Thoracic enteric cysts and diverticulae

Six cases of thoracic enteric cysts and diverticulae are described to illustrate a manifestation of the split notochord syndrome. The varied clinical, radiological, and operative picture in these cases is emphasized, the common triad being respiratory symptoms, a posterior mediastinal mass, and a vertebral anomaly. The symptoms may, however, be entirely gastrointestinal in the form of abdominal enlargement or gastro-intestinal haemorrhage. Because of the diversity of presentation these patients may come under the domain of the paediatric surgeon, the thoracic surgeon, or the neurosurgeon, and occasionally a combined team approach may be required to obtain satisfactory results in surgical treatment, which is mandatory.

Intra-abdominal injuries in the battered baby syndrome

In the period 1961 to 1970 six battered children suffering from intraabdominal visceral injuries were treated in the children's hospitals of Manchester. In addition to the signs of visceral lesions all the children were found to have histories and physical signs clearly pointing to the diagnosis of the battered baby syndrome. Epigastric and small intestinal injuries predominated in these children, and in this respect the pattern of trauma differs from that seen in children injured in road traffic and other accidents. Delay in referral contributed strongly to the death of two of the battered children.

Total intestinal aganglionosis presenting as duodenal obstruction

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Bisquaternary ammonium salts derived from 3α,12α-Diamino-5β-cholane and 3α,12α-Diamino-24-nor-5β-cholane

The preparation of 3α,12α-bisdimethylamino-5β-cholane dimethiodide, 3α,12α-bisdimethylamino-5β-cholane dimethiodide, 3α,12α- bisdimethylamino-24-nor-5β-cholanedimethiodide, and 3α,12α- bisdimethylamino-24-nor-5β-cholanediethiodide, from deoxycholic acid are described. During this work it was found that attempted copper- quinoline decarboxylation of dehydrocholic acid gives rise to lactol formation, and that what had previously been considered to be 3α,12α- dihydroxy-5β-cholane is a mixture of this compound and 12α,24- dihydroxy-5β-cholane. Comparable selectivity of attack by methanesulphonyl chloride and toluene-p-sulphonyl chloride occurs with various polyhydric alcohols derived from bile acids, as evidenced from the products of reduction of the sulphonates with lithium aluminium hydride. With both 5α- and 5β-cholane derivatives, a C 3 equatorial hydroxyl group exhibits comparable reactivity to the terminal primary hydroxyl group, generated from the bile acid carboxylic group, towards both sulphonyl chlorides. With axial hydroxyl groups at C 7 and C 12, toluene-p-sulphonate formation is much more difficult than methane- sulphonate formation. Reduction by means of lithium aluminium hydride of equatorial sulphonate esters at C 7 and C 12 gives rise to a methylene group, but the axial sulphonates under the same conditions give the axial alcohol. The same clear distinction between equatorial and axial sulphonate esters is not observed at C 3 and C 6, but 17α- methanesulphonyloxy-5α-androstane gives 5α-androstane and the 17β- ester gives 17β-hydroxy-5α-androstane. Reduction of 12-oximino groups in both 5α- and 5β-cholanes with sodium and ethanol, hydrogen in the presence of a catalyst, or lithium aluminium hydride gives solely the 12α-amino compound.

A huge acrochordon in labia majora - An unusual presentation

DOI: http://dx.doi.org/10.3329/bmrcb.v37i3.9123 BMRCB 2011; 37(3): 110-111

Primary sarcoma of the left atrium

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