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At least 217 records · Page 12Linked to original sources
PubMed2004

Detachable endoloop vs. elastic band ligation for bleeding esophageal varices.

BACKGROUND: Variceal bleeding is a serious complication with a mortality rate that ranges from 20% to 50%. Patients who have variceal hemorrhage usually are treated by endoscopic injection sclerotherapy or elastic band ligation to eradicate the varices. Endoloop ligation is a newly developed technique for achieving hemostasis and variceal eradication. This study compared endoloop ligation with elastic band ligation in patients with acute esophageal variceal bleeding. METHODS: Fifty patients with acute esophageal variceal bleeding were recruited: 25 were treated by elastic band ligation and 25 by endoloop ligation. RESULTS: Although the number of patients in whom bleeding recurred during a follow-up period of 6 months was smaller in the endoloop group (12%) vs. the band group (28%), this difference was not statistically significant. Furthermore, no statistically significant difference was found between the two groups with respect to the number of patients in whom variceal eradication was achieved, the number of treatment sessions required for variceal eradication, or the frequency of variceal recurrence. The total cost for variceal obliteration by endoloop ligation was 342 dollars per patient, whereas, the total cost of variceal eradication by elastic band ligation was 356 dollars per patient. The endoloop had certain technical advantages over band application: a better field of vision, tighter application, good results with junctional varices, and a lack of strain exerted by the device on the endoscope. CONCLUSIONS: Endoloop ligation is a promising new technique for management of patients with bleeding esophageal varices.

Acute Disease↗
PubMed1998

Esophageal/pyloric ligation enhances development of the murine fetal stomach in organ culture.

PURPOSE: The authors hypothesized that increased intraluminal pressure in the fetal stomach would enhance development in a murine organ culture model. METHODS: Gestation day 14 (Gd14) fetal stomachs from time-dated pregnant CD-1 mice (term, 20 days) were maintained in organ culture for 7 days. Some stomachs were ligated at the gastroesophageal (GE) and pyloroduodenal (PD) junctions. Others were left unligated. Gd14, Gd16, and Gd18 stomachs were taken as well to compare organogenesis in vivo. Tissues were processed for histological, morphometric, and immunohistochemical analysis, as well as total protein and DNA determination. RESULTS: The ligated stomachs were visibly distended compared with unligated stomachs in organ culture after 7 days. The length and width of the 7-day in vitro ligated stomachs were significantly increased compared with unligated (2.97+/-0.04 mm v 2.48+/-0.05 mm and 2.14+/-0.04 mm v 1.57+/-0.08 mm, respectively, P < .05). Mucosal epithelial cells showed nuclear polarization, and there was a distinct outer muscle layer in the ligated stomachs, but not in the unligated stomachs, which demonstrated pseudostratified epithelial cells in the mucosa. The ligated stomachs had increased in mucosal thickness compared with unligated (31.4+/-1.3 microm vs 24.9+/-0.9 microm, p < 0.05). The ligated stomachs also had significantly increased protein and DNA content when compared with unligated stomachs (65.8+/-3.1 microg and 23.3+/-1.2 microg v 55.0+/-2.7 microg and 19.0+/-1.2 microg, respectively, P < .05). However, there were no significant differences noted between the protein to DNA ratios. Immunohistochemical staining for proliferating cell nuclear antigen (PCNA), a marker for cell proliferation, demonstrated increased proliferative activity of the mucosal epithelial cells in the ligated stomachs. CONCLUSIONS: Esophageal and pyloric ligation enhanced the development of the fetal stomach in vitro in comparison with unligated stomachs cultured under similar conditions. Developmental characteristics of the ligated stomachs paralleled that of Gd16 stomachs in vivo.

Animals↗
PubMed1989

Recovery of testicular blood flow following ligation of testicular vessels.

To determine whether initial ligation of the testicular vessels of the high undescended testis followed by a delayed secondary orchiopexy is a viable alternative to the classical Fowler-Stephens procedure, a series of preliminary experiments were conducted in the rat in which testicular blood flow was measured by the 133xenon washout technique before, and 1 hour and 30 days after ligation of the vessels. In addition, testicular histology, and testis and sex-accessory tissue weights were measured in 6 control, 6 sham operated and 6 testicular vessel ligated rats 54 days after vessel ligation. The data demonstrate that ligation and division of the testicular blood vessels produce an 80 per cent decrease in testicular blood flow 1 hour after ligation of the vessels. However, 30 days later testis blood flow returns to the control and pre-treatment value. There were no significant changes in testis or sex-accessory tissue weights 54 days after vessel ligation. Histologically, 4 of the surgically operated testes demonstrated necrosis of less than 25 per cent of the seminiferous tubules while 1 testis demonstrated more than 75 per cent necrosis. The rest of the tubules in all 6 testes demonstrated normal spermatogenesis. From this study we conclude that initial testicular vessel ligation produces an immediate decrease in testicular blood flow but with time the collateral vessels are able to compensate and return the testis blood flow to its normal pre-treatment value. These preliminary observations lend support for the concept that initial ligation of the testicular vessels followed by a delayed secondary orchiopexy in patients with a high undescended testis may be a possible alternative to the classical Fowler-Stephens approach.

Animals↗
PubMedDate not supplied

Prospective randomised study of effect of octreotide on rebleeding from oesophageal varices after endoscopic ligation.

Up to a third of patients have early rebleeding from oesophageal varices after endoscopic variceal ligation. Octreotide infusion is effective for control of variceal bleeding. We investigated the efficacy of octreotide infusion as an adjunct to endoscopic variceal ligation to prevent early rebleeding from varices. 100 consecutive patients admitted with endoscopically confirmed oesophageal varices and active bleeding or signs of recent haemorrhage were randomly assigned endoscopic variceal ligation alone or octreotide (50 micrograms intravenous bolus injection followed by intravenous infusion at 50 micrograms per h for 5 days) plus endoscopic variceal ligation. Three patients in each group were excluded. Bleeding was controlled in 44 of 47 patients who received variceal ligation alone and in 45 of 47 who received combined treatment (p = 1.0). Recurrent bleeding was documented in 18 (38% [24-52]) patients who received variceal ligation alone and in four (9% [3-21] who received combined treatment (p = 0.0007). The relative risk of rebleeding was lower (0.22 [0.08-0.60]) in the combined therapy group. Ten patients in the variceal ligation group and one in the combined therapy group required balloon tamponade for massive haematesis and haemodynamic instability (p = 0.0039). The in-hospital and 30-day mortality rates were higher in the variceal ligation group than in the combined therapy group (19 vs 9% and 23 vs 11%), but the differences did not reach significance. The relative risks of in-hospital (0.5 [0.04=5.3]) and 30-day (0.45 [0.17-1.2]) mortality were lower in the combined therapy group. Octreotide significantly reduces recurrent bleeding and the need for balloon tamponade in patients with variceal haemorrhage treated by endoscopic variceal ligation.

Adolescent↗
PubMed1994

Endoscopic injection sclerotherapy vs. endoscopic variceal ligation in arresting acute variceal bleeding for patients with advanced hepatocellular carcinoma.

Patients with advanced hepatocellular carcinoma and acute esophageal variceal bleeding have a very poor prognosis. To compare the efficacy and complications of sclerotherapy and banding ligation, patients with acute esophageal variceal bleeding and concomitant hepatocellular carcinoma were randomly allocated to receive either sclerotherapy (endoscopic injection sclerotherapy group, 27 patients) or banding ligation (endoscopic variceal ligation group, 30 patients). All patients received treatment within 24 h of index bleeding. Initial control of bleeding was achieved in 41% of the endoscopic injection sclerotherapy group and 87% of the endoscopic variceal ligation group (p < 0.001). The re-bleeding rates were 73% and 42%, respectively (p < 0.05). The amount of blood transfused during the week after treatment was significantly higher in the endoscopic injection sclerotherapy than in the endoscopic variceal ligation group (3.9 +/- 1.5 vs. 1.5 +/- 0.8 units, respectively) (p < 0.01). Major complications were more often encountered in the endoscopic injection sclerotherapy group (22%) than in the endoscopic variceal ligation group (3%) (p < 0.05). Twenty-three patients in the endoscopic injection sclerotherapy group and 25 patients in the endoscopic variceal ligation group have so far died. The mean survival was 25 +/- 16 days in the endoscopic injection sclerotherapy group and 49 +/- 14 days in the endoscopic variceal ligation group (p < 0.05). Variceal bleeding was the main cause of mortality in the endoscopic injection sclerotherapy group (70%), whereas in the endoscopic variceal ligation group, hepatic failure (48%), rather than variceal bleeding (28%), was the major cause.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1996

The impact of endoscopic variceal ligation on the pressure of the portal venous system.

BACKGROUND/AIMS: Endoscopic variceal ligation is a viable substitute for injection sclerotherapy. It is still not known how endoscopic variceal ligation may influence the portal venous system. To clarify this issue we investigated the impact of endoscopic variceal ligation on the pressure of the portal venous system. METHODS: Twenty-nine patients with a history of esophageal variceal bleeding but without ascites were enrolled. All had cirrhosis; 63% of them were post-hepatitic. Ligation was performed at intervals of 2-3 weeks until all the varices were obliterated. Portal venograms were performed before institution of ligation and after variceal obliteration to assess venographic findings and pressure changes. The pressures of the main portal vein, splenic vein and superior mesenteric vein were recorded. RESULTS: Twenty-five patients completed the study. A mean of 4.4 sessions (range: 2-7) of ligation over a period of 2 months was needed. Seventeen (68%) patients experienced elevated pressure and eight (32%) patients reduced pressure after ligation. Mean (median) pressure changes were as follows: portal venous pressure, 26.5 +/- 4.7 (25.0) mmHg vs. 28.2 +/- 7.2 (28.0) mmHg (p > 0.05); splenic venous pressure, 28.2 +/- 4.9 (26.0) mmHg vs. 29.0 +/- 6.8 (29.0) mmHg (p > 0.05); superior mesenteric venous pressure, 28.4 +/- 6.0 (27.0) mmHg vs. 29.5 +/- 7.0 (29.0) mmHg (p > 0.05). Five patients (20%) experienced rebleeding before variceal obliteration; all of them presented elevated portal pressures after variceal obliteration. Among the eight patients with decreased portal pressure, seven (87%) had other major collaterals apart from esophageal varices, compared to three out of the 17 (18%) patients with elevated portal pressure who had other major collaterals (p < 0.01). CONCLUSIONS: Among patients receiving endoscopic variceal ligation, 68% experienced elevated portal pressure, while 32% had decreased portal pressure. Elevation of portal pressure after variceal ligation may be an important factor in variceal rebleeding. The presence of other major collaterals apart from esophageal varices may be responsible for the decrease in portal pressure after obliteration of esophagel varices.

Adult↗
PubMed1999

Evaluation of hepatocyte injury following partial ligation of the left portal vein.

BACKGROUND/AIMS: Total ligation of the left portal vein is thought to induce both hepatocyte apoptosis and necrosis. The pathological impact of partial ligation of a branch of the portal vein has not yet been evaluated. METHODS: We studied the degree of hepatocyte injury following 0, 43, 48, 59, 68, 72, 78 and 100% left portal vein stenosis in 200-g Sprague-Dawley male rats. Serum alanine aminotransferase levels, total body weight, and left and right liver lobe weights were measured at 2 and 7 days. Mitosis and 3H-thymidine labelling indices were measured as markers of proliferation; the apoptotic index and TUNEL stain were used as markers to measure apoptotic cell death. Necrosis was assessed morphologically. All these parameters were evaluated 2 days after ligation. RESULTS: There was a direct relation between the increase in weight of the right lobes and the reduction in weight of the left lobes. The degree of weight change correlated significantly with the degree of stenosis. In the right lobes, mitosis and 3H-thymidine labelling were increased in proportion to the degree of stenosis. In the left lobes, the decrease in volume of hepatocytes correlated with the degree of ligation, especially in the pericentral areas. Necrosis was identified only when ligation was > or = 68%, this being associated with an increase in alanine aminotransferase levels. On the other hand, apoptotic cells were identified in increasing numbers, starting from the lowest degree of ligation to 100% ligation. This was found both morphologically and with TUNEL stain. CONCLUSIONS: Partial ligation of the left portal vein induces left liver atrophy through hepatocyte volume loss and apoptosis. Necrosis is found only when the degree of ligation is severe.

Animals↗
PubMed2001

The changes in expression of three subtypes of TTX sensitive sodium channels in sensory neurons after spinal nerve ligation.

Our previous studies showed that the ectopic discharges in injured sensory neurons and mechanical allodynia that developed after spinal nerve ligation were significantly reduced by application of a low concentration of tetrodotoxin (TTX) to the corresponding dorsal root ganglion (DRG) of the ligated spinal nerve. Based on these data, we hypothesized that expression of TTX-sensitive sodium channels is up-regulated in the injured sensory neurons and that such up-regulation plays an important role in the generation of ectopic discharges and thus pain behaviors in spinal nerve ligated neuropathic rats. To test this hypothesis, the present study examined the changes in three subtypes of TTX-sensitive sodium channels in the DRG after spinal nerve ligation. The changes in the total amount of mRNA for alpha-subunits of sodium channel brain type I (type I), brain type II (type II) and brain type III (type III) were determined by RNase protection assays (RPA). The population of DRG neurons expressing type III sodium channel protein was examined by an immunohistochemical method with antibodies to type III sodium channels. In the normal DRG, the level of mRNA for the type I sodium channel is high while that for type II and type III is very low. After spinal nerve ligation, the expression of type III mRNA was significantly increased at 16-h postoperatively (PO), doubled by 3 days PO and then was maintained at this high level until the end of the experiment (7 days PO). By contrast, the amount of mRNA for type I and type II sodium channels started to decrease at 1 day PO and were reduced to 25-50% of the normal control levels by 7 days after nerve ligation. Neurons showing positive immunostaining for type III sodium channels were rare ( approximately 3.2% of total population) in the normal DRG but increased after nerve ligation to 21% and 15% of the total neuronal population by 1 day and 7 days PO, respectively. Type III immunoreactivity was found preferentially in medium to large sized neurons. Thus the majority of neurons with cell bodies having diameters > or =40 microm became type III-positive after nerve ligation. The data indicate that the increased expression of type III sodium channels in axotomized sensory neurons may be the critical factor for the TTX sensitivity of ectopic discharges in injured sensory neurons and thus the generation of ectopic discharges and neuropathic pain behaviors in spinal nerve ligated rats.

Animals↗
PubMed1982

The effect of artery ligation and asphyxia on auditory evoked brain stem response.

Auditory evoked brain stem response (ABR) was recorded in two groups of cats during artery ligation. Group A underwent bilateral ligation of the vertebral artery (V.A.) for 180 min after which bilateral ligation of the carotid artery (C.A.) was done. In group B animals, initially V.A. was bilaterally ligated and right C.A. was also ligated, then after the same period, left C.A. was additionally ligated. ABR changes were also observed under asphyxia induced by turning off the respirator. Ligation of V.A. bilaterally resulted in a trend toward prolongation of the ABR latencies (group A). Ligation of V.A. bilaterally and right C.A. resulted not only in a trend toward prolongation of the latencies, but also in an increase in the amplitude in wave III and V (group B). Asphyxia caused more rapid and remarkable changes in ABR than artery ligation. After the onset of asphyxia, temporary increase in the amplitude was observed before the waves deteriorated. ABR is affected by changes of the blood flow and asphixic condition. ABR changes possibly depend on the development of the collateral vessels, vasodilation effect, or increase in blood pressure after artery obstruction or sustained asphyxia.

Animals↗
PubMed2006

Emergency endoscopic variceal ligation versus somatostatin for acute esophageal variceal bleeding.

BACKGROUND: Endoscopic variceal ligation and somatostatin are widely used for treating acute esophageal variceal bleeding. This study compared the efficacy, safety, and survival of both therapies. METHODS: Acute esophageal variceal bleeding patients were randomized to undergo emergency ligation or receive a bolus of 250 microg somatostatin plus infusion at 250 microg/hour for 48 hours and undergo ligation subsequently. RESULTS: Three (4.8%) of 62 patients in the ligation group and 20 (31.7%) of 63 patients in the somatostatin group encountered treatment failure (p = 0.0001). Transfusion requirements were 4.7 +/- 3.2 units in the ligation group and 6.9 +/- 7.3 units in the somatostatin group (p = 0.03). Hospital stay was 7.7 +/- 4.0 days in the ligation group and 10.2 +/- 9.9 days in the somatostatin group (p = 0.07). Adverse effects occurred in the ligation group (20 episodes) and the somatostatin group (27 episodes) (p = 0.2). The 42-day mortality rates were 5 patients (8.1%) in the ligation group and 3 patients (4.8%) in the somatostatin group (p = 0.5). CONCLUSION: Emergency ligation was superior to somatostatin in treating acute esophageal variceal bleeding, with fewer requirements of transfusion and a tendency toward shorter hospital stay. The adverse effects and 42-day mortality rates were similar between both treatments.

Acute Disease↗
PubMed2000

Antinociceptive effect of intracerebroventricular administration of cholecystokinin antagonist in nerve-ligated mice.

In the present study we investigated the effects of intracerebroventricular injection of caerulein, the cholecystoki nin receptor agonist and proglumide, the receptor antagonist on morphine response in the sciatic nerve ligation in mice. Subcutaneous administration of morphine induced antinociception in the both intact and ligated mice, however, the response of the opioid was lower in the ligated mice as compared with the intact animals. Caerulein induced antinociception in the non-ligated but not in the nerve-ligated animals. Combination of caerulein with morphine elicited higher response in ligated animals, however, the response induced in ligated animals was much more prominent. Proglumide alone did not elicit any response in both animal groups. The antagonist decreased the response of caerulein in the nonligated mice. Low doses of proglumide in the combination with caerulein induced antinociception in the ligated mice. We conclude that cholecystokinin receptor mechanism(s) may alter morphine resistance induced by nerve ligation.

Analgesics, Opioid↗
PubMed1998

TNP-470 inhibits collateralization to complement the anti-tumour effect of hepatic artery ligation.

We examined hepatic artery ligation combined with an angiogenesis inhibitor, TNP-470, in the treatment of VX2 tumour inoculated into the liver of rabbits. Effects on tumour growth were correlated with arterial collateral development in this system. Three treatment methods were compared: (1) the left hepatic artery was ligated at the liver hilum (ligation group); (2) TNP-470 (40 mg per body) was infused continuously for 7 days via the common hepatic artery (TNP group); (3) the left hepatic artery was ligated and TNP-470 was infused continuously for 7 days via the common hepatic artery (ligation + TNP group). These treatments were started 12-14 days after tumour inoculation. The day of initiating treatment was defined as day 0. Although there were no significant differences in tumour volume among the three treated groups on day 7 after treatment, tumour volumes in the ligation + TNP group were significantly smaller than in the ligation group and the TNP group on day 14 after treatment. The vasculature and arterial collaterals around the tumour were demonstrated by the perfusion of a silicon rubber solution, Microfil. In the ligation + TNP group, the new microvasculature around the tumour decreased compared with the ligation group. The TNP-470 inhibition of microvascular proliferation may limit the development of collaterals that communicate with new feeding arteries. These results suggest that transarterial embolization combined with TNP-470 may enhance the anti-tumour effect of transarterial embolization alone in the treatment of liver tumours.

Alanine Transaminase↗
PubMed2003

Clinical ligation forces and intraoral friction during sliding on a stainless steel archwire.

The efficiency of tooth movement associated with some orthodontic mechanics can be compromised by friction between archwire and bracket. This study examined the effects of bracket ligation forces (F(N Ligation)) and mastication on friction when sliding a bracket along an archwire. Preliminary data from 5 orthodontists and 5 orthodontic residents characterized average tight and loose stainless steel F(N Ligation). These values were reproduced by a calibrated operator in a custom device used to estimate changes in the measurement of ex vivo and intraoral frictional forces, represented by mu(a), the apparent coefficient of static friction. Ten subjects chewed gum with the device in place to determine whether vibration eliminated friction when compared to ex vivo measurements. Nested analysis of variance and Tukey HSD tests determined the effects of ligation type and environmental variables. No significant differences (P >.01) were found between ex vivo and intraoral mu(a) values for tight and loose stainless steel ligation. Intraoral mu(a) values for elastic ligation were significantly greater than ex vivo mu(a) values (P <or=.001). The results suggested that vibration introduced by mastication did not eliminate friction when sliding a bracket along an archwire. In addition, there was considerable intraoperator variation in F(N Ligation), although ligation techniques were well controlled. Variations in clinical ligation forces are likely to be equal or greater than these experimental data. These variations could affect treatment efficiency.

Analysis of Variance↗
PubMed1999

An explanation of gastric hypersecretion in the pylorus-ligated rat.

The hypersecretion of gastric acid in the pylorus-ligated rat has been shown to be of vagal origin. The present series of experiments were performed to identify the stimulus. The pyloric sphincter was ligated in a series of Sprague Dawley rats. Along with pylorus ligation, various other surgical manipulations were performed. Intestinal obstruction by ligation approximately 20 cm aboral to the cecum reduced unstimulated gastric secretion in the pylorus-ligated rat. However, perfusion of the lower small intestine with bicarbonate (143 mEq/L) stimulated secretion. Perfusion with either saline or deoxycholic acid (20 mEq/L) did not alter secretion. This supports a role for bicarbonate in the hypersecretion of gastric acid in the pylorus-ligated rat. The reflex appears to involve the myenteric plexus, since section of the pylorus seemed to attenuate gastric secretion. Plasma from animals with pylorus ligation, either alone or with intestinal ligation, equally inhibited gastric secretion. This suggests that while some factor inhibiting gastric secretion may be present, it appears to be unrelated to pylorus ligation.

Animals↗
PubMed1999

The rebleeding course and long-term outcome of esophageal variceal hemorrhage after ligation: comparison with sclerotherapy.

BACKGROUND: Endoscopic variceal ligation is widely accepted as the optimum endoscopic treatment for esophageal variceal hemorrhage. However, the rebleeding course and long-term outcome of patients with esophageal variceal hemorrhage after ligation have been poorly defined. Therefore, we conducted a long-term follow-up study to delineate the outcome of ligation and compare it with that after sclerotherapy. METHODS: One hundred and eighty-five liver cirrhotic patients with endoscopically proven esophageal variceal hemorrhage were randomized to undergo endoscopic variceal sclerotherapy or ligation. These patients received regular follow-up and detailed clinical assessment. RESULTS: Two patients developed hepatoma within 6 months of entry in each group and were excluded. Another six patients in the sclerotherapy group and seven patients in the ligation group were excluded because of poor compliance or lost to follow-up. Therefore, 84 patients in each group were analyzed. In this long-term follow-up (55.3 +/- 12.5 months) the rebleeding rate for ligation was lower than that for sclerotherapy, regardless of whether the rebleeding was analyzed by patient number or Kaplan-Meier analysis. With regard to the rebleeding risk of various periods, the sclerotherapy risk was higher than that of ligation within 4 weeks of the initial endoscopic treatment or before variceal eradication. Multifactorial analysis showed hematemesis, poor hepatic function, and sclerotherapy were the risk factors determining rebleeding. The annual hepatocellular carcinoma incidence was 4.9%. There was no difference in survival between sclerotherapy and ligation. Multifactorial analysis showed that poor hepatic function was the only factor determining survival. CONCLUSIONS: The rebleeding risk was higher in sclerotherapy than in ligation before variceal eradication, especially within 4 weeks of the initial endoscopic treatment. Long-term survival was dependent on hepatic reserve regardless of the treatment method.

Chi-Square Distribution↗
PubMed1985

Lectin staining of rat testis and epididymis after ligation of excurrent ducts at different levels.

Seven rhodamine-conjugated lectins (PNA, RCA I, SBA, Con A, WGA, UEA I, and DBA; see Table 1) were utilized in studying the staining pattern of glycoproteins in rat testis and epididymis after ligation of ductuli efferentes (DE), corpus epididymidis (CE), and vas deferens (VD) for various time periods. Ductuli efferentes ligation caused a widening of seminferous tubules and detachment of spermatids with formation of multinuclear cells. These cells acquired a strong affinity for all lectins. Corpus epididymidis ligation also caused degeneration of spermatids with increased lectin staining in some tubules, but after 7 days another cell population close to the periphery of seminiferous tubules showed an increased nuclear affinity for some lectins followed by a clear degeneration and strong cytoplasmic staining with all lectins. Vas deferens ligation caused no degenerative changes in testicular spermatids. However, the peripheral cell population showed degenerative changes similar to those found after CE ligation. In both cases this was coincident with the formation of spermatic granulomas at the site of ligation. Ductuli efferentes ligation caused a gradual decrease of intratubular content in caput epididymidis, while the contrary was true after CE ligation. The latter was associated with intratubular accumulation of lectin-positive swollen cells and sperm aggregates as well as an increased lectin staining of narrow cells in initial segment and light cells in distal caput. After VD ligation an increased staining of light cells was initially found in distal cauda and distal caput, but, concomitant with distension of the tubules this reaction decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

Autonomic nerve changes in the mouse pancreas after pancreatic duct ligation.

INTRODUCTION: The mouse pancreas exhibits distinct atrophy of the exocrine tissue following pancreatic duct ligation. AIM: To investigate changes of innervation in the whole pancreas after pancreatic duct ligation. METHODOLOGY: The mouse pancreatic duct was ligated at 6 weeks of age. Pancreatic tissues were removed 7 days and 14 days after the ligation, fixed by perfusion and immersion with Zamboni solution, and embedded in gelatin. The whole organ was serially sectioned at a thickness of 100 microm, histochemically stained for cholinesterase, and observed by light microscopy. The number and volume of intrapancreatic ganglia, number of ganglion cells, and volume of each ganglion cell in the whole pancreas were quantitated. Some sections were analyzed using transmission electron microscopy after histochemically staining for cholinesterase. RESULTS: In the normal pancreas, ganglia were often situated on the outer surface of the islets of Langerhans. Thick nerve bundles ran along the arteries and emanated thin nerve fibers that surrounded the arterioles. In the atrophied pancreas following pancreatic duct ligation, ganglia remained on the islets of Langerhans as in normal mice, while the nerve fibers appeared dense, bending and curling in a more complex manner. The thin nerves also crossed each other in a complex network. Using morphometry in the pancreas following pancreatic duct ligation, the total ganglion cell number was found to decrease from normal levels. The mean ganglion cell volume in the ligated pancreas was significantly smaller than that in normal mice. As observed by transmission electron microscopy, some ganglion cells in the ligated pancreas were negative for cholinesterase activity but were surrounded by positive staining around the surface. CONCLUSIONS: These results suggest that the function of pancreatic ganglion cells changes with organ atrophy after pancreatic duct ligation.

Animals↗
PubMed1996

A report on the safety of unilateral vertebral artery ligation during cervical spine surgery.

STUDY DESIGN: This study retrospectively analyzed the outcome of unilateral vertebral artery ligation during cervical spine surgery. OBJECTIVES: To examine the influence of unilateral vertebral artery ligation on the function of brain and spinal cord. SUMMARY OF BACKGROUND DATA: There was little published information about the outcome of a vertebral artery ligation except for several reports from the field of neurosurgery. METHODS: Unilateral vertebral artery ligation was used in 15 patients with cervical tumors of the spine or the spinal cord (age range, 13-71 years; nine male patients and six female). The authors ligated the involved vertebral artery only when the tumor appeared on the minor or equal diameter artery side measured by pre-operative angiogram. The patient's condition was examined regarding signs of dysfunction of the brain stem, the cerebellum, or the spinal cord. RESULTS: Preoperative angiogram showed that the involved vertebral artery had a smaller diameter in four patients and had an equal diameter in 11 patients compared with the one not involved. The involved vertebral artery was severed at single site in four patients and was resected between two distant sites of ligation in 11 patients. Examination after surgery of the patient's condition (follow-up periods ranged from 10 months to 7 years) revealed that unilateral vertebral artery ligation did not provoke any symptoms of damage resulting from ischemia of the brain stem, the cerebellum, or the spinal cord. CONCLUSION: A vertebral artery could be ligated uneventfully when the diameter of the vertebral artery was not larger than the one not involved. Where vertebral artery ligation could not be avoided, it should be confirmed by preoperative angiogram that the other vertebral artery is large enough and that simultaneous occlusion testing of the involved vertebral artery is uneventful.

Adolescent↗