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Related Concept Videos

Spontaneity02:21

Spontaneity

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A spontaneous process is one that occurs naturally under certain conditions. A nonspontaneous process, on the other hand, will not take place unless it is “driven” by the continual input of energy from an external source. Processes have a natural tendency to occur in one direction under a given set of conditions. Water will naturally flow downhill (spontaneous process), but uphill flow (nonspontaneous process) requires outside intervention such as the use of a pump. Iron exposed to...
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Spontaneous mutations arise infrequently during DNA replication due to errors in the process. A key factor behind these errors is tautomeric shifts in nitrogenous bases, where bases transition from keto to enol forms or amino to imino forms. This shift can alter base-pairing rules, leading to mutations. Additionally, reactive oxygen species (ROS) arising from aerobic metabolism can damage DNA, resulting in depurination (loss of a purine base) or depyrimidination (loss of a pyrimidine base).
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The spontaneity of a process depends upon the temperature of the system. Phase transitions, for example, will proceed spontaneously in one direction or the other depending upon the temperature of the substance in question. Likewise, some chemical reactions can also exhibit temperature-dependent spontaneities. To illustrate this concept, the equation relating free energy change to the enthalpy and entropy changes for the process is considered:
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Second Law of Thermodynamics02:49

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In the quest to identify a property that may reliably predict the spontaneity of a process, a promising candidate has been identified: entropy. Processes that involve an increase in entropy of the system (ΔS > 0) are very often spontaneous; however, examples to the contrary are plentiful. By expanding consideration of entropy changes to include the surroundings, a significant conclusion regarding the relation between this property and spontaneity may be reached. In thermodynamic models, the...
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Gibbs Free Energy02:39

Gibbs Free Energy

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One of the challenges of using the second law of thermodynamics to determine if a process is spontaneous is that it requires measurements of the entropy change for the system and the entropy change for the surroundings. An alternative approach involving a new thermodynamic property defined in terms of system properties only was introduced in the late nineteenth century by American mathematician Josiah Willard Gibbs. This new property is called the Gibbs free energy (G) (or simply the free...
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There is no one solvent that can dissolve every type of solute. Some substances that readily dissolve in a certain solvent might be insoluble in a different solvent. A simple way to predict which substances dissolve in which solvent is the phrase "like dissolves like". This means that polar substances, such as salt and sugar, dissolve in a polar substance like water. In contrast, non-polar substances are more soluble in non-polar solvents such as carbon tetrachloride.
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Author Spotlight: Investigating Wound Healing in Mice Models of Oronasal Fistulas
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Spontaneous Tubercular Enterocutaneous Fistula.

Mudassar Shah1, Munir A Wani1

  • 1Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

Saudi Journal of Medicine & Medical Sciences
|February 22, 2019
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Tuberculosis is a rare cause of spontaneous enterocutaneous fistula. This case highlights a 60-year-old female with a gluteal fistula caused by tuberculosis, successfully managed conservatively.

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Biopsyfemaleintestinal fistulatuberculosis

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Radiology

Background:

  • Spontaneous enterocutaneous fistulas (SEFs) are uncommon, often linked to Crohn's disease, malignancy, or radiation.
  • Tuberculosis (TB) is an exceptionally rare etiology for SEFs, posing diagnostic challenges.

Observation:

  • A 60-year-old female presented with a 3-month history of a right gluteal fistulous opening with feculent discharge and extrusion of Ascaris worms.
  • Imaging revealed extensive iliac bone destruction and a fistulous tract connecting small bowel loops to the gluteal region.
  • Biopsy confirmed tuberculosis as the underlying cause of the fistula.

Findings:

  • The patient's enterocutaneous fistula was definitively diagnosed as tuberculous in origin.
  • Advanced imaging modalities, including MR fistulogram, were crucial in delineating the complex fistulous tract and associated bone destruction.
  • Conservative management led to successful resolution of the fistula.

Implications:

  • This case underscores the importance of considering tuberculosis in the differential diagnosis of SEFs, particularly in endemic areas or with suggestive imaging findings.
  • Early diagnosis and appropriate management of tuberculous fistulas can lead to favorable outcomes.
  • Further research into the pathogenesis and optimal treatment strategies for tuberculous enterocutaneous fistulas is warranted.