The minor hepatic veins: anatomy and classification.

A detailed description of the distribution and drainage pattern of the minor hepatic veins is presented in this paper. A classification based on the segmentation of the liver divides these veins into four main groups: 1) veins of Segment I which includes the veins of the caudate lobe and the veins of the caudate process; 2) veins of Segment VI; 3) veins of Segment VII; and 4) veins of Segment IX. A knowledge of the anatomy of the minor hepatic veins becomes more clinically valuable as the number of complex dissections of the retrohepatic areas, hepatectomies. and hepatic transplantations grow.

Budd-Chiari syndrome: typical and atypical scintigraphic aspects.

Budd-Chiari syndrome, a well known entity, is often difficult to diagnose, mostly due to the nonspecificity of its symptomatology. Radiocolloid liver scans were evaluated in eight cases of this disease, proven by surgical biopsy. Five cases showed the "classic" scintigraphic pattern of caudate lobe hypertrophy (62.5%), and other abnormalities observed included segmental hepatic insufficiency, diffuse hepatic insufficiency, and relative hypertrophy of both the caudate lobe and a portion of the parenchyma of segment VI (one case each). An experimental study of hepatic venous drainage performed on livers at autopsy revealed four groups of accessory hepatic veins in addition to the main hepatic veins. The occlusion of various parts of this drainage appears to relate to the various scintigraphic patterns that were encountered in patients with Budd-Chiari syndrome. A review of the literature revealed three additional patterns previously reported in association with Budd-Chiari syndrome (normal scan, diffuse hepatomegaly, and multiple filling defects). If all these variations are appreciated, liver scanning can be a valuable screening tool for Budd-Chiari syndrome and may also serve as a noninvasive means of follow-up.

[Histochemical observations of oral mucosa in the non-smoking cirrhotic patient (author's transl)]. / Observations histochimiques de la muqueuse buccale chez le patient cirrhotique non fumeur.

Buccal mucosa samples from non-smoking cirrhotic patients were studied with help of histochemical methods and compared with biopsies from smoking cirrhotic and healthy subjects. Very few differences were observed between the two cirrhotic groups, except for the following which were noted in the epithelium of the non smoking group: an increase of acid phosphatase, an increase of the DNA in the active cellular layers. The basal cells mitochondria were almost always reactive. The vascular walls showed enzymatic changes with a decrease of thiamine pyrophosphatase and alcaline phosphatase activity. These observations do not allow us to draw any conclusions regarding the pathogenesis of oral cancer in cirrhotic patients.

[Histochemical observations of oral mucosa in the non-smoking cirrhotic patient (author's transl)]. / Observations histochimiques de la muqueuse buccale chez le patient cirrhotique non fumeur.

Buccal mucosa samples from non-smoking cirrhotic patients were studied with the help of histochemical methods and compared with biopsies from smoking cirrhotic and healthy subjects. Very few differences were observed between the two cirrhotic groups, except for the following which were noted in the epithelium of the non smoking group: an increase of acid phosphatase, an increase of SS and SH contents of the surface keratin, and an increase of the DNA in the active cellular layers. The basal cells mitochondria were almost always reactive. The vascular walls showed enzymatic changes with a decrease of thiamine pyrophosphatase and alkaline phosphatase activity. These observations do not allow us to draw any conclusions regarding the pathogenesis of oral cancer in cirrhotic patients.

[Ultrastructure of the buccal mucosa in the non-smoking cirrhotic patient]. / Ultrastructure de la muqueuse buccale chez le patient cirrhotique non fumeur.

Ultrastructural analysis of biopsies of the buccal mucosa was carried out in 12 non-smoking patients and 10 smokers with a confirmed clinical diagnosis of alcoholic cirrhosis. Certain signs of epithelial dysplasia, including increase in nuclear cytoplasmic ratio, proeminence of the nucleolus, fragmentation and proliferations of the basal layer accompanied or not by epithelial projections into the chorion, were seen in non-smoking cirrhotics, as in the smokers. These findings emphasise the predominant role of alcohol alone in carcinogenesis.

Improved surgical treatment of cancer of the lower lip.

Combination (with some minor modifications) of the classic plastic procedures of broad resection of the lower lip with V-Y partial closure, specially designed Abbe flap and cheek transposition after a skin resection lateral of the nostril represents a most satisfactory surgical treatment for cancer of the lower lip.

The family physician and facial trauma from road accidents.

The family physician must feel concerned with the growing number of facial trauma from road accidents.He must play his role in prophylaxy by contributing to public education, about both the danger of driving under the influence of alcohol, and the usefulness of seat belts for facial protection. He must also know everything about first aid to traffic casualties, mostly right at the accident spot: not only the heroic gestures which will save lives and permit wounded people to reach the hospital, but the principles of facial traumatology, in order to protect both the fragile structure of the face, and its esthetic qualities.