{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T16:37:17Z","timestamp":1758127037153},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,2,28]],"date-time":"2014-02-28T00:00:00Z","timestamp":1393545600000},"content-version":"vor","delay-in-days":4107,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2002,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>It is not clear what contribution the internal anal sphincter (IAS) makes to the impaired motility observed in patients with Hirsch\u2010sprung\u2019s disease (HD). Nitric oxide (NO) has recently been shown to be a neurotransmitter in the nonadrenergic noncholinergic (NANC) inhibitory nerves in the human gut. To clarify the physiologic significance of NO in the IAS of HD (aganglionosis), we investigated the enteric nerve responses on lesional (aganglionic) and normal IAS muscle Strips above the dentate line. Lesional and normal LAS muscle strips above the dentate line were derived from patients with HD (10 cases) and patients who underwent rectal amputation for low rectal Cancer (12 cases). A mech\u2010anographic technique was used to evaluate in vitro muscle responses to electrical field Stimulation (EFS) before and after treatment with various autonomic nerve blockers, <jats:italic>N<\/jats:italic><jats:sup>G<\/jats:sup>\u2010L\u2010nitroarginine, and <jats:sc>L<\/jats:sc>\u2010arginine. The following results were obtained: (1) Cholinergic nerves are mainly involved in the regulation of enteric nerve responses to EFS in the normal LAS. (2) The aganglionic LAS of patients with HD was more strongly innervated by cholinergic nerves than the normal IAS (<jats:italic>p<\/jats:italic>&lt;0.05). (3) NANC inhibitory nerves were found to act on the normal IAS but had no effect on the enteric nerves in patients with aganglionosis. (4) NO was found to act on normal LAS, but no effect was observed in the aganglionic IAS. These findings suggest that innervation of the cholinergic nerves and a loss of NO mediation of NANC inhibitory nerves play an important role in the impaired motility observed in the IAS with HD.<\/jats:p>","DOI":"10.1007\/s00268-002-6384-7","type":"journal-article","created":{"date-parts":[[2002,12,5]],"date-time":"2002-12-05T15:48:22Z","timestamp":1039103302000},"page":"1493-1498","source":"Crossref","is-referenced-by-count":5,"title":["Role of nitric oxide in the internal anal sphincter of hirschsprung\u2019s disease"],"prefix":"10.1002","volume":"26","author":[{"given":"Ryouichi","family":"Tomita","sequence":"first","affiliation":[{"name":"Department of Surgery Nippon Dental University School of Dentistry at Tokyo 2\u20103\u201016 Fujimi Chiyoda\u2010ku 102\u20108158 Tokyo Japan"},{"name":"First Department of Surgery Nihon University School of Mediane 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku 173\u20100032 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Fujisaki","sequence":"additional","affiliation":[{"name":"First Department of Surgery Nihon University School of Mediane 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku 173\u20100032 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhisa","family":"Tanjoh","sequence":"additional","affiliation":[{"name":"First Department of Surgery Nihon University School of Mediane 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku 173\u20100032 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"First Department of Surgery Nihon University School of Mediane 30\u20101 Oyaguchi Kamimachi, Itabashi\u2010ku 173\u20100032 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,2,28]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"23","volume-title":"Hirschsprung\u2019s Disease","author":"Schari A","year":"1982"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01658706"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/200581a0"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00335780"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.1973.0015"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167\u20100115(93)90048\u2010D"},{"key":"e_1_2_1_8_1","first-page":"195","article-title":"Regulation of the enteric nervous System and innervation of the peptidergic nerve in the colonic segment of elongated sigmoid colon","volume":"15","author":"Tomita R","year":"1994","journal-title":"Biomed. 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