Li2100deplMoO4 Scintillating Bolometers for Rare-Event Search Experiments.

We report on the development of scintillating bolometers based on lithium molybdate crystals that contain molybdenum that has depleted into the double-ß active isotope 100Mo (Li2100deplMoO4). We used two Li2100deplMoO4 cubic samples, each of which consisted of 45-millimeter sides and had a mass of 0.28 kg; these samples were produced following the purification and crystallization protocols developed for double-ß search experiments with 100Mo-enriched Li2MoO4 crystals. Bolometric Ge detectors were utilized to register the scintillation photons that were emitted by the Li2100deplMoO4 crystal scintillators. The measurements were performed in the CROSS cryogenic set-up at the Canfranc Underground Laboratory (Spain). We observed that the Li2100deplMoO4 scintillating bolometers were characterized by an excellent spectrometric performance (∼3-6 keV of FWHM at 0.24-2.6 MeV γs), moderate scintillation signal (∼0.3-0.6 keV/MeV scintillation-to-heat energy ratio, depending on the light collection conditions), and high radiopurity (228Th and 226Ra activities are below a few µBq/kg), which is comparable with the best reported results of low-temperature detectors that are based on Li2MoO4 using natural or 100Mo-enriched molybdenum content. The prospects of Li2100deplMoO4 bolometers for use in rare-event search experiments are briefly discussed.

Mechanical Energy Absorption Ability of Titanium-Based Porous Structures Produced by Various Powder Metallurgy Approaches.

Porous materials are very efficient in absorbing mechanical energy, for instance, in combined armor, in order to improve the anti-ballistic protection characteristics. In the present study, porous titanium-based structures were manufactured via three different powder metallurgy methods using titanium hydride (TiH2) powder, which provided activated sintering, owing to dehydrogenation. The emission of hydrogen and shrinkage of powder particles on dehydrogenation also added an additional potential to control the sintering process and create desirable porosities. TiH2 powder was sintered with additions of NaCl or ammonium carbide as pore holding removable agents, while highly porous Ti-Al structures were formed via liquid phase reactive sintering of TiH2 and Al powders. The microstructures and porosities of sintered dehydrogenated titanium and Ti-Al structures were comparatively studied. Mechanical characteristics were evaluated using compression testing with strain rates varying from quasi-static to high levels. The resonant frequency method was also employed to determine damping parameters and elastic modulus of these materials. All testing methods were aimed at characterizing the energy-absorbing ability of the obtained porous structures. The desired strength, plasticity and energy-absorbing characteristics of porous titanium-based structures were assessed, and the possibilities of their application were also discussed. Based on the obtained results, it was found that porous titanium materials produced with the use of ammonium carbonate showed promising energy absorption properties.

Surface Heterogeneity in Amorphous Silica Nanoparticles Evidenced from Tapping AFM-IR Nanospectroscopy.

In this work, we propose to evaluate and validate an emerging spectroscopic space-resolved technique: atomic force microscopy coupled with infrared spectroscopy (AFM-IR) for inorganic materials in tapping mode at the nanoscale. For this aim, a preliminary investigation of sample preparation techniques was done and the stability of tapping AFM-IR spectra was evaluated on reference samples [poly(methyl methacrylate) and silica]. It was concluded that for a homogeneous polymer, it is possible to compare AFM-IR spectra with conventional Fourier-transform infrared (FTIR) spectra obtained in transmission. When an inorganic solid is considered, AFM-IR spectra are different from the global FTIR spectrum which indicates that the AFM-IR technique probes a volume which is not representative of global composition, that is, the external surface layer. Moreover, local infrared spectra recorded in the tapping mode of the external surface are significantly different depending on the analyzed regions of the same particle and between particles of the amorphous silica, implying surface heterogeneity. The AFM-IR technique allows surface description of amorphous inorganic materials at the nanoscale and opens new frontiers in the characterization of functional nanoscale and crystalline materials.

Retained bullet in the neck after gunshot wounds to the chest and arm in combat patient injured in the war in Ukraine: A case report.

INTRODUCTION AND IMPORTANCE: A gunshot wound is the most common injury in armed conflicts, resulting in severe trauma and increased morbidity usually due to damage to major vessels. Gunshot injury could be associated with the projectile location in one anatomical area, but the initial inlet place in another. PRESENTATION OF CASE: A 33-years old male patient received gunshot injuries to the left axillary area of the chest and left upper extremity in the battlefield area near Kyiv (Ukraine). The patient was diagnosed with multiple gunshot injuries, as judged from the presence of inlet and outlet holes in the chest and left upper arm. Without having any major complaints, the patient was examined by chest X-ray, showing a metal density fragment in the area of the first left rib, behind the left clavicle and adjacent to the left common carotid artery (CCA) and internal jugular vein (IJV). Surgery revealed 25 mm retained bullet in the area between CCA and IJV. CLINICAL DISCUSSION: Our case report is in line with others, showing that identification of the bullet or projectile fragment in unexpected locations was made by chance or due to routine application of protocols for the clinical evaluation of combat patients, including those without clinical signs or specific complaints. CONCLUSION: A gunshot injury could be associated with an unusual bullet trajectory. A routine whole-body CT scan or chest and abdominal X-ray should be performed for all patients with gunshot injury of any localization for early detection of a possible retained bullet.

PROGRAMMED LAPAROSCOPY IN THE OF DIFFUSE APPENDICULAR PERITONITIS TREATMENT OF CHILDREN.

OBJECTIVE: The aim: To analyze the implementation of programmed laparoscopy with the criteria definition for its termination in the treatment of diffuse appendicular peritonitis in children. PATIENTS AND METHODS: Materials and methods: Since 2017, the programmed laparoscopy in the treatment of diffuse appendicular peritonitis has been used in 28 children aged 1 to 16 years. RESULTS: Results: The programmed laparoscopy allows assessing the dynamics of the intra-abdominal infectious-inflammatory process and monitoring the treatment effectiveness. The modified abdominal index (AI) was determined based on integrated assessment of degree and nature of abdominal organs` damage during the first and repeated surgeries, the modified abdominal index (AI) was determined. AI identified during the primary laparoscopic intervention ranged from 14 up to 22 points and on average it was 17.5 ± 1.3 points, during the programmed laparoscopy AI was from 3 to 11 points, on average it was 9.15 ± 1.48 points. CONCLUSION: Conclusions: The programmed laparoscopy for diffuse peritonitis in children allows controlling the pathological process in the abdominal cavity and promptly eliminate intra-abdominal complications. Determination of AI allows objectifying the nature of the lesion and the dynamics of changes in the abdominal cavity.

A Case of Surgical Treatment of a Gunshot Wound to the Left Scapular Region With Damage to the Distal Axillary and Proximal Brachial Arteries.

INTRODUCTION: The incidence of vascular damage in modern combat conflicts is 5 times higher than in previous military conflicts, with one in five wounded having uncontrolled severe blood loss. Treatment of gunshot wounds of the main arteries is a complex multi-level process, which can be done only in the case of close cooperation of related surgical specialties. CASE REPORT: This case report details treatment of a 40-year-old man who was admitted with a gunshot wound to the left shoulder with injury of the distal axillary and proximal brachial arteries. Primary surgical treatment consisted of venous interposition graft of the injured artery and debridement of the scapular wounds in a peripheral hospital. He was transferred to Main Military Medical Clinical Center in Kyiv with acute thrombosis of the vascular repair graft. Urgent reoperation was performed, with removal of the previously placed vascular graft and revascularization of the distal axillary and proximal brachial artery with reverse venous graft, with accompanying fasciotomy. CONCLUSION: This case demonstrates the crucial role of rapid evacuation of wounded to a specialized level of care for complex cases such as arterial reconstruction.

DETECTION OF BREAST CANCERS REPRESENTED AS ARCHITECTURAL DISTORTION: A COMPARISON OF FULL-FIELD DIGITAL MAMMOGRAPHY AND DIGITAL BREAST TOMOSYNTHESIS.

OBJECTIVE: The aim: The aim of our study was to determine if digital breast tomosynthesis improves breast cancer detection associated with architectural distortion in comparison with full-field digital mammography in the absence of appropriate history of trauma or surgery. PATIENTS AND METHODS: Materials and methods: The overall rate of breast cancer involvement for the 34 patients with architectural distortion was 15 cases (44,1%) (invasive breast cancers, n=12 (36,4%); ductal cancer in situ, n= 3 (8,8%)) other findings associated with architectural distortion were high-risk lesions and benign findings (radial scar, n=5 (14,7%); sclerosing adenosis, n=9 (26,5%); typical lobular hyperplasia, n=3 (8,8%); typical ductal hyperplasia, n=2 cases (5,9%)). RESULTS: Results: Overall of 17/34 (50.0%) architectural distortions were identified at digital breast tomosynthesis that were missed at full-field digital mammography what was statistically significant difference ([95% CI, 2.56-7.45]; p=0.00001). Analysis of the results showed that sensitivity of full-field digital mammography for digital breast tomosynthesis detected breast cancers associated with architectural distortion was 53.3% [95% CI, 26.59% to 78.73%] and specificity was 52.63% [95% CI, 28.86% to 75.55%]. CONCLUSION: Conclusions: Our study suggests that digital breast tomosynthesis detects more breast cancers represented as architectural distortion which are occult on full-field digital mammography. Presence of microcalcifications within architectural distortion, in the absence of appropriate history of trauma or surgery, has a high likelihood of malignancy and obligatorily requires biopsy.

The geometry of diphtheria toxoid CRM197 channel assessed by thiazolium salts and nonelectrolytes.

The geometry of the channel formed by nontoxic derivative of diphtheria toxin CRM197 in lipid bilayer was determined using the dependence of single-channel conductance upon the hydrodynamic radii of different nonelectrolytes. It was found that the cis entrance of CRM197 channel on the side of membrane to which the toxoid was added at pH 4.8 and the trans entrance on the opposite side at pH 6.0 had effective radii of 3.90 and 3.48 Å, respectively. The 3-alkyloxycarbonylmethyl-5-(2-hydroxyethyl)-4-methyl-1,3-thiazolium salts reversibly reduced current via CRM197 channels. The potency of the blockers increased with increasing length of alkyl chain at symmetric pH 6.0 and remained high and stable at pH 4.8 on the cis side. Comparative analysis of CRM197 and amphotericin B pore size with the inhibitory action of thiazolium salts revealed a significant increase in CRM197 pore dimension at pH 6.0. Addition of thiazolium salt with nine carbons alkyl tail increased by ∼30% the viability of human carcinoma cells A431 treated with diphtheria toxin.

Phylogenetic assessment reveals continuous evolution and circulation of pigeon-derived virulent avian avulaviruses 1 in Eastern Europe, Asia, and Africa.

BACKGROUND: The remarkable diversity and mobility of Newcastle disease viruses (NDV) includes virulent viruses of genotype VI. These viruses are often referred to as pigeon paramyxoviruses 1 because they are normally isolated and cause clinical disease in birds from the Columbidae family. Genotype VI viruses occasionally infect, and may also cause clinical disease in poultry. Thus, the evolution, current spread and detection of these viruses are relevant to avian health. RESULTS: Here, we describe the isolation and genomic characterization of six Egyptian (2015), four Pakistani (2015), and two Ukrainian (2007, 2013) recent pigeon-derived NDV isolates of sub-genotype VIg. These viruses are closely related to isolates from Kazakhstan, Nigeria and Russia. In addition, eight genetically related NDV isolates from Pakistan (2014-2016) that define a new sub-genotype (VIm) are described. All of these viruses, and the ancestral Bulgarian (n = 2) and South Korean (n = 2) viruses described here, have predicted virulent cleavage sites of the fusion protein, and those selected for further characterization have intracerebral pathogenicity index assay values characteristic of NDV of genotype VI (1.31 to 1.48). A validated matrix gene real-time RT-PCR (rRT-PCR) NDV test detect all tested isolates. However, the validated rRT-PCR test that is normally used to identify the virulent fusion gene fails to detect the Egyptian and Ukrainian viruses due to mismatches in primers and probe. A new rapid rRT-PCR test to determine the presence of virulent cleavage sites for viruses from sub-genotypes VIg was developed and evaluated on these and other viruses. CONCLUSIONS: We describe the almost simultaneous circulation and continuous evolution of genotype VI Newcastle disease viruses in distant locations, suggesting epidemiological connections among three continents. As pigeons are not migratory, this study suggests the need to understand the possible role of human activity in the dispersal of these viruses. Complete genomic characterization identified previously unrecognized genetic diversity that contributes to diagnostic failure and will facilitate future evolutionary studies. These results highlight the importance of conducting active surveillance on pigeons worldwide and the need to update existent rapid diagnostic protocols to detect emerging viral variants and help manage the disease in affected regions.

Surgical Treatment of Tubular Breast Type II.

BACKGROUND: Tubular breasts are caused by connective tissue malformation and occur in puberty. The main clinical characteristics of the tubular breast are breast asymmetry, dense fibrous ring around the areola, hernia bulging of the areola, megaareola, and hypoplasia of quadrants of the breast. Pathology causes great psychological discomfort to patients. METHODS: This study included 17 patients, aged 18 to 34 years, with tubular breast type II who had bilateral pathology and were treated from 2013 to 2016. They had surgical treatment by method of the clinic. Correction technique consisted of mobilization of the central part of the gland and formation of a glandular flap with vertical and horizontal scorings, which looks like a "chessboard," that was sufficient to cover the lower pole of the implant. The flap was fixed to the submammary folds with stitches that prevented its reduction and accented a new submammary fold. To underscore the importance of the method and to study the structural features of the vascular bed of tubular breast tissue, a morphological study was conducted. RESULTS: Mean follow-up time was 25 months (range between 13 and 37 mo). The proposed technique achieved good results. Complications (hematoma, circumareolar scarring, and "double-bubble" deformity) were identified in 4 patients. CONCLUSIONS: Our morphological study confirmed that tubular breast tissue has increased vascularity due to the vessels with characteristic minor malformation and due to the high restorative potential of the vascular bed. Therefore, an extended glandular flap could be freely mobilized without damaging its blood supply; thus, the flap in most cases covered the implant completely and good aesthetic results were achieved.

Presence of Vaccine-Derived Newcastle Disease Viruses in Wild Birds.

Our study demonstrates the repeated isolation of vaccine-derived Newcastle disease viruses from different species of wild birds across four continents from 1997 through 2014. The data indicate that at least 17 species from ten avian orders occupying different habitats excrete vaccine-derived Newcastle disease viruses. The most frequently reported isolates were detected among individuals in the order Columbiformes (n = 23), followed in frequency by the order Anseriformes (n = 13). Samples were isolated from both free-ranging (n = 47) and wild birds kept in captivity (n = 7). The number of recovered vaccine-derived viruses corresponded with the most widely utilized vaccines, LaSota (n = 28) and Hitchner B1 (n = 19). Other detected vaccine-derived viruses resembled the PHY-LMV2 and V4 vaccines, with five and two cases, respectively. These results and the ubiquitous and synanthropic nature of wild pigeons highlight their potential role as indicator species for the presence of Newcastle disease virus of low virulence in the environment. The reverse spillover of live agents from domestic animals to wildlife as a result of the expansion of livestock industries employing massive amounts of live virus vaccines represent an underappreciated and poorly studied effect of human activity on wildlife.

Optical Properties of Pyrolytic Carbon Films Versus Graphite and Graphene.

We report a comparative study of optical properties of 5-20 nm thick pyrolytic carbon (PyC) films, graphite, and graphene. The complex dielectric permittivity of PyC is obtained by measuring polarization-sensitive reflectance and transmittance spectra of the PyC films deposited on silica substrate. The Lorentz-Drude model describes well the general features of the optical properties of PyC from 360 to 1100 nm. By comparing the obtained results with literature data for graphene and highly ordered pyrolytic graphite, we found that in the visible spectral range, the effective dielectric permittivity of the ultrathin PyC films are comparable with those of graphite and graphene.

Time- and behavioral state-dependent changes in posterior hypothalamic GABAA receptors contribute to the regulation of sleep.

Sleep-wake behavior is regulated by a circadian rhythm, homeostatically and by additional mechanisms that determine the timing of slow-wave sleep and rapid eye movement sleep (REMS) episodes. The posterior hypothalamus coordinates the neural and humoral signals with the rest-activity cycle. It contains wake-active neurons, and is a site where stimulation of inhibitory GABAA receptors promotes sleep, whereas their antagonism enhances wakefulness. We explored whether GABAergic mechanisms present in the posterior hypothalamus contribute to the homeostatic and other aspects of sleep-wake regulation. Using micropunches of tissue extracted from either the perifornical (PF) or dorsomedial (DM) regions of the posterior hypothalamus of rats, we determined that mRNA levels for selected subunits of GABAA receptors (ß1, ß3 and ε) were higher at the end of the active period or following sleep deprivation, when the need for sleep is high, than after several hours of sleep, when sleep need is partially fulfilled. Such a pattern was present in the PF region only, and was consistent with changes in ß1 subunit and GABA synthesizing enzyme (GAD) protein levels. In contrast, in the DM region, the levels of GABAA receptor subunit mRNAs and proteins (α1, α2, ß1) and GAD varied with circadian time, but were not responsive to sleep deprivation. Separate experiments with sleep-wake monitoring and local perfusion of the PF region with the GABAA receptor antagonist bicuculline revealed that the antagonist had a weaker sleep-reducing effect when sleep need was enhanced by sleep deprivation and that the increased amount of REMS characteristic of the late sleep period was dependent on endogenous GABAergic inhibition. These results support the concept that a varying magnitude of GABAergic inhibition exerted within the PF region contributes to the homeostatic regulation of sleep and shapes its temporal pattern, whereas GABAergic mechanisms in the DM region contribute to circadian regulation.

Loss of motoneurons in the ventral compartment of the rat hypoglossal nucleus following early postnatal exposure to alcohol.

Perinatal alcohol exposure (AE) has multiple detrimental effects on cognitive and various behavioral outcomes, but little is known about its impact on the autonomic functions. In a rat model of fetal alcohol spectrum disorders (FASD), we investigated neurochemical and neuroanatomical alterations in two brainstem nuclei, the hypoglossal nucleus (XIIn) and the dorsal nucleus of the vagus nerve (Xdn). One group of male Sprague-Dawley rats (n=6) received 2.625 g/kg ethanol intragastrically twice daily on postnatal days (PD) 4-9, a period equivalent to the third trimester of human pregnancy, and another group (n=6) was sham-intubated. On PD 18-19, the rats were perfused and medullary sections were immunohistochemically processed for choline acetyltransferase (ChAT) or two aminergic receptors that mediate excitatory drive to motoneurons, α1-adrenergic (α1-R) and serotonin 2A (5-HT(2A)-R), and c-Fos. Based on ChAT labeling, AE rats had reduced numbers of motoneurons in the ventral XIIn (XIIn-v; 35.4±1.3 motoneurons per side and section vs. 40.0±1.2, p=0.022), but not in the dorsal XIIn or Xdn. Consistent with ChAT data, both the numbers of α1-R-labeled motoneurons in the XIIn-v and the area of the XIIn-v measured using 5-HT(2A)-R staining were significantly smaller in AE rats (19.7±1.5 vs. 25.0±1.4, p=0.031 and 0.063 mm² ±0.002 vs. 0.074±0.002, p=0.002, respectively). Concurrently, both 5-HT(2A)-R and c-Fos staining tended to be higher in AE rats, suggesting an increased activation. Thus, postnatal AE causes motoneuronal loss in the XIIn-v. This may compromise upper airway control and contribute to increased risk of upper airway obstructions and sudden infant death in FASD victims.

Circadian dependence of receptors that mediate wake-related excitatory drive to hypoglossal motoneurons.

Serotonin (5-HT), norepinephrine and orexins (ORX) are the three best established mediators of wake-related activation of hypoglossal (XII) motoneurons that innervate the muscles of the tongue. Since the tongue's use is temporarily closely aligned with the rest-activity cycle, we tested whether expression of mRNA for relevant 5-HT, norepinephrine and ORX receptors varies in the XII nucleus with the rest-activity cycle. Adult rats (n=7-9/group) were decapitated at 8-9 am (near rest period onset) or at 6-7 pm (near active period onset). Tissue micropunches were extracted from medullary slices containing the XII motor and sensory external cuneate (ECN) nuclei. 5-HT2A, α1-adrenergic and ORX type 2 receptor mRNAs were quantified using RT-PCR. Only 5-HT2A receptor mRNA levels differed between the two time points and were higher at the active period onset; no differences were detected in the ECN. Consistent with the mRNA results, 5-HT2A protein levels were also higher in the XII nucleus at the active period onset than at rest onset. Thus, the endogenous serotonergic excitatory drive to XII motoneurons may be enhanced through circadian- or activity-dependent mechanisms that increase the availability of 5-HT2A receptors prior to the active period. Conversely, reduced levels of 5-HT2A receptors during the rest-sleep period may exacerbate the propensity for sleep-disordered breathing in subjects with anatomically compromised upper airway.

Reduced sleep and impaired sleep initiation in adult male rats exposed to alcohol during early postnatal period.

Prenatal alcohol exposure (AE) is associated with cognitive and neurobehavioral abnormalities, such as increased motor activity and elevated anxiety, that may last a lifetime. Persistent sleep disruption may underlie these problems. Using a rat model, we investigated long-term alterations of sleep-wake behavior following AE during a critical early developmental period. Male rats received 2.6 g/kg of alcohol intragastrically twice daily on postnatal days (PD) 4-9, a developmental period equivalent to the third trimester of human pregnancy (AE group), or were sham-intubated (S group). On PD52-80, they were instrumented for tethered electroencephalogram and nuchal electromyogram recording and habituated to the recording procedures. Sleep-wake behavior was then recorded during one 24 h-long session. Wake, slow-wave sleep (SWS) and rapid eye movement sleep (REMS) were scored in 10 s epochs during 6h of the lights-on (rest) and 6h of the lights-off (active) periods. During the active period, REMS percentage was significantly lower (4.7 ± 0.9 (SE) vs. 8.2 ± 0.9; p < 0.02) and the percentage of SWS tended to be lower (p = 0.07) in AE than S rats (N = 6/group). During the rest period, sleep and wake amounts did not differ between the groups, but AE rats had longer latency to both SWS and REMS onset (p = 0.02 and 0.003, respectively). Our data demonstrate that, in a rat model of prenatal AE, impaired sleep-wake behavior persists into the adulthood. Disordered sleep may exacerbate cognitive and behavioral disorders seen in human victims of prenatal AE.

Antagonism of orexin 1 receptors eliminates motor hyperactivity and improves homing response acquisition in juvenile rats exposed to alcohol during early postnatal period.

Consequences of prenatal alcohol exposure (AE) include motor hyperactivity, disrupted sleep and cognitive deficits. Hypothalamic orexin (ORX)-synthesizing neurons are important for the maintenance of vigilance and regulation of motor activity but their hyperactivity may contribute to anxiety disorders. Using a rat model, we tested whether ORX plays a role in behavioral consequences of prenatal AE. Male rat pups received 2.625 g/kg of alcohol (AE group) intragastrically twice daily on postnatal days (PD)4-9, a developmental period equivalent to the third trimester of human pregnancy. Control pups were sham-intubated (S group). On PD12-14, they received daily injections of either the ORX-1 receptor antagonist, SB-334867 (SB; 20mg/kg, i.p.) or vehicle (V) during the lights-off period. On PD16, they were subjected to the homing response (HR) test. On PD17, their motor activity was monitored in a novel environment. The percentage of tests in which HR acquisition was not achieved and the number of trials needed to reach the shortest HR latency were higher, whereas the percentage of successful trials was lower, in AE-V than in S-V rats (p = 0.0009-0.03). In contrast, these measures were not significantly different between AE-SB and either S-SB or S-V rats. Motor activity in AE-V rats was significantly higher than in S-V (p = 0.003), S-SB (p = 0.007) or AE-SB (p = 0.02) rats, with no difference between S-SB and AE-SB group. Our findings suggest that excessive activity of ORX neurons contributes to motor hyperactivity and impaired HR acquisition following perinatal AE and that these symptoms may be alleviated by systemic antagonism of ORX-1 receptors.

Sporadic Creutzfeldt-Jakob disease mimicking nonconvulsive status epilepticus.

BACKGROUND: Nonconvulsive status epilepticus (NCSE) in patients with confusion may be difficult to distinguish from nonepileptic (metabolic/toxic, postanoxic, and spongiform) encephalopathies. This study aimed to describe the misleading presentation of patients with sporadic Creutzfeldt-Jakob disease (sCJD) who were initially diagnosed with a refractory NCSE (rNCSE). METHODS: We retrospectively reviewed the clinical characteristics, EEG records, brain MRI scans, 14-3-3 protein detection in CSF, genotype of the prion protein gene, and neuropathologic data of patients referred to our neurologic intensive care unit (NICU) with this presentation. RESULTS: Ten patients with a final diagnosis of definite (n = 7) or probable (n = 3) sCJD were referred to our NICU with an initial diagnosis of rNCSE. Reanalysis of the EEG ruled out ictal rhythmic activities, but showed diffuse, periodic, or semiperiodic sharp-wave complexes (PSWC) with short period. PSWC were briefly attenuated by auditory (n = 5) or painful (n = 3) stimuli and by IV injection of antiepileptic drugs (n = 5) but without clinical improvement. In addition, PSWC showed fluctuations according to the vigilance level (n = 5). Brain MRI showed hyperintensities in basal ganglia (n = 9/10) and in cortical areas (n = 7/10). 14-3-3 Protein was detected in CSF (n = 10). Only 2 sCJD subtypes were found (MM1 5/7, MV1 2/7). CONCLUSIONS: This series of patients suggests that sporadic Creutzfeldt-Jakob disease should be considered as a differential diagnosis, rather than as a cause, of apparent refractory nonconvulsive status epilepticus. Criteria for nonconvulsive status epilepticus diagnosis should rely on careful examination of both EEG parameters and clinical state so that aggressive, unnecessary treatments can be avoided.

Direct synthesis of an heterometallic {Mn(II)3Cr(III)4} wheel by decomposition of Reineckes salt.

A new heterometallic Mn/Cr molecular wheel complex has been synthesized using zerovalent manganese, Reineckes salt, ammonium thiocyanate and triethanolamine (H(3)tea) as starting materials. The compound [Mn(3)Cr(4)(NCS)(6)(Htea)(6)] (1) has been characterized in terms of its electrochemical, IR and EPR spectroscopic as well as its magnetic properties. The magnetic susceptibility and magnetization data were treated simultaneously during the optimization routine and resulted in J(Mn-Cr) = +0.43 cm(-1), J(Cr-Cr) = -4.75 cm(-1), J(Mn-Mn) = +1.78 cm(-1), g(eff) = 1.878 with the ground state S = 15/2.

[Sensory neuropathy and autoimmune diseases]. / Neuropathies sensitives et maladies auto-immunes : Stratégie diagnostique à propos d'une observation.

If a sensory neuropathy appear from an autoimmune disease, it was important to precise the type with clinical and electrophysiological characteristic features (distal symmetric polyneuropathy, chronic inflammatory demyelinating polyneuropathy, Sensory mononeuritis multiplex, sensory neuronopathy, small-fiber neuropathy). The type of neuropathy have an influence on the complementary explorations. It was very important to determine the mechanism between the neuropathy and the autoimmune disease for the treatment. We present a young patient with systemic lupus erythemathosus and sensory neuropathy. This case illustrates this diagnosis strategy.