Ileal conduit to small intestine fistula following extensive abdominopelvic resection and radiation for metastatic colon cancer.

A woman in her mid-60s presented with decreased output from urostomy, which was an opening from the neobladder (ileal conduit). Presentation was preceded by a 6-month history of alternating faecaluria and increased colostomy output. Laboratory studies were notable for normal anion gap metabolic acidosis. Creatinine level of the colostomy output was 17.7 mg/dL, a finding indicative of the presence of urine in the sample. CT enterography and X-ray loopogram confirmed neobladder to small intestine fistula.Neobladder creation is commonly performed in patients with bladder cancer requiring resection. Fistulas between the neobladder and intestine are observed in fewer than 2.7% of cases. The patient's history of extensive abdominopelvic resection, colostomy creation and radiation likely contributed to fistula development. We highlight the need for a high index of suspicion for a fistula in a patient with a neobladder experiencing recurrent urinary tract infections or a high colostomy output concurrently with low neobladder output.

EBIT Observation of Ar Dielectronic Recombination Lines near the Unknown Faint X-Ray Feature Found in the Stacked Spectrum of Galaxy Clusters.

Motivated by possible atomic origins of the unidentified emission line detected at 3.55-3.57 keV in a stacked spectrum of galaxy clusters, an electron beam ion trap (EBIT) was used to investigate the resonant dielectronic recombination (DR) process in highly charged argon ions as a possible contributor to the emission feature. The He-like Ar DR-induced transition 1s22l-1s2l3l' was suggested to produce a 3.62 keV photon near the unidentified line at 3.57 keV and was the starting point of our investigation. The collisional-radiative model NOMAD was used to create synthetic spectra for comparison with both our EBIT measurements and with spectra produced with the AtomDB database/Astrophysical Plasma Emission Code (APEC) used in the Bulbul et al. work. Excellent agreement was found between the NOMAD and EBIT spectra, providing a high level of confidence in the atomic data used. Comparison of the NOMAD and APEC spectra revealed a number of missing features in the AtomDB database near the unidentified line. At an electron temperature of T e = 1.72 keV, the inclusion of the missing lines in AtomDB increases the total flux in the 3.5-3.66 keV energy band by a factor of 2. While important, this extra emission is not enough to explain the unidentified line found in the galaxy cluster spectra.

Arene-mercury complexes stabilized by aluminum and gallium chloride: catalysts for H/D exchange of aromatic compounds.

Dissolution of Hg(arene)(2)(MCl(4))(2) [arene = C(6)H(5)Me, C(6)H(5)Et, o-C(6)H(4)Me(2), C(6)H(3)-1,2,3-Me(3); M = Al, Ga] in C(6)D(6) results in a rapid H/D exchange and the formation of the appropriate d(n)-arene and C(6)D(5)H. H/D exchange is also observed between C(6)D(6) and the liquid clathrate ionic complexes, [Hg(arene)(2)(MCl(4))][MCl(4)], formed by dissolution of HgCl(2) and MCl(3) in C(6)H(6), m-C(6)H(4)Me(2), or p-C(6)H(4)Me(2). The H/D exchange reaction is found to be catalytic with respect to Hg(arene)(2)(MCl(4))(2) and independent of the initial arene ligand. Reaction of a 1:1 ratio of C(6)H(5)Me and C(6)D(6) with <0.1 mol % Hg(C(6)H(5)Me)(2)(MCl(4))(2) results in an equilibrium mixture of all isotopic isomers: C(6)H(5-x)D(x)Me and C(6)D(6-x)H(x) (x = 0-5). DFT calculations on the model system, Hg(C(6)H(6))(2)(AlCl(4))(2) and [Hg(C(6)H(6))(2)(AlCl(4))](+), show that the charge on the carbon and proton associated with the shortest Hg...C interactions is significantly higher than that on uncomplexed benzene or HgCl(2)(C(6)H(6))(2). The protonation of benzene by either Hg(C(6)H(6))(2)(AlCl(4))(2) or [Hg(C(6)H(6))(2)(AlCl(4))](+) was calculated to be thermodynamically favored in comparison to protonation of benzene by HO(2)CCF(3), a known catalyst for arene H/D exchange. Arene exchange and intramolecular hydrogen transfer reactions are also investigated by DFT calculations.