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PubMed1983

Effects of ureteral ligation on renal medullary lesions of potassium depletion.

In diet-induced potassium depleted rats, tissue potassium content of the renal medulla decreases and membrane-bound droplets form in the cytoplasm of medullary cells. To elucidate the interrelationship between medullary potassium concentration and intracytoplasmic droplets, ligation of the left ureter was performed on rats deprived of potassium for 2 weeks. Our results show that, even in the absence of supplemental potassium provision to the animal, a unilateral rise in tissue potassium of the ligated left kidney was significant. After 4 days of ligation, the left medullary potassium was 41.96 +/- 0.79 mEq/100 g dry weight compared to 32.51 +/- 0.84 mEq/100 g dry weight (P less than 0.001) of medullary potassium in the non-ligated right kidney. The rise in tissue potassium in the left kidney coincided with the dissolution of intracytoplasmic droplets. We conclude, that mechanical obstruction to urinary flow can dissolve storage droplets in medullary cells and that the lysis of droplets is made possible by the increase in medullary tissue potassium content.

Animals↗
PubMed1978

Planned extra-anatomic cerebral revascularization for carotid artery ligation.

Cerebral revascularization, using extra-anatomic bypass grafts of autologous saphenous vein, was performed in three patients to prevent or to compensate for ischemic effects of emergency ligation of a carotid artery. These ligations were required after spontaneous disruption of common carotid arteries in patients with previous irradiation and radical head and neck surgery. External-carotid-to-external-carotid cross-over (submandibular) bypass graft was performed once, and ipsilateral axillointernal carotid bypass grafts twice. The role of infection in carotid artery rupture, the unpredictable nature and different mechanisms of cerebral malfunctions after carotid ligation, technical details of extra-anatomic bypass grafts, and anatomic considerations in the prevention of recurrent infection and bleeding are discussed. A planned approach of cerebral revascularization at the time of ligation appears to be preferable to a fortuitous outcome. Neurological disability and death from cerebral ischemia can be prevented by using extraanatomic bypass vein grafts.

Brain↗
PubMed1984

The effect of tubal ligation on the incidence of epithelial cancer of the ovary.

A retrospective review of 666 women who underwent tubal ligation between 1930 and 1969 in Alberta, Canada, was undertaken to assess the effect of tubal ligation on the incidence of ovarian cancer. Tubal ligation did not affect the risk of ulterior ovarian cancer except in women who underwent tubal ligation between the ages of 20 and 29. These women showed a slight but statistically significant (p = 0.03) increase in observed versus expected cases of ovarian cancer.

Adolescent↗
PubMedDate not supplied

Renal complications to left renal vein ligation in abdominal aortic surgery.

Postoperative renal complications have been investigated in 31 patients subjected to left renal vein ligation during abdominal aortic surgery (11 ruptured and 18 non-ruptured aneurysms, 2 occlusive diseases). A marked increase in s-creatinine values was found in all patients after left renal vein ligation. The increase was significantly longer (p less than 0.01) and higher (p less than 0.005) as compared with control patients subjected to abdominal aortic surgery without ligation of the left renal vein. A sustained increase in postoperative s-creatinine values was found in 6 patients, one of whom had a total loss of left kidney function. Left-sided nephrectomy was necessary in 2 patients to control bleeding from the kidney. Acute haemorrhagic infarction and subinfarction of the left kidney were seen in 2 patients. A restricted application of left renal vein ligation during abdominal aortic surgery is recommended.

Aged↗
PubMed1983

Incompetent perforating veins subfascial ligation as an important adjunct to venous surgery of the lower extremities: evaluation of surgical results.

The role of incompetent perforating veins in chronic venous disease is well established. The determination of hemodynamic alterations and perforating veins location is evaluated by physical examination, phlebography and ultrasonography. All patients with perforating veins failure underwent surgical treatment. From 1971 to 1982, 6000 patients with lower limbs primary varicose veins underwent surgical treatment: 510 more patients were hospitalized for post-thrombotic disease. In 6% of patients suffering from primary varicose veins, in 18% with recurrent varicose veins and in 76% with secondary veins (8.1% of all patients), subfascial ligation of incompetent perforating veins was associated with complete vein stripping. Incompetent perforating vein ligation alone was performed in 0.6% of cases. The technique is based on subfacial ligation of perforating veins through a small skin incision (2.3 cm). This procedure allows a fast healing of surgical wounds and a good esthetical result. The subfacial ligation allows a complete cure of the disease in primary varicose veins and avoids the main causes of recurrence. Moreover in the post-thrombotic disease treated by this procedure, symptoms and trophic lesions are markedly decreased and a dramatic reduction in the ulceration rate, 62.5% to 15% at ten year follow-up, is achieved.

Femoral Vein↗
PubMed1983

Relation of carotid stump pressure to safety of carotid artery ligation.

Twenty-four patients underwent ligation of the internal carotid artery for a variety of clinical indications. These included cerebral embolization from surgically inaccessible carotid lesions, carotid disruption and resultant hemorrhage, unreconstructible carotid endarterectomies, and inoperable intracranial carotid aneurysms. The relation of preoperative stump pressures to safety of ligation was evaluated. the data reflect that a systolic stump pressure in excess of 70 mm Hg (13 patients) indicates adequacy of collateral hemispheric blood flow to allow safe ligation of the carotid artery. Pressures of 55 mm Hg or less constitute an unacceptable vulnerability to stroke (two of three patients), and intermediate pressures of 55 to 68 mm Hg constitute a genuine hazard (four of eight patients). The mechanisms of stroke appear to be thromboembolic with late propagation of thrombus into an intracranial low-flow system. Postligation maintenance of appropriate systemic blood pressure is essential, and systemic heparinization is recommended to reduce the morbidity and mortality in patients in the intermediate pressure zone (55 to 68 mm Hg). It is concluded that whenever carotid ligation becomes a therapeutic consideration, the preoperative or preligation measurement of carotid stump pressure is presently the most reliable determinant of safety of the operation.

Adult↗
PubMed1983

[Clinical experience with blood vessel ligation in uncontrollable nosebleed].

Between 1978 and 1980 in the ENT clinics of Mannheim 19 patients with severe epistaxis have been treated surgically. Nearly always epistaxis was due to hypertonus or arteriosclerosis. Before ligation of maxillary or ethmoid arteries Bellocq's nasal packing was used. Ligation was always successful. After one year in three cases we observed a recidive of epistaxis, not due to bad surgical treatment but rich anastomoses of the maxillary artery. It is strange, that artery ligation is recommended, when posterior nasal packing fails, although its complications are more severe and frequent than those of chirurgical treatment including the anesthesiological risk. Ligation in severe epistaxis is effective and of low risk. It is an alternative to posterior nasal packing.

Epistaxis↗
PubMed1982

Transantral sphenopalatine artery ligation.

Posterior epistaxis from branches of the sphenopalatine artery can be rapidly and effectively controlled by a new ligation technique. The sphenopalatine artery or its branches are directly ligated as they exit the sphenopalatine foramen to enter the nose, completely avoiding the pterygomaxillary fossa. The vessels are exposed via a transantral approach, through the posterior portion of the medial antral wall. The mucoperiosteum of the lateral wall of the nose (medial antral wall) is preserved, elevated medially and posteriorly and used to tense the sphenopalatine vessels, bringing them into view and accessible for ligation at the foramen. Advantages of this technique include direct, specific ligation of the end vessels; ease and speed of operation; and avoidance of complications associated with the pterygomaxillary space. The technique was defined in multiple dissections of anatomic specimens and has been successful to date in 14 cases of severe posterior epistaxis.

Arteries↗
PubMed1982

[Proximal ligation of the vertebral artery for treatment of vertebral aneurysms].

Vertebral aneurysms are not necessarily rare. In general neck clipping of vertebral aneurysms is the surest method for treatment of aneurysms, but as for vertebral aneurysms, it is often difficult to clip the neck without danger, because they cross over lower cranial nerves and are often fusiform. The indication of proximal ligation of the vertebral artery for treatment of vertebral aneurysms has not yet established. This procedure in 28 cases in the literature and our 3 cases treated successfully was discussed and following results were obtained. 1) Proximal ligation of the vertebral artery was useful for prevention of a rupture of vertebral aneurysms. 2) Intracranial ligation of the vertebral artery was better than the ligation in the cervical region. 3) It was necessary for the diameter of the contralateral vertebral artery to be, at least, approximately same. 4) In order the diameter of the vertebral artery to enlarge to 1.2 times as wide as that of a preoperative state, and the blood flow in the basilar artery to be enough, it was necessary for the contralateral vertebral artery not to be sclerotic.

Adult↗
PubMedDate not supplied

[Rheoencephalographic evaluation of cerebrovascular circulation in cases of ruptured intracranial aneurysms and after carotid artery ligation].

Rheoencephalographic (REG) investigations were performed in patients with ruptured intracranial aneurysms before and after common carotid artery ligation and in a group of healthy subjects. REG curves after ligation of the common carotid artery showed lowering of the amplitude of waves on the side of ligation and generalized vasospasm of varying intensity and different degree of penetration into the cerebral structures. These changes were more intensive on the side of ligation and persisted for over 2 weeks. REG is a valuable method for early diagnosis of vascular disturbances in acute postoperative period in these operations.

Adult↗
PubMed1981

Effect of bile duct ligation on bile acid metabolism in rats.

The effect of bile duct ligation on the quantitative and qualitative changes of bile acids in serum, liver, urine, and feces, and the concentration of cholesterol and phospholipids in serum and liver were examined in male rats. The concentration of bile acids in serum increased over 100-fold on day 5 but was lower than the 5-day level on days 10 and 15. The concentration in the liver also increased about 10-fold. beta-Muricholic acid predominantly increased but the secondary bile acids, deoxycholic acid and hyodeoxycholic acid, decreased. The urinary excretion of bile acids increased to about 40 mg/day per rat on the first day of bile duct ligation but this increase was reduced on day 2 to about half and remained at that level until day 24. These values exceeded that of fecal bile acids, 12 mg/day per rat, before bile duct ligation. The amount of bile acid sulfates in the urine was as low as 1% of the total. The urinary non-sulfated bile acids consisted mainly of beta-muricholic acid (60%) and cholic acid (20%), while the sulfates contained a considerable amount of unidentified acidic substances (40%) in addition to cholic acid and beta-muricholic acid. The concentration of cholesterol and phospholipids in serum markedly increased on day 5 but declined gradually thereafter. The liver cholesterol concentration did not change but the phospholipid concentration decreased. Fecal sterols did not change in both the total amount and composition. These data indicated that daily synthesis of bile acids, especially beta-muricholic acid, was accelerated in bile duct-ligated rats.

Animals↗
PubMed1981

[Follow-up study of the giant aneurysm by CT scan after unilateal carotid ligation (author's transl)].

We report a rare case of giant aneurysm of the anterior communicating artery, which was followed up by CT scan after unilateral carotid ligation. A 50-year-old female visited our clinic complaining of headache and visual disturbance. Neurological examination revealed bitemporal hemianopsia and loss of visual acuity. A giant anterior communicating artery aneurysm was found on right carotid angiograms. After ligation of the right common carotid artery, the aneurysm was reduced in size. Three weeks later, however, it ruptured and the patient died two months later. Autopsy showed the ruptured dome of the aneurysm. The wall of the sac lacked elastic fibers. It was considered that after carotid ligation the wall of the dome was pressed directly by the remaining blood flow, and the aneurysmal rupture was caused. We should give care to the aneurysm after carotid ligation.

Carotid Arteries↗
PubMed1993

[Isolation and characterization of hepatocytes from chronic cholestatic damage to rat livers after bile duct ligation].

The aim of these investigations was the isolation and characterisation of hepatocytes from chronic injured rat livers after bile duct ligation. In three months old female Uje:WIST rats the distal common bile duct was double ligated. 14 days after the ligation 80% of the rats survived. The content of hepatic OH-prolin was increased in relation to shamoperated control animals. The histological examination showed a marked fibrous and oedematous spreading of the portal tract as well as an extensive bile duct proliferation after 14 days. A correlation between OH-prolin content of the liver and index of fibrosis was found. 14 days after ligation the hepatocytes were isolated according to Seglen (7). The yield of hepatocytes isolated from the liver of cholestatic rats and from control animals was on average 4 x 10(8) cells with a viability of 80%. Ultrastructural the most hepatocytes showed intact organells without injury. We can conclude, that it is possible to isolate hepatocytes from chronic cholestatic rat livers with a good yield and viability as well as with an intact ultrastructure. These cells are suitable for additional metabolic investigations.

Animals↗
PubMed1995

Renal-portal vein shunt for renal failure after left renal vein ligation in children: a review.

PURPOSE: Interruption of the inferior vena cava and left renal vein in the patient with a solitary left kidney without permanent renal damage has been reported in the past. We assess the risks of similar venous interruption in children and establish guidelines for the management of those cases when collateral drainage of the kidney is uncertain. MATERIALS AND METHODS: We compared our case with a review of all previous reports in the literature concerning ligation of the vena cava and left renal vein in patients with a solitary left kidney. RESULTS: Ligation of the left renal vein in an isolated left kidney in children has been shown to carry the risk of significant renal damage. Renal-portal vein shunt provided adequate drainage of the left kidney after inferior vena caval ligation in our case. CONCLUSIONS: While there have been reported cases of successful inferior vena cava or left renal vein ligation in the isolated left kidney with good renal function, adequate renal drainage should be established in cases where collateral drainage is uncertain, especially in children. Renal-portal vein shunt is a viable therapeutic option to establish left renal drainage in select circumstances.

Anastomosis, Surgical↗
PubMed1995

Alterations in bile ducts and peribiliary microcirculation in rats after common bile duct ligation.

The chronological changes in ductular epithelium and peribiliary capillary plexuses (PBPs) after bile duct ligation are not well understood. Therefore, we examined alterations in both intrahepatic bile ductules and peribiliary microcirculation in rats after ligation of the common bile duct using immunohistochemistry, transmission electron microscopes (TEM), and scanning electron microscopes (SEM). Ductular proliferations appeared first in the peripheral areas of the portal spaces and then gradually advanced along with increasing jaundice. Distorted configuration of the hepatic parenchyma with interconnecting stroma rich in irregular ductules developed 4 weeks after the ligation. Numerous biliary cell types and cells of types intermediate between hepatocytes and biliary cells together with poorly fenestrated capillary-type vessels appeared in the periportal parenchyma, in association with an increased number of canalicular-ductular junctions on TEM. These biliary cells were often found within the lobules and apart from the stroma. SEM examination of hepatic microvascular casts using methacrylated resin showed formation of irregular portal and periportal capillary networks, partly derived from coarsened sinusoids. Direct connections between the newly formed capillary networks and the pre-existing PBPs or sinusoids were numerous, although there were few direct connections between the capillary networks and the hepatic arterial branches. Thus, these proliferated ductules and newly formed complicated capillary networks might play an important role in the effective transport of biliary materials between hepatocytes and native bile ducts or proliferated ductules through the altered microcirculation after bile duct ligation.

Animals↗
PubMed1994

Alterations of nucleolar organizer regions of smooth muscle cells in bile duct following biliary ligation in rat.

Clinical experience indicates that bile duct dilatation is often associated with patients presenting with cholestasis. The purpose of this study is to propose a hypothesis that such a biliary dilatation, resulting from extra-hepatic obstruction, partially contributes to the rapidly occurring hypertrophy and hyperplasia of the smooth muscle cells in the bile duct; and that such an alteration could possibly lead to the development of neoplastic tissue. Twenty seven male Wistar rats were divided into 4 groups: Control Group (n = 7) with sham operation, Day 4 Group (n = 6) with common bile duct ligated for 4 days, Day 7 Group (n = 7) with common bile duct ligated for 7 days, and Day 14 Group (n = 7) with common bile duct ligated for 14 days. Complete extrahepatic biliary obstruction was induced in Wistar rats by distal ligation of the common bile duct (CBD). The CBD specimens were stained by H & E and argyrophilic techniques (AgNOR method), and the smooth muscle cells were identified and studied with light microscopy and an image analyzer. To determine maximum width of cell size, the widths of smooth muscle cells were found to be 2.82 +/- 0.07 microns, 3.05 +/- 0.06 microns, 4.53 +/- 0.10 microns, and 4.89 +/- 0.12 microns (Mean +/- S.E.) for the Control Group, Day 4 Group, Day 7 Group and Day 14 Group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Percutaneous puncture of the external carotid artery or its branches after surgical ligation.

PURPOSE: To describe the technique and results of percutaneous puncture of the external carotid artery or one of its branches distal to a surgical arterial ligation. METHODS: Forty-three patients underwent 64 embolization attempts by percutaneous arterial puncture distal to an external carotid artery ligation. The punctured arteries were the trunk of the external carotid artery in 31 patients, the internal maxillary artery in nine, the facial artery in nine, the lingual artery in eight, the occipital artery in four, and the superficial temporal artery in three. RESULTS: In 64 attempts 57 were successful in one session, six were successful in two sessions, and one failed. Puncture-related complications were eight spontaneously resolving hematomas and six asymptomatic punctures of the internal carotid artery. CONCLUSION: After surgical ligation of the external carotid artery or its branches, arterial puncture above the ligation allowed selective catheterization and endovascular occlusion of vascular lesions.

Adolescent↗
PubMed1993

[Changes in hemodynamics after ligation and embolization of the external carotid artery].

The authors were the first ones who obtained the established collateral vascular anatomy after external carotid artery embolization and ligation with angiography, vascular transparent specimen filled with ink, microvessel casting and scanning electronic microscope. The results indicated that the rich collateral circulation would be established after external carotid artery ligation. Ligation itself could not cut off blood supply to lesion area. Embolization, in turn, can effectively obstruct blood supply by reducing collateral branches. So we suggest that it is better to use external carotid embolization rather than external carotid ligation for those oral maxillofacial lesions with rich blood supply.

Animals↗