[Enkephalin-like immunoreactivity in Leydig cell tumor]. / Immunoréactivité de type enképhaline au sein d'une tumeur à cellules de Leydig.

So far, the presence of an enkephalin-like immunoreactivity has never been reported in Leydig cell tumors at our knowledge. A 39 years old man having a painful gynecomastia and an impotency changing in time has been studied. At clinical examination, he was normal, without palpable testis tumor. The sperm count analysis showed an oligoastheno-spermia. Plasma testosterone (T) was low and plasma estradiol (E2) was high, varying from day to day. T/E2 ratio was always low (20 to 72 - N:220-240) and fell after HCG administration. Plasma LH was normal and plasma FSH was low. 17 hydroxyprogesterone (17 OH-P)/T ratio was increased (0.7 - N:0.23). A small tumor was localized in the left testis by ultrasonography. The spermatic vein catheterization, which was only possible on the left side, showed a decreased T, a high E2 and a low T/E2 ratio (19 - N:304). After unilateral orchidectomy, the histological study confirmed the diagnosis of Leydig cell tumor. With antibodies raised against synthetic Met-en-kephalin, it has been possible to detect an enkephalin-like immunoreactivity in the tumoral cells as well as in the surrounding normal cells.

[Axillo-femoro-distal bypass. Study of a series of 18 cases (author's transl)]. / Les pontages axillo-fémoro-distaux. Etude d'une série de 18 observations.

The present study involved 18 cases f axillo-femoro-distal bypass performed to revascularise either a popliteal artery (8 cases) or a leg artery (10 cases). The postoperative mortality (2 cases) was not directly related to the operative procedure. This type of operation was performed in particularly grave situations of severe ischaemia or sepsis. The results obtained were interesting in two-stage operations (7 good results in 11 operations) for ischaemia. In one-stage operations, corresponding to particularly grave situations, as well as in operations for sepsis (2 cases with 2 failures), the failure rate was by contrast very high. The results obtained were compared with those found in the literature. Such very long bypasses would finally appear to be justified in very grave situations in which there is no possibility of direct surgery with the aorta as the proximal source.