This paper presents a lake-level record established for the last millennium at Lake Saint-Point in the French Jura Mountains. A comparison of this lake-level record with a solar irradiance record supports the hypothesis of a solar forcing of variations in the hydrological cycle linked to climatic oscillations over the last millennium in west-central Europe, with higher lake levels during the solar minimums of Oort (around AD 1060), Wolf (around AD 1320), Spörer (around AD 1450), Maunder (around AD 1690), and Dalton (around AD 1820). Further comparisons of the Saint-Point record with the fluctuations of the Great Aletsch Glacier (Swiss Alps) and a record of Rhône River floods from Lake Bourget (French Alps) give evidence of possible imprints of proxy sensitivity on reconstructed paleohydrological records. In particular, the Great Aletsch record shows an increasing glacier mass from AD 1350 to 1850, suggesting a cumulative effect of the Little Ice Age cooling and/or a possible reflection of a millennial-scale general cooling until the mid-19th century in the Northern Hemisphere. In contrast, the Saint-Point and Bourget records show a general trend toward a decrease in lake levels and in flood magnitude anti-correlated with generally increasing solar irradiance.

Most rhythmic behaviors are produced by a specialized ensemble of neurons found in the central nervous system. These central pattern generators (CPGs) have become a cornerstone of neuronal circuit analysis. Studying simple invertebrate nervous systems may reveal the interactions of the neurons involved in the production of rhythmic motor output. There has recently been progress in this area, but due to certain intrinsic features of CPGs it is unlikely that present techniques will ever yield a complete understanding of any but the simplest of them. The chief impediment seems to be our inability to identify and characterize the total interneuronal pool making up a CPG. In addition, our general analytic strategy relies on a descriptive, reductionist approach, with no analytical constructs beyond phenomenological modeling. Detailed descriptive data are usually not of sufficient depth for specific model testing, giving rise instead to ad hoc explanations of mechanisms which usually turn out to be incorrect. Because they make too many assumptions, modeling studies have not added much to our understanding of CPCs; this is due not so much to inadequate simulations as to the poor quality and incomplete nature of the data provided by experimentalists.

A basic strategy that would provide sufficient information for neural modeling would include: (1) identifying and characterizing each element in the CPG network; (2) specifying the synaptic connectivity between the elements; and (3) analyzing nonlinear synaptic properties and interactions by means of the connectivity matrix. Limitations based on our present technical capabilities are also discussed.

Background and objective: Auditory impairment is among the lesser known complications of spinal analgesia. The aim of the present study was to determine the degree of vestibulocochlear dysfunction in patients undergoing spinal analgesia for lower abdominal surgery.

Methods: Eighty patients who had received spinal analgesia for lower abdominal surgery were studied. Males were undergoing inguinal herniorraphy and the females tubectomy. Audiograms were performed before operation and on the second and seventh postoperative days. Hearing levels were measured from 250 Hz-8 kHz. In Group 1 (n = 40) a 22-gauge, cutting type of spinal needle (Howard Jones) was used. In Group 2 (n = 40) a 25-gauge, non-cutting spinal needle (Whitacre) was used.

Results: Hearing loss ' 10 dB was noticed in three patients in Group 1 and none in Group 2. The mean hearing level was more reduced in Group 1 patients.

Conclusions: Use of cutting type spinal needle is associated with a greater decrease in mean hearing levels compared to the non-cutting type.

Malignant hyperthermia is an autosomal-dominant inherited disorder of the skeletal muscle cell characterized by a hypermetabolic response to all commonly used inhalational anaesthetics and depolarizing muscle relaxants. The clinical syndrome includes muscle rigidity, hypercapnia, tachycardia and myoglobinuria as result of increased carbon dioxide production, oxygen consumption and muscle membrane breakdown. In human beings and animals susceptible to malignant hyperthermia, it is generally accepted that an increase in the level of myoplasmic free calcium is the cause of the syndrome. Various hypotheses have been proposed to account for the increase of intracellular calcium levels, e.g. a defect in the calcium release channel of the sarcoplasmic reticulum (ryanodine receptor), an abnormality of the excitation-contraction coupling mechanisms, or alterations in second messenger systems of skeletal muscles. This review gives an overview of the main features of this disease and recent advances in research including pathophysiology, treatment, diagnosis and genetics as well as association with other disorders.

A 6-months pregnant woman suffering from severe tetanus was successfully treated with intrathecal baclofen. She delivered a premature but healthy neo-nate, and was safely discharged home 40 days after the onset of symptoms of tetanus. Specific aspects of intrathecal baclofen therapy in the pregnant woman are discussed.

A case is presented of a neonate with Hirschsprung's disease, associated with congenital central hypoventilation syndrome. After an ileostomy (at 2 days) and a stoma revision (at 10 days), postoperative pain management was established by continuous intravenous infusion of morphine, which caused severe postoperative respiratory depression. At 6 weeks a reexploration and stoma revision was performed using postoperative epidural analgesia with bupivacaine. This caused no respiratory depression. A colectomy under epidural analgesia at 8 months was also uneventful. Respiratory difficulties in children with congenital central hypoventilation syndrome associated with Hirschsprung's disease are discussed in relation to the technique of choice for postoperative pain management.

The results of a U.K. study of 145 cases of type 2 neurofibromatosis has shown generally very poor operative results in terms of hearing and facial nerve preservation. Only 9 out of 118 vestibular schwannoma (acoustic neuroma) operations resulted in any clinically detectable hearing preservation and only 32 left the patient with good or normal (House grade I or II) ipsilateral facial nerve function. Although operation is still the definitive treatment of vestibular schwannoma (acoustic neuroma) and may be a lifesaving procedure, it appears that the evidence in favour of early operation is only valid when carried out in highly specialized centres. The special problems of NF2 cases who may go on to develop multiple spinal and cranial tumours making them wheelchair bound and blind as well as deaf warrants a careful experienced approach. Timing of operations may be critical for the enhancement of useful years of quality life. We therefore propose the setting up of a national NF2 register, with the management of cases at a few supraregional centres.

The neurofibromatoses consist of at least two distinct autosomal dominant hereditary disorders. Neurofibromatosis type 1 (NF1) is due to a lesion on chromosome 17q. Neurofibromatosis type 2 (NF2) is caused by a defect on chromosome 22q. The hallmark of NF2 is the development, in the second and third decades, of bilateral acoustic neuromas. NF1 is characterized by the appearance of cafe-au-lait spots and neurofibromas in addition to iris hamartomas, or Lisch nodules, of the eye, during the first and second decades.

Ten families were personally studied. A total of 16 members were found to be affected with NF2. A protocol for evaluation and review of subjects and relatives of NF2 families is proposed. A team approach, coordinating the expertise of multiple specialties is recommended.