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PubMed1996

[Mathematical model of supersaturation of mixed venous blood by gases on decompression].

The paper deals with the negative role of a symptomless gas-formation in the blood; there deduced an equation making it possible to calculate and limit supersaturation of the mixed venous blood and there developed a mathematical model with the use of which it is possible to assess the supersaturation of human mixed venous blood during decompression. It is established that as a result of limitation of supersaturation of the mixed venous blood under decompression there appears a series of short deep-water stops which increases the mode safety. The use of this equation in an integrated mathematical model of decompression furnishes an opportunity to develop the more adequate decompression modes.

Decompression↗
PubMedDate not supplied

[Effectiveness of prostatylene in the prevention of decompression disease in an experiment].

Works done under elevated environmental pressures present a risk for decompression disease. The use of altitude chambers for its prevention and treatment is technically complex and expensive. The paper presents the results of studies into the effects of the new peptide regulator prostatylene isolated from the bovine prostate. Experiments were conducted on 132 albino noninbred male rats weighing 180-220 g. All the rats were divided into 10 groups by the dose (from 0.5 to 5.0 mg/kg) and frequency of prostatylene administration (1-11 days). The agent was injected in a single intramuscular dose. Altitude exposure was made in a 75-liter chamber provided by a chemical absorbent container. Air temperatures were constant (19-21 degrees C) humidity was no higher than 75%. A compressor was used to pump as high as 0.7 MPa. The duration of compression, isopression, and decompression was 3 min, 1 hour, and 80 sec, respectively. The percentage of rat deaths and the interval from the termination of decompression to death were used as an index for the efficacy of prostatylene. The preset altitude exposure led to 75% death in control rats. A single dose of prostatylene did not affect this index, but thrice preinjection of the agent showed as high as 25% animal death reductions. Its protective properties were shown when the agent was administered in a dose 1 mg/kg for 5 days. It is concluded that the prostate participates in the formation of nonspecific mechanisms of defense when the body is influenced by environmental factors and that prostatic peptides are able to prevent decompression disease in the experiment.

Animals↗
PubMed1997

Surgical decompression of thoracic outlet syndrome; is it a worthwhile procedure?

During a 20-year period from 1974 to 1994, 37 thoracic outlet decompressions were performed. There were 28 females and six males (ratio 5:1). The median age was 37 years (range 15-64). Symptoms were predominantly neurological in 29 limbs (78%), arterial in five limbs (14%) and venous in three limbs (8%). Limb pain and paraesthesia were the most common symptoms. Surgical decompression was performed via a supraclavicular approach in 24 limbs (65%) and a transaxillary approach in 13 limbs (35%). A cervical rib was excised in 21 limbs (57%), a first rib in 10 limbs (27%), a cervical and first rib in one limb (3%) and a cervical band in five limbs (13%). Arterial reconstruction was only required in three limbs (8%). There were a total of four complications (11%). The outcome of surgical decompression was assessed by using a questionnaire completed by the patient. Overall 27 patients (87%) felt that the operation was worthwhile. These results show that surgical decompression for thoracic outlet syndrome is a worthwhile procedure and is associated with relatively few complications.

Adolescent↗
PubMed1997

Core decompression in treating ischemic necrosis of the femoral head.

BACKGROUND: The application of core decompression in the treatment of ischemic necrosis of femoral head (INFH) is to preserve the joint at early stage of the disease. Although excellent results have been obtained in many series, its effectiveness is questionable because of high rates of failure. This study is to evaluate the effectiveness of this technique in our patients with INFH receiving core decompression as the sole treatment. METHODS: Although 91 patients were treated with core decompression in Veterans General Hospital-Taipei from 1980 to 1993, only 71 were considered as the valid cases after having been followed for 24 to 165 months (mean 56.7 months). Of 84 hips treated, 49 hips were steroid induced, 20 idiopathic, 14 alcohol related, and one related to trauma. Twenty-five hips were at Steinberg stage I, 32 at stage II, nine at stage III, 17 at stage IV, and one at stage VI. RESULTS: The results were poor in 22 (26.19%) hips since the patients required hip prosthesis. Fair results were rated in 37 (44.05%) hips since progressive collapse occurred in the femoral head and the patients suffered from moderate hip pain. Good results were found in nine (10.71%) hips since the lesion showed no progression and the patients had only occasional pain. Excellent results were obtained in 16 (19.05%) hips since the patients had no pain and the lesion had no progressive change. The satisfactory rate in the nonsteroid-related hips (33% or 12/35) was significantly higher than in the steroid-related hips (27% or 13/49). The overall satisfactory result was only 30%. CONCLUSIONS: Although core decompression may not be effective in preventing progression of INFH, it may relieve temporary pain and delays the need for hip arthroplasty in some patients.

Adolescent↗
PubMed1998

Information about venous gas emboli improves prediction of hypobaric decompression sickness.

HYPOTHESIS: Information about venous gas emboli (VGE) detected in the pulmonary artery such as the occurrence of VGE, Grade of VGE, the time when VGE first appear, and the time course of the Grade or occurrence of VGE, could be used to better assess the probability of decompression sickness [P(DCS)] in any hypobaric decompression. We hypothesized that these data would improve the estimate of P(DCS) since objective measurements of the decompression stress are available for the individual. METHODS: A binary correlation and survival analysis approach were used on information from 1,322 hypobaric chamber exposures to establish the relationships between VGE and DCS. RESULTS: Based on the correlation analysis, the absence of VGE is highly correlated with the absence of a DCS symptom, as evident from a negative predictive value of 0.98. However, the presence of VGE in the pulmonary artery is not highly correlated with a subsequent DCS symptom, as evident from a positive predictive value of 0.39 for Grades III and IV VGE. The correlation results suggest the presence of VGE in the pulmonary artery is a necessary, but not sufficient, condition for DCS. Based on the survival analysis, the log logistic survival model, a one-variable model with two parameters gave a log likelihood (LL) of -757. This model was expanded to include seven additional variables, including four about VGE, and the nine-parameter model gave a better LL of -481. CONCLUSION: Information about VGE plus other variables known to influence DCS is useful to better assess the P(DCS) for hypobaric decompressions.

Adult↗
PubMedDate not supplied

[The results of microvascular decompression of the accessory nerve in patients with spastic torticollis].

The results of microvascular decompression of accessory nerve in patients with spastic torticollis are reviewed. 40 patients with spastic torticollis were treated. Unilateral microvascular decompression of the XIth cranial nerve were used in 11 cases, lateral in 23 cases. 5 patient had complete recovery, positive results were achieved in 12 patients. Best results were observed after bilateral decompression including retrocollis patients. Surgical treatment of laterocollis patients was less successful. Unilateral microvascular decompression of accessory nerve proved to be effective in homolateral type of torticollis.

Accessory Nerve↗
PubMed1996

[Evaluation for therapeutic efficacy of decompression of optic nerve canal in 121 cases].

OBJECTIVE: To evaluate the therapeutic efficacy of decompression of optic nerve canal in the eye with indirect nerve injury in the optic nerve canal. METHODS: 121 patients with indirect injury of optic nerve in the canal were selected and decompression of optic nerve canal was performed on them. Then the outcomes were reviewed and analyzed. RESULTS: Visual acuities of 76 patients (62.81%) were improved. CONCLUSION: It is obvious that decompression of optic nerve canal is associated with significant improvement in cases with good preoperative vision. In cases without light perception, treatment of steroids and dehydrant should be firstly applied, afterwards according to the patient's individual situation, selectively the case is to perform the operation. Thus the therapeutic effectiveness can be greatly elevated. Decompression of optic nerve canal is safe and reliable.

Adolescent↗
PubMed1998

Optic nerve sheath decompression in pediatric pseudotumor cerebri.

The authors report a retrospective review of two cases of optic nerve sheath decompression in children (age younger than 16 years) and review the literature on the procedure. Two children underwent optic nerve sheath decompression. Optic disc edema resolved in both eyes after surgery. Some degree of visual improvement was obtained in one eye of each patient after surgery, but one eye was unchanged in one patient and one eye of the other patient had worsening of visual acuity after surgery. Neither patient suffered any systemic complications from the procedure. Of 12 patients in the literature (including these 2 patients), 66% experienced improved visual acuity following optic nerve sheath decompression, 33% had improvement in visual field, and 17% suffered worsening of visual acuity and visual field after surgery. Although optic nerve sheath decompression is a relatively safe and effective treatment for visual loss due to papilledema in adults, significant complications, including further visual loss, may occur. The experience with this procedure in children is limited, but retrospective data suggest that the safety and efficacy of the procedure may be comparable with that in adult patients.

Adolescent↗
PubMed1998

Decrease in intraocular pressure after orbital decompression for thyroid orbitopathy.

BACKGROUND: The effect of thyroid orbitopathy on intraocular pressure (IOP) remains controversial. We carried out a study to determine the effect of orbital decompression surgery on the IOP in patients with advanced thyroid orbitopathy. METHODS: The records of 12 consecutive patients (22 eyes) who underwent decompression surgery for severe thyroid orbitopathy between 1985 and 1996 were reviewed. All patients were maintained on essentially the same medications before and after surgery. The IOP readings, obtained by means of applanation tonometry in primary gaze, from the pre- and postoperative visits were recorded, and the net change was calculated. RESULTS: The mean preoperative and postoperative IOP values were 19.8 mm Hg and 16.8 mm Hg respectively, a significant difference (p = 0.008). Seven of eight eyes with an IOP of 21 mm Hg or greater preoperatively had a postoperative IOP less than 21 mm Hg; these eyes showed a mean decrease in IOP of 5.6 mm Hg. The degree of preoperative IOP elevation was found to be a strong predictor of the amount of IOP lowering after surgery (p = 0.014). INTERPRETATION: Our results support the concept that orbital congestion associated with thyroid orbitopathy produces an increase in IOP by elevation of episcleral venous pressure (EVP) and that orbital decompression may reduce the IOP by decreasing EVP. Decompression surgery may obviate the need for more aggressive management of glaucoma in patients with severe thyroid orbitopathy.

Adult↗
PubMed1998

[Bile duct decompression and immune correction in the surgical treatment of mechanical jaundice of non-tumor origin].

The aims of the study were: 1) to determine optimal duration of bile ducts decompression (BDD) and terms for radical operation performance; 2) to define criteria of effectiveness of the decompression and readiness of the patients for radical surgical treatment; 3) to analyze disorders in liver function and indices of immunoreactivity in relation to the method and duration of BDD; 4) to develop method of immunocompression for increase of effectiveness of BDD. The patients were divided in to three groups. 28 patients of group 1 had duration of jaundice up to 5 days and bilirubinemia up to 86.3 +/- 3.12 mmol/l. 35 patients of group 2 jaundice up to 15 days and bilirubinemia up to 184.7 +/- 4.22 mmol/l. In group 342 patients had bilirubinemia up to 124.4 +/- 2.23 mmol/l and cholangitis. External decompression of bile ducts quickly promotes restoration of drainage function of the liver and normalization of biochemical indexes. Restoration of immunological indexes in groups 2 and 3 is progressing slowly and demands immunocorrection. Indexes of immunoreactivity and biochemical data of functional status of the liver could serve as criteria of effectiveness of bile ducts decompression and possibility of radical surgical treatment. Regional immunocorrection is indicated for the patients' preparation for surgery.

Adjuvants, Immunologic↗
PubMed1993

Optic nerve sheath decompression for glaucomatous optic neuropathy with normal intraocular pressure.

OBJECTIVE: To report our therapeutic experience with optic nerve sheath decompression in patients with normal-pressure glaucoma. DESIGN: A case series of seven eyes from six patients with glaucoma and normal intraocular pressures who continued to have progressive visual field loss despite conventional therapy. SETTING: A hospital-based, referral glaucoma service. PATIENTS: Three men (67, 67, and 72 years of age) and three women (58, 61, and 70 years of age). INTERVENTIONS: Optic nerve sheath decompression. MAIN OUTCOME MEASURES: Visual field data and visual acuity measurements were obtained at regular intervals during the postoperative periods (range, 3 to 18 months). RESULTS: Two of seven eyes from six patients appear to have enjoyed an initial significant improvement in their visual fields with improved visual acuity in one eye of one patient. The visual fields, however, appear to have deteriorated 18 months after the initial procedure in these two patients. In the remaining four patients, no further improvement or deterioration was observed within a limited follow-up period. CONCLUSIONS: The transient improvement in the visual fields of one eye from each of two patients documents an initial successful use of optic nerve sheath decompression in patients with nerve fiber bundle damage in the absence of optic nerve head swelling. However, the long-term potential of optic nerve sheath decompression in these patients may be of limited value.

Aged↗
PubMed2002

Recurrent inner ear decompression sickness associated with a patent foramen ovale.

Isolated inner ear injuries occurring during shallow scuba dives are an uncommon manifestation of decompression sickness in recreational divers. We describe a patient who presented with the typical symptoms of inner ear involvement after 2 independent dives within the decompression limits. The diver reported symptoms of unilateral (right-sided) hearing loss, tinnitus, and vertigo after dives to 35 and 50 m. After treatment with hyperbaric oxygen, his symptoms completely resolved. To confirm the hypothesis of inner ear decompression sickness (IEDCS), we examined the patient for a right-to-left shunt by cranial Doppler ultrasound and found a patent foramen ovale. The existence of a patent foramen ovale is suspected to be a risk factor for developing neurological symptoms of decompression sickness. There was no evidence of any other risk factors, so we suggest that the relevant right-to-left shunt in our patient may have been the predisposing factor that caused the inner ear symptoms during his scuba dive.

Adult↗
PubMed1994

Precise and limited decompression for lumbar spinal stenosis.

Fifty-eight consecutive patients with lumbosacral nerve root entrapment due to spinal stenosis were treated with modified microsurgical decompression. Only the clinically relevant sides and levels were decompressed while the spinous processes, the interspinous ligaments, the medial portion of ligamentum flavum and the functionally important parts of the facet joints were preserved. The reviewers rated recovery as good or excellent in 71% of patients while patient self-assessment indicated 76% good or excellent outcome. These data suggest that microsurgical decompression of spondyloarthritic changes can effectively relieve the signs and symptoms of nerve root compression and that with careful evaluation of all available data the number of nerve roots requiring decompression is often fewer than what is suggested by diagnostic images alone.

Adult↗
PubMed1996

Intra-operative monitoring by facial electromyographic responses during microvascular decompressive surgery for hemifacial spasm.

The facial electromyographic response was monitored intraoperatively in 40 patients with hemifacial spasm who were operated on by microvascular decompression of the facial nerve. All 40 patients showed an abnormal facial electromyographic response (lateral spread response) with a latency of about 10 msec after stimulation. The abnormal response resolved before decompression in 22, resolved immediately with decompression in 16, and failed to resolve in two. Of the 38 patients in whom the abnormal response disappeared during surgery, 36 were postoperatively free from hemifacial spasm and two had mild hemifacial spasm. The two patients in whom the lateral spread response did not disappear during surgery showed persistent hemifacial spasm. In conclusion. Disappearance of the lateral spread response during surgery correlated with the absence of hemifacial spasm in the early postoperative period. The prognosis of hemifacial spasm was good in cases in whom the lateral spread response disappeared. Therefore, the authors think that intra-operative facial electromyography is very useful in assessing the efficacy of microvascular decompression and in predicting the prognosis of hemifacial spasm.

Adult↗
PubMed1978

[Decompression technique: intestinal emptying with a tube (author's transl)].

The goal of treating postoperative ileus must be decompression of the intestine in order to prevent further development of the disease. Two different methods are available: (1) closed decompression (a) by stripping the intestine orally or aborally, or (b) through an intraluminal intestinal tube, and (2) open decompression through enterotomy. Because stripping of the intestine leads to traumatization of the intestinal wall, suction through an intraluminal intestinal tube can be considered preservative. Preoperatively, the tube is inserted through the nose into the stomach and from there is directed through the pylorus and the duodenum into the upper jejunum. Decompression of the intestine with a long intestinal tube also permits prophylactic intestinal splinting and prevents additional adhesions, kinking, and resulting new ileus conditions.

Humans↗
PubMed1983

The influence of large decompressive craniectomy on the outcome of surgical treatment in spontaneous intracerebral haematomas.

The outcome of a series of 73 patients with spontaneous intraparenchymatous haematomas treated by surgical evacuation of the clot and decompressive craniectomy has been described. Comparing postoperative mortality of this series with another series of patients (54 cases) treated only with surgical removal of the clot without decompressive craniectomy a statistically significant improvement in the mortality rate after craniectomy could be observed in acute cases demanding surgical intervention for preservation of life in the first 24 hours. If signs of brain-stem suffering appear surgical mortality increases proportionally to the duration of this symptomatology. In these cases surgery, if it is to be useful, has to be performed as soon as possible. The morbidity of the surviving patients is not greater in this series with decompressive craniectomy than in series without decompression.

Adolescent↗
PubMed1995

Anterior decompressive microsurgery and osteosynthesis for the treatment of multi-segmental cervical spondylosis. Pathophysiological considerations, surgical indication, results and complications: a survey.

Surgical treatment of cervical myelopathy due to multi-segmental cervical spondylosis (MSCS) is currently performed by either anterior or posterior approaches. Considering the complex nature of the underlying disease involving more than one cervical segment, as well as the patho-biomechanical features of the spondylotic cervical spine, adequate decompression of the spinal cord and correction of hypermobility should be achieved by surgery in one stage, in order to achieve positive immediate and long-term benefit for the patient suffering from progressive myelopathy. Recently, anterior decompressive surgery, consisting of single or multi-level vertebrectomy, microsurgical epidural decompression and osteo-synthesis has emerged as an aggressive therapeutic approach for the treatment of MSCS. Based on the experience of a series of 92 patients with progressive cervical myelopathy due to MSCS operated on using the above described combined techniques, as well as the results from a limited number of clinical studies of anterior decompressive surgery in MSCS patients from the literature, the pathophysiological considerations, surgical indications, surgical technique as well as clinical results and complications of anterior surgery in patients with MSCS are reviewed and discussed.

Cervical Vertebrae↗
PubMed2001

Endoscopic transanal decompression with a drainage tube for acute colonic obstruction: clinical aspects of preoperative treatment.

PURPOSE: The study was undertaken to evaluate the clinical usefulness of endoscopic transanal decompression with a newly developed drainage tube for the treatment of acute colonic obstruction. METHODS: Thirty-six patients ranging in age from 46 to 87 years (average age = 69 years) with acute colorectal obstruction secondary to carcinoma were treated by means of intubation with a flexible drainage tube using combined endoscopic and fluoroscopic guidance. After tube placement, the obstructed colon was aspirated, decompressed, and cleaned with a 50 ml syringe and saline solution. The drainage tube was kept inserted and the colon was irrigated two or three times per day using 500 to 1,000 ml of saline until there were no contents in the colon. The colon was almost empty at the time of operation. The success rate, benefits, and complications of this technique were evaluated. RESULTS: Placement of the drainage tube was successful in 34 (94.4 percent) of 36 patients. Immediately after aspiration and decompression, symptoms related to obstruction were relieved in 21 patients (61.8 percent), within one hour in 9 patients (26.5 percent) and within four hours in 4 patients (11.8 percent). All 34 patients had elective single-stage surgery without severe complications at the anastomotic site such as anastomotic leakage and postanastomotic stenosis that needed treatment a few days after placement of the drainage tube. In the two cases of unsuccessful placement of the drainage tube, emergent colostomy was performed. CONCLUSION: Decompression with a transanal drainage tube is an easy and safe technique to relieve colonic obstruction effectively without any excess burden to patients. Because the procedure permits single-stage surgery in most cases, it is also cost effective.

Acute Disease↗