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PubMed1997

Unilateral vitelline vein ligation alters intracardiac blood flow patterns and morphogenesis in the chick embryo.

To study the role of blood flow in normal and abnormal heart development, an embryonic chicken model was developed. The effect of altered venous inflow on normal intracardiac blood flow patterns was studied by visualization of blood flow with India ink. At stage 17, India ink was injected into a capillary or small venule within a specific yolk sac region. After determination of the normal intracardiac flow pattern, the right lateral vitelline vein was ligated, and the new intracardiac flow pattern was studied. Ligation resulted in disturbance of normal intracardiac flow patterns, which was most obvious in the conotruncus. The long-term effect of these abnormal intracardiac flow patterns on the development of the heart and pharyngeal arch arteries was investigated by permanent ligation in ovo with a microclip at stage 17 and subsequent evaluation at stages 34, 37, and 45. These experiments revealed anomalies of the vascular system in 58 of the 91 ligated embryos studied. We observed intracardiac malformations consisting of subaortic ventricular septal defects (n = 52), semilunar valve anomalies (n = 19), atrioventricular anomalies (n = 7), and pharyngeal arch artery malformations (n = 32). It is concluded that abnormal intracardiac blood flow, resulting from hampered venous inflow, may result in serious intracardiac and pharyngeal arch artery malformations comparable to defects observed in embryonic chicken models subjected to neural crest ablation, cervical flexure experiments, and excessive retinoic acid treatment.

Animals↗
PubMedDate not supplied

Effect of carotid artery ligation and infusion of fluosol FC-43 emulsion on brain surface oxygen tensions.

In eight rabbits, the common carotid artery was ligated and multiple estimations of brain surface oxygen tension performed using a seven barrelled mini-electrode. In five rabbits ligation of the carotid artery resulted in impairment of cortical oxygenation. The remaining three rabbits showed no impairment in the supply of oxygen to the cerebral cortex after carotid occlusion. In the five rabbits who displayed a reduction in oxygen supply after carotid ligation, ventilation with 33% oxygen after the infusion of 15 ml/kg of Fluosol FC-43 produced an improvement in cortical oxygenation in only three of the five rabbits. When these animals were ventilated with 100% oxygen after carotid ligation and Fluosol infusion, oxygen supply in all five was commensurate with or greater than that during control conditions.

Animals↗
PubMedDate not supplied

Carotid ligation in gerbils. Influence of age, sex, and gonads.

The ill effects of carotid artery occlusion or ligation vary in man and experimental animals according to surgical techniques, environmental conditions, diet, stress, sex, age, strain of the animal, blood pressure, the state of cardiopulmonary system, and other diverse factors. Unilateral carotid artery ligation in most small laboratory animals is an innocuous procedure. The gerbil, a desert rat, has been found to be quite sensitive to unilateral carotid artery ligation. The present experiments were designed to study the influence of age, sex, and castration on end results of the unilateral carotid artery ligation in gerbils. It appears that the young animals prior to sexual maturity and the sexually mature female are more resistant than the sexually mature male. This difference is assumed to be due to the influence of the gonads on the blood flow of the brain.

Age Factors↗
PubMed1998

Endoscopic ligation of the internal maxillary artery for treatment of intractable posterior epistaxis.

Lack of universal success with both transantral ligation of the internal maxillary artery and percutaneous embolization of the distal branches of the internal maxillary distribution has led to consideration of alternative techniques to control intractable posterior epistaxis. One such technique takes advantage of advances in endoscopic technology and instrumentation, as well as a nearly constant anatomic configuration. The internal maxillary artery divides into terminal branches within the pterygomaxillary fossa, sending branches through the bony maxilla to exit the posterolateral nasal wall in the posterior aspect of the middle meatus. Endoscopic identification and ligation of these terminal branches of the internal maxillary artery (the sphenopalatine and nasopalatine arteries) as they exit the maxilla has been performed on 10 patients with a 100% success rate and no morbidity or mortality associated with the procedure. These results compare favorably to the average reported success rates of 89% for transantral ligation and 94% for percutaneous embolization, and average complication rates of 28% and 27%, respectively. This endonasal procedure has been performed for spontaneous epistaxis as well as postsurgical nasal bleeding with equal success. The ascending scale of treatment previously outlined in the literature may be amended, as a potentially definitive procedure is available, and we believe that this technique is easier to perform, has less associated morbidity, and has equal efficacy in comparison to transantral ligation or percutaneous embolization in the treatment of intractable posterior epistaxis.

Adult↗
PubMed1993

Responses of cerebral blood volume and oxygenation to carotid ligation and hypoxia in young rabbits: near-infrared spectroscopy study.

After ligation of the bilateral common carotid arteries with exposure to hypoxia in young rabbits, cerebral blood oxyhemoglobin, deoxyhemoglobin, and total hemoglobin were measured by near-infrared spectroscopy. Ligation of common carotid arteries decreased oxyhemoglobin, increased deoxyhemoglobin, and slightly decreased total hemoglobin. Exposure to hypoxia with bilateral carotid ligation more remarkably decreased oxyhemoglobin and increased deoxyhemoglobin than that without carotid ligation. However, the total cerebral blood volume did not change very much. This marked reduction in the cerebral oxygenation may cause brain damage and may be an important monitoring marker for the prevention of hypoxic-ischemic encephalopathy.

Animals↗
PubMedDate not supplied

Treatment of varicose veins: proximal saphenofemoral ligation comparing adjunctive varicose phlebectomy with sclerotherapy at a military medical center.

There is no consensus as to the single best approach to the treatment of varicose veins. There has been a trend toward less invasive procedures to reduce the number of incisions and provide more selective ablation of varicosities. Ultimately, therapeutic decisions have depended on surgeon preference and the patient population. The active duty military population presents a unique challenge in the treatment of varicose veins. This mobile and active population requires a treatment method that provides maximum relief with the lowest possible morbidity and rapid recovery. The authors previously reported their experience with 104 patients who underwent saphenofemoral ligation combined with perforator point ligation and staged sclerotherapy. This group was compared to 103 patients who underwent saphenofemoral ligation, point perforator ligation, and stab avulsion phlebectomy as a single procedure. Follow-up for the sclerotherapy group included patient satisfaction surveys and documentation of recurrent varicosities. All ambulatory phlebectomy patients responded positively with respect to symptomatic and cosmetic results. Overall satisfaction was favorable and there was no significant difference in patient satisfaction between the ambulatory phlebectomy and sclerotherapy groups. Twelve per cent of the sclerotherapy patients developed true recurrences or new varicosities compared to 11% in the ambulatory phlebectomy group. The most common complication was superficial thrombophlebitis (20% ambulatory phlebectomy, 16% sclerotherapy) which was mild in all cases. All but three patients in the ambulatory phlebectomy group returned to work within 7 days and 75% returned to full duty within 72 hours. Completion of therapy was accomplished in a much shorter period for the ambulatory phlebectomy group. Overall patient satisfaction was achieved for both ambulatory phlebectomy and sclerotherapy patients. Completion of therapy was achieved in a shorter period with fewer clinic visits in the ambulatory phlebectomy group and this has become our procedure of choice for active duty military patients.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Left renal vein reconstruction after right nephrectomy and inadvertent left renal vein ligation: a case report and review of the literature.

Left renal vein ligation has been used as a technical aid to gain exposure to the perirenal aorta and to control bleeding in abdominal aortic operations. Left renal vein ligation is considered to be well tolerated in patients with 2 functioning kidneys, but has rarely been described in the setting of concomitant right nephrectomy and presents a management challenge. Some reports suggest recovery of renal function may be possible after left renal vein ligation during right nephrectomy, but other suggest that a delay in revascularizing the left renal venous drainage may result in irreversible nephropathy. This article reports the inadvertent division of the left renal vein during right nephrectomy. Renal failure ensued postoperatively. The left renal vein was reconstructed, and renal function was recovered. The inability to reliably predict which patients will have adverse outcome after left renal vein ligation in the setting of a right nephrectomy may necessitate preemptive intervention.

Adult↗
PubMed1989

Ligating the ductus arteriosus before birth causes persistent pulmonary hypertension in the newborn lamb.

We determined whether closing the ductus arteriosus of the fetal lamb several d before birth would cause persistent pulmonary hypertension after birth. Six experimental fetuses who had their ductus arteriosus ligated 3-17 d before delivery, three control fetuses who had sham ligation of the ductus arteriosus 14 d before delivery, and six control fetuses who had no prenatal surgery were delivered by cesarean section between 138 and 144 d of gestation. Each was instrumented to measure pulmonary and systemic arterial pressures and pulmonary blood flow. Each newborn lamb was ventilated with room air during the first 45 min after birth and then with decreasing amounts of inspired oxygen from 100 to 9%. Pulmonary arterial pressure decreased significantly when ventilation was begun in the control lambs but not in the lambs who had their ductus arteriosus ligated before delivery. Throughout the experiment, pulmonary arterial pressure and total pulmonary resistance were significantly higher, and pulmonary blood flow was significantly lower in the lambs who had their ductus arteriosus ligated before delivery. In two of them, pulmonary arterial pressure was greater than or equal to systemic arterial pressure, even during ventilation with 100% oxygen. This animal preparation provides a method of investigating persistent pulmonary hypertension in the newborn lamb and may provide insight into an etiology of the syndrome of persistent pulmonary hypertension of the newborn.

Animals↗
PubMed1990

Uterine artery ligation in the maternal rat alters fetal tissue glucose utilization.

We studied the effects of maternal uterine artery ligation on fetal rat tissue glucose utilization (GU). Unilateral uterine artery ligations were performed on the 19th d of gestation (term 21.5 d) and 2-[3H]deoxy-D-glucose was used to measure GU of placenta, liver, brain, muscle, kidney, and heart from fetuses in the ligated (IUGR) and nonligated (control) uterine horns 24 and 48 h after the procedure. At both periods, IUGR fetuses weighed significantly less and had lower fetal/maternal plasma glucose ratios than controls. Twenty-four h after ligation, placenta, liver, brain, and muscle from IUGR fetuses had lower relative GU rates than corresponding tissues from control fetuses (p less than 0.01-0.05). However, at 48 h, IUGR liver, muscle, kidney, and heart had higher relative GU rates than control tissues (p less than 0.01-0.05). The lower GU of IUGR fetal tissues observed at 24 h postligation was likely related to the acute decrease in fetal glucose availability. Other factors, such as hypoxemia and acidosis, that affect cellular metabolism may also have led to lower GU rates. The increase in GU by IUGR tissues at 48 h occurred despite a persistence of low fetal glucose concentrations and can be explained by either: 1) an attempt by IUGR fetal tissues to compensate for the persistently low plasma glucose; 2) an increased demand for metabolic fuel for repair processes; or 3) a less efficient use of glucose due to alterations in cellular respiration. We speculate that this increase in fetal tissue GU may be partially responsible for the supranormal glucose requirements seen in small-for-gestational-age newborns.

Animals↗
PubMed1981

Neuroma formation and prevention by fascicle ligation in the rat.

Light and electron microscopic studies of the cut sciatic nerve in the rat showed typical neuroma formation. If the nerve was cut and the proximal segment was ligated as a whole, the neuromatous process appeared to be even more severe than that in the simply cut nerve. When the perineurium of the cut nerve was kept intact by fascicle ligation, the axonal regenerative process seemed to be altered significantly, and less neuroma formation occurred. The mechanism by which fascicle ligation limits axonal regeneration is unknown, but could involve peripheral as well as central mechanisms. Such a limitation of neuroma formation by fascicle ligation as was found in the rat might also apply to painful human neuromas.

Animals↗
PubMed1983

Extracranial-intracranial arterial bypass and basilar artery ligation in the treatment of giant basilar artery aneurysms.

Two patients with giant aneurysms of the basilar artery treated with prophylactic extracranial-intracranial arterial bypass (EIAB) to the rostral brain stem before basilar artery ligation are presented. In both cases, the bypass provided considerable collateral flow to the upper basilar, posterior cerebral, and superior cerebellar arteries. Basilar artery ligation has been shown to be an effective, albeit dangerous, means of treating giant aneurysms of the basilar artery. The risk of significant brain stem ischemia after ligation is at least 30%. EIAB to the rostral brain stem should be considered whenever basilar artery ligation is performed, especially in cases where angiography demonstrates poor collateral circulation to the distal basilar artery.

Aged↗
PubMed1991

Transcytotic vesicular carriers for polymeric IgA receptors accumulate in rat hepatocytes after bile duct ligation.

In rat hepatocytes, transcytotic vesicular carriers transport the mature 120 x 10(3) Mr form of the polymeric IgA receptor (pIgA-R), with or without its ligand, pIgA, from the sinusoidal to the biliary plasmalemma, where the ectodomain of the receptor is cleaved to produce an 80 x 10(3) Mr fragment that is secreted into the bile. Here we show that cholestasis induced by bile duct ligation results in the accumulation of transcytotic carriers, identified by the 120 x 10(3) Mr pIgA-R and pIgA, in the pericanalicular cytoplasm of hepatocytes. To determine the extent of pIgA-R accumulation, hepatic total microsomes (TM) were prepared from control and cholestatic rats. Solubilized TM proteins were separated by SDS-PAGE and receptor forms were detected by immunoblotting and autoradiography. Quantitative densitometry of these autoradiograms showed that after duct ligation the 120 x 10(3) Mr receptor accumulated to a level approximately threefold higher than the control. Concomitantly, immunologically related, novel 124, 90 and 80 x 10(3) Mr proteins (cholestatic antigens) became detectable. Immunoblot analyses of biliary and serum proteins showed that cholestasis resulted in: (1) a marked decrease in the concentrations of the 80 x 10(3) Mr receptor and pIgA in the bile, whereas albumin concentrations remained at control levels; and (2) a marked increase in the concentration of the 80 x 10(3) Mr receptor in the serum. Positive sites for pIgA-R were localized to the pericanalicular cytoplasm of hepatocytes by indirect immunofluorescence on semithin frozen sections in cholestatic hepatocytes. The sites were more numerous and the positive signal stronger than in controls. One day post-ligation, pIgA-positive sites were located to the same pericanalicular cytoplasm of hepatocytes; by three days, however, most pIgA appeared in sinusoidal endothelia and Kupffer cells. To validate the vesicular character of the receptor-positive sites, sham-operated and cholestatic livers were processed for either transmission electron microscopy (TEM) or immunogold localization of receptors on thin frozen sections. TEM verified the accumulation of pericanalicular vesicles in cholestatic hepatocytes. Immunogold tests localized pIgA-R to pleiomorphic, pericanalicular vesicles, which were increased in number, size and concentration of antigenic sites in cholestatic hepatocytes. These findings indicate that bile duct ligation provides a method for manipulating the in vivo transcytotic pathway and for accumulating previously unstudied transcytotic carriers in hepatocytes.

Animals↗
PubMed1995

Pharmacokinetics of theophylline: effects of hepatic fibrosis in rats induced bile duct ligation.

This experiment was performed to evaluate the usefulness of an experimental fibrosis model by bile duct ligation as a pharmacokinetic model of a disease state. First, experimental liver fibrosis was produced by bile duct ligation. At 4 weeks postoperation, a fibrotic condition was characterized by measurement of the aminoterminal procollagen type III peptide (PIIINP) level in serum, total collagen content in liver and light microscopic histology. Four weeks after bile duct ligation there was an increase in total collagen content of the liver to 430% of the initial values, accompanied by an increase of serum-PIIINP (385%). Secondly, we examined the pharmacokinetics of theophylline in the fibrotic rat induced by bile duct ligation. An i.v. dose of 8 mg of theophylline per kg of body weight was administered, and the levels of theophylline in serum were assayed by high performance liquid chromatography. The area under the serum concentration-time curve of theophylline was increased significantly in fibrotic rats compared with that of the control, and the total clearance of drug in fibrotic rats was low, averaging 22.6 mg/kg/h vs. 36.1 and 60.9 ml/kg/h in the control and the normal rat, respectively. However, the value of distribution during the beta-phase was not significantly affected by experimental liver fibrosis.

Alanine Transaminase↗
PubMed1979

Rate related block in the canine His-Purkinje system after ligation of the anterior septal artery--observation by His bundle electrocardiography.

In order to investigate the pathophysiology of tachycardia and bradycardia dependent block in the His-Purkinje system, anterior septal artery was ligated and the effects of vagal stimulation and atrial pacing were serially checked in 26 dogs. Tachycardia dependent intra-His bundle block or H-V blocks developed in all cases following ligation of the anterior septal artery and bradycardia dependent block ensued in 3 cases. The latter appeared only in the form of split His bundle or lengthening of the H-V intervals. Spontaneous second or third degree AV block appeared thereafter. Bundle branch block appeared in 19 cases after ligation of the artery. Rate dependent bundle branch block was observed before the development of stable bundle branch block. Frequently, a very long pause was necessary to produce bradycardia dependent block. On the other hand, bradycardia dependent H-V blocks by vagal stimulation were not necessarily dependent upon cardiac cycle length alone. Tachycardia dependent paroxysmal A-V blocks were induced in 7 cases by atrial pacing, soon before or after the onset of spontaneous second degree A-V block. In addition, this block was induced in the very early phase after ligation of the artery in one case. This repetitive intra-His bundle block or H-V block was induced not only by progressive increase in pacing rate but also by gradual decrease in pacing rate after a Wenckebach type of second degree A-H block.

Animals↗
PubMed1978

Antiarrhythmic effect of oxprenolol on halothane-epinephrine and coronary ligation induced ventricular arrhythmias in beagle dogs.

Antiarrhythmic effects of oxprenolol, a beta-blocker, were studied quantitatively on arhythmias produced by epinephrine during halothane anesthesia and by two-stage coronary ligation, and were compared to those of other beta-blockers, propranolol and Kö 1400, which have been already reported. Though oxprenolol has potent beta-blocking activity, the antiarrhythmic effect on halothane-epinephrine arrhythmia was significantly weaker than those of propranolol and Kö 1400. The effective dose of oxprenolol was 60 +/- 18 microgram/kg (mean +/- S.E., N = 6), which is in the range of the so-called beta-adrenergic blocking dose. The weaker antiarrhythmic effect of oxprenolol as compared to propranolol and Kö 1400 is probably due to the intrinsic positive chronotropic effect, which is most clearly observed in oxprenolol as compared to the other two drugs. As for two-stage coronary ligation arrhythmia, oxprenolol suppressed only that observed 48 hours after coronary ligation using higher doses (5 to 10 mg/kg). Other beta-blockers also showed similar effects. Because of the high doses necessary for the antiarrhythmic effects on the coronary ligation arrhythmia, the mechanism for suppressing the arrhythmia is probably due to the local anesthetic action of the beta-blockers.

Adrenergic beta-Antagonists↗
PubMed1983

Effects of prostaglandins on late coronary ligation arrhythmias in the dog.

Effects of an intravenous injection of indomethacin, prostaglandins (PGs) E1, E2 and F2 alpha and prostacyclin were examined by the use of a model of two-stage coronary ligation arrhythmias in conscious dogs. Indomethacin had no effect on the arrhythmias occurring 48 hr after coronary ligation. PGs and prostacyclin were injected after the injection of indomethacin. PGs did not show any significant antiarrhythmic effects on the arrhythmias occurring 48 hr after coronary ligation, while prostacyclin showed a transient arrhythmogenic effect. From the foregoing results, both endogenous and exogenous PGs do not seem to play a significant role in the genesis of late coronary ligation arrhythmias in the dog.

Animals↗
PubMed1993

The influence of buprenorphine or bupivacaine on the post-operative effects of laparotomy and bile-duct ligation in rats.

The post-operative effects of laparotomy and common bile-duct ligation were investigated in rats. Bile-duct ligation caused a significant reduction in food and water consumption, body weight and locomotor activity in the immediate post-operative period. Animals which underwent laparotomy in which bile-duct ligation was not carried out (sham operated groups) had significantly less depression of food and water consumption and body weight than groups which underwent bile-duct ligation. The detrimental effects on food and water consumption and body weight could be significantly reduced by the administration of buprenorphine (0.05 mg/kg, s/c), but not by infiltration of the surgical wound with the long-acting local anaesthetic agent, bupivacaine. The reduction of the depressant effects of surgery on food and water consumption by the opioid analgesic buprenorphine suggests that some of these changes may be related to the presence of post-operative pain.

Animals↗
PubMed1990

Intraoral-extramaxillary sinus approach for ligation of the maxillary artery: an anatomic study with clinical correlates.

Surgical control of severe epistaxis is usually reserved for cases refractory to more conservative techniques. We present our experience with intraoral ligation of the maxillary artery as it courses through the buccal fat pad before it enters the pterygopalatine fossa and branches posterior to the maxilla. This technique has been found useful in the control of nasal hemorrhage as well as an adjunct to other surgical procedures, such as removal of benign and malignant neoplasms involving the maxilla and paranasal sinuses. This technique was used for ligation of the maxillary artery in 20 patients. The artery was readily identified in some cases, but required more extensive dissection in others; therefore, an anatomic study in 18 preserved and fresh cadaver specimens was undertaken to investigate the variability of the maxillary artery in the region of the buccal fat pad. There appeared to be significant variation in the distance from the buccal mucosal incision site, as well as variation in the relationship to the pterygoid muscles. This relationship to the pterygoids explains the occasional difficulty in locating the artery for ligation. This technique represents a reasonable alternative to the more traditional transantral approach to ligation of the maxillary artery, as long as the surgeon understands the anatomy of the region, its variations, and where the artery may be located if not immediately apparent. No major complications have been experienced.

Adult↗