Cervical Ligation Research Articles

Cervical tourniquet during cesarean section to reduce bleeding in morbidly adherent placenta: a pilot study.

Objective:To evaluate a modified surgical technique aiming to reduce bleeding and preserve fertility in morbidly adherent placenta by cervical tourniquet in cesarean sections.Methods:The cesarean section operations and the cervical ligation approach were performed by a single expert consultant obstetrician. The general demographics and clinical characteristics for all participants were collected and studied.Results:Eleven participants were involved. The uterus was preserved in nine patients, whereas two patients had hysterectomy. The mean blood loss was 1688.8 ml for patients whose uterus was preserved. The mean length of stay was 5.5 days.Conclusion:Cervical ligation is a simple method that can be applied by junior and experienced obstetricians to preserve the uterus.

Deep Learning-Based Analysis of Efficiency and Surgical Timing for Patients with Cervical Insufficiency Using Transvaginal Ultrasound Images

Objective. This work aims to analyze the surgical timing and clinical efficacy of transvaginal cervical ring ligation based on the ultrasound image focus detection of patients with cervical insufficiency (CIC) under the ultrasound image theme generation model. Methods. 134 CIC patients who came to the hospital for ultrasound imaging diagnosis were collected. Observation group was treated with cervical cerclage (CC) and the pregnancy outcome was followed up. Control group was treated conservatively. Results. For patients in the control group, average gestational age was 21.12 ± 2.18 weeks, average cervical length (CL) was 15.54 ± 0.42 mm, and average uterine opening width was 3.06 ± 0.63 mm. In the observation group, average gestational age was 24.45 ± 4.12 weeks, average CL was 17.32 ± 4.09 mm, and average uterine opening width was 0.21 mm. There were significant differences between the two groups ( P < 0.05 ). There were also significant differences in the degree of uterine orifice dilation between the two groups ( P < 0.05 ). Pregnancy outcomes of the two groups were compared, and χ2 and P < 0.05 indicated significant differences. Conclusion. Convolution neural network (CNN) and long short-term memory model (LSTM) algorithm were used to classify patients' ultrasound images, which could effectively improve diagnosis and treatment efficiency. Surgical success rate, clinical outcomes, neonatal survival rate, and clinical effect of observation group were better than those of control group. Cervical ligation was best performed before 17 weeks of pregnancy in CIC.

Therapeutic Effect of Cervical Cerclage on Cervical Insufficiency during Pregnancy Analyzed by Magnetic Resonance Image under Neural Network Algorithm

Objective. This research was developed to investigate the effect of magnetic resonance imaging (MRI) analysis based on neural network algorithm for cervical ligation in the treatment of cervical insufficiency. Methods. 44 patients who were suspected to be pregnant with cervical insufficiency and needed cervical ligation were selected. MR imaging analysis was performed before cervical ligation. MR images were analyzed based on the back propagation neural network (BPNN) algorithm, and patients were randomly divided into experimental group and control group. Preoperative MRI analysis was performed in the experimental group, while simple transvaginal ultrasonography was used to diagnose cervical insufficiency in the control group. Then, postoperative fetal preservation time, vaginal bleeding rate, and infection rate within one week after surgery were compared between the two groups. Results. Based on experience and experimental testing, the relevant parameters were set as follows. The number of particles n = 50, the inertia weight ω = 0.9, and c1 = c2 = 2. The weight range of the output layer of the neural network was [−1, 1], the target error e = 10−5, and the maximum number of iteration steps was 3,000. Compared with the control group, the experimental group’s postoperative bleeding rate and infection probability were substantially reduced, while the normal delivery rate was substantially increased ( P < 0.05 ). Conclusion. MR image analysis based on neural network algorithm played an important role in cervical cerclage surgery. The image map showed the local anatomy clearly, increasing the success rate of the operation and improving the prognosis of the patient.

Efficacy of Modified Cervical Ligation in the Treatment of Lower Uterine Hemorrhage in Placenta Previa

Efficacy of Modified Cervical Ligation in the Treatment of Lower Uterine Hemorrhage in Placenta Previa

A case of severe soft birth canal laceration after cervical ligation

Li Yue, Family instead of narration: second child, After 37 weeks of pregnancy, Paroxysmal lower abdominal pain 2 hours into...

A Case of Severe Soft Birth Canal Laceration After Cervical Ligation

Li Yue, Family instead of narration: second child, After 37 weeks of pregnancy, Paroxysmal lower abdominal pain 2 hours into...

Recovery of Visual and Ophthalmologic Symptoms After Treating Large or Giant Internal Carotid Artery Aneurysm by High-Flow Bypass with Cervical Ligation

Large or giant internal carotid artery (ICA) aneurysms often cause visual deficits and cranial nerve palsy. The aim of this study was to investigate the efficacy of ligation of the ICA with high-flow bypass. We retrospectively analyzed the findings from patients with visual deficit and ophthalmologic symptoms due to ICA aneurysms. In addition, we analyzed the recovery factors associated with the visual deficit and ophthalmologic symptoms postoperatively, focusing on the type of cranial nerve palsy, aneurysm size, location, and the time to treatment from first symptoms. We identified 38 patients (35 women, 3 men) with a mean age at surgery of 63.6 years (range, 24-81 years) with visual and ophthalmologic symptoms due to large or giant internal carotid aneurysm. Aneurysms ranged in size from 15-50 mm (mean, 25.2 mm). Visual disturbance (7 cases, 18%) and ophthalmoplegia (31 cases, 82%) were the only preoperative cranial nerve palsies. Aneurysms were completely thrombosed in 94.7% of cases (36/38). Visual disturbance improved in 28.5% of cases (2/7), and ophthalmoplegia improved in 87.1% of cases (27/31). Time to therapy from developing a visual disturbance was longer than time to therapy from developing ophthalmoplegia (P= 0.001). Time to therapy was significantly associated with recovery from cranial nerve palsy (P < 0.0001). The recovery of visual disturbance was worse than that of ophthalmoplegia (P= 0.001). Early treatment is recommended when the visual and ophthalmologic symptoms are present because treatment delay is a risk factor for nonimprovement of symptoms.

Effects of TanIIA on expressions of interleukin-1β and interleukin-6 in neonatal rats with periventricular leukomalacia

Objective To study the effects of TanⅡA on expressions of interleukin-1β(IL-1β) and interleukin-6( IL-6) in brain tissues of neonatal rats with periventricular leukomalacia(PVL). Methods The PVL models were established by means of bilateral general cervical artery ligation followed by 0.5 h 80 mL/L oxygen and 920 mL/L nitrogen mixture exposure in 2-day rats, and then these rats were randomly divided into the model control group, the low-dose group treated with TaⅡA at 7.5 mg/(kg·d) and the high-dose group treated with TaⅡA at 15.0 mg/(kg·d), meanwhile the false operation group was established. The rats were killed 1 hour after administration on the third day, and the brain tissues pathological changes were detected by way of HE dyeing analysis. At the same time, the expressions of IL-1β and IL-6 in brain tissues were analyzed by means of enzyme linked immunosorbent assay(ELISA). Results HE staining showed that the cells around the lateral ventricle were disarranged, as white matter appeared sparse as cribriform and ischemic changed significantly in the rats of model control group. Compared with the model control group, the ischemia of brain tissue in the low-dose group improved. Ischemia of the high-dose TanⅡA group improved more significantly than the low-dose group. ELISA results showed that the expressions of IL-1β and IL-6 in the PVL rats were significantly higher than the false operation group (all P 0.05). Conclusions TanⅡA has the function of improving the state of ischemia and decreasing the expressions of IL-1β and IL-6 in tissues of PVL rats, thus it can relieve cerebral white matter lesions of neonatal rats. Key words: TanⅡA; Periventricular leukomalacia; Interleukin-1β; Interleukin-6; Neonatal rat

Esophageal rupture caused by explosion of an automobile tire tube: a case report

IntroductionThere have been no reports in the literature of esophageal rupture in adults resulting from an explosion of an automobile tire. We report the first case of just such an occurrence after an individual bit into a tire, causing it to explode in his mouth.Case presentationA 47-year-old Han Chinese man presented with massive hemorrhage in his left eye after he accidentally bit an automobile tire tube which burst into his mouth. He was diagnosed with esophageal rupture based on a chest computed tomography scan and barium swallow examination. Drainage of empyema (right chest), removal of thoracic esophagus, exposure of cervical esophagus, cardiac ligation and gastrostomy were performed respectively. After that, esophagogastrostomy was performed.ConclusionsSuccessful anastomosis was obtained at the neck with no postoperative complications 3 months after the surgery. The patient was discharged with satisfactory outcomes. We present this case report to bring attention to esophageal rupture in adults during the explosion of an automobile tire tube in the mouth.

Alfaxalone for total intravenous anaesthesia in dogs undergoing ovariohysterectomy: a comparison of premedication with acepromazine or dexmedetomidine

ObjectiveTo describe alfaxalone total intravenous anaesthesia (TIVA) following premedication with buprenorphine and either acepromazine (ACP) or dexmedetomidine (DEX) in bitches undergoing ovariohysterectomy. Study designProspective, randomised, clinical study. AnimalsThirty-eight healthy female dogs. MethodsFollowing intramuscular buprenorphine (20 μg kg−1) and acepromazine (0.05 mg kg−1) or dexmedetomidine (approximately 10 μg kg−1, adjusted for body surface area), anaesthesia was induced and maintained with intravenous alfaxalone. Oxygen was administered via a suitable anaesthetic circuit. Alfaxalone infusion rate (initially 0.07 mg kg−1 minute−1) was adjusted to maintain adequate anaesthetic depth based on clinical assessment. Alfaxalone boluses were given if required. Ventilation was assisted if necessary. Alfaxalone dose and physiologic parameters were recorded every 5 minutes. Depth of sedation after premedication, induction quality and recovery duration and quality were scored. A Student's t-test, Mann–Whitney U and Chi-squared tests determined the significance of differences between groups. Data are presented as mean ± SD or median (range). Significance was defined as p < 0.05. ResultsThere were no differences between groups in demographics; induction quality; induction (1.5 ± 0.57 mg kg−1) and total bolus doses [1.2 (0 – 6.3) mg kg−1] of alfaxalone; anaesthesia duration (131 ± 18 minutes); or time to extubation [16.6 (3–50) minutes]. DEX dogs were more sedated than ACP dogs. Alfaxalone infusion rate was significantly lower in DEX [0.08 (0.06–0.19) mg kg−1 minute−1] than ACP dogs [0.11 (0.07–0.33) mg kg−1 minute−1]. Cardiovascular variables increased significantly during ovarian and cervical ligation and wound closure compared to baseline values in both groups. Apnoea and hypoventilation were common and not significantly different between groups. Arterial haemoglobin oxygen saturation remained above 95% in all animals. Recovery quality scores were significantly poorer for DEX than for ACP dogs. Conclusions and clinical relevanceAlfaxalone TIVA is an effective anaesthetic for surgical procedures but, in the protocol of this study, causes respiratory depression at infusion rates required for surgery.

Effects of Multiple Drilling on the Ischemic Capital Femoral Epiphysis of Immature Piglets

PurposeThis study investigated the effects of multiple drilling on the immature capital femoral epiphysis following ischemic injury in a piglet model.Materials and MethodsIschemic necrosis of capital femoral epiphysis was induced bilaterally in 12 piglets using a cervical ligation method. Three weeks later, medial, central, and lateral 3 drill holes were made on the left femoral head using 0.062" K-wire. At 3, 6, 9, and 12 weeks following the multiple drilling, femoral heads were harvested from each three piglets. On histologic examination, percent of revascularization, percent of osteoblast surface, capital femoral epiphyseal quotient and proximal femoral growth plate height were evaluated. Untreated right femoral heads served as control.ResultsWhile percent of revascularization of left capital femoral epiphysis with multiple drilling was significantly higher than untreated control side (p<0.001), percent of osteoblast surface, capital femoral epiphyseal quotient and proximal femoral growth plate height showed no significant difference.ConclusionThis study indicates that multiple drilling could promote revascularization of ischemic capital femoral epiphysis, and multiple drilling does not appear to produce bony physeal bars at short-term, if using small diameter drill. However, multiple drilling alone does not seem to prevent femoral head deformity or to promote new bone formation.

Retrospective Analysis of 148 Cases between Ligation of Cervical Stump and Ligation of Uterine Vessels in Laparoscopic Supracervical Hysterectomy (LSH)

Retrospective Analysis of 148 Cases between Ligation of Cervical Stump and Ligation of Uterine Vessels in Laparoscopic Supracervical Hysterectomy (LSH)

Electroencephalography during ovariohysterectomy in rats anaesthetized with halothane

ObjectiveTo evaluate electroencephalographic (EEG) changes during ovariohysterectomy (OVH) in rats anaesthetized with halothane, and modification of the EEG changes by the co-administration of fentanyl, ketamine or thiopental. Study designProspective, randomized, blinded controlled study. AnimalsSixty adult female Sprague-Dawley rats. MethodsAnaesthesia was induced and maintained with halothane [Fe′HAL 0.95 ± 0.05%]. The electroencephalogram was recorded continuously from the left and right primary somatosensory cortices. Rats were randomly divided into four groups and a rapid IV infusion of physiological saline, thiopental, ketamine or fentanyl was administered. OVH started 10 minutes after drug administration. Blood samples, for assay of plasma drug concentrations, were collected 5 minutes after administration and at the end of surgery. Electroencephalograph descriptors median frequency (F50), spectral edge frequency 95% (F95) and total power (Ptot), recorded during non-surgical baseline periods, were compared with those recorded during defined surgical periods; skin incision, right and left ovarian pedicle ligation; cervical ligation. Plasma drug concentrations were measured using high performance lipid chromatography. ResultsAlthough a large number of statistical differences in EEG data were observed, these generally represented a reduction in F50 or F95 throughout the experimental recording period and were similar between groups. A significant reduction in Ptot occurred during ligation of the ovaries and cervix in the control group compared with other recording periods. The co-administration of ketamine, fentanyl and thiopental obtunded the reduction in Ptot. Conclusions and clinical relevanceElectroencephalographic changes, in the control group, mimicked changes reported in other studies using the minimal anaesthesia model. However, the stability in F50 during the surgical period compared with the baseline period indicated that OVH is an unsuitable surgical stimulus to investigate EEG changes with noxious stimulation. This may be attributed to the relatively prolonged duration of this surgical procedure and the primarily visceral afferent sensory innervation of the genital tract.

Lower-extremity lymphedema following neck dissection – an uncommon complication after cervical ligation of the thoracic duct

Thoracic duct injuries and chylous fistula are well-known complications of neck dissection, occurring in 1-2% of cases. Management of these injuries can be conservative or operative. Conservative treatment consists of fat restricted diet or total parenteral nutrition reducing the volume of chyle production. Operative management includes exploration of the neck or if necessary open thoracotomy to ligate the thoracic duct. Following cervical thoracic duct ligation only few complications like chylothorax or chylous ascites are described in the literature. To the best authors knowledge, this is the first report in the english literature describing lower-extremity lymphedema following cervical thoracic duct ligation.

Programmed cell death in flight muscle histolysis of the house cricket

We have characterized the process of flight muscle histolysis in the female house cricket, Acheta domesticus, through analysis of alterations of tissue wet weight, total protein content, and percent shortening of the dorsal longitudinal flight muscles (DLMs). Our objectives were to (1) define the normal course of histolysis in the cricket, (2) analyze the effects of juvenile hormone (JH) removal and replacement, (3) determine the effects of cycloheximide treatment, and (4) examine patterns of protein expression during histolysis. Our results suggest that flight muscle histolysis in the house cricket is an example of an active, developmentally regulated cell death program induced by an endocrine signal. Initial declines of total protein in DLMs indicated the JH signal that induced histolysis occurred by Day 2 and that histolysis was essentially complete by Day 3. Significant reductions in tissue weight and percent muscle shortening were observed in DLMs from Day 3 crickets. Cervical ligation of Day 1 crickets prevented histolysis but this inhibition could be reversed by continual topical treatments with methoprene (an active JH analog) although ligation of Day 2 crickets did not prevent histolysis. A requirement for active protein expression was demonstrated by analysis of synthesis block by cycloheximide and short-term incorporation of 35S-methionine. Treatment with cycloheximide prevented histolysis. Autofluorographic imaging of DLM proteins separated by electrophoresis revealed apparent coordinated regulation of protein expression.

Immunogenetic studies in habitual abortion.

Recent evidence suggests that immunological factors could play a role in the aetiology of habitual abortion. In this study, 71 couples with habitual abortion (i.e. more than 3 successive abortions) were investigated. Sharing of HLA-A, B, DR between partners was not found to be significantly increased. Anti-HLA antibodies in women against their partners' lymphocytes were found in 18.3%. After immunization with 10(7)-10(8) lymphocytes obtained from husband or unrelated donor, there was a seroconversion rate of 61% in those without antibodies initially. This was not dependent on the number of cells injected, source of cells, degree of sharing of HLA antigens or whether the couple were primary aborters (i.e. having had no advanced pregnancy), or secondary aborters. Seven pregnancies have resulted following the immunization procedure so far, 5 occurring in cross-match positive patients and 2 in cross-match negative. Growth retarded infants resulted from the pregnancy of 1 primary aborter and 2 secondary aborters.

Die ektopische A. carotis interna in der Paukenhöhle - Intraoperative Komplikationen und ihre Behandlung - Ein Fallhericht

Ectopy of the internal carotid artery involving the middle ear occurs only rarely. In this case, middle ear surgery will almost always result in severe haemorrhage. After package of the external auditory canal and the epipharynx, immediate closure or ligation of the internal carotid artery is mandatory. The authors describe the interventional neuroradiological treatment as an alternative way to the known neurosurgical methods like cervical and intracranial ligation of the artery. Intravasal blocking of the leakage was done by using a detachable balloon filled with contrast medium. During this procedure cortical evoked potentials were measured showing no decrease of the homolateral haemispheric blood flow. Although this procedure cannot maintain the continuity of the internal carotid artery, it preserves a maximum of collateral vessels. The cortical evoked potentials simultaneously show the brain function during blockage of the artery.

Development and endocrine effects on the synthesis of mitochondrial proteins in the fat body of the cockroach, Blaberus discoidalis

The pattern of mitochondrial protein synthesis was observed in the fat body during postemergence maturation of adult male Blaberus discoidalis cockroaches. The incorporation rate of [ 14C]-leucine into mitochondrial proteins was high between days 0 and 4 of adult life then decreased by about 40% to a lower, stable rate between days 6 and 30. Cycloheximide-insensitive, intramitochondrial protein synthesis paralleled this pattern. The half life of [ 14C-guanidino]-arginine was 36.2 days in mitochondrial proteins which suggests that the mitochondria are stable organelles in the fat body. Cervical ligation lowered the rate of mitochondrial protein synthesis by 60%, but attempts to return the synthetic rate to normal by injections of corpora cardiaca extracts were inconclusive.

Pathogenesis of hydrometra-endometritis complex in rats.

Among 31 rats with a cervical ligation for 79 to 88 days, hydrometra developed in 17 uterine horns of 13 rats. Eleven of those 17 uterine horns of hydrometra contained the turbid or transparent exudate with a bacterial contamination at the level of 107 to 109/ml, and affected with endometritis. The remaining 5 hydrometra were filled with sterile exudate and free from endometritis. On the other hand, the uterine luminal fluid in some cases of the apparently normal rats at the proestrous stage was contaminated with Streptococcus sp. and/or P. pneumotropica at the level of 103 to 105/ml. Another 14 rats, in which 14 uterine horns (9 rats) were preliminarily confirmed for bacterial contamination, were treated by ovariectomy, uterine ligation and subcutaneous injection of estradiol 0.2/μg/day for 20 days. However, hydrometra was macroscopically negative in all rats. Endometritis was also negative in 11 of 14 uterine horns except for a slight endometritis in the remaining 3 uterine horns. These results indicate that the luminal fluid of hydro-metra plays an important role in the growth of pre-existing bacteria and development of endometritis, accordingly, the transition of hydrometra to endometritis may occur in the rat uteri with a contamination by the pre-existing bacteria. Therefore, it was thought to be reasonable to include those abnormal uteri in the words of Hydrometra-endometritis complex.

Development and endocrine regulation of mitochondrial cytochrome biosynthesis in the insect fat body: δ-[ 14C]aminolevulinic acid incorporation

The rate of incorporation of [ 14C]aminolevulinic acid (ALA) into cytochrome hemes was used to measure mitochondrial cytochrome synthesis in the fat body of adult male Blaberus discoidalis cockroaches. The hemes of cytochromes aa 3+ b and c+ c 1, were chemically separated to observe differential rates in their synthesis and regulation. [ 14C]ALA was linearly incorporated into cytochrome hemes for at least 8 h. No significant pool of endogenous ALA was detected relative to the amount of administered [ 14C]ALA. Peak cytochrome synthesis occurred 4 to 6 days after adult emergence. Endocrine disruption by corpora cardiaca-corpora allata extirpation or cervical ligation eliminated the 4-day developmentally related increase in the rate of cytochrome aa 3+ b synthesis but had no effect on the production of cytochromes c+ c 1. Injections of corpora cardiaca extracts into cervically ligated animals stimulated the rate of production of cytochromes aa 3+ b by 2.5 times but did not affect cytochromes c+ c 1. By comparison, juvenile hormone injections did not affect the rate of synthesis of either cytochrome fraction. These findings indicate that a neurohormone regulates the rate of synthesis of cytochromes a+ b in insect fat body mitochondria.