Transjugular Liver Biopsy: The Efficacy of Quick-Core Biopsy Needle System

PURPOSE: To evaluate the efficacy of the Quick-Core biopsy needle system in performing transjugular liverbiopsy. MATERIALS AND METHODS: Between December 1995 and June 1997, eight patients underwent transjugular liverbiopsy involving use of the Quick-Core biopsy needle system; the conditions involved were coagulopathy (n=4),thrombocytopenia (n=3), and ascites (n=1). Via the right internal jugular vein, the right hepatic vein wasselectively catheterized with a 7-F transjugular guiding catheter, and a 14-guage stiffening cannula was theninserted through this catheter; to obtain core tissue, a Quick-Core needle was then advanced into the liverparenchyma through the catheter-cannula combination. Eighteen- and 19-guage needles were used in three and fivepatients, respectively; specimen size, adequacy of the biopsy specimen and histologic diagnosis were determined,and complications were recorded. RESULTS: Biopsy was successful in all patients. The mean length of the specimenwas 1.4 cm (1.0-1.8 cm), and all were adequate for pathologic examinations; specific diagnosis was determined inall patients. There were two malignant neoplasms, two cases of veno-occlusive disease, and one case each ofcirrhosis, fulminant hepatitis, Banti syndrome and Budd-Chiari syndrome. One patient complained of neck pain afterthe procedure, but no serious procedural complications were noted. CONCLUSION: Our preliminary study shows thatthe Quick-Core biopsy needle system is safe and provides adequate core tissues with high diagnostic yields.

The Effect of Rauwolfia Serpentina on the Retinal Arterial Blood Pressure in Hypertensive Patients

The diastolic retinal arterial blood pressure was measured by Ophthalmodynamometer in 15 patients of essential hypertension before and after the administration of Raudixin three times a days. The follow up period was 4 to 70 days. The average fall of the systolic brachial blood pressure was 38.1 mmHg(from 174.6 to 136.5 mmHg) 19 days after the treatment, whereas the average fall of the diastolic brachial blood pressure was 19.6 mmHg (from 166.6 to 94.7 mmHg) 24 days after treatment. A positive correlation was demonstrated between the retinal and brachial diastolic blood pressures prior to the treatment. The diastolic brachial blood pressure showed its fall only 15 days after treatment, the average fall being 17.1 mmHg. During this period of time, the average fall of the diastolic retinal arterial pressure was 10.2 mmHg. In 6 cases, the retinal arterial pressure didn't fall back to the normal valures and in 5 cases of Keith-Wagener group II, the retinal arterial pressure remained unchanged in spite of the treatment. The percentage ratio of the retinal to the brachial diastolic blood pressure remained stationary in 3 cases, rose in 4 cases. The number of cases which show fall in this ratio gradually increased and about 80% of the cases demonstrated definite fall one month after treatment. The retinal arterial pressure remained stationary during 2 weeks after treatment in 60% of the cases. The significant lowering of the retinal arterial blood pressure was observed only one month after treatment in the majority of cases. The retinal arterial pressure fell below normal range in no case.