[Ejaculation problems in traumatic paraplegia ]. / Troubles de l'éjaculation au cours des paraplégies traumatiques. A propos de cent quarante-neuf dossiers.

Basing themselves on 149 cases, the authors describe the spinal neurophysiology of ejaculation in spinal man, and put forward certain hypotheses. They suggest that the reflex of seminal emission is a lumbar reflex, which may be dependent on conductive factor originating in the upper neurological structures, and that the orthosympathetic system, which leaves the spinal cord through the thoracolumbar junction, could provide a highway for the psychological nerve impulses inducing seminal emission.

Effects of muscle length on an increased stretch reflex in children with cerebral palsy.

No inhibitory influence of length on the increased stretch reflex was found in the internal gastrocnemius muscle of 19 cerebral palsied children. A facilitory influence of length was found in at least five patients in which quantitative data were obtained. These results were compared with previous data on a facilitory influence in the hamstrings and inhibitory influence in quadriceps muscles.

Muscle hypoextensibility in children with cerebral palsy: II. Therapeutic implications.

Twenty-nine children with cerebral palsy and triceps surae hypoextensibility were divided into 2 groups. In group I trophic regulation of the muscle was defective and in group II it was normal. Torque values were plotted against tibiocalcanean angles before and after treatment, which consisted of muscle lengthening by successive plaster casting or of surgical elongation of the tendon or the aponeurosis. In group I, casting had no effect, but surgery increased passive dorsiflexion and gave definite clinical improvement without modifying the range of passive muscle stretch. In group II, with normal muscle adaptation, plaster casts were successful when tolerated. Children in this group required braces after surgery to prevent rapid recurrence of hypoextensibility. Both casting and surgery increased the passive muscle stretch. There was a displacement of the starting point of the passive and active curves in both groups. This is an unavoidable side-effect which makes walking on tiptoes impossible after casting or surgery.

Effects on torque angle curve of differences between the recorded tibia-calcaneal angle and the true anatomical angle.

The present study gives the results of a comparison of the recorded and true tibia-calcaneal angles in 17 normal subjects and in 14 patients with abnormally hypoextensible non contracting triceps. 1. For a minimal passive torque, the difference between true and recorded angles varied considerably from one individual to another. The mean and ranges for the two groups were respectively: -8 degrees (+7 degrees, -21 degrees) and -7 degrees (+5 degrees, -20 degrees). 2. When the passive torque increased as a result of slow passive lengthening of the muscle, the true curve was steeper than the recorded one, owing to differences between the two angle measurements. For each of the two groups the differences in means and ranges were respectively: 6 degrees (0 degrees, +13.5 degrees) and 8 degrees (3 degrees, 12 degrees). 3. Subjects made isometric voluntary contractions of the triceps surae at fixed angles which corresponded to step by step muscle lengthening. The resulting true curve was much steeper than the recorded curve. The differences in means and ranges were: 7 degrees (1.5 degrees, +15 degrees) in children of the two groups and respectively 3 degrees (0 degrees, +9 degrees) and 12 degrees (10 degrees, 14 degrees) in adults of the two groups. The present results show that this methodology was the only reliable way of correctly obtaining passive and active torque-angle curves, measuring differences between subjects, appreciating the effects of treatments and these by ascertaining whether or not trophic muscle regulation was defective.

Trophic muscle regulation in children with congenital cerebral lesions.

A decrease in sarcomere number and hypoextensibility of ankle extensors was observed in certain children with congenital cerebral lesions. This phenomenon was reproducible and reversible in normal animals, i.e. trophic regulation adapted the muscle to the imposed length. The form of the torque-ankle angle curve was studied in 30 children. Its modification after treatment was considered as a sign of muscle adaptation. This adaptation was present in one group of 14 children. The steepness of the curve increased or diminished depending on the initial disorder and the treatment administered. In another group, treatment failed to modify the shape of the curve. In certain cases trophic regulation of the muscle appeared to be absent.

Relationship of triceps surae torques to photographed tibia-calcaneum angles in man (II).

A previous paper described an apparatus and method for giving the relationship between triceps surae torque and the tibia-calcaneum angle. As a first approximation we took the angle between the calcaneum and the foot-plate as being invariable in all subjects, when the torque was zero. The aim of the present work is to measure the inter-individual variations of the angle. 1. Guide-marks are selected on the skin; showing the axes of the calcaneum and of the leg. Metal rods indicate the axes thus defined and the true angle between the leg and the calcaneum is measured by photography. The curves drawn from these true angles differ from the preceding curves by 0 degrees to 10 degrees for normal children and +12 degrees to -15 degrees for cerebral palsied children. 2. The photographic method verifies the exactitude of the trigonometrical method of correcting angles that we proposed in the previous paper.

An apparatus and a method for measuring the relationship of triceps surae torques to tibio-tarsal angles in man.

1. The apparatus and method described give the relationship of triceps surae torque to the absolute tibio-tarsal angle. Data of the anatomy of the foot and the axis of the ankle are taken into consideration. They make complementary measurements necessary, which in certain cases enable the angle recorded by the apparatus to be corrected so as to obtain the true angle. 2. The reliability of the apparatus and the technique of linkage of subject to apparatus are judged by examination of the torque-angle plots obtained by passive stretching of the triceps in 7 subjects for whom correction is monor. Good reliability was observed during the session and from one session to another. The plot is exponential. The merits of the method of correcting angles are illustrated in three subjects with the same protocol: when plots are not corrected, they are more dispersed during the session and no longer exponential. These results justify the considerable correction of the angle that we propose in the study of isometric contractions.