Neonatal-Onset Chronic Intestinal Pseudo-Obstruction Syndrome with In Utero Urological Manifestation as Megacystis

SummaryObjectiveWe describe a case of neonatal-onset chronic intestinal pseudo-obstruction syndrome (CIPS) with in utero urological manifestation as congenital megacystis. Pitfalls in the interpretation of prenatal sonographic appearance, genetic counseling, and differential diagnosis are discussed.Case ReportA 28-year-old Taiwanese woman, gravida 6, para 3, was referred for further sonographic examination because of a suspected fetal abdominal cyst. Targeted ultrasound at 28 weeks' gestation showed megacystis filling the abdominal cavity. The renal parenchyma appeared normal, and there was no evidence of reflux hydroureteronephrosis. At 38 weeks of gestation, the patient spontaneously delivered a female infant weighing 3,350 g with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. At the age of 12 days, the infant still required Foley catheterization because of voiding difficulty, so reduction cystoplasty was performed. The infant presented with recurrent episodes of intestinal obstruction thereafter and underwent ileostomy and resections of segmental intestine loops (3 times) in the ensuing years. At the age of 6 years, she is orally fed with partial parenteral infusion support, and the voiding act is satisfactory.ConclusionAttention should be given to the prenatal diagnosis of neonatal-onset CIPS when fetal congenital megacystis with unknown etiology is first detected. Whether there is any relationship between the megacystismicrocolon-intestinal-hypoperistalsis syndrome, CIPS, and pure congenital megacystis requires further study

Partial spin freezing in the quasi-two-dimensional La2(Cu,Li)O4

In conventional spin glasses, the magnetic interaction is not strongly anisotropic and the entire spin system freezes at low temperature. In La2(Cu,Li)O4, for which the in-plane exchange interaction dominates the interplane one, only a fraction of spins with antiferromagnetic correlations extending to neighboring planes become spin-glass. The remaining spins with only in-plane antiferromagnetic correlations remain spin-liquid at low temperature. Such a novel partial spin freezing out of a spin-liquid observed in this cold neutron scattering study is likely due to a delicate balance between disorder and quantum fluctuations in the quasi-two dimensional S=1/2 Heisenberg system.Comment: 4 pages, 4 figure

Supermassive Black Holes with High Accretion Rates in Active Galactic Nuclei. IV. Hβ\beta Time Lags and Implications for Super-Eddington Accretion

We have completed two years of photometric and spectroscopic monitoring of a large number of active galactic nuclei (AGNs) with very high accretion rates. In this paper, we report on the result of the second phase of the campaign, during 2013--2014, and the measurements of five new H$\beta$ time lags out of eight monitored AGNs. All five objects were identified as super-Eddington accreting massive black holes (SEAMBHs). The highest measured accretion rates for the objects in this campaign are $\dot{\mathscr{M}}\gtrsim 200$, where $\dot{\mathscr{M}}= \dot{M}_{\bullet}/L_{\rm Edd}c^{-2}$, $\dot{M}_{\bullet}$ is the mass accretion rates, $L_{\rm Edd}$ is the Eddington luminosity and $c$ is the speed of light. We find that the H$\beta$ time lags in SEAMBHs are significantly shorter than those measured in sub-Eddington AGNs, and the deviations increase with increasing accretion rates. Thus, the relationship between broad-line region size ($R_{_{\rm H\beta}}$) and optical luminosity at 5100\AA, $R_{_{\rm H\beta}}-L_{5100}$, requires accretion rate as an additional parameter. We propose that much of the effect may be due to the strong anisotropy of the emitted slim-disk radiation. Scaling $R_{_{\rm H\beta}}$ by the gravitational radius of the black hole, we define a new radius-mass parameter ($Y$) and show that it saturates at a critical accretion rate of $\dot{\mathscr{M}}_c=6\sim 30$, indicating a transition from thin to slim accretion disk and a saturated luminosity of the slim disks. The parameter $Y$ is a very useful probe for understanding the various types of accretion onto massive black holes. We briefly comment on implications to the general population of super-Eddington AGNs in the universe and applications to cosmology.Comment: 53 pages, 12 figures, 7 tables, accepted for publication in The Astrophysical Journa