It is recommended that hypnotic treatment be maintained in cases where withdrawal impairs the patient's quality of life and when all other therapeutic measures have failed. Experience suggests that intermittent treatment is better than continuous therapy. The available data do not confirm safety of hypnotics in pregnancy, lactation and childhood insomnia. Benzodiazepines are not indicated in decompensated chronic pulmonary disease but no significant adverse effects on respiratory function have been reported with zolpidem and zopiclone in stable mild to moderate chronic obstructive pulmonary disease and in treated obstructive sleep apnoea syndrome. Data for zaleplon are inconclusive. If the patient recovers subjective control over the sleep process, gradual discontinuation of hypnotic treatment can be considered.

[Retrograde endoscopic cholangiography after biliary surgery]. / La cholangiographie rétrograde endoscopique après chirurgie biliaire.

Retrograde cholangiography was conducted in 310 patients early or late after biliary system surgery. Principal indications for the investigation were angiocholitis (37% of cases), isolated jaundice (30%) or acute hepatic colic (17%). Biliary tract lesions were excluded in 7% of patients while in the remaining 93% it was possible to determine the precise cause of the disorder. In 30% of cases the disorder was unrelated to the previous operation or the lithiasic disease, whereas in 63% it was related to the latter (remaining or reformed stone, odditis) or to the surgical procedure (stenosis, common bile duct ligature or injury to main bile duct). These results, and those reported in the ligature, suggest that retrograde cholangiography can provide a precise diagnosis and ensure adapted therapy after biliary surgery.

[Zollinger-Ellison syndrome with unusual symptomatology. Demonstration of the gastrinoma by endoscopic wirsungography]. / Syndrome de Zollinger-Ellison à symptomatologie inhabituelle. Mise en èvidence du gastrinome par wirsungographie endoscopique.

A 58-year-old man developed diarrhoea and duodenal ulcer related to a malignant pancreatic gastrinoma. Initial evaluations of basal acid output and serum gastrin level were not significant. Two months later they were typical of Zollinger-Ellison syndrome. The tumor was detected by endoscopic retrograde pancreatography.

[Peptic esophageal strictures. Dilatation with the Eder-Puestow's olives system (author's transl)]. / Sténoses peptiques de l'oesophage. Traitement par le dilatateur d'Eder-Puestow.

Esophageal dilatations under topical pharyngeal anesthesia with the Eder-Puestow's metallic olives system were performed 101 times on 30 patients presenting peptic strictures. This method uses first a metallic wire introduced into the esophagus and the stomach under endoscopic control. Then, the wire allows to guide dilatating olives through very tight strictures. Functional results were excellent 28 times out of 30; two patients only required repeated dilatations because of uncomplete treatment (stenosis on esojejunal anastomosis). Finally, surgical procedure was never indicated. The use of Eder-Puestow's material together with fiberoptic esophagoscope reduces the hazard of peroral bougienage: no complication occured in our series.

[Menetrier's disease and edematous syndrome (author's transl)]. / Syndrome oedémateux révélateur d'une maladie de Ménétrier.

The authors report a case of Menetrier's disease revealed in a 51 years woman before oedomas by systematic gastroscopy. Somes particularities of this case authorize to argue problems put by this disease: a thyroid nodule treated by L + triodothyronin; an eosinophilia; a biological study of gastric secretion, gastrin and intrinsec factor level; an hormonal, immunologic and genetic exploration; an histochimic and ultra-structural study of operative portion; its favorable evolution after total gastrectomy.

[Syndrome of inappropriate secretion of vasopressin. Apropos of 3 cases]. / Syndrome de sécrétion inappropriée de vasopressine. A propos de 3 observations.

3 cases of inappropriate vasopressin secretion during one case of anaplastic carcinoma of the lung, one case of carcinoma of the prostate with bony metastases and one case of acute intermittent porphyria are presented. The plasma levels of vasopressin, measured by radioimmunoassay were high. Treatment with demeclocycline was attempted in one case. The clearance of free water was positive but the treatment was poorly tolerated by the digestive tract.

[Varicoid carcinoma of oesophagus (author's transl)]. / Forme varicoïde du cancer de l'oesophage

Two cases of diffuse squamous cell carcinoma of the oesophagus simulating the roentgenographic appearance of oesophageal varices are presented. Careful fluoroscopic examination may permit accurate diagnosis; however if the lesions are equivocally demonstrated by X-ray examination, oesophagoscopy confirms the diagnosis of carcinoma. R94.