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Biomedical subjects

M Swash

Publications and source records attributed to M Swash.

At least 253 records · Page 14Linked to original sources
PubMed1981

Familial multicore disease with focal loss of cross-striations and ophthalmoplegia.

Two brother are described with a congenital myopathy, including weakness of the external ocular muscles, whose biopsies showed multicores and focal loss of cross-striations, with failure of fibre type differentiation. In one patient changes in distribution and size of these core-like structures were observed in a second biopsy taken 5 years later. This family, together with others previously reported, may represent a genetically distinct subgroup of congenital multicore disease.

Adult↗
PubMed1981

Acute viral encephalitis: its diagnosis and outcome.

Sixty patients with acute viral encephalitis admitted to The London Hospital in the last fifteen years have been reviewed. These consisted of 12 patients with known viral infection, 29 patients with acute viral infection of undetermined type, and 19 patients in whom an encephalitic illness followed a viral infection (post-infection encephalitis). The patients with primary viral encephalitis presented with an inflammatory brain disorder, including headaches and fever, and developed focal or diffuse neurological signs. Patients with post-infection encephalitis, usually following a 'flu'-like illness, presented with an acute neurological disturbance. The results of investigations, including virological studies, CSF examination, electroencephalography and neuroradiology, are described. Biopsy or autopsy material was available in 11 patients and these pathological findings supported the clinical classification of these patients. The mortality was highest in patients with herpes simplex virus encephalitis and lowest in patients with post-infection encephalitis. A considerable morbidity was found, not only in patients with primary viral encephalitis, but also in patients with encephalitis of unknown aetiology and post-infection encephalitis.

Acute Disease↗
PubMed1981

Hypertrophy of the external and sphincter in haemorrhoids: a histometric study.

Biopsies of the external and sphincter taken from 24 male patients with haemorrhoids were subjected to examination using histochemical techniques. Fibre size (type 1 mean: 33 micrometers +/- 11.0 SD and type 2 mean: 47.9 micrometers +/- 15.0 SD) was increased when compared with control subjects. The distribution of muscle fibre types in these patients showed markedly greater type 1 fibre predominance (92%) than in control subjects. These abnormalities of the external sphincter did not show any clear relationship with age, degree of haemorrhoidal change, length of history of haemorrhoids, history of straining or of constipation, or perineal descent; however, increasing length of history up to 10 years was associated with increasing type 1 fibre predominance. We suggest that the external and sphincter in patients with haemorrhoids is in a state of increase tonic contraction, which causes work induced muscle hypertrophy and may contribute to increased resting pressure in the anal canal in patients with haemorrhoids.

Adult↗
PubMed1981

Post-encephalitic Parkinsonism: current experience.

The diagnosis of post-encephalitic Parkinsonism is rarely entertained today. In this paper we discuss eight recent patients, six of whom presented in the last 20 years, that conform to the diagnosis of encephalitis lethargica. The clinical features by which the diagnosis may be made are defined so that a contemporary definition of this disorder may be attained.

Adult↗
PubMed1980

Slowed nerve conduction with wrist flexion in carpal tunnel syndrome.

Phalen's wrist flexion test may reproduce the sensory symptoms of carpal tunnel syndrome (CTS). We have used this test in conjunction with motor and sensory latency studies in 20 patients with symptomatic CTS in one or both hands. The test caused an increase in the motor or sensory latency in half the patients. In 2 patients the latencies were abnormal only after wrist flexion. The test may thus be useful in diagnosis of borderline cases.

Adult↗
PubMed1980

The anal reflex in idiopathic faecal incontinence: an electrophysiological study.

We have recorded the latency of the anal reflex, using a simple electrophysiological method, in 22 patients with anorectal incontinence and in 33 control subjects without anorectal disease. The mean latency in the control subjects was 8.3 ms (range 5-11.3 ms). In the patients with faecal incontinence the mean latency of the anal reflex was 13.0 ms (range 6.5-22.0 ms). The reflex latency was within the normal range in only three incontinent patients. These findings support our concept, based on histological examination of the external anal sphincter musculature, that a major cause of this syndrome is denervation of these muscles due to damage to the innervation of the external anal sphincter and puborectalis muscles.

Adolescent↗
PubMed1980

Vulnerability of lower brachial myotomes in motor neurone disease: a clinical and single fibre EMG study.

Single fibre EMG was used to study the motor unit fibre density in the right biceps brachii, extensor digitorum communis and first dorsal interosseous muscles of 15 patients with motor neurone disease, with different patterns of initial weakness. There was an inverse relationship between strength and fibre density in these muscles. Abnormalities were more marked in patients whose initial symptom was arm weakness, but collateral reinnervation was not as effective as in other neurogenic disorders. These findings are consitent with a hypothesis that motor neurone disease begins segmentally, or at a discrete level within the motor system, before becoming generalised. The single fibre EMG fibre density is a useful quantitative technique for sequential assessment of patients with neurogenic disorders.

Adult↗
PubMed1980

Vision in the temporal crescent in occipital infarction.

Four patients with hemianopias due to occipital infarction are described. In each of these patients there was useful residual vision in the unpaired temporal crescent. Moving stimuli were particularly well perceived in this part of the field. Preservation of the temporal crescent results in strikingly incongruous fields. The significance of this part of the visual field is discussed in relation to perception of movement and to the fixation reflex, and also with regard to recent reports of residual visual ability in patients with striate cortex lesions, and to the possible role of the monocular temporal field in striate and tectal visual systems.

Cerebral Infarction↗
PubMed1980

Pattern of segmental motor involvement in syringomyelia: a single fibre EMG study.

Single fibre EMG has been used to study the pattern of upper limb motor involvement in syringomyelia. Biceps brachii, extensor digitorum communis (EDC) and first dorsal interosseous muscles (1stDI) representing C5/6, C7/8 and C8/T1 segments, were studied. In the biceps the fibre density was slightly increased in most patients, in EDC it was about twice the normal and in the 1stDI it was about three times normal. The potentials were least stable and of longest duration in the 1stDI. These findings seem to indicate a relatively constant pattern of involvement of anterior horn cells in the brachial segments in syringomyelia.

Adult↗
PubMed1980

Increased motor unit fibre density in the external anal sphincter muscle in ano-rectal incontinence: a single fibre EMG study.

The motor unit fibre density in the external anal sphincter muscle has been measured in 13 normal subjects aged 18 to 78 years, and in 14 patients with ano-rectal incontinence, aged 17 to 72 years. The mean fibre density in the normal subjects was 1.5 +/- 0.16, and in the incontinent subjects it was 2.17 +/- 0.28 (p less than 0.001). These findings provide support for the suggestion that ano-rectal incontinence commonly has a neurogenic basis.

Adolescent↗
PubMed1980

Effect of lecithin on disability and plasma free-choline levels in Friedreich's ataxia.

Four patients with Friedreich's ataxia took part in an open trial, in which they consumed 50-100g/day lecithin granules (containing approximately 22% phosphatidycholine) for 16 weeks, but no improvement resulted. Several unwanted effects including diarrhoea, nausea, depression, "hot flushes" and weakness were experienced. Resting levels of free-choline in plasma were within the range found in 19 normal subjects. Sixteen other patients with Friedreich's ataxia also had normal free-choline levels. Treatment with lecithin significantly increased plasma free-choline levels, but there was a trend for these to fall towards baseline levels, despite continued ingestion of lecithin.

Adolescent↗
PubMed1979

Pathogenesis of ano-rectal incontinence. A histometric study of the anal sphincter musculature.

Type 1 fibre predominance was found in the external anal sphincter, puborectalis and levator ani muscles of 17 control subjects, and of 16 patients with ano-rectal incontinence. In the external anal sphincter and puborectalis muscles of the control subjects the mean diameter of Type 2 fibres was slightly greater than that of Type 1 fibres, but in the levator ani muscles of control female subjects the mean diameter of Type 1 fibres was much greater than that of Type 2 fibres. In the patients with anorectal incontinence there was marked hypertrophy of fibres of both histochemical types. This was most marked in the puborectalis and external anal sphincter muscles. In 12 of the 16 incontinent patients there were histological and statistical features consistent with a neurogenic disorder. These histometric studies provide a quantitative basis for physiological and pathological studies of these muscles in incontinence and other anorectal disorders.

Adenosine Triphosphatases↗