CONTEXT: The pathogenesis of @entity698 remains poorly understood. Despite new diagnostic techniques, appendices removed from @entity1 with suspected @entity698 often appear histologically normal on conventional examination. There is increasing evidence of @entity3002 in immune regulation and in inflammatory responses in the gastrointestinal system. OBJECTIVE: To investigate the nitrergic innervation of (a) acutely inflamed appendices, (b) appendices classified as histologically normal from @entity1 with a clinical diagnosis of @entity698 , and (c) normal control appendix specimens, using the whole-mount preparation technique. @entity1 AND DESIGN: Full-thickness specimens were collected from 28 acutely inflamed appendices (age range, 3.2-13.4 years), 31 histologically normal appendices removed from @entity1 (age range, 5.7-13.6 years) with suspected @entity698 , and 23 histologically normal appendices from @entity1 (age range, newborn to 12.1 years) undergoing elective abdominal surgery (controls). Whole-mount preparation using @entity1110 ( @entity1110 ) diaphorase histochemistry and neuronal @entity842 synthase immunohistochemistry were performed. The density of myenteric plexus was measured with a computerized analysis system. RESULTS: The density of myenteric plexus in normal appendix specimens was similar to that of large bowel from the newborn period up to 3 years of age; this density decreased significantly thereafter. The myenteric plexus of normal appendix specimens from @entity1 older than 4 years demonstrated smaller ganglia connected by thin nerve bundles, compared to larger ganglia and nerve bundles in large bowel. Significant @entity528 was found in 55% of acutely inflamed and 41% of histologically classified normal appendix specimens. The myenteric plexus of these appendix specimens had even thicker nerve bundles connecting an increased number of ganglion cells. CONCLUSIONS: Differences in the architecture of the myenteric plexus in @entity1 older than 3 years suggest an altered function and motility of appendix in the early years of life. The significant increase in neuronal components of the myenteric plexus in a high proportion of acutely inflamed and histologically normal appendix specimens is unlikely to have developed during a single acute inflammatory episode. This suggests an underlying chronic abnormality as a secondary response to chronic luminal obstruction or repeated inflammatory episodes in the histologically normal appendix.

Nitrergic hyperinnervation in XXXX and in appendices histologically classified as normal.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity698 :: ('MESH:D001064', 'Disease') :: ['appendicitis'] @entity3002 :: ('MESH:D009421', 'Disease') :: ['involvement of the enteric nervous system'] @entity1110 :: ('MESH:D009249', 'Chemical') :: ['nicotinamide adenine dinucleotide phosphate', 'NADPH'] @entity842 :: ('MESH:D009569', 'Chemical') :: ['nitric oxide'] @entity528 :: ('MESH:D009410', 'Disease') :: ['neuronal hypertrophy']
@entity698 :: (MESH:D001064,Disease) :: ['appendicitis']
