Percutaneous transhepatic liver biopsy with tract embolization.

PURPOSE: To determine the success and safety of percutaneous transhepatic liver biopsy with tract embolization (PBTE) in patients at risk for standard transhepatic biopsy. MATERIALS AND METHODS: Eighty biopsies were performed in 76 patients with diffuse liver disease: 57 biopsies in patients with coagulopathy (11 of whom also had ascites), 16 in patients with mild coagulopathy and ascites, and seven in patients with ascites only. Biopsy was performed with a cutting needle placed through a 10-cm vascular sheath. Gelatin sponge was the embolization agent. RESULTS: All 80 biopsy specimens (100%) were adequate for histopathologic diagnosis. Six complications (8%) resulted from the procedure: one bleeding complication due to incomplete tract embolization, two bowel injuries, one hemobilia, one intercostal artery injury, and one posterior liver capsule perforation with bleeding. All complications occurred in patients with coagulopathy and with the operator's first or second PBTE. CONCLUSION: PBTE produces excellent diagnostic specimens. The high complication rate empirically appears to be related to the degree of coagulopathy and operator experience.

Wallerian degeneration after cerebral infarction: evaluation with sequential MR imaging.

The dynamic signal intensity changes at magnetic resonance (MR) imaging in active and chronic wallerian degeneration in the corticospinal tract were evaluated. Forty-three patients with wallerian degeneration seen on MR images after cerebral infarction were studied. When possible, patients with acute stroke were examined with MR imaging prospectively at the onset of symptoms and then at weekly intervals for several months. Focal infarction without distal axonal degeneration is demonstrated for the 1st month following onset of clinical symptoms. At 4 weeks, a well-defined band of hypointense signal appears on T2-weighted images in the topographic distribution of the corticospinal tract. After 10-14 weeks, the signal becomes permanently hyperintense. Over several years, accompanying ipsilateral brain stem shrinkage occurs. The dark signal intensity observed on T2-weighted images between 4 and 14 weeks is believed to result primarily from transitory increased lipid-protein ratio.

Sex differences in dendritic structure in the preoptic area of the juvenile macaque monkey brain.

Quantitative analysis of Golgi-stained neurons in the preoptic area of the brain of prepuberal Macaca fascicularis monkeys indicated structural differences between males and females. Neurons of males had more dendritic bifurcations and a higher frequency of spines. The bifurcation difference appeared in all cell types and was concentrated in the ventrolateral preoptic area. The spine difference was greatest in the central region of the preoptic area. No differences in gross measurements of this brain region were found. These results suggest that sexual dimorphism in the function of the monkey preoptic area may be based on differences in neuronal structure.