Resonance Studies Research Articles

Development of an Internet Web Application for the Study of Surface Plasmon Resonance Spectroscopy

An online web application was developed for the study of surface plasmon resonance (SPR) of different materials using angular and wavelength modulation. The present web application investigates the optical characteristics of the spectral and angular responses of a Kretschmann SPR sensor configuration that is widely applied for biological and chemical sensing by using the characteristic transmission matrix (CTM) method. The accuracy, efficiency, and reliability of the web application were validated by comparing the results generated by using the web application with other benchmark theoretical results and results of SPR experiments with standard samples.

Interference effect on resonance studies in searches of heavy particles

The interference between resonance signal and continuum background can be either constructive or destructive, depending on the relative sign of couplings between the signal and background amplitudes. Different interference schemes lead to asymmetric distortions of the resonance line shape, which could be distinguished in experiments, when the internal resonance width is larger than the detector resolution. Interpreting the ATLAS diboson excesses by means of a toy [Formula: see text] model as an illustrative example (though it is disfavored by the 13 TeV data), we find that the signs of resonance couplings can only be revealed in the line shape measurements up to a high confidence level at a high luminosity, which could bring us further information on the underlying theory beyond resonance searches at future lepton and hadron colliders.

Comparative study of transrectal ultrasonography and magnetic resonance in preoperative estimation of circumferential resection margin of mid-low rectal cancer

Objective To compare the value of transrectal ultrasonography(TRUS) and magnetic resonance(MR) in preoperative estimation of circumferential resection margin(CRM) of mid-low rectal cancer. Methods Both TRUS and MR were performed prior to surgery in 111 patients with mid-low rectal cancer. The CRM was evaluated and compared with the postoperative pathologic findings. Results The accuracy of TRUS and MR for CRM was 91.9%(102/111) and 85.6%(95/111), respectively, there was no statistical difference between them(P=0.137). Their specificities were 94.0%(79/84)and 84.5% (71/84), there was statistical difference between them(P=0.046). The consistency of the results between TRUS and pathology was better than that between MR and pathology(Kappa1=0.783, Kappa2=0.652). Conclusions TRUS is proved to have an important diagnostic value for CRM of mid-low rectal cancer. Key words: Endosonography; Rectal neoplasms; Circumferential resection margin; Magnetic resonance imaging

Identifying Performance Limiting Defects in Silicon Carbide pn-Junctions: A Theoretical Study

Dopant implantation is a high energy process which causes a significant damage to the crystal lattice and is usually accompanied by a post implantation anneal to repair the structure. Defects created in these processes may also persist in fully processed devices. Previous electron paramagnetic resonance (EPR) and EDMR studies have identified a series of nitrogen related defect complexes in N implanted silicon carbide (SiC) wafers.[1–3] This study examines the formation energy, charge transition levels and barriers to interconversion of two such defects: NCVSi and the NSiVC. The NCVSi center is favoured in a variety of charge states for a wide range of Fermi level positions. We found, however, that for Fermi level positions close to the valence band of 4H-SiC the NCVSi center is a favoured conformation with barriers to rearrangement of +1.2 eV and +3.8 eV in the neutral and +2 charge states, respectively.

Direct observation of UV-induced accumulated charges in inverted-type polymer solar cells with TiOx layer by electron spin resonance

ABSTRACTWe present an electron spin resonance (ESR) study of inverted-type polymer solar cells with the structure of indium tin oxide (ITO)/amorphous titanium oxide (TiOx)/regioregular poly(3-hexylthiophene) (P3HT):phenyl-C61-butryic acid methyl ester (PCBM)/Au. Two light-induced ESR signals with narrow and broad linewidth were observed by light irradiation. We found a strong correlation between typical light-soaking effects and the ESR signal with the broad linewidth under UV light irradiation. From the fact that the light-soaking effect requires UV irradiation, the ESR signal with the broad linewidth is found to be related with the light-soaking effect.

A study of the piezoelectric resonance in organic single crystal: glucuronic acid γ-lactone

An organic nonlinear optical material, namely glucuronic acid γ-lactone or glucuronolactone, was crystallized from aqueous solution. Crystals of large dimensions and full morphology were obtained by slow-cooling method in a custom-built solution growth setup. CHN analysis and X-ray diffraction confirmed the phase formation in the grown crystal. High-resolution XRD studies followed by Rietveld refinement yielded accurate lattice parameters which compared well with the reported values. UV–Vis spectrum recorded for a b-plate of 2 mm thickness revealed the low UV-cutoff at 250 nm. Dielectric constant and dielectric loss were monitored as a function of frequency. Piezoelectric resonance peaks were observed in the range 0.2–1.5 MHz which are dependent on the plate thickness. The temperature dependence of the resonance peak frequency was studied. Piezoelectric coefficients were estimated by resonance–antiresonance method.

Light-Induced EPR Spectroscopy of Charge Transfer in Low-Band-Gap PCDTBT:PC71BM Bulk Heterojunctions

The light-induced electron paramagnetic resonance (LEPR) study of spin charge carrier steady-state initiated by IR–Vis photons in an organic composite of a low-band-gap poly(N-9’-heptadecanyl-2, 7-carbazole-alt-5, 5-(4’, 7’-di-2-thienyl-2’, 1’, 3′-benzothiadiazole)) with a [6, 6]-phenyl-C 71-butyric acid methyl ester is reported. LEPR spectra of the composite were deconvoluted, and the main resonance parameters of polarons and anion radicals of methanofullerene were determined. The reversible formation in polymer backbone of spin traps, whose number, distribution, and depth is governed by the photon energy, has been shown. Part of the photoinduced charge carriers is pinned by such traps, resulting in the formation in the composite of polymer and fullerene domains with different band gaps and photon sensitivity. Relaxation and dynamics parameters of spin charge carriers were shown to depend on the energy of exciting photons. The mechanisms of polaron diffusion along and between polymer chains, as well as librations of methanofullerene cages in a polymer matrix, were proposed. Our results suggest that the use of C70-counterions as an electron accepter in the composite provokes its layered morphology. This hinders the formation of spin traps, increases the path length for charge carriers, and, therefore, accelerates their spin-assisted relaxation and dynamics through bulk heterojunctions within the visible and infrared regions of the sun spectrum with comparable effectiveness.

Comparison of Phase 3 Ibrutinib Results Versus Standard of Care in Sweden in Patients with Relapsed/Refractory (R/R) Chronic Lymphocytic Leukemia (CLL)

BackgroundIbrutinib (Ibr), an oral, first-in-class covalent Bruton's tyrosine kinase inhibitor, showed in the Phase 3 RESONATE trial significantly improved progression-free survival (PFS, hazard ratio [HR] =0.22, p<0.001) and overall survival (OS, HR=0.39,p=0.001) compared with ofatumumab (ofa) in patients with previously treated CLL who were not eligible for chemoimmunotherapy (Byrd et al, NEJM 2013). Long-term follow-up data from a single arm Phase 2 study have also demonstrated that patients treated with ibrutinib have long durable responses with a PFS at 2.5 years of 69% (Byrd et al, Blood 2015). While ofatumumab is a licensed comparator and included in treatment guidelines, some Health Technology Assessment (HTA) bodies require comparisons with a wider range of treatments. In the absence of direct head-to-head comparison of single-agent ibrutinib with other frequently used treatments in this patient population, additional comparative evidence against standard of care as observed in clinical practice can provide useful insights on the relative efficacy of ibrutinib. Naïve (unadjusted) comparisons of outcomes from different sources are prone to bias due to confounding, as treatment assignments were not randomly assigned, and populations can vary in important prognostic factors.The objective of this analysis was to compare the relative efficacy of Ibr versus physician's choice in R/R CLL-patients based on patient-level data from RESONATE pooled with an observational cohort, adjusting for confounders using multivariate statistical modelling.MethodsPatient-level data from the Phase 3 RESONATE trial (Ibr: n=195; ofa: n=196) were pooled with data from a retrospective observational study conducted in the Stockholm area in Sweden. This retrospective study collected efficacy and safety data from a detailed, in-depth retrospective review of individual patient files from 148 consecutively identified patients with R/R CLL initiated on second or later line treatment between 2002 and 2013 at the four CLL-treating centers in Stockholm, Sweden, with complete follow-up. Longitudinal follow-up in subsequent treatment lines was available for patients in 3rd (n=91), 4th (n=51), 5th (n=29), and 6+ (n=15) line, and as such individual patients could contribute information to the analysis for multiple lines of therapy, with baseline defined as the date of initiation of the actual treatment line. A multivariate cox proportional hazards model was developed to compare PFS and OS between treatments, including line of therapy, age, gender, Binet stage, ECOG, and refractory disease as covariates. Adjusted HRs and 95% CIs are presented vs. Ibr.ResultsAcross all treatment lines, fludarabine-cyclophosphamide (FC) (n=64), chlorambucil (n=59), alemtuzumab (n=33), FC+rituximab (FCR) (n=30), bendamustine+rituximab (BR) (n=28), and other rituximab-based combination chemotherapy (n=28) were the most frequently used treatments. Line of therapy, age and gender, Binet stage, ECOG performance status, and refractory disease were all independent risk factors for worse outcome on both PFS and OS. The adjusted HR for PFS and OS pooled observational data versus Ibr were 6.80 [4.72;9.80] (p<0.0001) and 2.90 [1.80;4.69] (p<0.0001). HR's for PFS/OS versus most frequent treatment regimens ranged between 2.50/1.82 (FCR) and 14.00/5.34 (anti-CD20 Mab). Baseline adjusted results for the Ofa-arm in RESONATE were comparable for both PFS and OS to outcome data from the consecutive historical cohort, however OS outcomes for Ofa were partly confounded by cross-over to Ibr.ConclusionsComparison of results from the Phase 3 RESONATE study with treatments used as part of previous standard of care in a well-defined cohort of consecutive Swedish patients shows that ibrutinib is superior to physician's choice in patients with relapsed/refractory CLL, suggesting a more than 6 fold improvement in PFS and almost 3 fold improvement in OS. Results were consistent across all different physician chosen treatments and provides further evidence that ibrutinib improves both PFS and OS vs current and prior standard of care regimens. [Display omitted] DisclosuresÖsterborg:Janssen Cilag: Research Funding. Asklid:Janssen Cilag: Research Funding. Diels:Janssen: Employment. Repits:Janssen Cilag: Employment. Söltoft:Janssen Cilag: Employment. Hansson:Jansse Cilag: Research Funding. Jäger:Janssen Cilag: Research Funding.

Insights into the Management of Adverse Events in Patients with Previously Treated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: Experience from the Phase 3 HELIOS Study of Ibrutinib Combined with Bendamustine/Rituximab

Insights into the Management of Adverse Events in Patients with Previously Treated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: Experience from the Phase 3 HELIOS Study of Ibrutinib Combined with Bendamustine/Rituximab

Atrial Fibrillation in CLL/SLL Patients on Ibrutinib

INTRODUCTION: Ibrutinib is approved for treatment (tx) of CLL in patients (pts) with previously treated disease and CLL with deletion (del) 17p. It has shown substantial improvements in progression free survival (PFS) and overall survival (OS) with a tolerable safety profile. Atrial fibrillation (Afib) has been observed in pts treated with ibrutinib, particularly in pts with cardiac risk factors, acute infections, and history of Afib. In the RESONATE study 3% of pts on ibrutinib developed Afib (median follow-up (f/u) 8.6 months (mo)) while 1% of pts on ofatumumab (median f/u 5.3 mo) developed Afib. Here we assessed the incidence of Afib in an independent cohort of pts with long f/u enrolled in our investigator-initiated trial of single agent ibrutinib.PATIENTS AND METHODS: This phase II trial (NCT01500733) enrolled 86 pts (Cohort 1: ≥ 65 years old (yo) without del 17p (n=35); Cohort 2: ≥ 18 yo with presence of del 17p (n=51)) who were treated with ibrutinib 420 mg daily continuously. Treatment-naive and previously treated pts in need of treatment (tx) were eligible. Safety data for Afib was compiled on all pts who received tx. All pts who developed Afib (per patient report or incidental finding) stopped ibrutinib therapy and underwent a cardiology evaluation which may have included an echocardiogram, stress test, and/or holter monitor at the discretion of the evaluating cardiologist. The annualized exposure adjusted incidence rate of Afib was estimated and compared between subgroups.RESULTS: At a median follow-up of 28 mo, 14 (16%) of 86 patients were found to have Afib while on study, 11 pts were ≥65 yo; 3 pts < 65 yo. In 9 (10%) pts this was the first recorded event, while 5 (6%) had a prior history of Afib. One patient developed Afib during pneumonia and in all other pts no contributing factors were identified. The median time to the first event on study was 18.24 (IQR: 10.8-26.0) mo. The annualized incidence was 0.052 (95% CI, 0.024- 0.099) events per person-year of treatment exposure among pts (n=81) without a prior history of Afib, 0.061 (95% CI: 0.025-0.126) in pts ≥65 yo (n=52), and 0.035 (95% CI: 0.004-0.125) in pts <65 yo (n=29, P =0.43 for difference in incidence based on age).In 11 (79%) of 14 pts Afib was grade 2, and in 3 (21%) grade 3. The grade 3 events required hospitalization and control of Afib through intravenous medications. All 3 pts had resolution of Afib and completed cardiology evaluation prior to restarting ibrutinib at a lower dose (280 mg), one received only aspirin (ASA) 81 mg, one received ASA 81 mg and an antiarrhythmic (sotalol), and one patient was anticoagulated with apixaban. Of 11 pts with grade 2 events, 6 (55%) pts currently do not have any symptoms or EKG findings of Afib, 3 (27%) pts intermittently have symptoms or EKG findings of Afib, and 2 (18%) pts have ongoing Afib. All of these 11 pts restarted ibrutinib at the same dose (420 mg); 5 received ASA 81 mg, 2 were on dabigatran transiently and then continued ASA 81 mg, and the other 4 pts started apixiban. F/u on apixiban ranges from 7-17 mo with no bleeding-related adverse events grade >1.CONCLUSION: The rate of Afib in this study at 16% is higher than previously reported, likely due to longer f/u. Indeed, the estimated Afib rate at 17 mo in RESONATE was 5.1%, similar to 5.6% at the same timepoint in our study. The annualized incidence rate of Afib in our study at 0.052 (95% CI, 0.024- 0.099) is higher than the estimated rate of 0.0124 per person-year in the general population (Schnabel et al, Lancet 2015). Given that the rate of Afib is higher in illness, longer follow-up in randomized studies will be needed to distinguish disease from drug-related factors. Notably, none of our pts had to discontinue ibrutinib because of Afib. Furthermore, there is currently no evidence that the severity of Afib in pts on ibrutinib differs from the general population. Given that the majority of our patients have del 17p and/or previously treated disease we feel that the risk-benefit profile favors continued ibrutinib treatment. In a small number of pts and with limited duration of observation we have not noted any serious bleeding complications in pts on ibrutinib and concurrent apixaban or 81 mg ASA.Research supported by the Intramural Research Program of NHLBI. We thank our patients for participation. We acknowledge Pharmacyclics for providing study drug. DisclosuresWiestner:Pharmacyclics: Research Funding.

Abstract 18017: The Modified History in Young Patients With Repaired Tetralogy of Fallot: A Longitudinal Magnetic Resonance Study

Introduction: No large scale longitudinal information is available on the change of ventricular size and function as well as of exercise tolerance in survivors after Tetralogy of Fallot (TOF) repair during childhood and adolescence. Objective: The objective of this study was to assess the rate of progression of right ventricular (RV) size and pulmonary regurgitation (PR) in relationship to clinical status and outcomes in pediatric TOF patients from a contemporary surgical era. Methods: We analyzed 429 cardiac magnetic resonance (CMR) studies (from 2001-2014) of 267 patients (age at CMR 13.5 +/-2.8 years) after TOF repair prior to any pulmonary valve replacement (PVR), including 96 patients with serial CMRs. Measurements of biventricular volumes, mass, function, and PR were performed by a single observer. Serial ECGs, Holters, echocardiograms, and exercise tests were reviewed. Results: No deaths occurred in our cohort. Three patients (1.1%) had non-sustained ventricular tachycardia and 4 (1.5%) had supraventricular tachycardia. Sixty seven (25%) patients underwent PVR at a mean age15.5 +/- 2.3 years.There was a linear progression of BSA-indexed RV end-diastolic volume (EDVi) at 3 ml/m2 per year (p.a., p&lt;0.001). PR volume changed only minimally over time while PR fraction progressed at a rate of 0.7% p.a. (p&lt;0.001). RV and LV ejection fractions (EFs) deteriorated over time (0.5% p.a., p&lt;0.001 and 0.4% p.a., p=0.001, respectively). RV and LV EDVi increased (p=0.02 and p=0.001, respectively) and RV EF (p&lt;0.001) decreased more rapidly in boys than in girls. Right atrial (RA) length correlated inversely with VO2max (% predicted, p=0.02). In a multivariable analysis, worsening PR fraction, RV EF, RA length, and LV EDVi were all predictors of PVR in the future. Conclusions: This study describes the rate and dynamic of progression of biventricular size and function in children after TOF repair in the hitherto largest cohort, with apparent differences between boys and girls. RA length was inversely correlated with exercise intolerance.The need for PVR is predicted by the degree of RV dysfunction as well as LV and RA enlargement. The latter may deserve routine assessment in patients after TOF repair.

Electron Spin Resonance and Magnetization Studies of Bi-Rich La-Manganites

In this paper, the temperature-dependent electron spin resonance and magnetization ( ${M}$ ) studies of La0.7− x Bi x Ca0.3MnO3 ( $x= 0$ , 0.35, 0.42, 0.56, and 0.63) manganites synthesized by the sol–gel method are reported. In all the samples, the coexistence of paramagnetic and ferromagnetic phases over a wide range of temperature is observed. The estimated Curie temperature ( $T_{C}$ ), the Curie–Weiss temperature ( $\theta _{C}$ ), and the temperature at which linewidth ( $\Delta {H}$ ) becomes minimum ( $T_{\rm min}$ ) decrease with the increase in the Bi content. The decreasing trend of these parameters is discussed in view of the difference in the ionic radii of La3+ and Bi3+ and the variations in 6s2 lone pair character of Bi3+ ions with the increase in the Bi content. The evolution of various types of magnetic interactions as a function of temperature and Bi content is discussed.

EPR, optical and superposition model study of Mn2+ doped L+ glutamic acid

Electron paramagnetic resonance (EPR) study of Mn2+ doped L+ glutamic acid single crystal is done at room temperature. Four interstitial sites are observed and the spin Hamiltonian parameters are calculated with the help of large number of resonant lines for various angular positions of external magnetic field. The optical absorption study is also done at room temperature. The energy values for different orbital levels are calculated, and observed bands are assigned as transitions from 6A1g(s) ground state to various excited states. With the help of these assigned bands, Racah inter–electronic repulsion parameters B = 869 cm−1, C = 2080 cm−1 and cubic crystal field splitting parameter Dq = 730 cm−1 are calculated. Zero field splitting (ZFS) parameters D and E are calculated by the perturbation formulae and crystal field parameters obtained using superposition model. The calculated values of ZFS parameters are in good agreement with the experimental values obtained by EPR.

Prazosin-Conjugated Matrices Based on Biodegradable Polymers and α-Amino Acids--Synthesis, Characterization, and in Vitro Release Study.

Novel and promising macromolecular conjugates of the α1-adrenergic blocker prazosin were directly synthesized by covalent incorporation of the drug to matrices composed of biodegradable polymers and α-amino acids for the development of a polymeric implantable drug delivery carrier. The cyto- and genotoxicity of the synthesized matrices were evaluated using a bacterial luminescence test, protozoan assay, and Salmonella typhimurium TA1535. A new urethane bond was formed between the hydroxyl end-groups of the synthesized polymer matrices and an amine group of prazosin, using 1,1′-carbonyldiimidazole (CDI) as a coupling agent. The structure of the polymeric conjugates was characterized by various spectroscopy techniques. A study of hydrogen nuclear magnetic resonance (1H-NMR) and differential scanning calorimetry (DSC) thermodiagrams indicated that the presence of prazosin pendant groups in the macromolecule structures increased the polymer’s rigidity alongside increasing glass transition temperature. It has been found that the kinetic release of prazosin from the obtained macromolecular conjugates, tested in vitro under different conditions, is strongly dependent on the physicochemical properties of polymeric matrices. Furthermore, the presence of a urethane bond in the macromolecular conjugates allowed for obtaining a relatively controlled release profile of the drug. The obtained results confirm that the pharmacokinetics of prazosin might be improved through the synthesis of polymeric conjugates containing biomedical polymers and α-amino acids in the macromolecule.

Study of Resonances in 1 × 25 kV AC Traction Systems

AC traction systems are 1 × 25 or 2 × 25 kV 50-Hz single-phase, non-linear, time-varying loads that can cause power quality problems. One of the main concerns about these systems is voltage distortion, because adjustable-speed drives for trains may inject harmonic currents of frequencies below 2 kHz. Since the presence of parallel resonances in the contact feeder section of the traction circuit worsens the scenario, traction system resonance phenomena should be analyzed to prevent problems. Several works addressed these phenomena, but they only drew weak numerical conclusions based on the frequency scan method. This article studies 1 × 25 kV traction system resonances at pantograph terminals and provides more effective analytical expressions to locate them and determine the impact of traction system parameters on them. These expressions are validated from several traction systems in the literature.

Some aspects of fission and quasifission processes

The discovery of nuclear fission in 1938–1939 had a profound influence on the field of nuclear physics and it brought this branch of physics into the forefront as it was recognized for having the potential for its seminal influence on modern society. Although many of the basic features of actinide fission were described in a ground-breaking paper by Bohr and Wheeler only six months after the discovery, the fission process is very complex and it has been a challenge for both experimentalists and theorists to achieve a complete and satisfactory understanding of this phenomenon. Many aspects of nuclear physics are involved in fission and it continues to be a subject of intense study even three quarters of a century after its discovery. In this talk, I will review an incomplete subset of the major milestones in fission research, and briefly discuss some of the topics that I have been involved in during my career. These include studies of vibrational resonances and fission isomers that are caused by the second minimum in the fission barrier in actinide nuclei, studies of heavy-ion-induced fission in terms of the angular distributions and the mass–angle correlations of fission fragments. Some of these studies provided evidence for the importance of the quasifission process and the attendant suppression of the complete fusion process. Finally, some of the circumstances around the establishment of large-scale nuclear research in India will be discussed.

Study of resonance in wind parks

Wind turbine harmonic current emissions are a well-known power quality problem. These emissions flow through wind park impedances, leading to grid voltage distortion. Parallel resonance may worsen the problem because it increases voltage distortion around the resonance frequency. Hence, it is interesting to analyze the parallel resonance phenomenon. The paper explores this phenomenon in wind parks and provides analytical expressions to determine parallel resonances.

Electron paramagnetic resonance and photoluminescence of NaBi(MoO4)2 crystals doped with gadolinium ions

The results of electron paramagnetic resonance (EPR) and photoluminescence studies of large NaBi(MoO4)2 crystals grown by the low-gradient Czochralski method and doped with gadolinium ions (0.1 wt %) have been presented. It has been found from the analysis of the angular dependence of EPR spectra that the gadolinium ions enter into the crystal structure in the state Gd3+ and occupy the bismuth position. The parameters of the EPR spectra of the gadolinium ions have been calculated and the analogy has been drawn based on these data between the specific features of the incorporation of gadolinium ions into the structures of double tungstates and molybdates. The observed shift of the maximum of the photoluminescence band of the NaBi(MoO4)2 crystals doped with Gd3+ ions with respect to the spectrum of the undoped crystal suggests the influence of gadolinium ions on the formation of the bottom of the conduction band caused by the states of the (MoO4)2−.

P90 – 2900: Menkes disease with atypical findings in neuroimaging: It's not only gold that glitters

Objectives To present a case of Menkes disease (MD) with atypical findings in neuroimaging and review the publications related to these findings. Method Systematic literature review and retrospective description of the case seen at our center. Results We present the case of a 3-month-old infant admitted at our Intensive Care Unit with status epilepticus. Initial brain magnetic resonance (MR) studies revealed the coexistence of an extensive T2 hyperintensity in the temporal white matter (WM) and in both caudate nuclei. Neurological examination showed marked psychomotor retardation, with no exploratory behaviour, severe hypotonia and swallowing difficulties. Complementary tests revealed decreased ceruloplasmin levels (3.6 mg/dL-normal: 39–51 mg/dL), increased lactate in cerebrospinal fluid (40 mg/dL), “Pili torti” on microscopic examination of the hair and a mutation in the gene ATP7A, which confirmed the diagnosis of MD. Treatment was iniciated with copper histidinate and three antiepileptic drugs (Levetiracetam, Lacosamide, and Clobazam). By the age of 6 months, MR studies revealed the disappearance of hyperintensities on WM and basal ganglia (BG), with marked atrophy and bilateral subdural hygromas. A rapidly deteriorating condition led to exitus at 8 months. Conclusion Neuroradiological atypical findings in MD published so far involve leukoencephalopathies (located in the temporal lobe, periventricular or diffuse), and BG anomalies, such as infarcts or cytotoxic lesions. As the presented case shows, and according to other cases published, there can be early damage in WM and BG in MD instead of the typically observed cortical atrophy and vascular abnormalities. The pathogenic mechanism could involve vasogenic edema caused by the initial status epilepticus, and cytotoxic damage of both caudates as a result from energetic failure. Thus, predominant diffuse involvement of the WM in the absence of cortical atrophy or vascular tortuosity should not exclude the diagnosis of MD, even in late infancy, when the clinical and biochemical picture supports it.

The treatment of venous thromboembolism with novel oral anticoagulants: warnings and limitations.

The treatment of venous thromboembolism with novel oral anticoagulants: warnings and limitations.