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At least 793 records · Page 44Linked to original sources
PubMed2005

[Surgical treatment of obstructive sleep apnea hypopnea syndrome after velopharyngeal ring ligation procedure].

PURPOSE: To evaluate the effect of removal of ligation thread combined adenoidectomy in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) after velopharyngeal ring ligation procedure (VRLP). METHODS: The upper airway was examined with dynamic fiberoptic pharyngoscope in six patients with cleft palate who were diagnosed as OSAHS by polysomnography(PSG) after VRLP. All the patients underwent removal of ligation thread and adenoidectomy. Three months after operation, they were recalled back and were examined with polysomnography and dynamic fiberoptic pharyngoscope. The preoperative and postoperative PSG data were analysed with t test and chi-square test to determine the statistical differences. RESULTS: In patients with OSAHS after VRLP, a ring scar was observed on the upper airway at the soft palate level and a remarkable narrow nasopharyngeal meatus was found mainly because of adenoidal hypertrophy. After removal of ligation thread and adenoidectomy, no velopharyngeal incompetence was found, the upper airway morphology was smooth, respiration disorder during sleeping was completely disappeared and sleep architecture became normal. There were significant differences between preoperative and postoperative PSG data. CONCLUSION: Removal of ligation thread combined adenoidectomy was an effective treatment for OSAHS after VRLP.

Adenoidectomy↗
PubMed1992

[Simple ligation superior to inversion of the appendiceal stump; a prospective randomized study].

OBJECTIVE: To compare two methods of treatment of the appendix stump after appendectomy for acute appendicitis. DESIGN: A prospective randomised trial of 134 consecutive appendectomies in which the appendix stump was either simply ligated or ligated and doubly invaginated. SETTING: Department of General Surgery, St Joseph Hospital, Veldhoven, the Netherlands. PATIENTS AND METHODS: During a period of 15 months all patients in whom an appendectomy for acute appendicitis was performed were allocated at random to the two groups. The following data were recorded: age, sex, histological diagnosis, hospital stay and occurrence of complications. All patients were followed until 6 months after the operation. The data were analysed statistically with the chi-square-test and the Mann-Whitney test. P less than 0.05 was considered significant. RESULTS: The appendix stump was ligated in 79 patients and invaginated in 55. Both groups were similar with respect to age, sex, degree of appendiceal inflammation, antibiotic treatment and hospital stay. There were significantly more wound infections in the 'invagination' group (p = 0.017). The other complications showed no statistical intergroup difference. CONCLUSION: Simple ligation facilitates and shortens appendectomy. It is a safe procedure, preventing deformation of the caecal wall and possibly reducing the risk of postoperative ileus due to adhesions. We therefore recommend simple ligation as the standard procedure at appendectomy.

Adolescent↗
PubMed1992

Endoscopic ligation of esophageal varices.

Endoscopic variceal ligation was developed to provide a safe alternative to conventional injection sclerotherapy which is known to be associated with a substantial incidence of non-bleeding treatment related complications. Laboratory studies in portal hypertensive dogs have shown the technique results in obliteration of vascular structures in the submucosa by scar tissue formation. The clinical technique of endoscopic ligation is performed in the endoscopy suite or intensive care unit in a fashion similar to endoscopic sclerotherapy except an endoscopic overtube is routinely employed. Initial single arm trials of endoscopic ligation in 146 consecutive patients showed the technique to be effective for control of active bleeding and eradication of varices while being associated with a low incidence of non-bleeding complications. Endoscopic ligation has been investigated in three additional single arm trials and is currently under investigation in three prospective randomized studies comparing the technique with sclerotherapy. Data from these studies have confirmed that endoscopic ligation is at least equal to sclerotherapy for treatment of actively bleeding varices and prevention of recurrent bleeding. The new technique appears to result in a significantly lower risk of non-bleeding treatment related complications than conventional sclerotherapy.

Animals↗
PubMed1991

Enhancement of rat liver mitochondrial function by portal branch ligation secures subsequent extended hepatectomy.

We have examined the effects of portal branch ligation on liver mitochondrial function and on subsequent extended hepatectomy in rat. In the occluded lobes, mitochondrial function was depressed immediately after the ligation. In the unoccluded lobes, mitochondrial function was enhanced and reached the maximum two days after the ligation. This enhancement was associated with increases in the enzymic activities and subunit amounts of the energy-transducing complexes, and with increase in mitochondrial DNA content. The ligation improved both survival rate and mitochondrial redox state monitored by the ratio of acetoacetate to beta-hydroxybutyrate after hepatectomy. These results suggest that the enhancement of mitochondrial function by portal branch ligation fills the energy demand for liver regeneration.

Animals↗
PubMed1991

[Evaluation of the effect of ligation of the inferior thyroid arteries during non-radical thyroidectomy in simple goiter on selected parameters of calcium-phosphate metabolism in the body].

The aim of the paper was to evaluate the effect of inferior thyroid arteries ligation during the incomplete excision of the thyroid gland in patients with simple goitre, exerted on selected parameters of phosphate-calcium balance in the organism as compared with a group of patients, in whom no inferior thyroid arteries were ligated. The study material comprised 84 patients with simple goitre, free of other diseases. The evaluation covered the following parameters of the phosphate-calcium balance in the organism, namely: the concentration of total calcium, protein, dialyzing calcium, inorganic phosphate as well as immunoreactive parathyroid hormone. The study was performed three times: prior to operative procedure, directly after the operative procedure, and three months after the procedure. It has been shown that there are slight, but statistically significant, differences in the behaviour involving the concentration of total and dialyzing calcium as well as IRPTH in serum, depending on the applied operative technique. Directly after the procedure the changes affecting the studied parameters were more pronounced in patients with ligated inferior thyroid arteries. Three months after the operative procedure the mean concentration of IRPTH, total and dialyzing calcium was somewhat higher in patients, whose inferior thyroid arteries were ligated, than in patients, in whom the arteries were not ligated. The described changes were of subclinical character.

Adolescent↗
PubMed1990

Altered hepatobiliary disposition of acetaminophen metabolites after phenobarbital pretreatment and renal ligation: evidence for impaired biliary excretion and a diffusional barrier.

The effects of phenobarbital (Pb)-pretreatment and bilateral renal ligation on the disposition of acetaminophen, acetaminophen glucuronide (AG) and acetaminophen sulfate (AS) were examined in serum, bile and urine of rats. Pb-pretreatment significantly decreased the percentage of the acetaminophen dose (100 mg/kg) excreted in bile as the glucuronide and sulfate conjugates in rats with intact kidneys [AG (0.94% vs. 6.49%); AS (1.41% vs. 4.19%)] and in renal-ligated rats [AG (2.22% vs. 7.71%); AS (6.12% vs. 9.13%)], compared to vehicle-pretreated controls. Decreased biliary recovery of AG occurred despite a Pb-induced increase in the fraction of the acetaminophen dose converted to AG. Similarly, biliary recovery of AS was reduced further than expected based on Pb-associated decreases in the fraction of the acetaminophen dose converted to AS. These observations suggest that the hepatobiliary disposition of AG and AS was altered at multiple sites due to 1) direct interactions with Pb (or a Pb metabolite) and/or 2) metabolic induction by Pb. Renal ligation shifted the metabolic pathway toward sulfation, with a subsequent increase in biliary recovery of AS. However, renal ligation did not alter the percentage of the dose excreted as AG in bile despite a marked elevation in AG serum concentrations. Furthermore, biliary excretion rate vs. time profiles of AG and AS in renal-ligated rats exhibited a terminal half-life exceeding that of acetaminophen in serum. These data provide evidence that diffusional barriers between blood and hepatocytes influence the hepatic disposition and routes of elimination of polar metabolites such as AG and AS.

Acetaminophen↗
PubMed1988

Endoscopic sclerotherapy versus endoscopic variceal ligation: esophageal symptoms, complications, and motility.

Endoscopic sclerotherapy is an effective method for treating bleeding esophageal varices. However, a number of complications may limit its usefulness. A newly developed method for treating bleeding varices, endoscopic variceal ligation, that uses small rubber bands to occlude and eradicate the varices, may cause less damage to the esophagus. Twenty-eight patients (seven with no prior treatment, eight undergoing sclerotherapy, and 12 undergoing variceal ligation) were evaluated with a symptom questionnaire and esophageal manometry. The lower esophageal sphincter (LES) pressures in the three groups did not differ. The percent LES relaxation was significantly (p = 0.04) less in the sclerotherapy group than in the untreated group. Contraction waves in the esophageal body were not different in amplitude, duration, and propagation speed in the three groups. There was no increase in the amount of heartburn after either form of treatment. Eight of the nine sclerotherapy patients had a stricture after treatment that required dilatation, whereas none of the ligation patients had strictures. We conclude from this that early in the course of sclerotherapy, stricture formation is common, but any long-lasting adverse effect on esophageal function is minimal. We also conclude variceal ligation therapy causes less esophageal dysfunction and has fewer local complications. Thus, endoscopic variceal ligation may be a safer and more easily tolerated alternative to endoscopic sclerotherapy.

Adult↗
PubMed1986

Disturbances in the regulation of glycaemia in rabbits following pancreatic duct ligation. Biochemical and immunocytochemical studies.

The effects of pancreatic duct ligation on endocrine function in the rabbit were studied over the short and medium term period (5 to 180 days). Hyperglycaemia appeared 30 days after ligation and persisted until the end of the experimental period (180 days). The highest glucose values were observed on day 90 after ligation (351 +/- 25 mg/100 ml). Glucose loading tests performed 5, 15, 30 and 180 days after ligation showed weak insulin release. Reduced pancreatic insulin stores could not account for this failure. Immunocytochemical studies showed dissociation of the islets (30 days after ligation) leading to small clusters of B cells scattered in a degenerative exocrine tissue (180 days).

Animals↗
PubMed1987

[Experimental study on rat hepatic injury by copper--effect of copper overload on the cholestatic liver induced by bile duct ligation].

In the cases of protracted obstructive jaundice, it is reported that there was a positive correlation between the hepatic copper concentration and the severity of destruction of the bile ducts. The author produced the model of obstructive jaundice in rats by common bile duct ligation and investigated whether additional copper overload can cause injury on the liver. The simple ligating procedure induced a significantly increased level of the copper concentration (p less than 0.001). The copper concentration of the group with the additional copper overload showed about an eighteen-fold increase in comparison with the group of the only ligation (p less than 0.005). Histologically, the group with the overload alone exhibited no significant finding. The groups with the ligation showed bile duct proliferation with subsequent fibrosis around portal areas (pericholangiolar fibrosis); however, the fibrosis in the group with an additional overload was more prominent than that without an additional overload. By the orcein stain, the positive granules in the group with the ligation alone were preferentially present in the liver cells around the proliferated bile ducts. The group with the additional overload exhibited diffuse and more pronounced staining. Ultrastructurally, the liver cells in the group with the additional overload contained lysosomes with electron-dense material, some of which showed a feature consistent with focal interruption of their membranes. By X-ray microanalysis, these lysosomes were revealed to include copper as well as sulfur. The sulfur was considered to represent copper-binding protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Outcome of pneumococcal challenge in rats after splenic artery ligation or splenectomy.

Reports of postsplenectomy septicemia led to development of various methods for splenic salvage, including ligation of the splenic artery. For study of susceptibility to pneumococci after splenectomy or splenic artery ligation, 35 Sprague-Dawley rats, in three groups, underwent splenectomy or central ligation of the splenic artery, or sham operation with omental resection. Blood cell counts prior to injection of pneumococci (3 X 10(3) intravenously in each rat) showed no intergroup differences. All the splenectomized rats died, but only 20% of those with splenic artery ligation (p = 0.000047). None of the rats with sham operation died, but this was not significantly different from the mortality in the group with splenic artery ligation (p = 0.22).

Animals↗
PubMed1984

Serotonin-induced blood flow changes in the rat hindlegs after unilateral ligation of the femoral artery. Inhibition by the S2 receptor antagonist ketanserin.

Collateral arteries can clearly be visualized in corrosion cast material after ligation of the femoral artery in rats. To characterize the influence of serotonin on the blood circulation under the experimental condition of unilateral ligation, we performed intermuscular thermoflow measurements. The data showed that intraperitoneal serotonin (8.7 and 20 mg.kg-1) injection markedly reduced the muscle temperature in both hindlegs. However, the effect was significantly more pronounced on the ligated side, where the blood was supplied through a collateral circulation, than on the non-ligated side with its normal arterial vasculature. Almost identical changes were obtained in rats with an early as well as in animals with a more advanced stage of collateral development (challenge with 8.7 mg.kg-1 serotonin). Evans blue dye experiments and angiographic data further revealed that, after challenge with 20 mg.kg-1 serotonin, the severe temperature decrease at the ligated side probably reflected a nearly complete blockage of blood supply. Pretreatment with the S2 receptor antagonist ketanserin (2.5 mg.kg-1) resulted in a significant reduction in the extent and duration of the serotonin-induced temperature decrease as revealed by the temperature measurements; such a treatment inhibited also the blockage in blood flow as seen with the other techniques. This study shows that serotonin, through its vasoconstrictive properties, can restrict the blood flow to the lower extremities of the rat, particularly when the blood is supplied through collateral circulation. This probably results in moderate to severe skeletal muscle ischaemia. It also suggests that the vasoconstriction is not only important in the inhibition of collateral blood flow in recently established collaterals but also in collateral vessels in a more advanced stage of development. The in vivo vasoconstriction and subsequent reduction of the blood supply caused by serotonin can be effectively counteracted by pretreatment with ketanserin.

Angiography↗
PubMed1984

[Occlusion (ligation) of a branch of the portal vein for carcinoma of the liver].

Rous and Larimore reported that ligation of a branch of the portal vein in rabbits resulted in atrophy of the corresponding hepatic lobe together with hypertrophy of the other lobe. Hirono, one of my collaborators, observed that experimentally produced carcinoma of the liver regressed more or less after ligation of a branch of the portal vein supplying the tumor-bearing area. Kozaka also demonstrated experimentally that occlusion of the portal blood supply to the area destined to be resected caused no serious impairment on the animals even those with liver damage. The principle of this operative procedure is ligation of the right or left branch of the portal vein supplying the affected hepatic lobe. Ligation of one branch was used for tumors confined to one hepatic lobe, and right portal branch ligation combined with lateral segmentectomy was used for multiple tumors, sparing only the middle hepatic lobe. The operation was performed in twenty patients with carcinoma of the liver. An average survival after operation is 13.6 months in 12 patients with primary carcinoma and 10.6 months in 7 patients with metastatic one excluding one patient now living over 16 years after surgery.

Adult↗
PubMed1983

The changed activity of the serum kallikrein-kinin system after ligation of the superior mesenteric artery in rats.

The aim of the experiments was to study the effect of ligation of the superior mesenteric artery on the activity of the kinin-kallikrein system in the plasma and on arterial blood pressure. Ligation of 60 minutes did not change the free kallikrein activity of the plasma, while prekallikrein activity significantly decreased. Blood pressure showed a tendency to increase but not to a significant degree. Five minutes after the release of the ligation (during the period when the functional parameters of the intestinal mucosa returned to normal) free kallikrein activity increased and the arterial blood pressure decreased significantly. A rinse of the intestine with 5 p.c. glucose solution prior to the release of ligation prevents the increase in free kallikrein activity and the fall of blood pressure. The substances absorbed from the bowel lumen and activating the kinin system are probably responsible for the circulation failure following the ligation of the superior mesenteric artery.

Animals↗
PubMed1980

Alterations in pentobarbital and meperidine pharmacokinetics induced by bile duct ligation in the rat.

Although impaired microsomal drug metabolism has been demonstrated in response to bile duct ligation, there has been little previous assessment of the effects of extrahepatic biliary obstruction on drug pharmacokinetics in vivo. In this study, the effects of bile duct ligation on overall disposition on pentobarbital and meperidine in the rat have been assessed in vivo and in isolated perfused rat livers. A significant reduction in clearance of both compounds was seen in response to bile duct ligation. No change in protein binding of either drug was demonstrated, but alterations in initial volume of distribution of both drugs occurred in response to extrahepatic biliary tract obstruction. A significant reduction in the rate of perfusate flow was also seen in perfused liver experiments using livers from animals with previous bile duct ligation. Reduction in clearance of both a high extraction drug (meperidine) and a lower extraction drug (pentobrbital) in response to bile duct ligation suggests that both hepatic blood flow and drug metabolizing enzyme activity may be altered by extrahepatic biliary tract obstruction.

Animals↗
PubMed1994

Hemodynamic changes after ligation of a major branch of the portal vein in rats: comparison with rats with portal vein constriction.

In chronic portal-hypertensive rat models, such as portal vein constriction or cirrhosis, the portal blood flow that effectively perfuses the hepatocytes is substantially reduced because of anatomical or functional shunts. It is possible therefore that a feedback mechanism from the liver to the splanchnic bed is responsible for the splanchnic hyperemia observed in chronic portal hypertension. To investigate the possible role of such a feedback mechanism, we examined the chronological changes in both portal and systemic hemodynamics in rats after ligation of a major branch of the portal vein that supplies about 80% of the liver circulation. Rats submitted to sham surgery and portal vein-constricted rats were also studied. Blood flow and portal-systemic shunting were measured by radioactive microsphere techniques. For 7 days after portal-branch ligation, transient portal hypertension resulted from an elevated portal resistance. However, no significant changes in portal venous inflow or splanchnic arteriolar resistance were found in the portal branch-ligated rats, whereas in the portal vein-constricted rats significant hyperdynamic changes in these parameters were noted. On the other hand, transient hyperdynamic changes occurred in the systemic circulation during the period from the fourth to the sixth day after portal-branch ligation, similar to those observed in the portal vein-constricted rats. The lack of hyperdynamic changes in the portal territory of the portal branch-ligated rats suggests that the splanchnic hyperemia found in chronic portal-hypertensive states is unlikely to be caused by a feedback mechanism from the ischemic hepatic parenchyma.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1977

Morphologic, biophysical, and biochemical consequences of ligation of the common biliary duct in the dog.

Common biliary ducts of 32 adult mongrel dogs were ligated for a period of 2 days to 6 weeks. Sham-operated animals served as controls. Bile ducts were removed at sacrifice, and biophysical, morphologic, and biochemical parameters were measured. Our study shows that biliary duct ligation results in an immediate increase of intraductular pressure and is followed quickly by significant increase in the rate of collagen synthesis and the activity of prolyl hydroxylase. Histologic data show subepithelial inflammation followed by marked increases in periductular fibrosis. This fibroproliferative response is paralleled by peak levels of prolyl hydroxylase activity at 2 weeks prostligation. Paradoxically, bile ducts continuously distend throughout the ligation period despite increased fibroplasia. We present here the first topographic (SEM) study of normal and ligated common bile duct epithelium. Following 2 weeks of ligation large crater-like fenestrae are seen ductular epithelial surfaces. This is followed by focal epithelial sloughing. We speculate that the continuous distention and epithelial necrosis seen in the present study may be due to biliary stasis and/or subepithelial infiltration of bile through epithelial fenestrae. This hypothesis is supported by our studies which show that collagen extractibility is markedly increased by the addition of bile to the homogenate.

Animals↗
PubMed1995

Supplemental oxygen during endoscopic variceal ligation: effects on arterial oxygenation and cardiac arrhythmia.

OBJECTIVES: Endoscopic variceal ligation may affect cardiopulmonary function. The aim of this study was to determine the effect of either nasal oxygen (2 L/min) or no oxygen on arterial oxygenation and cardiac arrhythmia during variceal ligation. METHODS: A prospective, endoscopy team-blinded, randomized, cross-over study (first session vs second session) was conducted in 30 cirrhotic patients undergoing variceal ligation. Oxygen saturation (SaO2) and cardiac arrhythmia were assessed by a pulse oximeter. In this study, 15 patients received supplemental oxygen in the first sessions, and 15 received oxygen in the second sessions. RESULTS: Oxygen desaturation (nadir SaO2 < 90%) occurred in 23% of patients breathing room air but was prevented by oxygen (p < 0.01), and the nadir SaO2 was significantly lower in patients breathing room air than in those receiving oxygen (93.2 +/- 0.7% vs 98.3 +/- 0.3%, p < 0.01). During the procedure, premature ventricular contraction was more frequently observed in patients breathing room air than in those receiving oxygen (14.0 +/- 3.2/h vs 5.4 +/- 1.5/r, p < 0.05). CONCLUSIONS: These data suggest that oxygen desaturation and cardiac arrhythmia are common in patients undergoing variceal ligation and that low flow nasal oxygen can alleviate these events. Supplemental oxygen is therefore advisable to avoid potential serious cardiopulmonary accidents in patients undergoing variceal ligation.

Administration, Intranasal↗
PubMedDate not supplied

[Prevention of hemorrhagic recurrences caused by rupture of esophageal varices, with endoscopic ligation. Prospective study of 50 patients].

OBJECTIVES: Endoscopic sclerotherapy is effective to prevent bleeding of oesophageal varices but is associated with frequent adverse effects. Endoscopic ligation represents a new endoscopic alternative treatment to sclerotherapy. The purpose of this study was to assess efficacy and safety of endoscopic variceal ligation in 50 consecutive patients with cirrhosis who had recently bled from oesophageal varices. METHODS: Patients were followed from 6 to 1140 days (median 310 days). Nine patients were bleeding actively when ligation was performed. RESULTS: Eleven patients (22%) had 13 recurrent bleedings requiring blood transfusion during follow-up. Six recurrences occurred during the first month (3 from bleeding varices, 3 treatment-induced); seven recurrences occurred latter (6 from bleeding varices, 1 treatment-induced). Varices were eradicated in 33 patients (66% of all patients, 82% of patients who survived more than 30 days). Variceal eradication was achieved in 2-9 endoscopic ligation sessions (median 3). Eighteen patients died during the study; one died from bleeding. No patient developed major complications; five patients only complained of mild dysphagia for 24 to 48 hours. CONCLUSION: Endoscopic ligation is a safe and effective method to prevent recurrent bleeding from oesophageal varices.

Endoscopy↗