[Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients]. / Traitement de l'hépatite alcoolique par la silymarine. Une étude comparative en double insu chez 116 malades.

A randomized double-blind trial of silymarin versus placebo was carried out in 116 patients with histologically proven alcoholic hepatitis, 58 of them with cirrhosis. Patients were not included in case of hepatic encephalopathy, contraindication to percutaneous liver biopsy, hepatocellular carcinoma, evident lack of discipline or refusal to enter the trial. Fifty-seven patients received silymarin orally 420 mg/day and 59 received placebo during 3 months. Biologic parameters were assessed in the serum, and a percutaneous liver biopsy was obtained at the start of the trial and 3 months later. Histologic scores of alcoholic hepatitis and fibrosis were established on each biopsy specimen by two independent pathologists. The 2 groups were comparable at inclusion; 26 p. 100 of patients were lost to follow-up at 3 months, abstinence was obtained in 46 p. 100 of patients at the end of the trial. These percentages were similar in the two groups. Four patients died of hepatic failure during the trial, 3 in the placebo group. Significant improvement in the score of alcoholic hepatitis and serum amino transferase activity, was noted in both groups during the trial, irrespective of treatment with silymarin or placebo. No side-effects were noted. Our results suggest that silymarin 420 mg/d is not clinically relevant in the treatment of moderate alcoholic hepatitis.

[Ultrasonic pseudotumoral aspect of cirrhosis]. / Aspect échographique pseudo-tumoral des cirrhoses.

Seven cases of cirrhosis with non-tumoral nodules on ultrasound imaging are reviewed. Comparison of ultrasound and histopathologic data provided information on mode of formation and pathologic significance of these images. They correspond usually to a particular distribution of fibrosis and steatosis, exceptionally to regenerating nodules. Nodule formations seen on ultrasound images are independent of histopathologic criteria defining micro- and macro-nodular cirrhosis. Ultrasound guided cytohistology is the only examination allowing their distinction from true tumoral lesions.

Immunolocalization of angiotensin 1 converting enzyme in the human male genital tract by the avidin-biotin-complex method.

Immunoreactivity for Angiotensin 1 Converting Enzyme was investigated in a series of 12 fixed and paraffin-embedded normal human genital tract specimens. The Avidin-Biotin-Complex immunoperoxidase method was used with overnight (12 h) incubation with a polyclonal antihuman kidney Angiotensin 1 Converting Enzyme antiserum. All tissues, including testis, different parts of epididymis, ductus deferens, prostate and seminal vesicles, demonstrated a staining pattern. Immunoreactivity was observed on the luminal surface of these epithelia especially on non-motile stereocilia. An intracellular positivity was only observed in spermatids on the acrosomal cap. Besides, an immunologic identity of Angiotensin 1 Converting Enzyme located on the different epithelia of the human male genital tract, on the endothelial cells of vessels and on the proximal tubule brush border of the kidney was observed.

[Immunohistochemical localization of angiotensin converting enzyme in epithelioid sarcoidosis granulomas]. / Détection immunohistochimique de l'enzyme de conversion de l'angiotensine dans les granulomes épithélioïdes de la sarcoïdose.

An immunohistochemical study of the localization of Angiotensin one Converting Enzyme in sarcoidosis granulomas was made in 20 cases of sarcoidosis. Immunoreactive Angiotensin one Converting Enzyme was found in 92% of these cases. At the cellular level the staining was observed on the plasma membrane. No correlation was observed between the serum Angiotensin one Converting Enzyme value and the immunostaining intensity.

[Pseudotumoral and subacute pathology of the epididymis. Contribution of ultrasonics]. / Pathologie pseudo-tumorale et subaiguë de l'épididyme. Apport de l'échographie.

Three patients presented with atypical subacute epididymal disorders diagnosed clinically as a scrotal tumor. Ultrasound imaging provided satisfactory morphologic data on lesions. Cold surgery was performed, either because of major functional disturbance (multiple epididymal abscesses) or because of doubt with respect to diagnosis (spermatic granuloma and epididymal hematoma). Castration was the final procedure in each case. Even though this surgical attitude appears logical because of the serious nature of the lesions, the revised clinical diagnosis provided by ultrasonography and the very good correlation between pathologic and ultrasonic findings should lead to a more eclectic therapeutic attitude in other cases.