[Clinical and experimental studies of hepatocytes following surgical decompression for cholestasis].
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There is no consensus on the cause of Bell's palsy, just as there is no proven medical therapy. Disregarding the numerous theoretic causes, preponderant anatomic, electrophysiologic, radiologic, clinical, and pathologic evidence supports entrapment at the medical foramen of the fallopian canal as a final common pathway resulting in facial nerve ischemia and degeneration. Middle cranial fossa decompression of the meatal foramen may benefit those patients most severely affected with Bell's palsy.
In this study, 50 consecutive patients over age 60 with obstructive jaundice secondary to malignant stricture of the distal common bile duct were identified by endoscopic cholangiography. The patients were then randomized to palliative therapy with either endoscopic endoprosthesis or bypass surgery. Prospective indices of survival time, complication rates, hospitalization requirements, and quality of life were followed. All 25 patients randomized to endoprosthesis were treated by this procedure, whereas only 19 of 25 patients randomized to bypass surgery underwent operative biliary-digestive anastomosis. No difference in the above indices were found between the two groups. The authors concluded that palliation of obstructive jaundice due to a malignant bile duct stricture with endoscopically placed biliary stent is as effective as operative bypass.
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A filly with ataxia and splinting and crepitation in the neck was found to have atlantoaxial subluxation. Radiographic diagnosis was based on the same criteria as those used in other species, ie, increased distance between the atlas and spine of the axis and increased distance between the dens and floor of the atlas. Extensive hemilaminectomy was performed to decompress the spinal cord. Stabilization was not attempted. Immediate postoperative response was encouraging, but the untimely death of the filly prevented further evaluation of the procedure.
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17 cases of severe facial paralysis were studied before and after microsurgical decompression, by quantitative electromyography (electromyogram integrated in volts) at the site of the zyogmatic arch. -- In 76% of cases, no significant improvement was measured. -- An immediate, frank improvement occurred infrequently (12%), was short-lived and did not have any influence on the final result.
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