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PubMed2000

Effect of high ligation on the long-term result of patients with operable colon cancer, particularly those with limited nodal involvement.

OBJECTIVE: To find out what effect the extent of nodal dissection has on patients with operable colonic cancer. DESIGN: Retrospective study. SETTING: Teaching hospital, Japan. PATIENTS: 564 consecutive patients who had potentially curative operations for colon cancer. Patients treated by limited nodal dissection, in which only pericolonic nodes were dissected, were excluded. MAIN OUTCOME MEASURES: Disease free survival classified by extent of nodal dissection. RESULTS: High ligation gave no significant advantage when patients were subgrouped according to degree of nodal involvement. However, number of patients with aggressive involvement (including intermediate or central nodes) was small. 511 patients (91%) had limited nodal involvement (no nodal involvement or nodal involvement confined to pericolonic nodes). High ligation of the vessels gave no advantage even with meticulous subgrouping according to age, site, and depth of invasion. CONCLUSION: Most patients with colonic cancer had limited nodal involvement. High ligation did not affect the long term results in these patients, so, less invasive low ligation should be considered. A larger study will be necessary to clarify the indications for low and high ligation for patients with aggressive nodal involvement.

Aged↗
PubMed2004

Vascular control of the renal pedicle using the hem-o-lok polymer ligating clip in 50 consecutive hand-assisted laparoscopic nephrectomies.

BACKGROUND AND PURPOSE: A crucial step in laparoscopic nephrectomy is control and ligation of the renal pedicle. Commonly, an endovascular gastrointestinal anastomosis (GIA) stapling device, titanium staples, or both is employed for vascular control. Herein, we report on the use of the Hem-o-Lok polymer ligating clip (Weck Closure Systems, Research Triangle Park, NC) for the routine control of the renal pedicle (both venous and arterial) during hand-assisted laparoscopic radical nephrectomies. PATIENTS AND METHODS: From March 2001 to December 2002, 50 hand-assisted simple or radical nephrectomies were performed by a single surgeon. The Hem-o-lok polymer ligating clip was utilized exclusively for ligation of the renal pedicle, with placement of two clips on the patient's side and one distally on the specimen side. RESULTS: Vascular control was achieved safely in all cases. Neither slippage nor complications were found in any of these cases. CONCLUSIONS: Vascular control of the renal pedicle via the Hem-o-Lok polymer ligating clip is safe and dependable for laparoscopic radical/simple nephrectomies.

Adult↗
PubMed1993

Hypogastric artery ligation: a new perspective.

This study was conducted at the Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Bombay. An analysis was made of the hypogastric artery ligations done at our institution from January 1985 to December 1990. A prospective pilot study beginning June 1989 was added to the existing data. The hemostasis achieved intraoperatively and the collateral circulation maintained after main trunk ligation vs selective anterior division ligation have been studied prospectively with pelvic angiography postoperatively. Pelvic angiography using the standard Seldinger technique was done 14 days posthypogastric artery ligation in emergency obstetric cases. In selected gynecologic cases posted for Wertheim's hysterectomy, pelvic angiography was done both before and after hypogastric artery ligation. All the collected data, including operative time, blood loss, and complications, have been tabulated and compared with other studies in the literature.

Abortion, Induced↗
PubMed1998

Frictional forces related to self-ligating brackets.

Orthodontic tooth movement can be regarded as teeth sliding on a wire like pearls on a string, the force being supplied by springs or elastics. The movement implies friction between wire and bracket, taking up part of the force and leaving an uncontrolled amount to act on the teeth. The friction is likely to depend on bracket construction and wire material. Therefore, in this investigation the friction of self-ligating brackets and beta-titanium wires was evaluated, as opposed to more conventional configurations. Carried by low-friction linear ball bearings, a bracket was made to slide along an out-stretched archwire with minimal (and known) basic friction, either parallel or at an angle to the wire. Two self-ligating brackets were used in their closed position without any normal force. Friction was tested against four wires: stainless steel and beta-titanium, both in round and rectangular cross-sections. The force used to overcome friction and to move the bracket was measured on a testing machine at 10 mm/min, and the basic friction was subtracted. The results show that round wires had a lower friction than rectangular wires, the beta-titanium wires had a markedly higher friction than stainless steel wires, and friction increased with angulation for all bracket/wire combinations. The self-ligating brackets had a markedly lower friction than conventional brackets at all angulations, and self-ligating brackets, closed by the capping of a conventional design, exhibited a significantly lower friction than self-ligating brackets closed by a spring. The selection of bracket design, wire material, and wire cross-section significantly influences the forces acting in a continuous arch system.

Analog-Digital Conversion↗
PubMed2001

Adenoviral vector transfection into the pulmonary epithelium after cecal ligation and puncture in rats.

BACKGROUND: Adenoviral-targeted gene delivery to respiratory epithelium can augment production of specific proteins. Therefore, it may be valuable in treating the acute respiratory distress syndrome. The authors tested the hypothesis that adenoviral vector uptake after cecal ligation and double puncture in rats, an animal model of the acute respiratory distress syndrome, is higher than that observed in controls that did not undergo operation ("nonoperated") or those that underwent a sham operation ("sham-operated"). METHODS: Adenoviruses expressing green fluorescent protein or Lac-Z were delivered into the lungs of anesthetized rats via tracheal catheter. Animals were killed 24 or 48 h later. Histopathology and green fluorescent protein expression were examined using light of fluorescence microscopy. Cellular localization of Lac-Z was determined with electron microscopy or semithin sectioning. Viral receptor density and localization were determined using imunoblotting and immunohistochemistry. RESULTS: After cecal ligation and double puncture, rats were hypoxic and tachypneic. Alveoli were segmentally consolidated, contained proteinaceous debris and neutrophils, and had thickened septa. Administration of adenoviruses to rats that were sham-operated or underwent cecal ligation and double puncture resulted in high levels of marker protein expression in cells lining alveoli. Use of 3 x 10(11) plaque-forming units instead of 3 x 10(12) plaque-forming units resulted in similar levels of green fluorescent protein expression with negligible viral-mediated lymphocytic infiltration. Semithin section and electron microscopy revealed expression primarily localized to type II alveolar cells. Abundance of alpha(v)beta3 integrins and human coxsackie-adenovirus receptor (receptors that modulate viral attachment and internalization) was increased after cecal ligation and double puncture, predominantly in type II pneumocytes. CONCLUSIONS: Cecal ligation and double puncture induces histologic and functional changes consistent with the acute respiratory distress syndrome, increases surface expression of viral receptors, and enhances adenoviral-mediated gene transfer.

Adenoviridae↗
PubMed2003

Inhibition of spinal prostaglandin synthesis early after L5/L6 nerve ligation prevents the development of prostaglandin-dependent and prostaglandin-independent allodynia in the rat.

BACKGROUND: Prostaglandins, synthesized in the spinal cord in response to noxious stimuli, are known to facilitate nociceptive transmission, raising questions about their role in neuropathic pain. The current study tested the hypothesis that spinal nerve ligation-induced allodynia is composed of an early prostaglandin-dependent phase, the disruption of which prevents allodynia. METHODS: Male Sprague-Dawley rats, fitted with intrathecal drug delivery or microdialysis catheters, underwent left L5-L6 spinal nerve ligation or sham surgery. Paw withdrawal threshold, brush-evoked behavior, and the concentration of prostaglandin E2 (PGE2) in spinal cerebrospinal fluid ([PGE2]dialysate) were determined for up to 24 days. PGE2-evoked glutamate release from spinal slices was also determined. RESULTS: Paw withdrawal threshold decreased from at least 15 g (control) to less than 4 g, beginning 1 day after ligation. Brushing the affected hind paw evoked nociceptive-like behavior and increased [PGE2]dialysate (up to 257 +/- 62% of baseline). There was no detectable change in basal [PGE2]dialysate from preligation values. The EC50 of PGE2-evoked glutamate release (2.4 x 10-11 M, control) was significantly decreased in affected spinal segments of allodynic rats (8.9 x 10-15 M). Treatment with intrathecal S(+)-ibuprofen or SC-560, beginning 2 h after ligation, prevented the decrease in paw withdrawal threshold, the brush-evoked increase in [PGE2]dialysate, and the change in EC50 of PGE2-evoked glutamate release. R(-)-ibuprofen or SC-236 had no effect. CONCLUSIONS: The results of this study provide solid evidence that spinal prostaglandins, synthesized by cyclooxygenase-1 in the first 4-8 h after ligation, are critical in the pathogenesis of prostaglandin-dependent and prostaglandin-independent allodynia and that their early pharmacologic disruption affords protection against this neuropathic state in the rat.

Animals↗
PubMed1992

Rapid increase in plasma levels of atrial natriuretic peptide after common bile duct ligation in the rabbit.

Previous studies have shown that common bile duct ligation in the rabbit is followed by a reduction of the extracellular water compartment. To further elucidate the mechanisms leading to volume depletion in this model, water and sodium balances and changes in plasma concentrations of atrial natriuretic peptide (ANP), vasopressin (ADH), plasma renin activity (PRA) and aldosterone (Ald) were investigated during the first 4 days after common bile duct ligation (group OJ,) or sham operation (group SO). Water and chow intakes were lower in group OJ (148 +/- 30 versus 226 +/- 40 mL/4 days; p = 0.004 and 12 +/- 9 versus 171 +/- 40 g/4 days; p = 0.0001). There were no differences in urine output. Sodium urinary losses were marginally higher in group OJ (12.4 +/- 7 versus 6.7 +/- 5 mEq/4 days; p = 0.06). Water balance was lower in group OJ (-50 +/- 56 versus 101 +/- 71 mL/4 days; p = 0.0001). At 24 hours, plasma ANP (41 +/- 7 versus 10.7 +/- 1 fmol/mL, p = 0.0001), ADH (21.8 +/- 7 versus 12.3 +/- 6 pg/mL, p = 0.008) and Ald (14.5 +/- 5 versus 3.7 +/- 3 ng/dL, p = 0.001) were higher in group OJ. These alterations persisted 72 hours after bile duct ligation, when a concomitant increase in PRA (10.7 +/- 5 versus 3 +/- 1.6 ng/dL, p = 0.006) was also observed. A group of pair-fed pair-watered sham-operated controls (group SO2, n = 13) showed a metabolic profile similar to group OJ but a low ANP concentration. Multiple venous sampling in five rabbits 24 hours after bile duct ligation showed the highest plasma levels of ANP in the aorta and infrarenal vena cava. These results suggest that common bile duct ligation in the rabbit is followed by marked hypodipsia and hypophagia, possibly mediated by ANP, leading to isotonic volume depletion and secondary activation of the water and sodium retaining hormones.

Acute Kidney Injury↗
PubMed2003

Outcomes of endoscopic treatment of gastroduodenal Dieulafoy's lesion with rubber band ligation and thermal/injection therapy.

BACKGROUND: Dieulafoy's lesion is a rare but important cause of upper gastrointestinal bleeding. Current endoscopic methods used to treat Dieulafoy's lesion include injection, with or without thermal methods, and mechanical methods. The latter include variceal ligation and hemoclips. There are no studies comparing the outcomes of rubber band ligation and injection with or without thermal therapy. AIM: To report the outcomes of Dieulafoy's lesion treated endoscopically with rubber band ligation and injection with or without thermal therapy at a single institution. METHODS: Patients with the diagnosis of Dieulafoy's lesion treated endoscopically at the Carl T. Hayden VA Medical Center in Phoenix, between August 1994 and August 2002 were analyzed. Demographic data, mode of presentation, risk factors for gastrointestinal bleeding, hemodynamic parameters, blood transfusion requirements, endoscopic findings, details of endoscopic therapy, length of stay in ICU/hospital, complications, recurrence of bleeding, and mortality rates were collected and compared between those receiving endoscopic band ligation (EBL group) and those receiving injection with or without thermal therapy (non-EBL group). RESULTS: Twenty-three patients with Dieulafoy's lesion (14 in the EBL group and nine in the non-EBL group) were studied. All patients were men. The mean age, hemoglobin levels on admission, and the transfusion requirements before therapy were similar in both groups. Fourteen patients (eight in the EBL- and six in the non-EBL groups) presented with hematemesis and the remaining with melena. The majority of Dieulafoy's lesions (91.3%) were located in the stomach and two in the duodenum. Active bleeding at the time of endoscopy was seen in 61% of cases, and immediate hemostasis was achieved with either method in 100% of patients. Early rebleeding (within 72 hours of endoscopic therapy) occurred in only one patient treated with epinephrine plus heater probe therapy. The length of stay in ICU was longer in the non-EBL group (6.7 days) compared with the EBL group (1.8 days) (P = 0.2). There were six deaths (three in the non-EBL group and three in the EBL group) within 30 days of the index hospitalization. The causes of death included infection/sepsis (n = 3), complications of acute myocardial infarction (n = 2), and end-stage liver disease (n = 1). CONCLUSIONS: Endoscopic rubber band ligation is as effective as injection with or without thermal therapy in the treatment of Dieulafoy's lesion.

Adult↗
PubMed1996

Treatment of high undescended testes by low spermatic vessel ligation: an alternative to the Fowler-Stephens technique.

PURPOSE: We determined whether testis viability after a Fowler-Stephens orchiopexy depends on ligating the spermatic vessels high and far proximal to the undescended testis. MATERIALS AND METHODS: Based on studies of testicular vascular anatomy we developed a technique of low spermatic vessel ligation and performed it on 39 high undescended testes in 33 patients. RESULTS: Testis viability was 97% at 1 month and 93% (25 of 27) at 1 year. CONCLUSIONS: Ligation of the spermatic vessels does not need to be performed high to ensure testis viability. Testicular vascular anatomy supports low spermatic vessel ligation and by decreasing tension on the testis low spermatic vessel ligation may enhance viability. A 2-stage laparoscopic approach to the high undescended testis is difficult to justify on the basis of cost or outcome analysis.

Adolescent↗
PubMed1989

Protective effect of misoprostol, a synthetic prostaglandin E1 analog, on experimental pancreatitis induced by pancreatic duct ligation in rat.

This study was performed to assess the effects of misoprostol (M), a synthetic prostaglandin E1 analog, on experimental pancreatitis in rat. Pancreatitis was induced by ligation of the main pancreatic duct of 3-month-old male Wistar rats. Pancreatic lesions were observed at 6, 12, 24, 48, and 96 h after pancreatic duct ligation (PDL). A time of 48 h was chosen to evaluate M treatment. M was injected intraperitoneally (500 micrograms/kg every 4 h) between time 0 and 48 h after PDL. Stereological analysis was performed on light and electron microscopy. Total pancreatic amylase and chymotrypsin concentrations were determined. Four groups of five rats were studied: sham operated (SO), M without PDL (PG), duct ligation without M (DL), and duct ligation with M (DLPG). Edema, dedifferentiation of pancreatic acinar cells, and heterogeneous distribution of zymogen granule diameters observed after PDL were significantly decreased by M in the DLPG group. Enzyme concentrations were also decreased by M in the DLPG group. Enzyme concentrations were also decreased by M both in normal (PG) and duct ligated rats (DL). M has protective effects against pancreatic lesions induced by PDL. In this model, the protective effect of M may be due to a blockade of the autodigestive secretions of the pancreatic acinar cells.

Alprostadil↗
PubMed1979

Effect of ureteral ligation and nephrectomy on granulocyte-macrophage progenitor cells and azathioprine toxicity.

Using an in vitro quantitative clonal culture technique of bone marrow granulocyte-macrophage progenitor cells (colony-forming units culture (CFU-c)), we studied the hematopoietic toxicity of azathioprine after unilateral and bilateral ureteral ligation, unilateral and bilateral nephrectomy, and splenectomy in C57BL/6 mice. Analysis of femoral bone marrow 18 hr after i.p. injection of azathioprine (300 mg/m2) revealed increased CFU-c toxicity in comparison to controls as follows: (1) bilateral ureteral ligation, P less than 0.01; (2) bilateral nephrectomy, P less than 0.01; (3) unilateral ureteral ligation, P greater than 0.05 less than 0.1; (4) unilateral nephrectomy, P, not significant; and (5) splenectomy, P, not significant. Extrapolation from a dose-response curve for the toxicity of azathioprine on the bone marrow CFU-c indicated that bilateral ureteral ligation and bilateral nephrectomy had the effect of a 25 to 50% increase in the azathioprine dose. After bilateral ureteral ligation, serum granulocyte-macrophage colony-stimulating factor levels were increased and in vitro tritiated thymidine suicide studies showed an increased proliferative rate of the CFU-c. Since azathioprine is a predominantly cell cycle-specific agent, we suggest that increased sensitivity to azathioprine is related to the increased proliferative rate of the CFU-c. The findings provide a rationale for a clinical policy of azathioprine reduction when there is depressed renal function.

Animals↗
PubMed2000

A randomized controlled trial of rubber band ligation versus infra-red coagulation in the treatment of internal haemorrhoids.

OBJECTIVE: Despite the presence of numerous non-surgical therapies for the treatment of haemorrhoids, none of these therapies has clearly been proven to be superior. The effectiveness and patient tolerance of rubber band ligation (RBL) and infra-red coagulation (IRC) in the treatment of haemorrhoids was assessed. DESIGN: Prospective randomized trial. SETTING: Academic hospital (tertiary care). PARTICIPANTS: A total of 133 consecutive patients (73 males, 60 females, mean age 48 years (range 19-82)) with internal haemorrhoids, and without concomitant anorectal disease, were randomized to rubber band ligation (RBL, n = 65) or infra-red coagulation (IRC, n = 68). INTERVENTIONS: Rubber band ligation or infra-red coagulation was performed in one or more sessions with four-week intervals until symptoms had resolved. Treatment outcome and side-effects were assessed after each treatment session and one month after the last treatment by proctological examination and a questionnaire, including a pain score (visual analogue scale from 0 to 10). Recurrence of complaints was assessed by telephone questionnaire [mean follow-up of 19.2 months (SD 7.8)]. RESULTS: Treatment outcome was assessed in 124 patients (60 RBL, 64 IRC). The mean number of treatment sessions was 1.6 (SD 0.9) for both therapies. For RBL, 58 patients (97%), and for IRC, 59 patients (92%) were symptom-free or had satisfactorily improved. Only third-degree haemorrhoids seemed to respond better to RBL (five of five patients symptom-free) than to IRC (two of four patients symptom-free). Pain following treatment was more common and more severe after RBL (VAS 5.5 +/- 3.7) than after IRC (VAS 3.3 +/- 3.3, P= 0.018). The telephone questionnaire was answered by 105 patients. Nine of 50 patients (18%) treated with RBL and 11 of 55 patients (20%, P= 0.81) treated with IRC had experienced symptomatic relapse to pre-treatment levels. CONCLUSIONS: Infra-red coagulation and rubber band ligation are equally effective in the treatment of haemorrhoids. The rate and severity of pain is higher after rubber band ligation. Infra-red coagulation should be the first-line treatment for haemorrhoids.

Adult↗
PubMed2005

Incidence and postoperative outcomes of accidental ligation of the testicular artery during microsurgical varicocelectomy.

PURPOSE: In this study the frequency and outcomes of unintentional testicular artery ligation during microsurgical varicocelectomy were evaluated. MATERIALS AND METHODS: From 1984 to 2002, 2,102 cases of microsurgical varicocelectomy were evaluated. Accidental artery ligation was confirmed intraoperatively by observation of pulsatile twitching of the ligated vessel stump under 25x magnification. RESULTS: The complication was identified in 19 cases (0.9%) and all occurrences were unilateral, with 74% on the left side and 42% on the right side. In addition to the vasal artery at least 1 alternative artery was identified in all cases. Average testis volume before surgery was 15.8 ml. Azoospermia was found in 26% of cases. After surgery during the median followup of 19 months testicular atrophy developed in 1 patient (5%). In this cohort significant improvement was found in serum total testosterone in 80% (from 362 to 493 ng/dl) and in sperm count in 80% (from 12 to 22 x 10 per ml). Return of motile sperm to the ejaculate was found in 40% of azoospermic cases. The natural pregnancy rate was 14%, which is significantly lower than the 46% previously reported in the historical cohort of varicocelectomy cases. CONCLUSIONS: The incidence of accidental testicular artery ligation in microsurgical varicocelectomy was approximately 1%. Testicular atrophy developed in 1 patient (5%). Preservation of cremasteric and/or secondary internal spermatic arteries likely contributed to a low incidence of adverse outcomes. The natural pregnancy rate was low which may be due to the high proportion of azoospermic men before surgery. It is possible that the smaller testes usually associated with azoospermia indicate smaller testicular arteries, thus posing a greater risk of accidental ligation.

Adult↗
PubMed2006

Comparative study between nadolol and 5-isosorbide mononitrate vs. endoscopic band ligation plus sclerotherapy in the prevention of variceal rebleeding in cirrhotic patients: a randomized controlled trial.

BACKGROUND: After variceal bleeding, cirrhotic patients should receive secondary prophylaxis. AIM: To compare nadolol plus 5-isosorbide mononitrate (5-ISMN) with endoscopic band ligation. The end points were rebleeding, treatment failure and death. METHODS: One hundred and nine cirrhotic patients with a recent variceal bleeding were randomized: nadolol plus 5-ISMN in 57 patients and endoscopic band ligation in 52 patients. RESULTS: The mean follow-up was 17 and 19 months in nadolol plus 5-ISMN and endoscopic band ligation groups, respectively. No differences were observed between groups in upper rebleeding (47% vs. 46%), variceal rebleeding (40% vs. 36%), failure (32% vs. 22%), major complications (7% vs. 13.5%) and death (19% vs. 20%), respectively. The actuarial probability of remaining free of rebleeding, failure and deaths were similar in both groups. Time to rebleeding shows that endoscopic band ligation patients had an early rebleed, with a median of 0.5 month (95% CI: 0.0-4.2) compared with patients from nadolol plus 5-ISMN, 7.6 months (95% CI: 2.9-12.3, P < 0.013). Multivariate analysis indicated that outcome-specific predictive factor(s) for rebleeding was Child A vs. B + C (P < 0.01); for failure was Child A vs. B + C (P < 0.02); and for death ascites (P < 0.01) and rebleeding (P < 0.02). CONCLUSION: This trial suggests no superiority of endoscopic band ligation over nadolol plus 5-ISMN mononitrate for the prevention of rebleeding in cirrhotic patients.

Endoscopy, Gastrointestinal↗
PubMed1975

The ligation of the male reproductive organs and the role of the spermatic cyst.

The effects of ligation of the vas deferens, the corpus epididymis and the vasa efferentia on spermatozoa and testicular morphology were studied in sexually mature rats. Following the ligation of the vas deferens, headless and immotile spermatozoa were observed on the second day in the vas deferens. Decapitation occured in more than ninty per cent of the spermatozoa on the sixth day and the motility became almost zero. On the contrary, in the epididymis normal spermatozoa were observed for a relatively long period. Even three weeks after the vas ligation, more than ninty per cent of spermatozoa showed normal morphology. Spermatic cyst formation was observed so early as four days following ligation of the vas. By the third week cysts were observed in most rats, either unilaterally or bilaterally. In addition, ligation of the corpus epididymis resulted also in the formation of a spermatic cyst on the proximal site of the ligature. A strong correlation was observed between spermatic cyst formation and the occurrence of morphological changes in the testis, as well as the motility and the normality of spermatozoa. When the spermatic cyst was formed, the testis showed almost normal morphology for a long period as well as spermatozoa in the ductal system. When a spermatic cyst was not formed, degenerative changes took place promptly and abnormal spermatozoa were observed in the ductal system. These observations suggest that the seminiferous tubules may be very sensitivie to the increase in intratubular pressure and in such instances the spermatic cyst acts as a "shock absorber" to prevent the abnormal increase of pressure within the ductal system, especially the seminiferous tubules. In addition, the result suggests further that a need for caution and careful follow-up are necessary in the vasectomized man.

Animals↗
PubMed1996

Magnolol reduces infarct size and suppresses ventricular arrhythmia in rats subjected to coronary ligation.

1. Magnolol is an active component of Magnolia officinalis. It is 1000-times more potent than alpha-tocopherol in inhibiting lipid peroxidation in rat heart mitochondria. In the present study, the in vivo antiarrhythmic and anti-ischaemic effects of magnolol in coronary ligated rats were investigated. 2. Male Sprague-Dawley rats were anaesthetized with urethane. Magnolol, at dosages of 10(-7), 10(-8) and 10(-9) g/kg, was administered intravenously 15 min before ligation of the coronary artery. 3. The incidence and duration of ventricular tachycardia and ventricular fibrillation during 30 min coronary ligation were significantly reduced by magnolol. Ventricular arrhythmias during 10 min reperfusion after the relief of coronary ligation were also reduced. 4. In rats subjected to 4 h coronary ligation, 10(-7) and 10(-8) g/kg magnolol significantly reduced infarct size. 5. We conclude that magnolol may protect the myocardium against ischaemic injury and suppress ventricular arrhythmia during ischaemia and reperfusion.

Analysis of Variance↗
PubMed2005

Lymphotoxin-beta production following bile duct ligation: possible role for Kupffer cells.

BACKGROUND AND AIMS: Lymphotoxin-beta (LT-beta) may play a role in the pathogenesis of chronic liver injury. The aim of this study was to determine in an animal model of bile duct ligation liver injury whether LT-beta expression is induced and whether Kupffer cells are an intrahepatic source of LT-beta. METHODS: Sprague-Dawley rats were divided into two groups: one group received a single dose of GdCl (a Kupffer cell-blocking agent, 10 mg/kg i.v.), whereas the other group received saline. One day later, the groups underwent bile duct ligation or a sham operation. Liver tissue was obtained on days 1, 3, 5, and 8 for assessment of Kupffer cell numbers, early fibrogenic events and LT-beta gene expression. Kupffer cells were isolated using pronase/collagenase perfusion and centrifugal elutriation. RESULTS: Hepatic LT-beta mRNA expression increased early following bile duct ligation. Pretreatment of bile duct-ligated animals with GdCl significantly reduced the number of Kupffer cells, delayed the rise in LT-beta expression, but had no effect on fibrogenesis. Recovery of the Kupffer cell population in these animals was accompanied by increased hepatic LT-beta expression. The LT-beta ligand and receptor were expressed by isolated normal Kupffer cells. CONCLUSIONS: Hepatic LT-beta expression is induced early following bile duct ligation. Kupffer cells may be an intrahepatic source of LT-beta.

Animals↗
PubMed1981

The treatment of second degree haemorrhoids by injection, rubber band ligation, maximal anal dilatation, and haemorrhoidectomy: a prospective clinical trial.

One hundred and twenty patients with confirmed second degree haemorrhoids were randomly allocated to four treatment groups; injection, rubber band ligation, maximal anal dilatation, and haemorrhoidectomy. Each groups consisted of 30 patients. All patients were regularly followed up for at least one year. Assessment at one year showed that haemorrhoidectomy "cured" the haemorrhoids in 29 out of 30 patients. Rubber band ligation relieved 25 out of 30 and maximal anal dilatation 24 out of 30. Injection was the least effective treatment, and relieved 18 of the 30 patients, with a cure rate of 60% only. Haemorrhoidectomy caused pain in all cases, anal stenosis in two, postoperative haemorrhage in two, and the patients required an average hospital stay of 11.5 days and an average of a further 15.5 days off work. Rubber band ligation was painless in 26 patients out of 30, and maximal anal dilatation was painless in 25 our of 30. There were no postoperative complications in the latter two treatment groups. Haemorrhoidectomy is good in "curing" the disease, but the higher possibility of postoperative pain and complications and longer hospital stay would not justify its use in the treatment of second degree haemorrhoids. Both rubber band ligation and maximal anal dilatation are effective and relatively free from complications. Rubber band ligation has the additional advantage of not requiring hospital stay or anaesthesia and is therefore considered to be the most appropriate method of treatment for second degree haemorrhoids.

Adult↗