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PubMed1989

Effects of bile duct ligation and dietary change on hepatic carbohydrate metabolism in rats.

Effects of bile duct ligation and dietary change on hepatic carbohydrate metabolism in rats were studied by analyzing the levels of fructose 2,6-bisphosphate (fructose-2,6-P2) and other metabolites. There was no significant difference in the levels of fructose-2,6-P2 and glycolytic intermediates between rats with and without bile duct ligation when rats were in a fed state. However, the levels of fructose-2,6-P2, hexose monophosphates, and triose phosphates increased and the level of plasma glucose decreased in rats with bile duct ligation in a starved state. The crossover analysis of gluconeogenic intermediates in rats with bile duct ligation showed accumulations of hexose monophosphates together with fructose-2,6-P2 in spite of the starved state of rats, indicating an impaired conversion of glucose 6-phosphate to glucose. Despite the activation of the fructose 6-phosphate-fructose 1,6-bisphosphate futile cycle as indicated by these findings, the energy charge levels were not reduced. The block at the level of glucose production may explain the relative predominance of insulin effect on glycolysis.

Adenine Nucleotides↗
PubMedDate not supplied

Surgical ligation of patent ductus arteriosus in a neonatal intensive care setting is safe and cost effective.

The physiological and biochemical status of two groups of neonates with patent ductus arteriosus (PDA) requiring surgical ligation were compared. One group (n = 14) had ductus ligation in the operating room (OR) and the other group (n = 14) had the same operation in an isolation room in the Neonatal Intensive Care Unit (NICU). The groups were closely matched in terms of gestational age and weight. Nursing time and disposable equipment savings were significantly different. We have confirmed that PDA ligation can be done safely in the NICU and is more cost efficient than ligation in the OR.

Cost-Benefit Analysis↗
PubMed1986

Invagination versus simple ligation of the caecal tip with reference to the strength of the caecal closure. An experimental study in the rat.

In an experimental model using the rat, the role of invagination and double invagination for efficient closure of the caecum was studied. A standardized opening of the tip of the caecum was closed in three different ways, thus placing the animals in three groups. I: Closed with simple ligation. II: Closed with simple ligation and a purse-string suture invagination. III: Closed with simple ligation and a purse-string suture and a Z-suture causing double invagination. The caecum was filled with methylene blue and obstructed by a balloon catheter introduced via a caecostomy. Pressure inside the obstructed caecum was measured through a channel opening at the tip of the catheter. The pressure was increased with 4 cm of water every 10 minutes. The maximal pressure reached before leakage of methylene blue from the caecal closure or a drop in pressure in the lumen, was seen to be significantly higher in the groups with invagination and double invagination of the caecal closure, respectively, when compared with those with simple ligation only. The experimental data suggest that the invagination is important for secure closure of the caecal wall.

Animals↗
PubMed1986

High ligation or embolization of varicocele.

The presence of a varicocele was confirmed in 121 of 123 patients complaining of scrotal pain or infertility, in whom radionuclide scanning was performed. In the first 29 patients (retrospective study), a high ligation of the internal spermatic vein was performed. In 94 patients, a percutaneous venography was done via the jugular vein followed by embolization by Gianturco coils (occluding spring embolus, Cook Group Company, USA) in 84 of them. In eight patients, due to technical difficulties during the embolization trial, a high ligation was performed at a later date. Eleven patients underwent embolization after failed high ligation. A posttreatment follow-up radionuclide study revealed recurrences in two of the 95 patients who underwent embolization. Embolization can be performed on an outpatient basis with minimal risks. Reembolization is feasible, and it in no way prevents a further high ligation should this be necessary.

Adolescent↗
PubMed1986

Caval ligation versus clipping to counteract pulmonary embolism.

In 1967-1983 31 patients underwent surgical interruption of the inferior vena cava (IIVC) with ligation, and in 1984-1985 five patients were treated by IIVC with clipping (Adams-de Weese clip). The early adverse effects in the legs and complications were studied, and all five IIVC patients with clipping underwent isotope phlebography. The most serious early complication was sudden death on the 9th postoperative day after ligation. In one half of the affected legs moderate or severe oedema was found after the ligation. After clipping early adverse effects in the legs were minimal, and isotope phlebography showed an open inferior vena cava in all cases; only in one patient were collateral veins found past the inferior cava. It is concluded that when IIVC is indicated clipping is the optimal surgical method. IIVC with ligation is indicated only in septic embolism.

Adult↗
PubMed1986

Sertoli cells and various types of multinucleates in the rat seminiferous tubules following temporary ligation of the testicular artery.

The effects of temporary ligation of the testicular artery have been analysed in rats with respect to Sertoli cells and multinucleated spermatogenic cells. The first cells to show ultrastructural changes are the Sertoli cells which progressively degenerate, leading to complete necrosis as the duration of ligation and post-ligation survival interval increases. The degree of degeneration of spermatogenic cells depends on the severity of Sertoli cell destruction. Temporary ligation of the testicular artery causes the formation of various types of multinucleated spermatogenic cells in the seminiferous epithelium. The mechanisms involved in the multinucleate formation are cell fusion, karyokinesis devoid of cytokinesis and phagocytosis. The variety of noxious agents causing formation of multinucleated spermatogenic cells in the seminiferous tubules of a number of species including man implies that the occurrence of multinucleated spermatogenic cells is not a specific response of the testis to a particular type of agent.

Animals↗
PubMed1979

Pancreatic duct ligation in the therapy of chronic pancreatitis.

Total ligation of the pancreatic ducts of a normal gland in dogs and man results in atrophy of the acinar cells with preservation of islet cell function. Theoretically, this might be applied in the therapy of chronic pancreatitis since, in effect, an exocrine pancreatectomy results. Sustained islet cell function, as evidenced by a normal glucose tolerance test, following pancreatic duct ligation, was demonstrated in dogs for periods of up to two years. Resection of the head of the pancreas and ligation of the distal gland in six patients with chronic pancreatitis and an abnormal glucose tolerance test resulted in the development of insulin-dependent diabetes in all instances. Insulin-dependent diabetes was also demonstrated in one patient with a normal preoperative glucose tolerance test. Recurrent pancreatitis developed in only one patient. The study suggests that pancreatic duct ligation is effective in treating chronic pancreatitis but casts considerable doubt on the effectiveness of this procedure in preventing the development of diabetes, if the glucose tolerance test is abnormal

Adult↗
PubMed1985

The efficacy of internal iliac artery ligation in obstetric hemorrhage.

During 1966 to 1982, 18 patients with severe obstetric hemorrhage underwent hypogastric artery ligation at our institution. Eight of 14 patients or 57 per cent (excluding three pregnancies which were terminated and a planned cesarean hysterectomy) had failed hypogastric artery ligations necessitating hysterectomy. Placenta accreta accounted for six patients of whom three required a hysterectomy. Uterine laceration was the second largest cause of hemorrhage in five patients, all of whom required a hysterectomy after hypogastric artery ligation failed. Hypogastric artery ligation does have a specific role in the management of obstetric hemorrhage, but it is not without substantial risk of failure. The obstetrician should carefully weigh whether or not the patient can undergo a more conservative procedure at the expense of a delay in the definitive treatment of hemorrhage. The instances presented herein should aid the clinician in deciding what is appropriate management for acute obstetric hemorrhage.

Acute Disease↗
PubMed1985

Hypogastric artery ligation for obstetric hemorrhage.

Ligation of the hypogastric arteries has been recommended for control of obstetric hemorrhage. However, specific information regarding its effectiveness is lacking. The hospital charts of 19 patients undergoing bilateral hypogastric artery ligation for the control of otherwise intractable obstetric hemorrhage were reviewed. Indications included uterine atony (15), lateral extension of a low-transverse uterine incision (three), and placenta accreta (one). This procedure was effective in controlling bleeding in eight of 19 patients (42%). Hysterectomy was necessary in the remaining 11 patients. In these patients, blood loss, operating time, and intraoperative morbidity was increased when compared with a group of 59 patients undergoing emergency hysterectomy for obstetric hemorrhage without prior ligation of the hypogastric arteries. Surgical approaches to hypogastric artery ligation are discussed.

Arteries↗
PubMed1986

The interrelationships between the lipid peroxidation, superoxide dismutase activity, development of gastric H+ secretion and gastric mucosal damage produced by intragastric administration of aspirin in pylorus-ligated rats.

Gastric mucosal damage of pylorus-ligated rats was induced by the intragastric administration of aspirin at 200 mg/kg at the time of ligation. The animals were sacrificed at 0, 1, 2, 3, and 4 h after the treatment. The gastric lesions (ulcers) were counted and their severities were calculated, and the volume of gastric secretion and the H+ output were measured. The extent of lipid peroxidation was assessed by measuring the malondialdehyde (MDA) in the gastric mucosa, simultaneously with measurement of the activity of superoxide dismutase (SOD). It was found in these pylorus-ligated rats that: the number of visible gastric lesions was significantly higher 1 h after aspirin administration than at other times; the severity of gastric lesions increased significantly at the 3rd and 4th hour after administration of aspirin; the volume of gastric secretory responses increased gradually after administration of aspirin and to a higher extent than the H+ output; the H+ output was significantly less after aspirin administration than that after pylorus ligation only; the gastric mucosal SOD activity significantly increased 1 h after administration of aspirin, decreasing significantly and gradually thereafter; the tissue level of MDA remained unchanged 1 h after aspirin administration, decreasing significantly thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Consequences of complete bile-duct ligation on the pubertal process in the male rat.

Prepubertal male rats underwent bile-duct ligation or a sham operation. Sham-operated animals were divided into two groups: isocalorically-fed (matched to the bile-duct-ligated animals) and ad-libitum-fed animals. At 60 days of age (after puberty in a male rat) all animals were killed. Bile-duct-ligated animals had larger livers, greater bilirubin, greater bile acid, greater aspartate transaminase, and greater alkaline phosphatase levels and lower testosterone and luteinizing hormone levels in their serum than did the controls. Moreover, the testes and seminal vesicles were smaller in the bile-duct-ligated animals than in the controls. These data suggest that chronic cholestasis contributes, at least in part, to the pubertal and maturational failure that occurs with the chronic cholestatic diseases of childhood.

Animals↗
PubMed1985

Assessment of splenic function in dogs following arterial ligation and autotransplantation.

Two methods for the preservation of splenic function following trauma to the spleen were studied and compared in dogs and puppies. One method was splenectomy and autotransplantation of small pieces of splenic tissue, and the other--ligation of the main branches of the splenic artery after partial splenectomy. Dogs subjected to splenectomy alone or laparotomy alone served as controls. Splenic function was assessed on the basis of resistance to sepsis by virulent pneumococci. Cultures were obtained from the blood, peritoneal fluid and intraabdominal organs 3 days after i.v. injection of the pneumococci; none of the adult dogs in any of the groups had positive cultures. Among splenectomized puppies, 55.5% had positive cultures for pneumococci, whereas those which underwent ligation of the splenic artery and partial splenectomy had negative cultures. Microscopic examination of the autotransplants revealed loss of the characteristic structure of splenic tissue, whereas in the dogs in which the splenic artery had been ligated, the spleen showed numerous islands of tissue with well-preserved follicular structure. We suggest that in children with severe splenic trauma, ligation of the splenic artery may provide a promising alternative to splenectomy.

Animals↗
PubMed1979

Traumatic injuries of the portal vein. The role of acute ligation.

Injuries to the portal vein are rare but have a high risk with a mortality of 50--70% secondary to exsanguinating hemorrhage. When managing injuries to the portal vein, lateral venorrhaphy, end to end anastomosis, or an interposition graft should be attempted whenever possible. However, in a hemodynamically unstable patient or when confronted with a nonreconstructable injury, acute portal vein ligation may be the procedure of choice as it is safely tolerated in some 80% of patients. Of eleven reported patients in whom the portal vein was ligated acutely for traumatic injury, six survived. Four of the nonsurvivors died of massive associated injuries. Of the six surviving patients, five tolerated acute ligation of the portal vein without complication. Should portal vein ligation be performed a "second look" operation is essential in 24 hours to examine the bowel for viability. A portosystemic shunt with its inherent complications should not be done as a primary procedure when attempts at reconstruction of the portal vein have failed. Shunting should be reserved for those few patients who develop stigmata of portal hypertension or impending infarction of the bowel.

Abscess↗
PubMed1979

Changes in the main submandibular salivary duct of rabbits resulting from ductal ligation.

Normal submandibular ducts from rabbits have been examined by mucosubstance histochemistry, transmission and scanning electron microscopy. The results were compared with the appearances of ducts removed 4...6 weeks after ligation. The normal ducts were composed mainly of columnar "light" cells and basal cells but, in addition, some "dark" cells and scattered goblet containing sulphated mucins were always present. The luminal surface of the ductal cells possessed numerous microvilli protruding into the lumen, and a rim of negatively charged mucin was present on this surface of these cells. After ligation the ducts became greatly distended by their fluid contents which remained under pressure until the duct was incised. The epithelial cells were flattened and appeared to contain less cytoplasm per cell; "light" cells, basal cells and "dark" cells were still recognisable. Goblet cells were much more plentiful than in the control ducts and often protruded into the lumen despite the increased intraluminal pressure. The development of a number of ciliated cells had also occurred and they were often situated close to goblet cells. Lymphatic vessels were more prominent around the ligated ducts. Luminal microvilli were less numerous than in the control ducts but the rim of negatively charged mucin on the luminal surface of ductal cells was more conspicuous. Mixed inflammatory cells were present within the lumina of ligated ducts especially in those parts adjacent to the ductal cells. No inflammatory cell has been observed passing through the wall of a main duct and the possibility exists that these cells had entered lumina within the gland and migrated from there to the main duct. The above findings may serve to help our understanding or physiological events in the ducts.

Animals↗
PubMedDate not supplied

Pirmenol hydrochloride (CI-845): antiarrhythmic profile in coronary artery ligated conscious dogs.

The antiarrhythmic profile of CI-845 (pirmenol hydrochloride) was assessed in conscious, coronary artery ligated dogs. In single-dose studies in these arrhythmic dogs, CI-845 administered by the intravenous, intranuscular, and oral routes was highly effective in restoring normal sinus rhythm. A 2.5 mg/kg dose was effective against the arrhythmias occurring on the second day after ligation, while 5 mg/kg was effective against the higher-rate arhythmias of the first day after ligation. The reference agents ajmaline, aprindine, disopyramide, lidocaine, mexiletine, procainamide, and quinidine were also tested, and in this model, CI-845 had greater efficacy, a longer duration of activity, and/or a wider safety margin. In slow rate intravenous infusion studies, 1-2 mg/kg/hr of CI-845 maintained near total arrhythmia conversion in first-day postligation dogs. Rapid rate intravenous infusion studies (10 mg/kg/hr) demonstrated a good correlation between the CI-845 dose, plasma level, and arrhythmia conversion, as well as a wide margin of safety. Mean conversions to 80% normal rhythm were achieved at 2.5 mg/kg, with associated plasma levels of 0.8 +/- 0.1 micron/ml, while first sings or gross toxicity occurred at 21.7 +/- 2.4 mg/kg at plasma levels of 6.2 +/- 0.4 micron/ml. There were minimal effects on cardiac conduction and blood pressure even at large doses. In drug interaction studies, CI-845 was safe and effective in combination with disopyramide, lidocaine, procainamide, propranolol, and quinidine. The results clearly show CI-845 to be an orally effective, long-acting antiarrhythmic agent with a favorable margin of safety in the coronary artery ligated dog model.

Administration, Oral↗
PubMed1980

Effect of coronary artery ligation on the pharmacokinetics of N-acetylprocainamide in dogs.

The effect of ligation of the left anterior descending and septal coronary arteries on the distribution of N-acetylprocainamide (NAPA) was studied in 13 mongrel dogs. The animals received a rapid i.v. infusion of 20 mg/kg NAPA.HCl. In 6 dogs the arteries were ligated simultaneously 10 min after administration of the drug. The other dogs received the same dose without anesthesia or surgery and served as control. Coronary ligation procedure resulted in a significantly higher initial plasma concentration of NAPA, presumably because of a significant decrease in the apparent volume of central compartment. The biologic half-life, the apparent volume of distribution and the total clearance of the drug remained unchanged in both groups of animals. The results of this study suggest that while the pharmacokinetics of elimination of NAPA remain unchanged, the distribution and the effective plasma concentration might be altered by the coronary ligation procedure under anesthesia.

Acecainide↗
PubMed1980

[Characteristics of development of collateral vessels after experimental ligation of the femoral artery under conditions of venous insufficiency].

Isolated ligation of the femoral artery and its combined ligation with the vein was performed in experiments on 62 dogs. Anatomical and physiological methods were used. It was stated that at the combined ligation collaterals developed sooner, number of anastomoses in muscles of the femoral posterior osseous-fascial case was greater, and their lumen was wider than at the isolated ligation of the femoral artery. However, the combined arterio-venous insufficiency was followed by a more severe postoperative course and noticeable biochemical disturbances. Thus, a certain discrepancy between the development of collaterals and the function of the tissue they feed was revealed. Analysing the data obtained it is possible to conclude that venous insufficiency, despite accelerating the transformation of the collaterals as a whole, aggravates conditions for collateral arterial circulation in the extremity.

Animals↗
PubMed1981

Indications for cholecystectomy in ligation of the hepatic artery.

Ligation of the hepatic artery has been successfully used in the management of massive bleeding, secondary to hepatic trauma, and in the treatment of metastatic neoplastic disease. The indications for a concomitant cholecystectomy are less well defined. It is generally accepted that cholecystectomy should be performed when ligation is used to control bleeding. In our study, ligation of the hepatic artery was performed, leaving the gallbladder in situ. At autopsy, no pathologic process could be detected in the gallbladder. Microscopic analysis showed fibrosis in the mucosal surface, mild chronic inflammation and nonspecific mononuclear infiltration. We conclude that the changes are insufficient to warrant the removal of a normal gallbladder when ligation of the hepatic artery is performed as treatment for neoplastic disease.

Adult↗