Cecum perforation due to tuberculosis in a renal transplant recipient: a case report

<p>Abstract</p> <p>Introduction</p> <p>Tuberculosis can present in many varied clinical situations in immunosuppressed patients. It has been reported that the sigmoid colon is the most common site for colonic perforation in renal transplant recipients and diverticulitis is its most common cause. Cecal perforation because of tuberculosis is extremely rare in a renal transplant recipient. We present the case of a renal transplant patient with cecal perforation due to tuberculosis, 10 years after renal transplantation.</p> <p>Case presentation</p> <p>A 39-year-old Caucasian man, who was a renal transplant recipient, was admitted to our emergency surgery unit with an acute abdomen. A cecal perforation was found at exploratory laparotomy, and a right hemicolectomy with an end ileostomy and transverse colonic mucous fistula were performed. Necrotizing granulomatous colitis due to tuberculosis was reported in the histopathologic examination.</p> <p>Conclusion</p> <p>Colonic perforations in immunosuppressed patients may have unusual presentations and unusual causes. Tuberculosis infection should be considered in the differential diagnosis during the histopathologic evaluation in immunocompromised patients such as renal transplant recipients.</p

Kinetics and Mechanism of the Oxidation of Alkylaromatic Compounds by a trans-Dioxoruthenium(VI) Complex

The oxidations of a series of 21 alkylaromatic compounds by trans-[Ru VI(L)(O) 2] 2+ (L = 1,12-dimethyl-3,4:9,10-dibenzo-1,12-diaza-5,8-dioxacyclopentadecane) have been studied in CH 3CN. Toluene is oxidized to benzaldehyde and a small amount of benzyl alcohol. 9,10-Dihydroanthracene is oxidized to anthracene and anthraquinone. Other substrates give oxygenated products. The kinetics of the reactions were monitored by UV-vis spectrophotometry, and the rate law is: -d[R VI]/dt = k 2[Ru VI][ArCH 3]. The kinetic isotope effects for the oxidation of toluene/d 8-toluene and fluorene/d 10-fluorene are 15 and 10.5, respectively. A plot of ΔH‡ versus ΔS‡ is linear, suggesting a common mechanism for all the substrates. In the oxidation of para-substituted toluenes, a linear correlation between log k 2 and σ 0 values is observed, consistent with a benzyl radical intermediate. A linear correlation between ΔG‡ and ΔH 0 (the difference between the strength of the bond being broken and that being formed in a H-atom transfer step) is also found, which strongly supports a hydrogen atom transfer mechanism for the oxidation of these substrates by trans-[Ru VI(L)(O) 2] 2+. The slope of (0.61 ± 0.06) is in reasonable agreement with the theoretical slope of 0.5 predicted by Marcus theory.link_to_subscribed_fulltex