This study aimed to clarify the features of static standing when opening and closing the eyes in patients with brain injury and asomatognosia. Participants included 45 patients with brain injury who were given the task of standing for 30 s with their eyes opened and subsequently closed. The total locus length was measured for assessing posture control. We used behavior observation to assess asomatognosia in these patients, who were divided into two groups: those with asomatognosia (A group) and those without asomatognosia (Non-A group). The data analysis compared the total locus length of the opening and closing of eyes in patients with brain injury using the Wilcoxon signed-rank test. It also compared the total locus length and Romberg rate with the opening and closing of the eyes between the A group and the Non-A group using the Mann–Whitney U test. The significance was set at 5%. The total locus length when opening and closing the eyes in patients with brain injury and with asomatognosia was significantly extended (p<0.01). Further, the Romberg rate of the total locus length significantly increased (p<0.01). The A group had a significantly wider total locus length and higher Romberg rates regardless of visual condition than the Non-A group.
Hirschsprung’s disease (HD) is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the distal intestine, resulting in functional intestinal obstruction. Surgical excision of the aganglionic segment is the standard treatment for HD. The presence of ganglion cells is generally confirmed by histological examination during surgery. A transition zone between histologically normoganglionic and aganglionic segments exists in almost every patient. This zone should be excised because a residual transition zone may contribute to postoperative obstructive symptoms. However, there is no definite criterion for determining the number of ganglion cells present in normoganglionic bowel segments in patients with HD. This study aimed to determine the distribution and number of ganglion cells in normoganglionic bowel segments in patients with HD. A pull-through procedure was performed in nine patients with HD, and the number of ganglion cells in their intestines was counted histologically using immunohistochemistry with anti-Hu C/D antibody. The distribution of ganglion cells on the antimesenteric side of the transition zone tended to extend more distally than that on the mesenteric side. The number of Meissner and Auerbach ganglion cells in the normoganglionic bowel of patients with HD was 93.77±20.9 /cm and 110.3±23.0 /cm, respectively. The present study suggests that multiple tissue samples should be obtained from both the mesenteric and antimesenteric sides of the intestine for intraoperative histologic examination. Moreover, the presence of at least 100 Auerbach ganglion cells per centimeter circumferentially should be confirmed to avoid a residual transition zone.