Clinical–Alimentary TractEnteric nerves and interstitial cells of Cajal are altered in patients with slow-transit constipation and megacolon*,**
Section snippets
Control group
Patients in the control group (n = 13; mean age, 61.1 years; range, 23–83 years; 7 women and 6 men) underwent partial colectomy for nonobstructive carcinoma (T1–T2) or adenoma not suitable for endoscopic resection. All control patients reported normal bowel habits with stool frequencies at regular intervals. Radiographic studies showed normal anatomy of the colon and rectum. Rectal manometry did not show any abnormalities.
Patients with STC
All patients (n = 11, mean age, 49.8 years; range, 19–70 years; all
Control group
ICC were readily discernible throughout the entire smooth muscle coat. ICC processes running within the circular and longitudinal muscle layer were orientated preferably parallel to the axis of the smooth muscle cells (Figure 2A).
Alterations of ICC
It has been established that, apart from the ENS, ICC are actively involved in the mediation of intestinal motility. The scientific “renaissance” of ICC, originally described about 100 years ago,25 is based on the observations that ICC generate electrical slow-wave activity13, 14 and are capable of mediating neuronal input.15, 16, 22 Evidence of these 2 main roles has mostly been derived from animal experiments in which ICC have been removed mechanically26 or damaged chemically27 or in which
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Address requests for reprints to: Thilo Wedel, M.D., Department of Anatomy, University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany. e-mail: [email protected]; fax: (49) 451-500-4034.
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Supported by grants from the Deutsche Forschungsgemeinschaft (DFG Kr 1257/2-2) and the Research Foundation of the Medical University of Luebeck (1599/J-25).