[Leydig cell testicular tumors. A series of 10 observations]. / Les tumeurs testiculaires à cellules de Leydig. A propos de 10 observations.

OBJECTIVES: To define the clinical and laboratory characteristics and natural history of Leydig cell tumours in order to define a general management plan. MATERIAL AND METHODS: The files of 10 patients operated for Leydig cell testicular tumour between 1982 and 1996 were studied retrospectively. RESULTS: In nine out of ten cases, the presenting complaint was gynaecomastia, erectile dysfunction or infertility. In every case, serum testosterone was normal or low and oestradiol was normal or elevated. Eight patients were treated by radical orchidectomy, and two by subcapsular orchidectomy. The course was favourable in 9 out of 10 cases in the absence of any other treatment. Only one patient had an immediately malignant form with a fatal outcome. CONCLUSION: Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it is subsequently followed by close surveillance, as it preserves maximum fertility, and these tumours usually have a favourable prognosis.

[Erectile dysfunction secondary to hyperprolactinemia. Apropos of 13 cases]. / Dysérection secondaire à une hyperprolactinémie. A propos de 13 cas.

Hyperprolactinemia is the cause of erectile dysfunction in less than 1% of cases. From 1989 to 1996, 13 patients consulted for erectile disorders associated with hyperprolactinemia. The mean age was 47.5 years. 10 patients complained of decreased libido. 3 patients had gynecomastia. Plasma prolactin levels ranged from 31.3 ng/ml to 1,300 ng/ml. 7 patients had a plasma testosterone less than 4 ml/ng. 7 patients had a micro- or macroadenoma of the sella turcica visualized by MRI. After drug treatment, plasma prolactin levels returned to normal in all patients in whom assays were performed. 6 patients considered that their erectile function was restored. 5 of the 6 patients with no improvement of their sexual function had a concomitant disease able to explain the impotence. Hyperprolactinemia is a rare cause of erectile dysfunction, but it must be considered in any patient presenting with idiopathic erectile dysfunction associated with decreased libido, gynecomastia, and decreased plasma testosterone. Drug treatment is effective and MRI of the sella turcica should be performed looking for a pituitary adenoma.

[Associated rectal and genital prolapse: value of Delorme's operation. A case report]. / Prolapsus rectal et génital associés: intérêt de l'intervention de Delorme. A propos d'une observation.

Rectal prolapse is a rare disorder, which usually affects patients suffering from genital prolapse (rectal prolapse is associated with genital prolapse in 50% of cases). On the basis of a study of the literature and with regard to one case history, the authors set out to explore the simplest and most effective way of treating these two disorders simultaneously. The treatment remains surgical and should combine treatment of the genital prolapse by vaginal route with treatment of the rectal prolapse by means of the Delorme operation. The mortality and morbidity rates are zero if this operation is used and the relapse rate is only 8 to 11% for the rectal prolapse. It would appear that the two approaches are rarely associated by the authors and would seem to be interesting to reconsider this question by indicating mixed treatment of the two prolapses whenever possible.

Bacillus sphaericus asporogenous mutants: morphology, protein pattern and larvicidal activity.

Asporogenous mutants from Bacillus sphaericus strains 2297 and 1593-4, blocked at different stages of the sporulation process, were isolated. Two mutants (2297 Aspo30A and 2297 Aspo34) which were blocked early in sporulation did not possess any crystalline inclusions and were poorly toxic to Culex pipiens mosquito larvae. Other mutants (2297 Aspo115, 2297 Aspo24 and 1593-4 Aspo12) which were blocked at later stages synthesized crystal-like inclusions next to the forespores, and were highly toxic to mosquito larvae. Electrophoretic protein analysis of alkali extracts from mutants and wild type strains confirmed the absence of toxic crystal-related proteins in early-blocked mutants and their presence in later ones. Western blots with antisera directed against the crystal proteins confirmed those observations.

Sporulation of Bacillus sphaericus 2297: an electron microscope study of crystal-like inclusion biogenesis and toxicity to mosquito larvae.

Sporulation of Bacillus sphaericus strain 2297 in a synchronous liquid culture was studied by electron microscopy. The t0 of sporulation occurred 7 h after the beginning of the lag phase. Crystal-like inclusions first appeared at t2 and reached their final size between t5 and t6. The release of the spore/inclusion complex occurred at about t15 (22 h after inoculation). Toxicity against Culex pipiens larvae was related to sporulation and appeared during the early stages of sporulation. The LC50 (24 h) decreased about 10(5)-fold between t0-2 and t7, in correlation with the formation of crystalline inclusions. Heat resistance of spores appeared later than toxicity.