Background/Aims: Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL. Methods: Seventy-nine patients who underwent EBL for CDB at St. Luke's International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated. Results: Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (14.2 minutes vs. 18.2 minutes, p=0.02). No adverse events were observed in either group. Conclusions: The N-EBL device is safe and useful and may reduce EBL procedure time.
It was examined whether the ceca and the back-flow of urine into the lower intestine are involved in water intake and excretion in chickens and food intake affects those. Colostomy significantly increased water intake, total water excretion and the ratio of the water intake to food intake in the ceca-ligated chickens under restrict and ad libitum feeding conditions (P<0.05), but the increases were much larger in chickens fed ad libitum than in those fed restrictedly. Cecal ligation increased water intake, total water excretion and the ratio of water intake to food intake in the colostomised chickens which were fed freely (P<0.05). but not in those fed restrictedly, None of colostomy and cecal ligation affected the resultant water balances in chickens under both feeding conditions. Colostomy increased food intake in the ceca-ligated chickens (P<0.05), but no increase by cecal ligation was observed in colostomised chickens. It is concluded that the lower intestine takes a very important role in water recovery from urine to maintain water balance in chickens.
The objective of this study was to assess the complications of titanium clip application after ovariohysterectomy (OHE) and find the proper surgical technique to minimize the complications by comparing the ligation method of ovarian pedicle. Six female beagle dogs were used for this study and they were divided randomly into two groups by ligation techniques: ligation and non-ligation of the suspensory ligament of ovary including ovarian pedicle. To evaluate the difference between two techniques, the location and embedded pattern of applied clips in the abdominal cavity were identified through radiographic tests and autopsy. Hematology tests were also performed to check the existence of inflammation by applied clips and all tests were carried out monthly for 1 year. There were few changes in location of clips of both groups on X-ray views without any migration. Almost all values in hematology of two groups were within the normal range and there were no inflammatory symptoms. All of applied clips in two groups were found near the kidney, but the embedded forms of them showed slight differences. The clips ligating suspensory ligament and ovarian pedicle were located in deep place and thickly surrounded with thin layers of peritoneum. But the clips ligating only ovarian pedicle were found with ease on surface of layer and located in lower place compared with the clips ligating suspensory ligament. These results indicate that the suspensory ligament holds applied clips and minimizes the movement of them. Therefore, ligation of suspensory ligament would be the preferred technique in titanium clip application for OHE.
Kim, Bum-Dae;Lee, Kyoung-Yeob;Kim, Seong-Ho;Han, Dong-Ro;Bae, Jang-Ho;Kim, Oh-Lyong;Choi, Byung-Yearn;Cho, Soo-Ho;Shin, Hyun-Jin
Journal of Yeungnam Medical Science
/
v.11
no.1
/
pp.167-180
/
1994
In order to inquire the most effective management of increased intracranial pressure(ICP), mannitol, steroid and hyperventilation were used in rabbits after ligation or non-ligation of the carotid artery. Mannitol was more effective than steroid and hyperventilation in the degree of the reduction of ICP. The intracranial pressure was decreased 43~45% for 25~30 minutes after injection of mannitol. Steroid was less effective than mannitol in the degree of the reduction of ICP. But the time of reduction of ICP was longer, that is, the degree of reduction was 24~60 minutes after injection of steroid. Hyperventilation is effective in the initial time only, for 10 minutes after hyperventilation. The degree of ICP reduction was 13.5~16.7% for 10 minutes after hyperventilation. The combined group, that is three kinds of mangenent were used, is the most effective treatment to reduce ICP of ICP. The degree of the reduction of ICP was 42.1~49.3% for 20 minutes, 47.7~52.5% for 30minnutes. There was no significant difference between ligation and non-ligation group.
Purpose: The aims of this study are to measure the serum levels of fat soluble vitamins (vitamin A and D) from bile duct ligated rats, and to evaluate the effect of oral bile acids administration to facilitate absorption of fat soluble vitamins. Methods: We measured serum ALT, total bilirubin, vitamin A, and vitamin D of Sprague-Dawley rats 1 week before and 4 weeks after experimental bile duct ligation. Rats were consisted with 3 groups. Group 2 had been fed bile acids and group 3 ursodeoxycholic acid after operation for 4 weeks. Multi-vitamin was given to all groups. Results: 1) Base line (mean value before duct ligation): ALT 74.2 IU, total bilirubin 0.26 mg/dL; vitamin D 13.01 ng/mL vitamin A $0.87\;{\mu}g/mL$, total bile acids $25.16\;{\mu}mol/L$. 2) Four weeks after ligation: ALT 100.7 IU, total bilirubin 2.58 mg/dL; vitamin D 7.89 ng/mL vitamin A $1.37{\mu}g/mL$, total bile acids $278.22\;{\mu}mol/L$. 3) 4 weeks after ligation, each group (group 1, group 2 and group 3) showed vitamin D (7.62, 8.10 and 7.99) ng/mL, vitamin A (1.68, 1.06 and 1.33) ${\mu}g/mL$, total bile acids (233.17, 345.80 and 268.57) ${\mu}mol/L$, which were statistically not significant. Conclusion: Serum level of vitamin A is increased after bile duct ligation although vitamin D is decreased. Oral administration of bile acids does not affect the serum levels of vitamin A and D in bile duct ligated rats.
Liver tissues were taken from rats 20 min after administration of dehydrocholic acid and biligrafin, fasted for 8 days, and bile duct ligation for 48 hr. And the zonulae occludentes around the bile canaliculi were investigated by the freeze fracture method. In the normal rats, the zonulae occludentes showed networks consisting of one to four strands in many regions. After administration of dehydrocholic acid, the depth of zonulae occludentes were increased and networks consist of six to nine strands. The zonulae occludentes, however, were disorganized, and strands were reduced after administration of biligrafin. In the fasting rats, the zonulae occludentes showed one or two strands which were loosely linked. After ligation of bile duct, the zonulae occludentes were disorganized, and strands were reduced or still in a state not to be reduced. The strands were interrupted by gaps or linear particles in all the groups, especially in the biligrafin and the ligation. The free ends were remarkable in the fasting group and contact or surround the lateral gap junctions in the dehydrocholic acid group. The discontinuities and free ends of strands were also encountered in the normal group, thus suggesting that the barrier is not complete even in the normal state. The aggregation of particles appeared within the meshwork of zonulae occludentes in all the group, except for the ligation. From the evidence, it is assumed that zonulae occludentes are labile, differ in the structure according to the situation of bile canaliculi and show regional alterations even in the same bile canaliculi, that zonulae occludentes are affected by mechanical stress or certain other factors, and that there is a correlation between the strands and particle aggregations in association with the alteration of zonulae occludentes.
Atrial natriuretic peptide (ANP) is associated with the variety of disorders of myocardial function. The effect, however, of myocardial infarction (MI) on ANP has not been fully described. Thus, this study investigated the effect of experimental MI, induced by left coronary artery ligation, on ANP secretion. Male Sprague-Dawley rats aged 60 d underwent ligation of the left anterior descending coronary artery to induce MI and were compared with a group that underwent a sham operation. Rats of sham operation had a similar procedure without having the suture tightened around the coronary artery. Animals were sacrificed at 1, 3, 6, 12, and 18 h or 1, 3, 5, 7, 14, and 30 d after the procedure. MI size was assessed by planimetry and perimetry, and plasma ANP levels were determined by radioimmunoassay. Mean infarct size was 39.6-44.5% of the left ventricle after coronary occlusion in experimental groups. No significant differences were observed in infarct size among groups. In contrast, the concentration of plasma ANP was significantly higher at 1, 3, 6, 12, 18, and 24 h after left coronary artery ligation than in sham animals. This parameter, however, did not differ significantly at 3, 5, 7, 14, and 30 d after ligation compared with sham-ligated controls. These results demonstrate that plasma ANP levels are markedly increased in the early phase of MI in the male rat and can be a useful biomarker for diagnosis in acute MI.
Background: CM1 (Centrocyte/-blast Marker I) defined by a mAb developed against concanavalin-A activated PBMC, is expressed specifically on a subpopulation of centroblasts and centrocytes of human germinal center (GC) B cells. Burkitt lymphoma (BL) is a tumor consisting of tumor cells with the characteristics of GC B cell. Previously we reported that CM1 ligation with anti-CM1 mAb induced apoptosis in Ramos $(IgM^{high})$ and Raji $(IgM^{low})$ cells. Methods & Results: In the present study, we observed that CM1 ligation with anti-CM1 mAb induced Fas ligand and Fas expression in Ramos cells, but not in Raji cells. Furthermore, anti-Fas blocking antibody, ZB4, blocked CM1-mediated apoptosis effectively in Ramos cells, but not in Raji cells. Increased mitochondrial membrane permeabilization, which was measured by $DiOC_6$, was observed only in Raji cells. In contrast to no significant change of Bax known as pro-apoptotic protein, anti-apoptotic protein Bcl-2 was significantly decreased in Raji cells. In addition, we observed that CM1 ligation increased release of mitochondrial cytochrome c and upregulated caspase-9 activity in Raji cells. Conclusion: These results suggest that apoptosis induced by CM1-ligation is mediated by Fas-Fas ligand interaction in Ramos cells, whereas apoptosis is mediated by down-regulation of Bcl-2 and subsequent decrease of mitochondrial membrane potential in Raji cells.
Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.
Purpose: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. Methods: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. Results: The mean gestational age and birth weight (BW) of all infants were $27^{+6}{\pm}1^{+6}$ weeks and 951${\pm}$245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033${\pm}$285 g vs. 821${\pm}$126 g, P=0.048) and weight on operation day (1,195${\pm}$404 g vs. 893${\pm}$151 g, P=0.042), longer hospital days (105${\pm}$29 vs. 141${\pm}$39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative $FiO_2$ (0.29${\pm}$0.06 vs. 0.38${\pm}$0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. Conclusion: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high $FiO_2$ might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
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