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Biomedical subjects

A Shafik

Publications and source records attributed to A Shafik.

319 records · Page 18Linked to original sources
PubMedDate not supplied

Detrusor-rectal neck dyssynergia syndrome. A new syndrome with report of nine cases.

Nine patients with detrusor-rectal neck dyssynergia syndrome are presented. Six were females and three were males. The complaint was constipation and straining at stool in all the patients and fecal soiling in four. Eight subjects with normal rectal functions acted as controls. Investigative results have shown that frequency and weight of stools are within normal range. Rectal neck pressure at rest was lower than the normal values (average 16.2 mmHg), while on voluntary squeeze it was normal (average 146.2 mmHg). The rectal pressure recorded normal values (20.6 mmHg). The recto-inhibitory reflex showed internal sphincter contraction on rectal distension; rectal neck pressure registered an average of 82 mmHg and rectal pressure 68 mmHg. Excessive straining at stool is due to failure of the rectal neck to open on rectal distension as a result of internal sphincter contraction. Fecal soiling could be due to the low pressure zone in the rectal neck at rest. Myectomy effected improvement in strainodynia and prevented internal sphincter contraction on rectal distension. Fecal soiling however did not improve after the operation. Myectomy specimens did not show histologic abnormalities.

Adult↗
PubMedDate not supplied

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. XXIII. An injection technique for the treatment of idiopathic pruritus ani.

An injection technique for the treatment of idiopathic pruritus ani is presented. The technique was performed on 67 patients after failure of other methods to achieve permanent cure. The technique comprises injection of 5% solution of phenol in almond oil in the subcutaneous tissue of the rectal neck aiming at destruction of the "epithelial debris" which exists in this area and is considered the primary cause in idiopathic pruritus. Cure was obtained in 62 patients (92.5%). The remaining five patients underwent recurrence after a period of remission, and were cured after a second injection. The advantages of the present technique over others in common use are discussed.

Adult↗
PubMedDate not supplied

Epididymal ligaments: anatomy and function.

Three ligaments are described in relation to the epididymis: superior and inferior epididymal, and vasal ligaments. The study was conducted on 38 cadavers and included direct dissection and histologic examination. The superior and inferior epididymal ligaments are triangular folds of the visceral tunica vaginalis, and extend from epididymis to testicle. The superior ligament binds the epididymal head to the testicle, protecting the fine efferent ductules from damage. The inferior ligament fixes body and tail and mesoepididymis; further, it prevents epididymal convolutions from unraveling. The vasal ligament is a fibrous band, which binds the proximal end of the vas to the epididymal tail. It maintains an acute epididymovasal angle. In two cadavers, the inferior epididymal and vasal ligaments were absent. Convolutions of the lower body and tail of the epididymis were unraveled. The mesoepididymis was broad, and the epididymis was freely mobile from side to side; the epididymo-vasal angle was opened. The role of the epididymal and vasal ligaments in fixation of the epididymis, preservation of blood supply to both testicle and epididymis, and preventing unraveling of epididymal convolutions is stressed. Absent epididymal ligaments lead to "mobile epididymis," which may cause infertility.

Cadaver↗
PubMedDate not supplied

Olfactory micturition reflex. Experimental study in dogs.

The relation of olfaction to urination was studied in 14 dogs. A stimulating surface electrode was applied to the nasal mucosa and a recording electrode to each of the external (EUS) and internal (IUS) urethral sphincters. Electrostimulation of the nasal mucosal led to diminished EMG activity of IUS, and effected no change in the response of the EUS. IUS did not respond to stimulation of the anesthetized nasal mucosa. The reproducibility as well as the non-response of IUS to stimulation of the anesthetized nasal mucosa point to the constancy of a reflex relationship between the IUS and nasal mucosa, which we call 'olfactory micturition reflex'. The latency of the reflex (mean +/- SD) was 49.2 +/- 8.2 ms. It seems that the olfactory micturition reflex induces micturition in the absence of a full bladder. This would explain the repeated successive urination of small amounts of urine, characteristic of dogs, on smelling a uriniferous odor.

Anesthetics, Local↗
PubMedDate not supplied

The electrified drain. A new device for sterilizing the field of drainage.

A randomized control study was performed on 24 patients to evaluate the effect of a new drainage system. Two types of drains were used: electrified and the conventional corrugated rubber drains. All of the 24 patients had an incisional hernia repair operation. In 12 patients, the wound was drained with an electrified drain (ED) and in the other 12 by the conventional drain (CD). The ED consisted of a corrugated rubber drain to which 2 silver-silver chloride electrodes were fixed. The wounds were drained for the first 3 post-operative days during which antibiotics were given. A peroperative and daily swab from the wound was taken during the time of drainage and for 4 days thereafter, and cultured. For evaluation, a pathogen count of less than 10(5) colony-forming units per ml of discharge from wound cultures was considered as successful drainage, while counts above this level were defined as failures. Drainage failure occurred in 4/12 patients (33%) of the CD group. Pathogens encountered were Streptococcus pyogenes, Staphylococcus aureus and albus and P. aeruginosa. Manifestations of wound inflammation occurred in 2 of the 4 patients. The appropriate antibiotic was given to the 4 patients after culture and sensitivity tests were performed. Drainage failure did not occur in any of the ED group. Post-operative laboratory assessment of blood count, liver and kidney functions and serum electrolytes recorded insignificant changes against preoperative values in both groups. The results demonstrate the superiority of the ED over the CD. The electric field produced by the ED seems to be lethal to organisms. The ED is simple, safe and cost-effective.

Catheterization↗
PubMedDate not supplied

Polytetrafluoroethylene injection for the treatment of partial fecal incontinence.

Perianal injection of polytetrafluoroethylene (Teflon or Polytef) paste was used in the treatment of 11 patients with partial fecal incontinence which followed internal sphincterotomy in 7 patients and was idiopathic in 4. All patients had been incontinent for more than 4 years, and had failed to respond to conservative measures. 5 ml of Polytef paste were injected, without anesthesia, in the rectal neck submucosa, above the pectinate line at each of the 3 and 9 o'clock positions. Patients were followed for 18 to 24 months. They were categorized into 3 scores: 1, cured; 2, improved, and 3, no change. Long-term cure (score 1) occurred in 45.4% after the 1st injection and in 63.6% after the 2nd injection. 36.4% showed partial improvement (score 2). No failures occurred. Improvement is believed to be due to the increase in rectal neck pressure produced by the cushion-effect of the polytef submucosal injection. The technique is simple, easy and without complications. It is performed on an outpatient basis.

Adult↗
PubMedDate not supplied

Esophago-rectal reflex. Description and clinical significance.

The present communication describes the "esophago-rectal reflex" and its clinical significance. The study was performed in 19 healthy volunteers and 14 constipated subjects. The technique comprised the introduction into the esophagus of a balloon-tipped tube so that the balloon lay within the lower esophageal sphincter (LES). The rectal and rectal neck pressures were measured by means of perfused open-ended tubes. The esophageal balloon was inflated with 2, 4 and 6 ml water and the responses of the rectal and rectal neck pressures were recorded. Distension of the LES was accompanied by significant rectal pressure increase (P < 0.001); the pressure increased with increasing LES distension. Anesthetized LES mucosa did not evoke the rectal pressure response. The rectal neck pressure did not show significant change with LES distension (P > 0.05). Both the rectal and rectal neck pressures showed insignificant response to LES distension in constipated subjects (P > 0.05). The esophago-rectal reflex seems to be conducted through the myenteric plexus from the esophagus down along the gut wall to the rectum, initiating rectal contractions. It is likely that these signals alarm the rectum for the entrance of new contents in the gut so that the rectum may evacuate its contents.

Adult↗
PubMedDate not supplied

Intratesticular testosterone concentration following intratunical administration in the hypogonadal animal.

The serum and intratesticular testosterone concentration (ITC) after testosterone administration in the tunica vaginalis (TV) sac compared to parenteral administration was studied in 20 dogs that were rendered hypogonadal by gonadotropin-releasing hormone antagonist ('Nal-Glu' GnRH antagonist) in a daily dose of 80 micrograms for 15 days. The 20 dogs were divided into two equal groups. Twenty milligrams of testosterone propionate were administered in the TV cavity in the TV group and intramuscularly (IM) in the IM group. In addition four dogs acted as controls and another four as sham controls. Serum and ITC were determined in all the dogs 1, 2, and 15 days after testosterone administration. Biopsies from TV were taken 3 weeks after testosterone injection for histologic examination. Serum and ITC were significantly reduced (P < 0.01) 15 days after GnRH antagonist. They increased after intratunical testosterone administration to reach the pre-GnRH antagonist level (P > 0.05). After IM testosterone injection, the serum testosterone increased to the pre-GnRH antagonist level (P > 0.05), while the ITC did not. The TV did not show histopathologic abnormalities apart from submesothelial infiltration with inflammatory cells in one dog. In conclusion, TV testosterone administration delivers a major dose of testosterone to the testicle without exposing other tissues to high testosterone levels. The method is safe and may be used as an office treatment. It may be tried in the treatment of patients who are infertile due to a low ITC.

Animals↗
PubMedDate not supplied

Electrocauterization in the treatment of pilonidal sinus.

In view of the morbidity and recurrence rates associated with the various current techniques adopted for the treatment of pilonidal sinus, sinus electrocauterization (EC) was practiced in 18 patients. The results were compared with those obtained after excision operation in another 18 patients. The 2 groups were matched for age, gender and follow-up. Entry criteria comprised non-recurrent quiescent pilonidal sinus. In the EC group, the sinus tracks were laid-open, the debris removed and sinus walls cauterized. In the excision group, the sinus tracks were excised and the wound was left open. Patients were followed up for a mean of 29.6 months. Of the EC group, healing was achieved in 16 patients after the 1st cauterization and in 2 after recauterization. 15 cases of excision group were cured; sinus re-excision was performed in 3 patients in 2 of whom healing was accomplished. The technique of EC compared favourably with the other conventional techniques in terms of recurrence rate. In addition, it is simple, easy, has no complications and is performed as an outpatient procedure.

Adult↗
PubMedDate not supplied

Recto-colic reflex: role in the defecation mechanism.

As urge is felt and defecation starts, it is postulated that the colon continuously feeds the rectum with stools until the colon is empty. The relationship of rectal distension at defecation to colonic activity is not yet fully explored. The current communication studies this relationship in 11 patients (mean age 48.4+/-18.8 years, 6 men and 5 women) with transverse colostomy performed after transverse colectomy for cancer of the transverse colon. The rectum was distended by a condom-ended catheter in increments of 10 ml of H20, and the pressures in the right and left colon were measured by balloon catheters introduced through the colostomy. The test was repeated after anesthetizing the rectum or colon, respectively. Upon rectal distension up to sensation of urge, there was no colonic pressure response. At urge (mean distension volume of 160+/-36.7 ml), the left colonic pressure showed a significant rise (p<0.001), while the right colon revealed no response (p>0.05). Rectal distension during rectal or colonic anesthetization effected no colonic pressure response (p>0.05). The left colonic contraction upon rectal distension, being reproducible and absent with the anesthetized rectum or colon, postulates a reflex relationship which we call "recto-colic reflex". This reflex acts at defecation to feed the rectum successively with fecal material until the colon is emptied. Reflex derangement may play a role in defecation disorders.

Adult↗
PubMedDate not supplied

Is the rectum a conduit or storage organ?

The rectum is claimed to be a conduit; as it receives the stools, the rectoanal inhibitory reflex is evoked and defecation occurs. However, in many healthy subjects, stools could be palpated in the rectum by digital rectal examination (DRE) without the subject feeling the desire to defecate. The purpose of this communication is to study whether the rectum is a conduit or a storage organ. The study comprised 48 healthy volunteers (mean age 38.4 +/- 15.8 SD years; 30 men, 18 women). Number of stools per week was recorded and DRE was carried out followed by air enema radiography. The subjects had a normal stool frequency of 7.8 +/- 1.4 per week. Most of them last defecated a mean of 6.2 +/- 3.4 hours prior to the test. Stools were palpated in the lower rectum by DRE in 31/48 subjects and by radiography in 12/16. DRE correlated with radiologic examination in 9/12 subjects; in 3 of them, DRE revealed an empty rectum while radiography showed stools in the upper rectum. The 17 subjects with an empty rectum had their last defecation 5.2 +/- 3.6 hours before DRE, and the 31 subjects with palpable stools 15.6 +/- 12.9 hours. In conclusion, the rectum might be considered not simply as a conduit for stools but also as a storage organ. This occurs when it receives from the sigmoid colon an amount of stools too small to evoke the defecation reflex, or when this reflex is neglected due to unfavorable circumstances of defecation.

Adolescent↗
PubMedDate not supplied

Electroorchidogram. A preliminary study of the electric activity of the testicles in dogs.

Since electric activity could be registered from various organs in the body, this study investigates the feasibility of recording such activity from the testicle. The testicles of 12 male dogs were exposed under anaesthesia and 3 electrodes were sutured to the tunica albuginea. In addition, transcutaneous recordings of the electric waves were performed. The effect of traumatic insult induced by testicular irradiation and by induction of hypogonadism on electric activity was studied. Spermatic cord clamping and orchidectomy was done to test their effect on the electric waves of the testicles. Electric waves were registered from the electrodes applied both directly and transcutaneously to the testicle. Each wave consisted of a negative followed by a positive deflection, with a mean frequency of 10.2 +/- 1.8 cycle s-1 and amplitude of 56.6 +/- 8.4 microV. The waves recorded from the 6 electrodes applied (3 directly and 3 transcutaneously) in the same animal had similar amplitude and frequency readings. No abnormal waves were registered. After testicular irradiation or induction of hypogonadism, a 'silent' or 'dysrhythmic' electroorchidogram was obtained. Spermatic cord clamping did not change the normal electroorchidographic pattern. No waves were recorded after orchidectomy (silent electroorchidogram). To conclude, an electroorchidogram was configurated for the normal testicle. It showed changes after testicular insult. It is assumed that the electroorchidogram might reveal changes in the pathologic conditions of the testicle and this requires further study.

Animals↗