Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review.

Rectal vascular malformation is a rare disease on which few reports have been published. Here, we report the case of a 38-year-old woman who presented with severe weakness, dyspnea, and recurrent episodes of rectal bleeding. Her colonoscopy showed an extensive pigmented lesion in the lower rectum. CT angiography showed diffuse circumferential wall thickening of the rectum, perirectal fat stranding, tiny round foci of calcification, and no arterial feeders. Multiphasic MRI confirmed the diagnosis. The patient underwent a total mesorectal excision with hand-sewn coloanal anastomosis. The venous malformation was confined to the mesorectal tissue. The avascular plane between the ectodermal and mesodermal tissue was well maintained. Blood loss was 200 mL. The patient has had no recurrence of disease in the 18 months since surgery. Although total mesorectal excision is described for rectal cancer, it may be indicated for benign disease like rectal vascular malformation to achieve complete removal of the disease and to minimize intraoperative blood loss.

Identification of p38α MAP kinase inhibitors by pharmacophore based virtual screening.

The p38α mitogen-activated protein (MAP) kinase plays a vital role in treating many inflammatory diseases. In the present study, a combined ligand and structure based pharmacophore model was developed to identify potential DFG-in selective p38 MAP kinase inhibitors. Conformations of co-crystallised inhibitors were used in the development and validation of ligand and structure based pharmacophore modeling approached. The validated pharmacophore was utilized in database screening to identify potential hits. After Lipinski's rule of five filter and molecular docking analysis, nineteen hits were purchased and selected for in vitro analysis. The virtual hits exhibited promising activity against tumor necrosis factor-α (TNF-α) with 23-98% inhibition at 10µM concentration. Out of these seven compounds has shown potent inhibitory activity against p38 MAP kinase with IC50 values ranging from 12.97 to 223.5nM. In addition, the toxicity study against HepG2 cells was also carried out to confirm the safety profile of identified virtual hits.