{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T02:23:45Z","timestamp":1771467825720,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Health and Medical Research Council, Australia (NHMRC)","award":["MRFF: APP2009049"],"award-info":[{"award-number":["MRFF: APP2009049"]}]},{"name":"the National Health and Medical Research Council, Australia (NHMRC)","award":["DE180100261"],"award-info":[{"award-number":["DE180100261"]}]},{"name":"the National Health and Medical Research Council, Australia (NHMRC)","award":["DE190101209"],"award-info":[{"award-number":["DE190101209"]}]},{"name":"REACHirschsprung Foundation Research","award":["MRFF: APP2009049"],"award-info":[{"award-number":["MRFF: APP2009049"]}]},{"name":"REACHirschsprung Foundation Research","award":["DE180100261"],"award-info":[{"award-number":["DE180100261"]}]},{"name":"REACHirschsprung Foundation Research","award":["DE190101209"],"award-info":[{"award-number":["DE190101209"]}]},{"DOI":"10.13039\/100000163","name":"Australian Research Council","doi-asserted-by":"publisher","award":["MRFF: APP2009049"],"award-info":[{"award-number":["MRFF: APP2009049"]}],"id":[{"id":"10.13039\/100000163","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000163","name":"Australian Research Council","doi-asserted-by":"publisher","award":["DE180100261"],"award-info":[{"award-number":["DE180100261"]}],"id":[{"id":"10.13039\/100000163","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000163","name":"Australian Research Council","doi-asserted-by":"publisher","award":["DE190101209"],"award-info":[{"award-number":["DE190101209"]}],"id":[{"id":"10.13039\/100000163","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Hirschsprung disease (HSCR) is characterised by the absence of enteric ganglia along variable lengths of the distal bowel. Current gold standard treatment involves the surgical resection of the defective, aganglionic bowel. Clear and reliable distinction of the normoganglionated bowel from the transition zone is key for successful resection of the entire defective bowel, and the avoidance of subsequent postoperative complications. However, the intraoperative nature of the tissue analysis and the variability of patient samples, sample preparation, and operator objectivity, make reproducible identification of the transition zone difficult. Here, we have described a novel method for using muscle units as a distinctive landmark for quantifying the density of enteric ganglia in resection specimens from HSCR patients. We show that the muscle unit to ganglion ratio is greater in the transition zone when compared with the proximal, normoganglionated region for long-segment HSCR patients. Patients with short-segment HSCR were also investigated, however, the muscle unit to ganglion ratio was not significantly different in these patients. Immunohistochemical examination of individual ganglia showed that there were no differences in the proportions of either enteric neurons or glial cells through the different regions of the resected colon. In addition, we identified that the size of enteric ganglia was smaller for patients that went on to develop HSCR associated enterocolitis; although the density of ganglia, as determined by the muscle unit to ganglia ratio, was not different when compared with patients that had no further complications. This suggests that subtle changes in the enteric nervous system, even in the \u201cnormoganglionated\u201d colon, could be involved in changes in immune function and subsequent bacterial dysbiosis.<\/jats:p>","DOI":"10.3390\/biom12081101","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T09:42:56Z","timestamp":1660124576000},"page":"1101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Novel Method for Identifying the Transition Zone in Long-Segment Hirschsprung Disease: Investigating the Muscle Unit to Ganglion Ratio"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5698-9645","authenticated-orcid":false,"given":"Wendy","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, Australia"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10663, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian K.","family":"King","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Parkville 3052, Australia"},{"name":"Department of Paediatric Surgery, The Royal Children\u2019s Hospital, Parkville 3052, Australia"},{"name":"Department of Paediatrics, The University of Melbourne, Parkville 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald F.","family":"Newgreen","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Parkville 3052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0457-8710","authenticated-orcid":false,"given":"Heather M.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8925-7894","authenticated-orcid":false,"given":"Lincon A.","family":"Stamp","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene M.","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1038\/nrgastro.2012.32","article-title":"The enteric nervous system and neurogastroenterology","volume":"9","author":"Furness","year":"2012","journal-title":"Nat. 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