Hepatic falciform ligament artery: angiographic anatomy and clinical importance

Summary The hepatic falciform ligament artery (HFLA) was evaluated by angiography and also by dissections. Based on the findings, the mechanism of the post-chemoembolization skin rash was studied. A total of 340 liver cirrhosis patients who underwent hepatic artery chemoembolization for hepatocellular carcinoma were reviewed in terms of the angiographic incidence of the HFLA, variations in its origin, and the incidence of skin rash. The HFLA was demonstrated in 26 (7.6%) of the 340 patients on angiography. Two HFLAs were observed in one patient. The origin was the middle hepatic artery (A4) in 16 cases, the superior branch of the middle hepatic artery in three, the inferior branch of the middle hepatic artery in two, the inferior branch of the left hepatic artery (A3) in three, and the confluence of A3 and A4 in three cases. There were no patients who developed post-chemoembolization skin rash. Two cadavers were dissected to investigate the anastomosis between the HFLA and the subcutaneous artery. Two different anastomoses were found: (1) direct and (2) via the ensiform branch of the internal thoracic artery. These were located at the lower and upper part of the falciform ligament, respectively. The distribution of a chemotherapeutic agent through these anastomoses is the likely cause of post-chemoembolization skin rash. If prophylactic embolization of the proximal portion of the HFLA using a metallic coil is performed, the skin rash will be prevented.

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L'artère du ligament rond du foie : anatomie angiographique et implication clinique

Résumé L'artère du ligament falciforme hépatique (ALFH) fut étudiée par des angiographies et des dissections. D'après les résultats, le mécanisme d'un rash cutané après chimio-embolisation est discuté. Un total de 340 patients présentant une cirrhose hépatique ayant eu une chimio-embolisation de l'artère hépatique pour un carcinome hépato-cellulaire fut revu en fonction de l'incidence angiographie de l'ALFH, les variations d'origine de l'ALFH, et l'incidence d'un rash cutané. L'ALFH fut objectivée angiographiquement chez 26 (7,6%) des 340 patients. Deux ALFH furent objectivées chez un patient. L'origine des ALFH était située sur l'artère hépatique moyenne (A4) dans 16 cas, la branche supérieure de l'artère hépatique moyenne dans 3 cas, la branche inférieure de l'artère hépatique moyenne dans 2 cas, la branche inférieure de l'artère hépatique gauche (A3) dans 3 cas, et la confluence A3 et A4 dans 3 cas. Aucun patient ne développa un rash cutané après chimio-embolisation. Deux cadavres furent disséqués pour étudier les anastomoses entre l'ALFH et les artères sous-cutanées. Deux types d'anastomoses entre l'ALFH et des artères sous-cutanées furent individualisés directement et par l'intermédiaire de l'artère xiphoïde et de l'artère thoracique interne. Celles-ci étaient respectivement situées à la partie inférieure et à la partie supérieure du ligament falciforme. La distribution de l'agent chimiothérapique par ces anastomoses est vraisemblablement la cause des rash cutanés après chimio-embolisation. Dans le cas d'une embolisation prophylactique de la portion proximale de l'ALFH par utilisation d'un coil métallique le rash cutané pourrait être prévenu.

     

Leukocytosis and low serum IgA in workers exposed to the epoxy compound,t-methyl-3-phenylglycidate

Summary Forty-nine out of 54 male workers engaged in the production of an epoxy compound, t-methyl-3-phenylglycidate, showed skin symptoms in varing degrees that may be due to the skin-irritative effect of the compound. The exposed workers were also shown to have subjective symptoms which may be related to the irritative property of the compound on surface tissue. Laboratory examinations on the blood obtained from the exposed workers showed significantly higher values of leukocyte concentration as compared with the non-exposed controls. This was chiefly caused by the increase of neutrophilic granulocytes and T-cell lymphocytes. Serum IgA levels of the exposed workers were shown to be significantly lower than those of the control group. Hemoglobin concentration, hematocrit value and red cell count of the exposed workers remained at the same level as those of the control subjects. Liver or kidney damage was not found in biochemical analyses on the sera of exposed workers.     

CD1d deficiency exacerbates inflammatory dermatitis in MRL-lpr/lpr mice

Mechanisms responsible for the development of autoimmune skin disease in humans and animal models with lupus remain poorly understood. In this study, we have investigated the role of CD1d, an antigen-presenting molecule known to activate natural killer T cells, in the development of inflammatory dermatitis in lupus-susceptible MRL-lpr/lpr mice. In particular, we have established MRL-lpr/lpr mice carrying a germ-line deletion of the CD1d genes. We demonstrate that CD1d-deficient MRL-lpr/lpr mice, as compared with wild-type littermates, have more frequent and more severe skin disease, with increased local infiltration with mast cells, lymphocytes and dendritic cells, including Langerhans cells. CD1d-deficient MRL-lpr/lpr mice had increased prevalence of CD4(+) T cells in the spleen and liver and of TCR alpha beta (+)B220(+) cells in lymph nodes. Furthermore, CD1d deficiency was associated with decreased T cell production of type 2 cytokines and increased or unchanged type 1 cytokines. These findings indicate a regulatory role of CD1d in inflammatory dermatitis. Understanding the mechanisms by which CD1d deficiency results in splenic T cell expansion and cytokine alterations, with increased dermal infiltration of dendritic cells and lymphocytes in MRL-lpr/lpr mice, will have implications for the pathogenesis of inflammatory skin diseases.     

异位性皮炎患者循环T细胞激活表型和化学趋化功能研究

目的：为了明确异性皮炎患者循环Ｔ细胞的体外细胞生物学功能,和阐明Ｔ细胞在异位性皮炎发病过程中的可能作用。方法：运用４８孔微型化学趋化装置,测定２１例异位性皮炎患者与２０例正常人的纯化Ｔ细胞对白细胞介素８（ＩＬ－８）的化学趋化反应,同时用单克隆抗体荧光免疫法在流式细胞仪上测定Ｔ细胞表面ＨＬＡ－ＤＡ和白细胞介素２受体（ＩＬ－２Ｒ）等激活表型,以及用ＥＳＫＳＡ法测定血肖ＩＬ－８水平。结果：（１）异们性皮     

A cross-sectional study of workers in the chemical industry with occupational exposure to hexamethylenetetramine

Objectives: To assess the health effects of hexamethylenetetramine (HMT) on the airways and the skin of workers in the chemical industry. Methods: A cross-sectional study was performed with 17 employees of a HMT-producing chemical plant and 16 control subjects from the plant. In addition, we examined 4 out of 5 subjects who had left the production for medical reasons during the last 10 years. Anamnestic data, total and specific IgE to four environmental allergens, lung function and bronchial responsiveness to methacholine were assessed by standard procedures. Skin prick tests (SPT) and patch tests were performed with known sensitizing substances and HMT 100 mg/ml and 2% pet and aq. Results: A high number of exposed subjects and controls reported symptoms during the previous year (64.7% vs 68.8%), most of them were not related to work. Work-related symptoms and objective parameters did not show differences between groups. No sensitizations to HMT as assessed by SPT or patch tests were found. Among those who had left the HMT production for medical reasons, 2 former baggers showed sensitizations to HMT by patch tests. These reported eczema during exposure but lost symptoms after removal from exposure. Geometric mean HMT concentrations as assessed by personal sampling were 0.3 [95% confidence intervals (CI) 0.1; 0.9] mg/m³ in shiftleaders and 0.6 (95% CI 0.3; 1.1) mg/m³ in baggers. Conclusion: High exposures to HMT may cause allergic contact dermatitis. There was no evidence of an increased risk for occupational asthma at mean airborne HMT concentrations below 1 mg/m³. Received: 4 February 1999 / Accepted: 10 July 1999     

深圳市区学龄前儿童异位性皮炎现况调查

目的了解深圳市区3～6，5岁儿童异位性皮炎(AD)的发病情况。方法对深圳市区3～6，5岁学龄前儿童进行调查，调查以问卷的方式进行。结果调查总数2450名。符合AD诊断标准者共53例，总患病率为2.16％。结论深圳市区3～6．5岁儿童异位性皮炎患病率与全国的患病率相近。     

丙酸氟替卡松治疗湿疹皮炎43例

目的：观察丙酸氟替卡松乳膏治疗湿疹、皮炎类皮肤病的临床疗效。方法：对43例湿疹、皮炎患者分别用0．05％丙酸氟替卡松乳膏（治疗侧）和0．1％糠酸莫米松乳膏（对照侧）治疗，qd，共2周。结果：两侧的临床症状、体征评分，治疗后第1周、第2周与治疗前比较明显降低（P〈0．01）。治疗侧与对照侧疗效比较差异无显著性（P〉0．05），均无不良反应发生。结论：0．05％丙酸氟替卡松乳膏治疗湿疹、皮炎类皮肤病有效、安全。     

澳门中学生脂溢性皮炎现患情况及相关因素分析

目的评估中学生脂溢性皮炎现患情况及其相关因素,为防治工作提供依据。方法随机整群抽取澳门特别行政区内7所中学12~20岁的中学生4 600名,对其逐一检查并以问卷调查的方法收集脂溢性皮肤病的流行病学资料,将所有资料以SPSS 10.0软件进行统计分析。结果澳门地区中学生脂溢性皮炎总患病率为2.7%,其中男生为2.5%,女生为2.9%(χ2=0.594,P=0.441);各年龄组男生患病率差异有统计学意义(χ2=16.529,P=0.035),而女生差异无统计学意义(χ2=6.032,P=0.644);患病高峰年龄为女生17岁,男生18岁。多元Logistic回归分析得出正上腹痛、腹胀、经常排气、上唇汗毛或胡须多、乳晕周围体毛较长等为其相关因素。结论澳门特别行政区中学生脂溢性皮炎患病率较低,相关因素主要涉及内分泌、消化道功能紊乱等。