Embolization of percutaneous transhepatic portal venous access tract with N-butyl cyanoacrylate.

OBJECTIVE: To evaluate the safety and feasibility of N-butyl cyanoacrylate (N-BCA) embolization of percutaneous transhepatic portal venous access tract and to establish an appropriate technique. METHODS: 40 consecutive patients underwent percutaneous transhepatic portal venous intervention for various reasons. Embolization of percutaneous transhepatic portal venous access tract was performed after the procedure in all of the patients using N-BCA and Lipiodol® (Lipiodol Ultra Fluide; Laboratoire Guerbet, Aulnay-sous-Bois, France) mixture. Immediate ultrasonography and fluoroscopy were performed to evaluate perihepatic haematoma formation and unintended embolization of more than one segmental portal vein. Follow-up CT was performed, and haemoglobin and haematocrit levels were checked to evaluate the presence of bleeding. RESULTS: Immediate haemostasis was achieved in all of the patients, without development of perihepatic haematoma or unintended embolization of more than one segmental portal vein. Complete embolization of percutaneous access tract was confirmed in 39 out of 40 patients by CT. Seven patients showed decreased haemoglobin and haematocrit levels. Other complications included mild pain at the site of embolization and mild fever, which resolved after conservative management. 16 patients died during the follow-up period owing to progression of the underlying disease. CONCLUSION: Embolization of percutaneous transhepatic portal vein access tract with N-BCA is feasible and technically safe. With the appropriate technique, N-BCA can be safely used as an alternate embolic material since it is easy to use and inexpensive compared with other embolic materials. ADVANCES IN KNOWLEDGE: This is the first study to investigate the efficacy of N-BCA for percutaneous transhepatic portal venous access tract embolization.

Effects of word predictability, child development, and aging on time-gated speech recognition performance.

This study examined the interaction of acoustic-phonetic information with higher-level linguistic contextual information during the real-time speech perception process in child, young adult, and older adult listeners. Five age groups were studied: (a) young children ranging in age from 5 to 7 years, (b) older children aged 8 to 10 years, (c) young adults aged 18 to 23 years, (d) older adults aged 60 to 69 years, and (e) older adults aged 70 to 83 years. All subjects were presented with time-gated monosyllabic target words presented in sentence contexts containing contrasting levels of word predictability. Findings indicated that target word predictability influenced the timing and nature of the real-time recognition process including the listeners' use of initial word sounds. Predictability-high (PH) words were recognized earlier and with greater confidence than predictability-low (PL) words. PH recognition performance was more influenced by child development and aging than PL recognition performance. Older adult listeners required more PH-gated word stimuli to produce accurate responses than younger adults. Older children showed more effective use of PH contexts than younger children.