The evaluation of functional anorectum for impaired anal sphincters

肛门括约肌受损的肛门直肠功能评估

• 批准号: 03454326
• 负责人: YOKOYAMA Jotaro
• 金额: $ 3.33万
• 依托单位: Keio University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1992
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-03454326/
• 关键词: anorectal continence; anorectal anomalies; sacral anomalies; feacal incontinence; sacral denervation; neurofilament; synaptic vesicle; 酵素組織化学

In recent years numerous methods for improving anorectal continence in patints with anorectal anomalies have been developed. Severe anorectal incontinence frequently develops in high type anal atresia with sacral anomalies which lead to defective innervation of anal sphincter. The feacal incontinence of these cases is thought to be caused not only by the quantative insufficiency but also by the qualitative dysfunction of the anal sphincter muscles.We established the canine model of feacal incontinence by the sacral nerve denervation. We studied the electrophysiological and histochemical changes in the anal sphincter muscles caused by the sacral nerve denervation.In the electrophysiological examination, we proved that the rectoanal reflex was dependent reaction of the internal sphincter, and that the sacral nerve denervation caused the uninhibited state of innervation in the internal sphincter that the inhibitory neuron and accelance neuron in the sphincter muscles were freed from the central inhibition.In the histochemical examination we proved that the sacral nerve denervation caused abnormalities of both neurofilament and synaptic vesicle expression in the nerve fivers which innervated the internal sphincter muscle.We propose that the electrophysiological and immunohistochemical studies could be available techniques to seek clue the complex pathophisiology of anorectal incontinence in patients with anorectal anomalies, and these studies may give us a hint to develop a new operative procedure for improving continence.

近年来，已经开发出许多用于改善患有肛门直肠异常的患者的肛门直肠节制的方法。严重的肛门直肠失禁经常发生在高度型肛门闭锁中，伴有骶骨异常，导致肛门括约肌的神经支配缺陷。这些病例的大便失禁被认为不仅是由于肛门括约肌的量不足引起的，而且还与肛门括约肌的质功能障碍有关。我们通过去骶神经神经建立了犬大便失禁模型。我们研究了骶神经去神经引起的肛门括约肌的电生理和组织化学变化。在电生理检查中，我们证明了直肠反射是内括约肌的依赖性反应，骶神经去神经导致了括约肌中的抑制神经元和加速神经元的神经支配处于不受抑制的状态。 在组织化学检查中，我们证明骶神经去神经导致支配内括约肌的神经丝和突触小泡表达异常。我们认为电生理和免疫组织化学研究可以成为寻找肛门直肠失禁患者复杂病理学线索的可用技术 肛门直肠异常，这些研究可能会提示我们开发一种新的手术方法来改善失禁。

项目成果

Jotaro Yokoyama: "Sphincters: Normal Function---Changes in Diseases" CRC Press,Inc, 12P (1992)

横山承太郎：“括约肌：正常功能---疾病的变化”CRC Press,Inc, 12P (1992)