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Biomedical subjects

S Sabato

Publications and source records attributed to S Sabato.

18 recordsLinked to original sources

Spinal involvement in children and adolescents with Gaucher disease.

Nineteen patients with type I Gaucher disease with spinal involvement first diagnosed during childhood, were followed for 2 to 24 years (average 9 years), and their clinical and radiologic history reviewed. Patients presented with three types of pain: mild pain that was defined as nonspecific, severe pain due to bone crisis, and pain associated with vertebral collapse. Collapse of vertebra occurred gradually anywhere along the thoraco-lumbar spine, and usually more than one vertebra was involved. In three patients, rectangular collapse was noted. Six patients suffered from central vertebra collapse, and two from anterior wedge compression. Further vertebral collapse with signs of root and cord compression developed in three patients as they grew. Awareness to the possibility of progressive vertebral collapse and periodic follow-up might prevent severe complications.

Adolescent↗

Halothane anesthesia is neuroprotective in experimental spinal cord injury: early hemodynamic mechanisms of action.

The neuroprotective potential of halothane anesthesia was explored in a weight-drop model of spinal trauma in the rat (N = 252). In initial experiments, animals were subjected to 25, 50 or 100 g cm impact injuries at T10 during pentobarbital or halothane anesthesia and their outcomes determined using somatosensory-evoked potentials, blinded neurologic evaluations for two weeks, and post-mortem analysis of spinal serotonin levels. Subsequently, halothane anesthesia was combined with either pentobarbital or nitrous oxide or given as a late treatment to pentobarbital anesthetized rats subjected to 50 g cm injuries. A series of acute studies were then performed in order to assess the hemodynamic and respiratory concomitants of halothane vs. pentobarbital, as well as the effect of mechanical ventilation and bicarbonate treatment upon halothane neuroprotection. Finally, the effect of a 50 g cm impact upon local white matter spinal cord blood flow was measured during halothane or pentobarbital anesthesia using laser-Doppler flowmetry. Results demonstrate an active neuroprotective action for halothane anesthesia that is not altered by the presence of other anesthetics and is most prominent at severe injury levels. The data suggest the importance of immediate injury responses in this action. Late halothane treatment was ineffective when given as early as 10 minutes postinjury while both the electrophysiological and hemodynamic effects of halothane vs. pentobarbital were apparent during this 10 minute period. Thus, halothane was associated with the prevention of spinal ischemia during the first 10 minutes after trauma in comparison to pentobarbital.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗

Safety versus efficacy of spinal cord stimulation for the generation of motor-evoked potentials in the rat.

The relative safety and efficacy of direct versus indirect methods of spinal cord stimulation for the production of descending motor-evoked responses was studied in pentobarbital-anesthetized rats (n = 39). Electrical stimuli were delivered for 1 h, either directly to the cord dorsum using silver ball electrodes or indirectly through jeweler's screws implanted in the intact laminae. Compound muscle action potentials (CMAPs) were recorded differentially in the quadriceps and evaluated for their morphology and reproducibility. The traumatic effects of stimulation were assessed using intraoperative somatosensory-evoked potentials, blinded neurological examinations for 2 weeks postoperatively, and histopathological and neurochemical analyses in postmortem spinal tissues. In separate experiments, the neural substrates of the muscle-evoked response to indirect cord stimulation were examined. Direct, epidural stimulation of the spinal cord at intensities sufficient to elicit reproducible CMAPs consistently resulted in mild behavioral deficits (13 of 18 animals) that were accompanied by postmortem changes in spinal histology and chemistry. Some of these behavioral deficits (5 of 13 animals) were resolved at 2 weeks. There was rarely an early sign of motor or sensory conduction derangement in these animals. In 2 animals with severe behavioral dysfunction, the somatosensory-evoked response was abolished immediately after spinal stimulation. However, CMAP responses were unaltered. Examination of the strength-duration relationship for the production of threshold responses to translaminar constant current stimulation, as well as experiments using selective transection of the dorsal columns, revealed the CMAP responses to be neurally mediated and conducted through the cord independent of the ascending sensory tracts that mediate the rat's somatosensory-evoked response. Data are discussed in terms of the potential experimental usefulness of CAMPs elicited by indirect dorsal spinal stimulation.

Action Potentials↗

[Regional hemodynamic evaluation of heterotopic liver transplantation by the determination of the hepatic artery resistance index].

Hepatic artery resistance index (I.R.) was evaluated in six pigs through Doppler scan after progressive gauge reduction of the portal vein up to complete clamping. The I.R. values were (mean +/- S.D.): 0.48 +/- 0.01 in basal conditions; 0.37 +/- 0.03, and 0.33 +/- 0.01 with a reduction of 1/3 and 2/3 respectively; 0.27 +/- 0.02 after complete portal clamping. These data confirm the close relationship existing in the hepatic circulation between changes of the arterious resistence and those of the portal flow. The same animals, subsequently, underwent heterotopic liver transplantation in the right paracolic gutter. Immediately after surgery the I.R. values of the transplanted hepatic artery were recorded without clamping (basal portal flow 0.52 +/- 0.02) and after clamping of the transplanted portal vein (0.33 +/- 0.03), while maintaining clamped the recipient portal vein at the hilus. These values were comparable to those obtained in the recipient hepatic artery. These data suggest that, in spite of parenchymal damages secondary to surgical procedure and of the haemodynamically unfavorable site in which the organ is transplanted, heterotopic liver transplantation does not produce significant changes in hepatic arterious resistance.

Animals↗

Anesthesia influences the outcome from experimental spinal cord injury.

The effect of anesthesia upon the functional outcome after experimental spinal cord injury (SCI) was studied in 221 rats subjected to graded weight drop contusion in the thoracic cord. Neurologic function was assessed in a blinded fashion for one week after injury using a modification of the method of Tarlov. The post-mortem concentrations of serotonin and its metabolite were measured in injured and surrounding spinal tissues in a subset of animals in order to estimate the survival of descending long-tract axons. In initial studies using non-ventilated animals where body temperature was not controlled (n = 130), halothane anesthesia was associated with significantly better neurologic scores at all levels of injury (50, 100 and 250 g.cm) in comparison to pentobarbital. In a second experiment under these conditions (n = 53) the effect of halothane was observed after a 50 g.cm injury in comparison to both pentobarbital and nitrous oxide. Improved neurologic recovery was accompanied by the preservation of normal serotonin and metabolite concentrations in spinal tissue caudal to the site of injury. These values did not differ from those measured in sham-operated animals. Separate experiments (n = 12) revealed halothane's preservation of somatosensory-evoked responses during the early postinjury period in animals showing improved neurologic recovery. Subsequent experiments (n = 12) were performed to assess the effect of oxygen supplementation and the control of rectal temperature and a separate series of acute experiments (n = 14) examined arterial blood pressure responses to injury in halothane- and pentobarbital-anesthetized animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗

Spongious and cortical osteoblastoma of the axial skeleton.

Eleven cases of osteoblastoma (spongious osteoblastoma) and four cases of osteoid osteoma (cortical osteoblastoma) involving the spine, diagnosed at Hadassah Hospital between 1970 and 1983 were analyzed. The age range was 7 to 34 years and the average clinical follow up was 63 months. The cervical spine was involved in four patients, thoracic in four, lumbar in six and the sacrum in one patient. Back or neck pain associated with stiffness was present in all cases and was often accompanied by scoliosis or torticollis. All the patients with osteoid osteoma were symptom relieved by surgery without recurrence. Seven of the patients with benign osteoblastoma presented with neurological signs or symptoms and three of these had recurrence following primary surgery. Although cortical and spongious osteoblastoma are considered as members of the same family of benign tumors of osteoblastic derivation, spongious osteoblastoma does not seem to be limited in growth potential as is cortical osteoblastoma.

Adolescent↗

The surgical management of pathological fractures.

Recent advances in radiotherapy and chemotherapy frequently prolong the life of patients with carcinomatosis, but the suffering and disability resulting from pathological fracture require aggressive local treatment in order to alleviate pain and restore skeletal stability. Out of 89 patients with 102 pathological fractures, 28 patients underwent surgery for 30 fractures. Radical local excision of tumour tissue and filling of the defect with methylmethacrylate was augmented by internal fixation. These procedures resulted in immediate and significant pain relief with consequent improvement in the quality of the patient's life.

Bone Neoplasms↗

A new method of measuring bone density in the lower tibia of normal and postinjury limbs. A quantitative and comparative study.

In osteoporosis, a pathologic state of diminution of bone mass, radiography is the most widely used diagnostic method, but it is only descriptive and mainly depicts changes in the compacta. Based on the Compton photon-scattering phenomenon, a noninvasive yet quantitative measuring method for analyzing bone density was developed. The values of repeated measurements taken at identical locations did not vary by more than 2%. Using this technique, bone density of the lower tibia was measured in 39 men and 36 women; 14 had been affected by an injury to a knee or calf and immobilized five to eight years prior to this investigation. The measured values demonstrated an impressive equality between the tibiae of each individual and between the two sexes up to 50 years of age. However, these values correlated poorly with the bone density of the distal radius. In women older than 50 years of age, bone density decreased. Bone density was also low in all postinjury limbs. When compared with radiographic and bone mineral content (BMC) measurements of the same limb at the same location, the bone density measurements were useful and reduced the range of uncertainty of diagnosing osteoporosis by radiography only. Little or no correlation was found between bone density values and BMC measurements. The Compton scattering technique may become a precise and sensitive method for the clinical diagnosis of postinjury osteoporosis and quantitation of the long-term effects of limb injuries.

Adolescent↗

Radial trans-scaphoid perilunate dislocation.

An unusual case of trans-scaphoid perilunate fracture-dislocation of the carpus with radial displacement in a 19-year-old man is reported. On the basis of the clinical and radiologic findings it was assumed that the tip of the radial styloid process caused the scaphoid fracture. Following closed reduction with acceptable positioning of the carpal bones, the patient has good function and slight pain, and was able to return to almost full employment about 1 year postinjury.

Adult↗

[Absence of the formation of wrinkles of the finger tips in leprosy].

Soaking of the hand of leprosy patients in water of 38 degrees--40 degrees C during half an hour does not lead to the formation of wrinkles, in contrast to healthy individuals. We tend to relate this lack of wrinkles to the damaged nerve ends which are often found in leprosy patients. The number of investigated individuals is small and repeated experiments are therefore required. Should the above results be established, the soaking test could serve as an additional tool for the diagnoses of leprosy.

Adult↗

Platelet aggregation abnormalities in idiopathic scoliosis.

Platelet aggregation studies were performed in 22 adolescent girls with idiopathic scoliosis. Impaired ADP-induced platelet aggregation was found in washed platelets of the 22 patients with idiopathic scoliosis when compared with the controls (76.5% of control values; p less than 0.01). Furthermore, platelets from patients with progressive curves showed a greater degree of abnormality than platelets from those with nonprogressive curves, e.g., 57.6 +/- 22% of control values (p less than 0.001). No significant differences in aggregation could be detected when platelets were aggregated with the ionophore A-23187 in either the absence or the presence of calcium. Platelet aggregation studies in patients with other spinal deformities did not differ from the healthy controls. Because platelets share similar contractile proteins as muscles, the present study suggests that a muscle disorder may play an important pathogenic role in idiopathic scoliosis.

Adenosine Diphosphate↗