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Liver biopsy is indicated in two general clinical scenarios. The first scenario occurs when a diffuse liver disease is suspected, typically after a patient has abnormal liver function tests. In this instance, a nontargeted or random biopsy is performed to obtain a sample of tissue for determination of severity of diffuse liver disease. Random biopsy may also be used to monitor effectiveness of treatment, or for post-transplant monitoring. As these cases require histologic assessment, cytologic assessment is generally not indicated. Conversely, when a targeted liver biopsy is ordered to diagnose a focal liver mass or abnormality that cannot otherwise be characterized, cytology is frequently utilized as a first line diagnostic test.
Outcome of moderate to severe traumatic brain injury (TBI) includes impaired emotion regulation. Emotion regulation has been associated with amygdala and rostral anterior cingulate (rACC). However, functional connectivity between the two structures after injury has not been reported. A preliminary examination of functional connectivity of rACC and right amygdala was conducted in adolescents 2 to 3 years after moderate to severe TBI and in typically developing (TD) control adolescents, with the hypothesis that the TBI adolescents would demonstrate altered functional connectivity in the two regions. Functional connectivity was determined by correlating fluctuations in the blood oxygen level dependent (BOLD) signal of the rACC and right amygdala with that of other brain regions. In the TBI adolescents, the rACC was found to be significantly less functionally connected to medial prefrontal cortices and to right temporal regions near the amygdala (height threshold T = 2.5, cluster level p < .05, FDR corrected), while the right amygdala showed a trend in reduced functional connectivity with the rACC (height threshold T = 2.5, cluster level p = .06, FDR corrected). Data suggest disrupted functional connectivity in emotion regulation regions. Limitations include small sample sizes. Studies with larger sample sizes are necessary to characterize the persistent neural damage resulting from moderate to severe TBI during development. (JINS, 2013, 19, 1–14)
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