Functional innervation of the aganglionic segment in Hirschsprung's disease--a comparison of the short- and long-segment type.
The authors examined the neuro-effector transmission in the aganglionic segment from 13 patients with Hirschsprung's disease, 10 patients had short-segment type and three patients had long-segment type. Circular muscle strips were prepared and the responses to transmural electrical field stimulation were examined using the isometric tension recording technique. In the ganglionic preparations from the short- and long-segment cases, the stimulation evoked a biphasic response consisting of a relaxation and an atropine-sensitive contraction. The relaxation was partly inhibited by N-omega-nitro-L-arginine (NNLA, a nitric oxide [NO] synthase inhibitor), and the effect of NNLA was abolished completely in the presence of L-arginine, which suggested the presence of NO-mediated inhibitory innervation. In the aganglionic preparations from the short-segment-type cases, stimulation evoked only an atropine-sensitive contraction, while in the aganglionic preparations from the long-segment-type cases, a weak inhibitory response persisted after the contractile response was abolished by atropine. This NO-mediated inhibitory response was frequently detected as the examined region approached the ganglionic segment. These results suggest that the aganglionic segment in the long-segment-type cases might therefore receive NO-mediated inhibitory input from the proximal ganglionic segment.
Kamimura
T
T
Department of Pediatric Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kubota
M
M
Suita
S
S
D012809:Colon, Sigmoid / Q000294:innervation*; D004558:Electric Stimulation; D005260:Female; D006627:Hirschsprung Disease / Q000145:classification / Q000503:physiopathology*; D006801:Humans; D007082:Ileum / Q000294:innervation; D007223:Infant; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects; D009126:Muscle Relaxation / Q000187:drug effects; D009130:Muscle, Smooth / Q000187:drug effects; D009569:Nitric Oxide / Q000502:physiology; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors
D009569:Nitric Oxide; D019001:Nitric Oxide Synthase