PubMed · 15664108
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Umut Sarpel, Maithao N Le, Raffaella A Morotti, Stephen E Dolgin. 2005. Complete colorectal duplication.. https://doi.org/10.1016/j.jamcollsurg.2004.09.039
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A novel high-yielding and environment-friendly synthesis of the anticancer compound 3-(4'-geranyloxy-3'-methoxyphenyl)-2-trans-propenoic acid is described. This compound was conjugated to H2N-Ala-Pro dipeptide to give a prodrug to be activated by intestinal ACE and to be used in the treatment of different forms of colon cancer. Data on the chemical and enzymatic stability of this novel prodrug are reported.
Fourteen cases of colonic atresia seen over a 38-year period are reviewed with particular reference to clinical presentation and pitfalls in management. Seven had Type I atresia, two Type II and five Type IIIa. Ten had associated gastrointestinal anomalies. Management varied considerably. Six had primary colonic anastomosis. Two of these developed complications due to unrecognized distal hypoganglionosis, two had associated jejunal atresias resulting in short bowel syndrome, and two had primary anastomosis protected by proximal ileostomies. Seven had a staged repair with initial defunctioning enterostomy with only one complication, an unfixed mesentery that later resulted in midgut volvulus. The only mortality was a patient in which a jejunal atresia repair leaked as a result of a missed colonic atresia. Operative strategy should depend on the clinical state of the patients, the level of atresia, associated small bowel pathology and exclusion of distal pathology. Primary anastomosis would only rarely be advised with a circumspect approach. Long-term outlook, as in small bowel atresia is generally excellent.
The etiology of sudden infant death syndrome (SIDS) is not known. Various maternal and infant risk factors have been identified. Adoption of the non-prone position has reduced the incidence of SIDS but has not eliminated the problem. Some sulfate reducing bacteria in the colon produce hydrogen sulfide (H2S) which is as toxic as hydrogen cyanide. Normally, the colonic mechanism for metabolizing and detoxifying H2S is very effective and no H2S appears in the exhaled breath although small amounts are present in the flatus. We are putting forth the hypothesis that in some cases of SIDS colonocytic mechanism for detoxifying H2S may not have matured by the age of 3 months and H2S may be absorbed resulting in SIDS. The hypothesis can be tested by in vitro evaluation of colonic tissue from SIDS cases for its ability to detoxify H2S.