Biomedical subjects

A Shafik

Publications and source records attributed to A Shafik.

At least 253 records · Page 14Linked to original sources

PubMed1980

Invagination of the hernial sac stump. Technique for repair of inguinal hernia.

A technique for repair of indirect inguinal hernia is presented. The hernial sac stump is invaginated in an attempt to secure high ligation of the sac and obliterate any residual peritoneal diverticulum. Four hundred forty-two patients were operated on. The technique consists essentially of division of the internal spermatic fascial tube at the neck as well as embedding of the sac stump by purse-string sutures in a narrow neck of Lembert sutures in a wide neck. The defect in the fascia transversalis is closed over the stump. Three hundred eighty-one patients were followed up 2 to 15 years, with a recurrence rate of 1.6 percent. The concept that in indirect hernia the problem involves the sac rather than the defect is put forward. Recurrence results essentially from the existence of a handmade sac rather than an improperly repaired defect. The role of invagination of the sac in securing complete excision of the sac and proper closure of the defect is discussed. In initiating recurrence, the part played by the redundant peritoneum deep to the internal ring is emphasized. Changes in the dynamics of intraabdominal tension induced by stump embedding are explained.

Adolescent↗

PubMed1980

Venous tension patterns in cord veins. I. In normal and varicocele individuals.

A study on venous tension patterns in the cord veins was done on 30 normal individuals and 32 patients with a left varicocele. Semen analyses and testicular biopsies were done. Venous tension was measured with the patient at rest and during Valsalv's maneuver with a saline manometer. The average normal venous tension with the patient at rest was 58.7 mm. Hg on the right side and 59.9 mm. Hg on the left side. In varicocele patients venous tension on the right side was slightly higher than normal (the average difference being 0.9 mm. Hg), whereas on the left side it was considerably higher (the average difference being 19.7 mm. Hg with the patient at rest and 22 mm. Hg during Valsalva's maneuver). The average increase of venous tension in varicose veins during demonstrates conclusively the presence of venous reflux and hypertension in patients with varicocele. The possible effects of venous reflux on cord veins and testes are presented. The role of venous hypertension in the bilateral effect of varicocele is discussed.

Adolescent↗

PubMed1979

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. VII. Anal fistula: a simplified classification.

The pathology of anal fistulas was studied in 300 patients and a simple classification is put forward. Two main types of fistula are recognized: intrasphincteric and extrasphincteric, according to the relation of the track to the external sphincter. All fistulas start as a central space infection which either remains confined to the intrasphincteric compartment or spreads extrasphincterically. Intrasphincteric fistulas include both central and intersphincteric fistulas. The latter fistula, as well as the extrasphincteric, are either low or high according to the relation of the track to the levator plate. The classification is simple and practical. It clearly demonstrates the precise anatomic position of fistulas as related to anal musculature so proper planning for the treatment can be safely achieved.

Abscess↗

PubMed1979

Aligamentous testicle. New clinicopathologic entity in genesis of male infertility and its treatment by orchiopexy.

Absent scrotal ligament or the aligamentous testicle is a clinicopathologic entity which plays an important role in the genesis of male infertility. Twenty-four cases of aligamentous testicle, collected from 300 idiopathic infertile subjects, were studied. Clinical, endocrine, semen, and testicular biopsies were performed. The criteria of diagnosis of the aligamentous testicle are outlined and the role in infertility is discussed. Eighteen infertile patients with aligamentous testicle were treated by orchiopexy aiming to create an artificial scrotal ligament. The technique is described. The results were satisfactory. Failures were due to bad selection of patients.

Adult↗

PubMed1979

Constrictive albuginitis: report of 3 cases.

Three sterile patients with constrictive albuginitis are described. The most common presenting symptom is a long duration of scrotal pain and the testicles are small and firm. Testicular biopsy is characterized by peritubular fibrosis. Spermatogenesis may be complete but the cells are degenerated. The condition is bilateral. At operation the tunica albuginea is thick, yellowish and rigid and, microscopically, it shows excessive fibrosis and hyalinosis. Sterility is related to the constrictive effect of the tunica albuginea. Treatment by decompression albugineotomy was successful in 2 patients. The benefits derived from the operation are discussed. A primary degenerative process of the tunica albuginea is suggested as causal.

Adult↗

PubMed1978

Absent dartos.

Explore the source record for details and available documents.

Adult↗

PubMed1977

Anatomy and function of scrotal ligament.

The anatomy of the scrotal ligament has been studied in 22 cadavers by dissection and histologic examination. The ligament could be identified in 20 cadavers. It binds the scrotal skin firmly to the tunica vaginalis at the lower testicular pole. The embryonic nature of the ligament is discussed. It synchronizes the crematerico-dartos action under normal and varied temperatures. Absence of the ligament results in disordered testicular thermoregulation and may be a factor in the genesis of subfertility; the mechanisms involved are discussed. The difference between the aligamentous testicle and the high scrotal undescended testicle is discussed.

Adult↗

PubMed1976

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. III. The longitudinal anal muscle: anatomy and role in anal sphincter mechanism.

A study of the longitudinal anal muscle was performed in 16 cadaveric specimens. The study comprised dissection and microscopic examination. The bundles of the longitudinal were found arranged in three layers: medial, intermediate, and lateral; each has a different origin and is separated from the other by a fascial septum. Four fascial septa related to the longitudinal muscle could be identified. They split and decussate below the lower end of the longitudinal muscle to form the "central tendon." The central tendon lies between the base loop of the external anal sphincter and the longitudinal muscle. It gives rise to multiple small fibrous septa in different directions; those which penetrate the base loop split and decussate to form the corrugator ani cutis. A mechanism of action of the corrugator is presented. The role of the longitudinal muscle in the anal sphincter mechanism and during defecation is discussed. The muscle plays its major role during defecation. The part played by the muscle in anal fixation is considered. It helps to fix the anal canal to the side wall of the pelvis during defecation, thus preventing anal prolapse.

Adult↗

PubMed1976

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. IV. Anatomy of the perianal spaces.

A study of the perianal spaces was performed in 22 cadaveric specimens using dissection and microscopic examination. Six spaces could be recognized: subcutaneous, central, intersphincteric, ischiorectal, pelvirectal, and submucous. A mention of the central and intersphincteric spaces could not be traced in the literature. The anatomic relations and communications of the perianal spaces are discussed. The central space occupies the area between the longitudinal muscle termination and the base loop of the external anal sphincter. It is the headquarters of all of the perianal spaces as it communicates with all of them. The intersphincteric spaces lie along the longitudinal anal muscle. They constitute the main tracks for extension of pus along the anal canal. The ischiorectal space communicates directly with main tracks for extension of pus along the anal canal. The ischiorectal space communicates directly with the subcutaneous space without the intervention of a septum. The pelvirectal space communicates with the perianal skin through the intersphincteric spaces. The author failed to demonstrate the musculus submucous space; in its place a collagenous internal anal septum could be identified. Furthermore, no trace for the suspensory ligament of Parks was detected; the lower anal lining was found to be pulled by the medial central septum derived from the central tendon.

Adolescent↗

PubMed1975

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. The external anal sphincter: a triple-loop system.

Since anal sphincters are used as the continent sphincters in some urologic operations, a study of their anatomic structure and function seems necessary. The anatomy of the external anal sphincter has been studied in 18 cadavers by dissection and serial histologic sections. The muscle has been found to consist of a series of U-shaped loops which are distinguishible as three main "loops": top, intermediate, and base. The puborectalis and the deep portion of the external sphincter have been found to be one muscle which is given the name "top loop." No concentric circular muscle bundles could be detected at any level of the external sphincter except in the base loop. A new concept of the mechanism of action of the external sphincter in anal continence and during defecation is presented. An air-tight occlusion of the anal canal could be achieved by the "triple-loop system" of the external sphincter which compresses opposed alternating anal segments. An incomplete anal occlusion by a single loop contraction is completed and potentiated by the succeeding loop action. The last fecal portion is dispelled from the anal canal by a process of "vermicular contractions" which is the result of the loop arrangement of the muscle bundles. Single-loop continence has been discussed. It is suggested that unless all three of the loops are destroyed, any single loop can act as a sphincter which maintains continence to solid stools but not to fluid ones or flatus.

Adult↗

PubMed1975

New concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. II. Anatomy of the levator ani muscle with special reference to puborectalis.

A study of the surgical anatomy of the levator ani muscles, with special stress on the puborectalis, was performed on 22 cadaveric specimens. The study comprised dissection and microscopic examination. The levator ani was found to consist of two portions only: pubococcygeus and iliococcygeus, the puborectalis being a part of the external anal sphincter. Both levatores decussate at the anococcygeal raphe, which represents a "decussation line" and not a site of insertion for the muscle fibers. A "digastric" pattern of the levator is demonstrated, which is responsible for the harmonic nature of the function of the muscle bundles on each side of the pelvis. The levator hiatus was found to be formed of the medial borders of the pubococcygeus, , and not the puborectalis. A "hiatal ligament" was identified, stretched between the edges of the levator hiatus and the intrahiatal viscera. The role of the pubococcygeus in anal fixation is discussed, and a new concept that the puborectalis does not belong to the levator ani but constitutes na integral portion of the external and sphincter. The puborectalis and the deep external anal sphincter were found to be fused together and identical from the morphologic, histologic, and functional points of view as well as with respect to innervation. Both form a single U-shaped loop which is given the name "top loop."

Adolescent↗

PubMed1973