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Biomedical subjects

E A Awad

Publications and source records attributed to E A Awad.

At least 19 recordsLinked to original sources
PubMed1983

Clinical application of sacral reflex latency.

We determined the sacral reflex latency in 108 neurologically normal subjects and 110 patients with neurological lesions by applying stimulating current to the glans penis or clitoris and measuring the response with electrodes inserted in the external urethral and anal sphincters. In normal men the mean latencies were 34.6 plus or minus 5.1 (standard deviation) msec. at the external urethral sphincter and 36.0 plus or minus 5.2 msec. at the external anal sphincter. In normal women the mean latencies were 37.4 plus or minus 5.5 msec. at the external urethral sphincter and 38.6 plus or minus 4.0 msec. at the external anal sphincter. The mean reflex latency in patients with upper motor neuron lesions was significantly shorter. To our knowledge this is the first single electrophysiological test to show a difference between such patients and normal subjects. An increased mean latency was found in patients with lower motor neuron impairment. We conclude that measurement of sacral reflex latency can add to the diagnostic information obtained from conventional electromyography and cystometry.

Adolescent↗
PubMed1981

The ultrastructure of the avian Golgi tendon organ.

The ultrastructure of the avian Golgi tendon organ (GTO) is described and compared with those of mammals using transverse sections through the myo-tendinous junctions of wing muscles of adult mallard ducks. The capsule, which is continuous with the perineural epithelial sheath of the Ib afferent nerve fiber, consists of four to seven flattened cellular lamellae. Two to four muscle fibers attach to large collagen bundles which enter the GTO through a tight collar at the proximal end of the fusiform capsule. These collagen bundles divide into many smaller bundles, which run longitudinally through the lumen in compartments formed by septal cells. The septal cells contain many prominent lipid accumulations. The Ib axon divides several times, and the unmyelinated branch axons weave between the small collagen bundles. Schwann cell processes or basement membrane usually intervene between the axons and collagen bundles. The small collagen bundles regroup into larger bundles, which pass through tight capsular collars and merge with the main muscle tendon. The size of the duck GTOs was measured and found to be smaller than the GTOs of man, cat or rat.

Animals↗
PubMed1981

Structure and ultrastructure of mechanoreceptors at the human musculotendinous junction.

The structure and ultrastructure of 122 lamellated corpuscles and 33 Golgi tendon organs (GTO) from adult human musculotendinous junctions were studied by light microscope and electron microscope techniques. One Meissner corpuscle from a human fingertip was examined for comparison. At the musculotendinous junction the axon terminals of the GTO were observed in direct contact with the tendon collagen. The lamellated corpuscles were located in the connective tissue surrounding the musculotendinous junction. The axon terminals of the lamellated corpuscles were separated from the surrounding tissues by the inner core lamellar cell processes and the capsule layers. A great variation in the structure of both types of receptors was observed. The lamellated corpuscles that were found close to the musculotendinous junction and the GTO may respond simultaneously to muscular contraction, thus providing proprioceptive feedback for sensorimotor control from within the tendon and from the tissues surrounding the musculotendinous junction. Mechanoreceptors found in dermis, subcutaneous and deep tissues can be classified into 2 broad groups. This practical morphologic classification is based on the characteristics of the sensory nerve terminals which have been found to be in contact with the surrounding tissue (muscle spindle, GTO) or with the lamellar cell processes (Vater, Pacini, Meissner), rather than the inconsistent features of the entire receptor such as the size, the shape, or the encapsulation.

Adolescent↗
PubMed1981

Muscle and serum enzymes and isoenzymes in muscular dystrophies.

Total activity of creatine kinase (CK), lactate dehydrogenase (LD), aldolase (Ald), glutamico-oxaloacetic transaminase (GOT), and LD-isoenzyme distribution was studied in serum and muscle biopsies from normal persons and 117 patients with different types of muscular dystrophy: 82 Duchenne type (DMD), 12 BEcker type, 7 facioscapulohumeral (FSHMD), and 16 limb girdle (LGMD). Total enzyme activity in sera and muscle homogenates was determined by spectrophotometric assays. LD isoenzymes were separated by electrophoresis on agarose gel plates in barbital buffer (pH 8.6), scanned and quantitated. The amounts of the 2 types (M and H) of LD isoenzymes were calculated and the ratio of M/H in serum and muscle was used as an index to differentiate among the types of muscular dystrophy. Serum enzyme activity was elevated to variable degrees reflecting a corresponding decrease in muscle enzymes in the different muscular dystrophies. Patterns of LD isoenzymes in serum and muscle were specific to each type of muscle disease. Increase in serum LD5 (the muscle LD fraction) was a common feature in muscle damage. Changes in the amounts of M and H types in the subunits of LD correlated to the existence and severity of muscle damage. The mean muscle M/H ratio was 6.4 in controls, 1.8 in early DMD, 0.1 in late DMD, 3.0 in Becker type, 3.8 in FSHMD and 3.9 in LGMD. The muscle LD isoenzyme distribution in DMD showed a shift toward a more aerobic fetal muscle pattern. This is a result of the gradual disappearance of the mature anaerobic LD-type (M) and the increase in synthesis of the aerobic fetal LD-type (H) during the progression of the disease. This report provides a comparative study of the LD isoenzyme patterns in muscular dystrophies which may help in differential diagnosis.

Adolescent↗
PubMed1978

Isoenzyme distribution of creatine kinase and lactate dehydrogenase in serum and skeletal muscle in Duchenne muscular dystrophy, collagen disease, and other muscular disorders.

We determined the total activity and isoenzyme distribution of lactate dehydrogenase and creatine kinase in serum and biopsy specimens from skeletal muscle of nine normal individuals and nine patients with Duchenne muscular dystrophy (I), five with collagen disease (II), and four with non-progressive unclassified myopathy (III). Mean total serum creatine kinase in patients with Duchenne muscular dystrophy (867 U/liter, SD = 197) was 31-fold that in the control group (28 U/liter, SD = 14). There was also a small (3.3-fold) increase in the mean total serum creatine kinase of patients with III, but none in the serum from patients with II. Changes in the creatine kinase isoenzyme distribution of skeletal muscle were primarily in the MB isoenzyme. The mean percentage of creatine kinase-MB activity in muscle from patients with I (2.81, SD = 1.15) and patients with III (1.69, SD = 1.07) significantly (P less than 0.005) exceeded that of the control group (0.43, SD = 0.18). Muscle from patients with II showed little change. The most striking changes in lactate dehydrogenase were also observed in patients with I, in whom the mean total serum activity (356 U/liter, SD = 115) was 3.4-fold that of serum from the control group (105 U/liter, SD = 19). Skeletal muscle from these patients also showed a significant decrease in mean percent isoenzyme 5 activity (from 50 to 23) and an increase in that of isoenzymes 1 and 2 (from 1 to 9 and 8 to 20, respectively). These changes in the distribution of these two sets of isoenzymes in muscle were reflected in the serum.

Adolescent↗
PubMed1978

Electromyogram-gas cystometrogram: its use in the management of neurogenic bladder of spinal cord injury.

The electromyogram (emg)-gas cystometrogram was used to study spinal-cord-injured patients with indwelling catheters before trial of voiding (TOV) to remove an indwelling catheter. Twenty-four patients were studied during 27 consecutive admissions. A coaxial needle electrode was placed in the external urethral sphincter. The output of a cystometer was simultaneously recorded on the emg printout so that the relationship of the shpincter response to distention of the bladder could be observed. Of 10 patients without bladder contractions, 7 had active urethral sphincters and 6 of these failed to achieve less than 50 ml residual thereby failing the TOV. The seventh patient succeeded in the trial and on subsequent study was found to have developed bladder contractions with a coordinated bladder-sphincter synergy. The 3 patients without bladder contractions or sphincter activity succeeded in their TOV using Credé's method. Seventeen patients with bladder contractions were divided into synergic, nonsynergic and partially synergic patterns. The 3 patients with synergic patterns succeeded in their TOV. Thirteen of 14 nonsynergic or partially synergic patients failed the TOV. The 1 nonsynergic patient who succeeded had bladder contractions of 70 cm of water compared to a mean of 28 cm of water for all other patients with bladder contraction. The emg-gas cystometrogram was helpful in selecting those patients who were successful in removing the Foley catheter. Important factors governing success in the multiple effort trial of voiding were the amplitude of the detrusor contraction, the presence of detrusor-sphincter synergy and the presence of a flaccid sphincter.

Catheters, Indwelling↗
PubMed1977

Cervical orthoses effect on cervical spine motion: roentgenographic and goniometric method of study.

Movement of the cervical spine in the sagittal plane was studied in ten normal subjects from 20 to 30 years of age without and with four different cervical orthoses: (1) polyethylene Camp plastic collar with chin and occiput piece, (2) plastizote Philadelphia collar, (3) four-poster and (4) SOMI (sternal occipital mandibular immobilization). The effect of the orthoses on restricting sagittal motion was measured simultaneously using roentgenographic and bubble goniometric methods. The subject was immobilized in a straight back chair to eliminate trunk motion, and lateral cervical spine films were taken of each subject in neutral, flexion and extension without and with each orthotic device. Distortion forces exerted on the orthotic devices were standardized by measurement of pressures at the chin and occiput. Roentgenographic measurements of flexion and extension and anteroposterior displacement of the cervical spine were compared to the measurements obtained by bubble goniometry. The four-poster and SOMI were found to be most effective in restricting extension and flexion respectively. The polyethylene and plastizote orthoses were significantly less effective in restricting motion. The bubble goniometer is an adequate clinical tool in assessing overall flexion-extension of the cervical spine but is not so precise and does not give information on the degree of motion at an individual vertebral level.

Adult↗
PubMed1977

Lactate dehydrogenase isoenzyme levels in collagen disease.

Serum lactate dehydrogenase (LDH) isoenzymes were determined in 27 patients with collagen disease and 88 normal subjects. The mean value for LDH-3 isoenzyme was 20.4 +/- 3% in normal controls, 31.47 +/- 8.9% in patients with collagen disease who showed activity of the disease, and 20 +/- 3.74% in patients in complete remission. Six patients who had positive rheumatoid factor showed higher LDH-3 levels. There was also some correlation between the activity of the disease and serum LDH-3 level in patients with connective tissue disorders.

Adolescent↗