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T Wester

Publications and source records attributed to T Wester.

23 records · Page 2Linked to original sources
PubMed1996

Alterations in neurotrophin and neurotrophin-receptor localization in Hirschsprung's disease.

Interactions of the trk family of tyrosine kinase receptors with neurotrophins promote growth and differentiation of nervous-system cells during development. Disturbances in neurotrophic signalling could be involved in functional or aganglionic conditions of the intestine such as Hirschsprung's disease (HD). Intestinal resection specimens from 20 children with HD and from 10 normal age-matched controls were evaluated immunocytochemically for the presence of TrkA, TrkB, and TrkC protein, and the neurotrophin ligands brain-derived neurotrophic factor [BDNF] and neurotrophin-3 (NT-3). All three neurotrophin receptors are localized with cellular specificity to the enteric nervous system of normal and proximal ganglionic HD intestine; however, none was detected in the hypertrophic nerve fibers of aganglionic HD segments. Aganglionic HD intestine lacked intense and specific TrkC and BDNF enteric ganglionic immunoreactivity. NT-3, localized to enteric plexuses and basal lamina of ganglionic intestine, was not detected in ganglion cells located at the "transitional zone" of HD intestine. These data suggest that neurotrophic influences may be involved in enteric nervous-system cellular survival and differentiation in functional intestinal disorders such as HD.

Brain-Derived Neurotrophic Factor↗
PubMed1996

Localization of neurotrophins and their high-affinity receptors during human enteric nervous system development.

BACKGROUND & AIMS: Interactions of neurotrophins with the appropriate trk receptors result in growth and maturational alterations in nervous system cells during development. The aim of this study was to examine whether similar interactions could be involved in human enteric nervous system (ENS) survival or differentiation as well. METHODS: Immunocytochemical detection of TrkA, TrkB, and TrkC, as well as the ligands neurotrophin 3 (NT-3) and brain-derived neurotrophic factor (BDNF), was accomplished on normal human fetal and postnatal intestine. RESULTS: Neither neurotrophins nor their receptors were identified in immature postmigrational ENS progenitors at 7 weeks' fetal developmental age; however, TrkC and TrkA were specifically localized to developing ENS cells after 19 developmental weeks. From infancy through adulthood, TrkA and TrkB immunoreactivities were localized to both enteric ganglion cells and glia, whereas TrkC was localized exclusively to enteric ganglion cells. In postnatal intestine, BDNF immunoreactivity was primarily localized to enteric ganglion cells, with NT-3 localized to enteric plexuses, intermuscular basal lamina, and along or between circular and longitudinal smooth muscle cells. CONCLUSIONS: These data indicate that neurotrophic influences may be involved in ENS development and survival, with potential importance in functional differentiation disorders of the intestinal ENS.

Adult↗
PubMed1995

Rehbein's anterior resection in Hirschsprung's disease, using a circular stapler.

The results of 30 patients with Hirschsprung's disease, operated by Rehbein's anterior resection, have been evaluated. In 26 children the anastomosis was constructed with a circular stapler (Ethicon Proximate ILS) and in 4 it was handsutured. When a stapler was used, technical problems in 4, with a defect in the rings of bowel after firing the instrument, necessitated reinforcing sutures. The level of the anastomosis was significantly lower in the children in which a stapler was used. Eight children were operated by dorsal myectomy (DRM) prior to and 4 after anterior resection. The children with DRM prior to anterior resection had a significantly lower requirement for postoperative dilations. Early postoperative complications included 3.3% mortality, 6.7% enterocolitis, 3.3% anastomotic insufficiency, 3.3% early ileus and 10.0% wound infection. Three patients (10.0%) were operated for postoperative anastomotic stricture, one requiring anastomotic revision and two requiring DRM. At follow-up two children (7.4%) reported constipation with regular requirement for enemas and two (7.4%) reported daily encopresis. Twenty-three patients had 1-5 bowel movements per day and 4 patients had more than 5. In our experience the use of a circular stapler makes it possible to perform a lower anastomosis. We believe that this technique gives a wider and more elastic anastomosis and is technically less difficult to handle than a handsutured anastomosis.

Anastomosis, Surgical↗