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Biomedical subjects

H S Steinberg

Publications and source records attributed to H S Steinberg.

10 recordsLinked to original sources
PubMed2001

[Laparoscopic cholecystectomy in a patient with honeycomb lung].

Laparoscopic surgery of the gallbladder has increasingly replaced open techniques due to postoperative benefits (less pulmonary complications, less postoperative pain, earlier mobilisation). Specific intraoperative effects of pneumoperitoneum have led to some uncertainty if cardiac and/or pulmonary high-risk cases should be done laparoscopically. We describe anaesthesiological management of a 72 year old patient with a unilateral leftsided honeycomb lung (two very large cysts) to undergo laparoscopic cholecystectomy. Vital capacity was reduced to 45%, forced expiratory 1 second volume to 41%, preoperative bloodgas analysis revealed a paO2 of 64 mmHg and a paCO2 of 40 mmHg. Under spontaneous breathing the patient was fiberoptically intubated with a left sided double lumen tube (Mallinckrodt, Athlone/Irland; 37 Ch) using balanced anaesthesia. The healthy right lung was hand ventilated with 100% oxygen to avoid excessive airway pressures (peak airway pressure 27 mbar, mean airway pressure 22-24 mbar). The diseased left lung was passively insufflated with oxygen. The intraabdominal pressure was limited to 10 mmHg. Muscle relaxation was achieved with atracurium under monitoring using a nerve stimulator. The paCO2 increased from 40 to 57 mmHg during the operation, but returned to normal immediately postoperatively. All other ventilatory and hemodynamic parameters were uneventful during the 35 minute procedure. The patient was extubated at the end of the procedure and monitored on the intensive care ward for one night. A postoperative chest X-ray revealed a mediastinal shift of 2 cm to the right, healthy side as well as an atelectasis on this side. The shift was most likely due to hypoventilation of the right lung, with the ensuing atelectasis drawing the mediastinum to the right. Under physiotherapy this shift had resolved by the next morning. The patient could be discharged from hospital on day seven and fully recovered. Especially the severely cardiopulmonary compromised patient benefits from a laparoscopic procedure, due to less postoperative reduction of pulmonary function. Careful and individually adapted monitoring and anaesthetic techniques are necessary to successfully counteract the special implications of pnemoperitoneum.

Aged↗
PubMed2000

Cerebellar degeneration in Old English Sheepdogs.

OBJECTIVE: To evaluate related and unrelated Old English Sheepdogs (OESD) by clinical examination, histologic evaluation, and pedigree analysis to determine whether cerebellar degeneration develops in this breed and whether there are genetic implications. DESIGN: Case study and pedigree analysis. ANIMALS: 24 clinically normal or affected OESD; brain tissue specimens from 25 unaffected or affected OESD. PROCEDURE: Twenty-four OESD that were chosen because of a family history of gait abnormalities were given physical and neurologic examinations to determine whether they had clinical signs of cerebellar degeneration. Tissue specimens from 25 brains of OESD were examined histologically. Nine OESD that were determined to have cerebellar degeneration histologically as well as 2 clinically affected littermates of the histologically confirmed affected OESD were included in the pedigree analysis. Standard statistical evaluation of pedigrees for hereditary conclusions was used. RESULTS: Twelve of the 24 OESD evaluated by neurologic examination had a progressive gait abnormality. Clinical signs of cerebellar degeneration typically started later in life in OESD, compared with description for other dog breeds, and progressed ore slowly. Results of pedigree analysis revealed that 11 of 49 dogs were affected in 9 litters, providing an affected-to-total ratio of 22.49%. CONCLUSIONS AND CLINICAL RELEVANCE: Results of our study indicate that a slowly progressing late-onset form of cerebellar degeneration develops in OESD, and the mode of inheritance is by an autosomal recessive gene.

Animals↗
PubMed1990

In vitro inhibition of hemopoietic cell line growth by hepatitis B virus.

The effects of hepatitis B virus (HBV) on established human cell lines of various tissue origins were evaluated by clonal or colorimetric assays in methylcellulose culture. HBV exposure inhibited the growth of six hemopoietic cell lines, while similar incubation did not affect the growth of seven nonhemopoietic carcinoma cell lines of breast, colon, liver, and stomach origin. The inhibition of hemopoietic cell line colony formation was dependent on the presence of intact viral (Dane) particles and the ratio of exposure of virions to cells and was reversible with antibodies to pre-S1, pre-S2, and S envelope protein epitopes. Purified HBV DNA, surface antigen pre-S antigens, and core antigen did not inhibit cell line growth. These results further demonstrate the tropism of HBV for cells of hemopoietic origin, confirming our previous findings on the effects of HBV on the growth of normal bone marrow progenitor cells in vitro. Established human tissue culture cell lines may be used to study the interactions of hemopoietic cells with HBV.

Cell Division↗
PubMed1989

Laryngeal paralysis in immature and mature dogs as one sign of a more diffuse polyneuropathy.

Six dogs with laryngeal paralysis had clinical, electrophysiologic, and pathologic evidence of a more generalized polyneuropathy. Three of the dogs were young Dalmatians, one was a young Bouvier des Flandres, and two were older, large-breed dogs. The results of this study suggest that laryngeal paralysis in dogs may frequently be one clinical sign of an underlying, more generalized polyneuropathy. Two forms of this generalized polyneuropathy may exist: an early form, as seen in young dogs with congenital or hereditary disease, and a delayed-onset form that is usually found in older dogs with so-called idiopathic laryngeal paralysis, some of which may have hypothyroidism.

Animals↗
PubMed1988

Brachial plexus injuries and dysfunctions.

The brachial plexus and its associated structures demonstrate a propensity for certain disease processes not common to other areas of the nervous system. Brachial plexus disease produces a gait disturbance that may mimic musculoskeletal disease. When evaluating a case with possible traumatic brachial plexus disease, one relies heavily on historical, physical, and neurologic information when differentiating musculoskeletal disorders, although both may sometimes be present simultaneously in the same limb. With inflammatory disease, electromyography is extremely helpful, although an empiric dietary change may help confirm a suspicion. Brachial plexus surgery requires careful planning and meticulous technique. Attempts to remove malignant schwannomas have not been as successful as one would hope (Table 2). To a large extent, these dogs are treated late in the course of their disease because they are often treated for extended periods of time for musculoskeletal disease first. Early diagnosis and prompt surgical intervention would help many of these dogs. New histopathologic techniques, electrodiagnostic equipment, and radiographic techniques are helping to define peripheral nerve disease in the companion animal. These techniques will help us categorize and treat these diseases with greater success in the future.

Animals↗
PubMed1981

Clinical features of inherited cerebellar degeneration in Gordon setters.

We evaluated a kindred of Gordon Setters affected with inherited ataxia. Six adults and 4 pups clinically affected by the disease were examined. Pathologic studies were performed on a 3-year-old affected female dog and on a 2-month-old pup born to affected parents. The dogs were normal at birth; the 1st signs of neurologic dysfunction (wide-based stance and hypermetria) appeared between 6 and 10 months of age. As the disease progressed, increased tone of the extensor musculature, truncal ataxia, and nystagmus were noted. The disease had a slowly progressive course. The pathologic abnormalities were limited to the cortex of the cerebellum. There was atrophy with loss of Purkinje cells and granule cells affecting predominantly the vermis and paravermian regions of lobules IV, V, and VI. The study of the pedigree and our observations of the progeny of 2 affected dogs indicated that the mode of inheritance of this ataxia is compatible with an autosomal recessive trait.

Animals↗
PubMedDate not supplied

Idiopathic polyneuropathy in Alaskan malamutes.

Clinical and morphologic features of a progressive polyneuropathy in young mature Alaskan Malamutes are described. Clinical signs included progressive paraparesis, synchronous pelvic limb gait, exercise intolerance, hyperesthesia, hyporeflexia, muscle atrophy, and tetraplegia. Electromyographic testing revealed diffuse fibrillation potentials and positive sharp waves in limb muscles, especially in muscles below the elbow and stifle. Pathologic findings in skeletal muscles and peripheral nerves included neurogenic muscle atrophy, focal or diffuse loss of myelinated nerve fibers, myelinoaxonal necrosis, and variable demyelination or remyelination. Ultrastructural changes included axonal degeneration, presence of numerous Büngner bands, and denervated Schwann cell subunits. The nature and distribution of abnormal electrophysiologic and pathologic findings were suggestive of a distal sensorimotor polyneuropathy, which we have termed idiopathic polyneuropathy of Alaskan Malamutes to distinguish this condition from hereditary polyneuropathy of Norwegian Alaskan Malamutes, last described in 1982.

Animals↗
PubMedDate not supplied

A retrospective evaluation of 51 cases of peripheral nerve sheath tumors in the dog.

Fifty-one cases of canine peripheral nerve sheath tumors were reviewed. Signalment, presenting clinical signs, duration of clinical signs, physical and neurological examination findings, results of diagnostic procedures, type of surgery performed, tumor location, relapse-free intervals and survival times, and causes of death were evaluated. Tumors were divided into three anatomical groups: tumors involving nerves distal to the brachial or lumbosacral plexus (Peripheral Group), tumors involving nerves of the brachial or lumbosacral plexus (Plexus Group), and tumors involving the vertebral canal (Root Group). The most common clinical findings were unilateral forelimb lameness and muscle atrophy. The most useful diagnostic tests were myelography and electromyography. Although there was no significant difference, dogs in the Root Group tended to have shorter relapse-free intervals and survival times than dogs in the Plexus Group. The overall prognosis for surgical management of peripheral nerve sheath tumors is guarded to poor.

Animals↗