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The cavernoso-anal reflex： response of the anal sphincters to cavernosus muscles＇ stimulation

Asian Journal of Andrology 2006年第A3期8卷 331-336页

作者： Ahmed shafik ismail shafik Ali A. shafik Olfat El Sibai Department of Surgery and Experimental Research Faculty of Medicine Cairo University Cairo 11121 Egypt Department of Surgery Faculty of Medicine Menoufia University Shebin El-Kom Egypt

Aim： To prove the hypothesis that cavernosus muscles＇ contraction during coitus affects the reflex contraction of anal sphincters. Methods： Electromyographic response of external and internal anal sphincters to ischiocavernosus and bulbocavernosus muscle stimulation was studied in 17 healthy volunteers （10 men, 7 women, mean aged 38.3 ± 11.6 years）. The test was repeated after individual anesthetization of anal sphincters and the two cavernosus muscles,and after using saline instead of lidocaine. Results： Upon stimulation of each of the two cavernosus muscles,external and internal anal sphincters recorded increased electromyographic activity. Anal sphincters did not respond to stimulation of the anesthetized cavernosus muscles nor did anesthetized anal sphincters respond to cavernosus muscles＇ stimulation. Saline infiltration did not affect anal sphincteric response to cavernosal muscles＇ ***： Cavernosus muscles＇ contraction is suggested to evoke anal sphincteric contraction, which seems to be a reflex and mediated through the ＂cavernoso-anal reflex＂. Anal sphincteric contraction during coitus presumably acts to close the anal canal to thwart flatus or fecal leak.

关键词： bulbocavernosus muscle ischiocavernosus muscle erection sexual act orgasm erectile dysfunction

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Duodeno-jejunal junction dyssynergia: Description of a novel syndrome

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World Journal of Gastroenterology 2007年第30期13卷 4112-4116页

作者： Ahmed shafik ismail a shafik Olfat El Sibai Ali A shafik Department of Surgery and Experimental Research Faculty of Medicine Cairo University Cairo Egypt Department of Surgery Faculty of Medicine Menoufia University Shebin El-Kom Egypt

AIM: To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction. METHODS: Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study. A condom which was inserted into the 1st duodenum was filled up to 10 mL with saline in increments of 2 mL and pressure response to duodenal distension was recorded from the duodenum, duodeno-jejunal junction and the jejunum. RESULTS: In healthy volunteers, duodenal distension with 2 and 4 mL did not produce pressure changes, while 6 and up to 10 mL distension effected significant duodenal pressure increase, duodeno-jejunal junction pressure decrease but no jejunal pressure change. In patients, resting pressure and duodeno-jejunal junction and jejunal pressure response to 2 and 4 mL duodenal distension were similar to those of healthy volunteers. Six and up to 10 mL 1st duodenal distension produced significant duodenal and duodeno-jejunal junction pressure increase and no jejunal pressure change. CONCLUSION: Duodeno-jejunal junction failed to open on duodenal contraction, a condition we call ‘duodeno- jejunal junction dyssynergia syndrome’ which probably leads to stagnation of chyme in the duodenum and explains patients' manifestations.

关键词：消化道疾病腹胀呕吐反胃

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Effect of thermal cutaneous stimulation on the gastric motor activity:Study of the mechanism of action

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World Journal of Gastroenterology 2008年第14期14卷 2226-2229页

作者： Ahmed shafik Ali A shafik Olfat El Sibai ismail a shafik Department of Surgery and Experimental Research Faculty of Medicine Cairo University Cairo 11121 Egypt Department of Surgery Faculty of Medicine Menoufia University Shebin El-Kom Egypt

AIM:To investigate the mechanism of action of thermal cutaneous stimulation on the gastric motor inhibition. METHODS:The gastric tone of 33 healthy volunteers (20 men, mean age 36.7 ± 8.4 years) was assessed by a barostat system consisting of a balloon-ended tube connected to a strain gauge and air-injection system. The tube was introduced into the stomach and the balloon was inflated with 300 mL of air. The skin temperature was elevated in increments of 3℃ up to 49℃ and the gastric tone was simultaneously assessed by recording the balloon volume variations expressed as the percentage change from the baseline volume. The test was repeated after separate anesthetization of the skin and stomach with lidocaine and after using normal saline instead of lidocaine. RESULTS:Thermal cutaneous stimulation resulted in a significant decrease of gastric tone 61.2% ± 10.3% of the mean baseline volume. Mean latency was 25.6 ± 1.2 ms. After 20 min of individual anesthetization of the skin and stomach, thermal cutaneous stimulation produced no significant change in gastric tone. CONCLUSION:Decrease in the gastric tone in response to thermal cutaneous stimulation suggests a reflex relationship which was absent on individual anesthetization of the 2 possible arms of the reflex arc:the skin and the stomach. We call this relationship the"cutaneo-gastric inhibitory reflex". This reflex may have the potential to serve as an investigative tool in the diagnosis of gastric motor disorders, provided further studies are performed in this respect.

关键词：胃结石恒压器胃功能障碍治疗方法

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Functional activity of the rectum:A conduit organ or a storage organ or both?

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World Journal of Gastroenterology 2006年第28期12卷 4549-4552页

作者： Ahmed shafik Randa M Mostafa ismail shafik Olfat EI-Sibai Ali A shafik Department of Surgery and Experimental Research Faculty of MedicineCairo UniversityCairoEgypt Department of Physiology Faculty of MedicineSharkia UniversityBanha-ZagazigEgypt Department of Surgery Faculty of MedicineMenoufia UniversityShebin El-KomEgypt

瞄准：为了调查直肠的扩张的度是否能定义直肠，作为一根水管或水库工作。方法：到 2 的直肠、肛门的压力的反应直肠的汽球扩张打字，快速的多卷、慢的渐渐的膨胀，在 21 个健康志愿者被记录(12 个男人， 9 个女人，变老 41.7 +/- 10.6 ... 详细信息

瞄准：为了调查直肠的扩张的度是否能定义直肠，作为一根水管或水库工作。方法：到 2 的直肠、肛门的压力的反应直肠的汽球扩张打字，快速的多卷、慢的渐渐的膨胀，在 21 个健康志愿者被记录(12 个男人， 9 个女人，变老 41.7 +/- 10.6 年) 。测试在迫切感觉上与括约肌 squeeze 被重复。结果：快速的多卷的直肠的扩张导致了重要直肠的压力增加(P < 0.001 ) ，肛门压力衰落(P < 0.05 ) 并且汽球逐出。这些题目感到了迫切感觉但是没感到第一直肠的感觉。在迫切感觉上，肛门引起重要直肠的压力减少的 squeeze (P < 0.001 ) 并且紧急消失。慢增长的直肠的充满与一个“音调”拉了 rectometrogram 在直肠的充满期间代表渐渐的直肠的压力增加的手足，和“撤退手足”在汽球逐出期间代表锋利的压力增加。曲线记录了第一直肠的感觉和迫切感觉。结论：直肠显然有二功能：交通(水管) 和存储，两个都取决于直肠的充满的度。如果直肠收到的烘便的材料是小的，它在直肠被存储直到大体积被到达那个罐头影响足够的直肠的扩张的度开始澄清反射。直肠的扩张直接唤起的大体积书籍的右页有产生澄清的肛门禁止的反射。

关键词：直肠疾病感觉功能病理机制治疗

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儿科患者调强放射治疗的治疗前鉴定:有关耐受范围的适当评估(英文)

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The Chinese-German Journal of Clinical Oncology 2012年第11期11卷 621-625页

作者： Ehab M. Attalla Hassan shafik Hany Ammar ismail Eldesoky Mohamed Farouk Shimaa Shoier Radiotherapy & Nuclear Medicine Department National Cancer Institute Cairo University Children Cancer Hospital

Objective: The objective of this work was to establish adequate tolerance limits based on a certain defined institutional indices and generate published data presenting our results to the radiotherapy community. Methods: One hundred paediatric patients were treated using 6-MV X-ray beams produced by Siemens ONCOR Expression linear accelerator. The clinical step-and-shoot intensity-modulated radiation therapy (IMRT) treatment plans were designed using KonRad release 2.2.23. For two treatment sites (abdomen, head and neck), the fluence maps generated by the treatment planning system were all delivered for the quality assurance (QA) which included absolute dose verification for all treatment fields, relative dose verification for each treatment field. Results: The 724 fluence maps were analyzed at three different criteria using the gamma index tool. The 3% dose difference of local prescribed dose /3 mm was considered adequate. The passing rate for all fields of all plans always exceeded 70%. The dose differences between the measured and calculated doses ranged from -2.2% to +4% [mean and standard deviation (s): 1.4 ± 1.5] for the abdominal case, and from -3.3% to +5.6% (1.3 ± 1.6) for head and neck case with total confidence limit 0.046 (4.6%). The 14/100 (14%) of the absolute point dose measurements were out of ±3% from the dose predicted by the treatment planning system. Only two cases were below -3%, while 12 cases over +3%. Conclusion: At 3% dose difference of local prescribed dose /3 mm criteria, a 75% passing a gamma criterion and 3% for absolute point dose can be achieved for abdomen and head and neck treatments site. We considered the tolerance limits based on these indices for IMRT QA adequate.

关键词：放射治疗公差范围验证患者儿科治疗计划系统剂量测量标准偏差

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