Open preperitoneal vs. open anterior repair for the treatment of emergency femoral hernia: a bicentric retrospective study

PURPOSE

The aim of this study is to compare the postoperative results, in terms of complications and recurrence, between the anterior and open preperitoneal approaches in emergency femoral hernia.

METHODS

This bi-centric retrospective cohort study included patients who underwent emergency femoral hernia repair between January 2010 and December 2018. Postoperative complications and recurrence were analyzed comparing anterior and open preperitoneal approaches. The predictors of complications, mortality and recurrence were investigated using multivariate logistic regression.

RESULTS

A total of 204 patients met the inclusion criteria. Open anterior approach was performed in 128 (62.7%) patients and open preperitoneal was performed in 76 (37.3%). Open preperitoneal approach was associated with lower rates of recurrence (P = 0.033) and associated midline laparotomies (P = 0.006). Multivariable analysis identified patients with chronic nephropathy (OR, 3.801; 95%CI, 1.034-13.974; P = 0.044), preoperative bowel obstruction (OR, 2.376; 95%CI, 1.118-5.047; P = 0.024) and required midline laparotomy (OR, 12.467; 95%CI, 11.392-102.372; P = 0.030) as risk factors for complications and ASA ≥ III (OR, 7.820; 95%CI, 1.279-47.804; P = 0.026), COPD (OR, 5.064; 95%CI, 1.188-21.585; P = 0.028), necrotic contents (OR, 36.968; 95%CI, 4.640-294.543; P = 0.001), and required midline laparotomy (OR, 11.047; 95%CI, 1.943-62.809; P = 0.007). as risk factors for 90-day mortality. Male gender (OR, 4.718; 95%CI, 1.668-13.347; P = 0.003) and anterior approach (OR, 5.292; 95%CI, 1.114-25.149; P = 0.036) were risk factors for recurrence.

CONCLUSION

Open preperitoneal approach may be superior to anterior approach in the emergency setting because it can avoid the morbidity of associated midline laparotomies, with a lower long-term recurrence rate.

Open Emergent Groin Hernia Repair: Anterior or Posterior Approach?

Introduction: The current literature has not yet provided a definitive conclusion on the best emergency groin hernia repair. The aim of this study was first to compare the short and long-term outcomes between open preperitoneal and anterior approach in emergency groin hernia repair and second to identify risk factors for postoperative complications, mortality, and recurrence. Materials and Methods: This retrospective cohort study included patients who underwent emergency groin hernia repair between January 2010 and December 2018. Short and long-term outcomes were analyzed comparing approach and repair techniques. The predictors of complications and mortality were investigated using multivariate logistic regression. Cox regression multivariate analysis were used to explore risk factors of recurrence. Results: A total of 316 patients met the inclusion criteria. The most widely used surgical techniques were open preperitoneal mesh repair (34%) and mesh plug (34%), followed by Lichtenstein (19%), plug and patch (7%) and tissue repair (6%). Open preperitoneal mesh repair was associated with lower rates of recurrence (p = 0.02) and associated laparotomies (p < 0.001). Complication and 90-day mortality rate was similar between the techniques. Multivariable analysis identified patients aged 75 years or older (OR, 2.08; 95% CI, 1.14-3.80; p = 0.016) and preoperative bowel obstruction (OR, 2.11; 95% CI, 1.20-3.70; p = 0.010) as risk factors for complications and Comprehensive Complication Index ≥26.2 as risk factor for 90-day mortality (OR, 44.76; 95% CI, 4.51-444.59; p = 0.01). Female gender was the only risk factor for recurrence. Conclusion: Open preperitoneal mesh repair may be superior to other techniques in the emergency setting, because it can avoid the morbidity of associated laparotomies, with a lower long-term recurrence rate.

Males and females with first episode psychosis present distinct profiles of social cognition and metacognition

Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider sex when planning interventions.

Assessing the effect of catchment characteristics to enhanced coagulation in drinking water treatment: RSM models and sensitivity analysis

Coagulation is the main process for removing natural organic matter (NOM), considered to be the major disinfection by-products (DBPs) precursor in drinking water production. In this work, k-means clusters analysis were used to classify influent waters from two different surface drinking water treatment plants (DWTPs) located in the Mediterranean region. From this, enhanced coagulation models based on response surface methodology (RSM) were then developed to optimise coagulation at two water catchments (river and reservoir). The cluster analysis classified the water quality of the raw waters into two groups related to baseline and peak organic loads. The developed enhanced coagulation models were based on the turbidity, total organic carbon (TOC) and UV₂₅₄ removals. Sensitivity analysis applied to the models (after predictors selection) determined the factors relative individual contributions for each DWTP scenario. Then, profile plots for enhanced coagulation were studied to identify the optimal levels for each case. Models mean R² were 0.85 and 0.86 in baseline and 0.85 and 0.84 in peak scenario for river and reservoir catchments, respectively. Results of this study indicate that the surface water quality variation in river DWTP is seasonal and is expressed by an increase of turbidity, while in the reservoir DWTP is related to extreme weather events showing high levels of dissolved organic load (TOC and UV₂₅₄). During baseline cases, where raw waters present low levels of organics, the three factors optimal adjustment should be ensured to optimise coagulation. Then, during peak scenarios, where influent waters present high organics, the optimal for enhanced coagulation relies on the correct adjustment of C_d. The presented work provides models for drinking water production aimed to propose the optimum conditions for enhanced coagulation, considering the influent water characteristics under different weather conditions.

Persons with first episode psychosis have distinct profiles of social cognition and metacognition

Subjects with first-episode psychosis experience substantial deficits in social cognition and metacognition. Although previous studies have investigated the role of profiles of individuals in social cognition and metacognition in chronic schizophrenia, profiling subjects with first-episode psychosis in both domains remains to be investigated. We used latent profile analysis to derive profiles of the abilities in 174 persons with first-episode psychosis using the Beck's Cognitive Insight Scale, the Faces Test, the Hinting Task, the Internal, Personal and Situational Attributions Questionnaire, and the Beads Task. Participants received a clinical assessment and a neuropsychological assessment. The best-fitting model was selected according to the Bayesian information criterion (BIC). We assessed the importance of the variables via a classification tree (CART). We derived three clusters with distinct profiles. The first profile (33.3%) comprised individuals with low social cognition. The second profile (60.9%) comprised individuals that had more proneness to present jumping to conclusions. The third profile (5.7%) presented a heterogeneous profile of metacognitive deficits. Persons with lower social cognition presented worse clinical and neuropsychological features than cluster 2 and cluster 3. Cluster 3 presented significantly worst functioning. Our results suggest that individuals with FEP present distinct profiles that concur with specific clinical, neuropsychological, and functional challenges. Each subgroup may benefit from different interventions.

[Case report of severe acute eosinophilic pneumonia induced by amoxicillin]

INTRODUCTION

Acute eosinophilic pneumonia (AEP) is a rare and potentially severe disorder, characterized by an acute febrile respiratory illness with diffuse pulmonary infiltrates, pleural effusions and an eosinophilic alveolitis identified on broncho-alveolar lavage or lung biopsy. The condition can be idiopathic, or induced by the inhalation of toxic substances, by infections or by medications. The condition tends to respond rapidly to treatment with systemic steroids.

CASE REPORT

We report the case of a 16-year old patient who presented severe acute interstitial pneumonia with eosinophilia (1.17g/L). They had taken a seven-day course of amoxicillin treatment two weeks previously for a dental abscess. The patient initially required respiratory support by mechanical ventilation followed by extracorporeal membrane oxygenation due to severe refractory hypoxemia. After exhaustive investigation a diagnosis of amoxicillin-induced acute eosinophilic pneumonia was made. After steroid treatment was initiated the clinical response was rapidly favorable and remission was achieved. The patient has been advised to avoid beta lactam antibiotics for life.

CONCLUSION

This case illustrates a rare case of severe acute eosinophilic pneumonia induced by amoxicillin.

Application of Ant-Colony-Optimization algorithm for improved management of first flush effects in urban wastewater systems

The first flush effect in combined sewer systems during storm events often causes overflows and overloads of the sewage treatment, which reduces the efficiency of the sewage treatment and decreases the quality of the receiving waters due to the pollutants that are contributed. The use of retention tanks constitutes a widely used way to mitigate this effect. However, the management of the pollutant loads encounters difficulties when the retention tanks are emptied. A new approach is proposed to solve this problem by fulfilling the treatment requirements in real time, focussing on the characteristics of the wastewater. The method is based on the execution of an Ant Colony Optimisation algorithm to obtain a satisfactory sequence for the discharge of the retention tanks. The discharge sequence considers the volume of stormwater and its concentration of pollutants including Suspended Solids, Biological Oxygen Demand and Chemical Oxygen Demand, Total Nitrogen and Total Phosphorus. The Ant Colony Optimisation algorithm was applied successfully to a case study with overall reduction of pollutant loads stored in retention tanks. The algorithm can be adapted in a simple way to the different scenarios, infrastructures and controllers of sewer systems.

Time- and dose-related effects of three 5-HT receptor ligands on the genioglossus activity in anesthetized and conscious rats

Clinical trials in obstructive sleep apnea syndrome patients reported moderate effects of serotoninergic drugs on oropharyngeal apneas, although numerous specific 5-HT ligands highly modulate the genioglossus muscle (GG) activity in experiments performed in anesthetized animals. The purpose of this study was to investigate time- and dose-related effects of central and systemic injections of 8-OHDPAT (5-HT1A agonist), SB224289 (5-HT1B antagonist), and DOI (5-HT2A/2C agonist) on the GG activity in anesthetized and conscious rats. Electromyographic recordings of the GG activity (GGemg) were analyzed after central and systemic injections of each drug in ketamine-xylazine anesthetized rats. Electroencephalograms (EEG), as well as neck and GG muscle activities (Nemg and GGemg), were recorded in 15 additional rats to analyze changes in sleep-wake states before and after systemic injection of the drugs. Central injections of 8-OHDPAT and DOI in anesthetized rats induced clear dose-related increases in phasic and tonic GGemg activities, respectively. The time-responses were inferior to 30 min with 8-OHDPAT and over 50 min with DOI. Moderate increases in phasic GGemg activity were also observed after central, but not peripheral injection of SB and DOI. The total sleep time measured in conscious rats significantly decreased after systemic injections of DOI and 8-OHDPAT, although no change was observed in phasic or tonic GGemg activity. The dose- and time-responses of the DOI in anesthetized rat partly explain the lack of GGemg tonic change in conscious rat. The moderate effect on the GGemg phasic activity of peripheral 5-HT1A ligand injection easily explains the lack of change in conscious rat. The serotonergic modulation of the respiratory component of the GGemg remains complex, but is highly sensitive to 5-HT1A receptors after central injection in rats under anesthesia. Forthcoming therapy in OSAS should be made of mixed profiled neurotransmitters and different routes of administration.

Mixed valency and magnetism in cyanometallates and Prussian blue analogues

Prussian blue (PB) is a well-known archetype of mixed valency systems. In magnetic PB analogues {CxAy[B(CN)6]z}.nH2O (C alkali cation, A and B transition metal ions) and other metallic cyanometallates {Cx(AL)y[B(CN)8]z}.nH2O (L ligand), the presence of two valency states in the solid (either A-B, or A-A' or B-B') is crucial to get original magnetic properties: tunable high Curie temperature magnets; photomagnetic magnets; or photomagnetic high-spin molecules. We focus on a few mixed valency pairs: V(II)/V(III)/V(IV); Cr(II)/Cr(III); Fe(II)-Fe(III); Co(II)-Co(III); Cu(I)-Cu(II); and Mo(IV)/Mo(V), and discuss: (i) the control of the degree of mixed valency during the synthesis, (ii) the importance of mixed valency on the local and long-range structure and on the local and macroscopic magnetization, and (iii) the crucial role of the cyanide ligand to get these original systems and properties.

Un pneumoperitoine compliquant un pneumomediastin au cours de la ventilation non invasive

INTRODUCTION

Pneumoperitoneum is known to be a rare complication of invasive mechanical ventilation. However it has not previously been described as a consequence of non-invasive ventilation.

CASE REPORT

The authors report a case of pneumoperitoneum associated with pneumomediastinum occurring in a 64-year-old patient treated for 3 years with bilevel ventilation via a nasal mask (expiratory pressure = 9 cm H2O, inspiratory pressure = 15 cm H2O) for obesity hypoventilation syndrome. Respiratory and gastroenterological investigations did not demonstrate a cause for this complication which resolved spontaneously following the cessation of ventilation. Nine months later, clinical deterioration and a worsening of blood gas parameters led to a recommencement of non-invasive mechanical ventilation at the same levels as previously. Over two years of follow up there have been no clinical or radiological signs of a recurrence of pneumomediastinum or pneumoperitoneum.

CONCLUSION

In the absence of any other explanation, barotrauma due to nasal ventilation appears to be the most likely explanation for this complication.

[Angioplasty of intra-stent restenosis of a saphenous graft complicated by massive embolism]

The main risk of angioplasty of saphenous vein aortocoronary bypass grafts is myocardial infarction by distal embolism, explaining the introduction of systems of distal protection with encouraging results. Although embolism of an atheromatous stenosis is classical, that of intra-stent restenosis is exceptional. The authors report a very unusual case of atheromatous and/or thrombotic embolism occurring during angioplasty of an intra-stent restenosis which was recovered by a micropore filter system.

Local magnetic susceptibility of the positive muon in the quasi-one-dimensional S=1/2 antiferromagnet dichlorobis (pyridine) copper (II)

We report muon spin rotation measurements of the local magnetic susceptibility around a positive muon in the paramagnetic state of the quasi-one-dimensional spin 1/2 antiferromagnet dichlorobis (pyridine) copper (II). Signals from three distinct sites are resolved and have a temperature dependent frequency shift which is significantly different than the magnetic susceptibility. This difference is attributed to a muon induced perturbation of the spin 1/2 chain. The obtained frequency shifts are compared with transfer matrix density-matrix renormalization-group numerical simulations.

Photoinduced ferrimagnetic systems in Prussian blue analogues C(I)xCo4[Fe(CN)6]y (C(I) = alkali cation). 4. Characterization of the ferrimagnetism of the photoinduced metastable state in Rb1.8Co4[Fe(CN)6]3.3-13H2O by K edges X-ray magnetic circular dichroism

In Part 2 of this work, the electronic and local structure of the photoinduced metastable magnetic state of the Prussian blue analogue Rb1.8Co4[Fe(CN)6]3.3-13H2O were characterized. To determine directly the relative orientation of the magnetic moments of Co(II) and Fe(III) ions in the metastable state, and the nature of the exchange interaction between them, we performed X-ray magnetic circular dichroism (XMCD) experiments at the cobalt and iron K edges. We present the first direct experimental evidence of the antiferromagnetic interaction between the cobalt and the iron ions, leading to the ferrimagnetism of the photoinduced metastable state.

Photoinduced ferrimagnetic systems in Prussian blue analogues C(I)xCo4[Fe(CN)6]y (C(I) = alkali cation). 3. Control of the photo- and thermally induced electron transfer by the [Fe(CN)6] vacancies in cesium derivatives

We synthesized a series of CoFe Prussian blue analogues along which we tuned the amount of cesium cations inserted in the tetrahedral sites of the structure. Structure and electronic structure have been investigated, combining XANES, infrared spectroscopy, powder X-ray diffraction experiments, and magnetization measurements. The change of the magnetization induced by light along the series shows that the efficiency of the photoinduced magnetization, evidenced a few years ago in similar compounds by Hashimoto et al. (Sato, O.; Iyoda, T.; Fujishima, A.; Hashimoto, K. Science 1996, 272, 704-705; Sato, O.; Einaga, Y.; Iyoda, T.; Fujishima, A.; Hashimoto, K. J. Electrochem. Soc. 1997, 144, L11-L13; Sato, O.; Einaga, Y.; Iyoda, T.; Fujishima, A.; Hashimoto, K. J. Phys. Chem. B 1997, 101, 3903-3905; Einaga, Y.; Ohkoshi, S.-I.; Sato, O.; Fujishima, A.; Hashimoto, K. Chem. Lett. 1998, 585-586; and Sato, O.; Einaga, Y.; Fujishima, A.; Hashimoto, K. Inorg. Chem. 1999, 38, 4405-4412), depends on a compromise between the number of excitable diamagnetic pairs and the amount of [Fe(CN)6] vacancies giving the network flexibility. Besides the efficiency of the photoinduced process, the amount of [Fe(CN)6] vacancies also controls a thermally induced electron transfer.

Optically active molecule-based magnets: enantioselective self-assembling, optical, and magnetic properties

In this short communication we describe the synthesis and the optical and magnetic properties of optically active three dimensional (3D) bimetallic [Cr-Mn] networks [[Delta Cr(III) Delta Mn(II)(ox)(3)][Delta Ru(II)(bpy)(3)]ClO(4)](n)1 - Delta, [[Lambda Cr(III)Lambda Mn(II)(ox)(3)][Lambda Ru(II) (bpy)(3)]ClO(4)](n) 1 - Lambda and [[Delta Cr(III)Delta Mn(II)(ox)(3)][Delta Ru(II)(bpy)(2)p p y]](n) 2 - Delta,[[Lambda Cr(III)Lambda Mn(II)(ox)(3)][Lambda Ru(II)(bpy)(2)ppy]](n) 2 - Lambda (ox = oxalate, bpy = bipyridine, ppy = phenyl-pyridine).

Exchange coupling in cyano-bridged homodinuclear Cu(II) and Ni(II) complexes: synthesis, structure, magnetism, and density functional theoretical study

The synthesis and structural characterization of several new cyano-bridged copper(II) and nickel(II) homodinuclear complexes is presented. The measure of magnetic properties for these complexes is complemented with a computational study of the exchange coupling for several model structures representing this family of compounds. The influence of several factors on the coupling constant has been examined, coordination position occupied by the bridging ligand, distortions of the coordination environment, and relative disposition of the cyanide ion with respect to the M-M vector. Comparison of experimental and calculated coupling constants allows for the rationalization of the most relevant features of the exchange interaction between two identical metal ions through a cyano bridge.

Rational design of three-dimensional (3D) optically active molecule-based magnets: synthesis, structure, optical and magnetic properties of ([Ru(bpy)3](2+), ClO4(-), [Mn(II) Cr(III)(ox)3](-))n and ([Ru(bpy)2ppy](+), [M(II)Cr(III)(ox)3](-))n, with M(II) = Mn(II), Ni(II). X-ray structure of ([deltaRu(bpy)3](2+), ClO4(-), [deltaMn(II)DeltaCr(III)(ox)3](-))n and ([lambdaRu(bpy)2ppy)](+), [lambdaMn(II)lambdaCr(III)(ox)3](-))n

To elucidate the relation between structural and magnetic properties, we have synthesized molecular materials having both Cotton effects and a ferromagnetic long range order. Such optically active 3D molecule-based magnets were rationally designed using the enantioselective template effect of optically active cations, namely Delta or Lambda [Ru(bpy)3, ClO4](+) or Delta or Lambda [Ru(bpy)3ppy](+) (bpy = bipyridine; ppy = phenylpyridine). Such cations are able to template the formation of optically active 3D anionic networks in which transition metal ions (Cr-Mn) and (Cr-Ni) are connected by oxalate ligands (ox). Following this strategy, we described the synthesis of ([Ru(bpy)3](2+), ClO4(-), [Mn(II)Cr(III)(ox)3](-))n and ([Ru(bpy)2ppy](+), [M(II)Cr(III)(ox)3](-))n with M(II) = Mn(II), Ni(II) in their optically active forms. In these 3D networks, all of the metallic centers have the same configuration, Delta or Lambda, as the template cation. We have determined the structure of ([DeltaRu(bpy)3][ClO4][DeltaMnDeltaCr(ox)3])n and ([LambdaRu(bpy)2ppy](+), [LambdaMn(II)LambdaCr(III)(ox)3](-))n by X-ray diffraction studies. These optically active networks show the Cotton effect and long-range ferromagnetic order at low temperatures. The magnetic circular dichroism of ([Ru(bpy)3](2+), ClO4(-), [Mn(II)Cr(III)(ox)3](-))n at 2 K is reported.

[Fe(Phen)(CN)4]-: a versatile building block for the design of heterometallic systems. Crystal structures and magnetic properties of PPh4[Fe(Phen)(CN)4]*2H2O and [[Fe(Phen)(CN)4]2M(H2O)2]*4H2O [Phen = 1,10-phenanthroline; M = Mn(II) and Zn(II)]

The mononuclear PPh4[Fe(phen)(CN)4]*2H2O (1) complex and the cyanide-bridged bimetallic [[Fe(phen)(CN)4]2M(H2O)2]*4H2O compounds [M = Mn(II) (2) and Zn(II) (3); phen = 1,10-phenanthroline; PPh4 = tetraphenylphosphonium cation] have been synthesized and structurally and magnetically characterized. Complex 1 crystallizes in the monoclinic system, space group P2(1)/c, with a = 9.364(4) A, b = 27.472(5) A, c = 14.301(3) A, beta = 97.68(2) degrees, and Z = 4. Complexes 2 and 3 are isostructural and they crystallize in the monoclinic system, space group P2(1)/n, with a = 7.5292(4) A, b = 15.6000(10) A, c = 15.4081(9) A, beta = 93.552(2) degrees, and Z = 2 for 2 and a = 7.440(1) A, b = 15.569(3) A, c = 15.344(6) A, beta = 93.63(2) degrees, and Z = 2 for 3. The structure of complex 1 is made up of mononuclear [Fe(phen)(CN)4]- anions, tetraphenyphosphonium cations, and water molecules of crystallization. The iron(III) is hexacoordinate with two nitrogen atoms of a chelating phen (2.018(6) and 2.021(6) A for Fe-N) and four carbon atoms of four terminal cyanide groups (Fe-C bond lengths varying in the range 1.906(8)-1.95(1) A) building a distorted octahedron around the metal atom. The structure of complexes 2 and 3 consists of neutral double zigzag chains of formula [[Fe(phen)(CN)4]2M(H2O)2] and crystallization water molecules. The [Fe(phen)(CN)4]- entity of 1 is present in 2 and 3 acting as a bridging ligand toward M(H2O)2 units [M = Mn(II) (2) and Zn(II) (3)] through two cyanide groups in cis positions, the other two cyanide remaining terminal. Two water molecules in trans positions and four cyanide-nitrogen atoms from four [Fe(phen)(CN)4]- units build a distorted octahedral surrounding Mn(II) (2) and Zn(II) (3). The M-O bond lengths are 2.185(3) (2) and 2.105(3) A (3), whereas the M-N bond distances vary in the ranges 2.210(3)-2.258(3) A (2) and 2.112(3)-2.186(3) A (3). The structure of the [Fe(phen)(CN)4]- complex ligand in 2 and 3 is as in 1. The shorter intrachain Fe-M distances through bridging cyano are 5.245(5) and 5.208(5) A in 2 and 5.187(1) and 5.132(1) A in 3. The magnetic properties of 1-3 have been investigated in the temperature range 2.0-300 K. Complex 1 is a low-spin iron(III) complex with an appreciable orbital contribution. The magnetic properties of 3 correspond to the sum of two magnetically isolated spin triplets, the magnetic coupling between the low-spin iron(III) centers through the -CN-Zn-NC- bridging skeleton (iron-iron separation larger than 10.2 A) being negligible. More interestingly, 2 exhibits one-dimensional ferrimagnetic behavior due to the noncompensation of the local interacting spins (S(Mn) = 5/2 and S(Fe) = 1/2) which interact antiferromagnetically through bridging cyano groups. A comparison between the magnetic properties of the isostructural compounds 2 and 3 allow us to check the antiferromagnetic coupling in 2.

Crystal structure and magnetic properties of an octacyanometalate-based three-dimensional tungstate(V)-manganese(II) bimetallic assembly

A single crystal of the title compound [MnII6(H2O)9[W(V)(CN)8]4 x 13H2O]n was synthesized in a hot aqueous solution containing octacyanotungstate, Na3[W(CN)8] x 3H2O, and Mn(ClO4)2 x 6H2O. The compound crystallized in the monoclinic system, space group P2(1)/c with cell constants a = 15.438(2) A, b = 14.691(2) A, c = 33.046(2) A, beta = 94.832(9) degrees, and Z = 4. The crystal consists of a W(V)-CN-MnII linked three-dimensional network [[MnII(H2O)]3[MnII(H2O)2]3[W(V)(CN)8]4]n and H2O molecules as crystal solvates. There are two kinds of W sites: one is close to a dodecahedron geometry with six bridging and two terminal CN ligands; the other is close to a bicapped trigonal prism with seven bridging and one terminal CN ligands. The field-cooled magnetization measurement showed that the compound exhibits a spontaneous magnetization below Tc = 54 K. Further magnetization measurements on the field dependence reveal it to be a ferrimagnet where all of the MnII ions are antiparallel to all the W(V) ions.

[Aneurysm of the sinus of Valsalva. Apropos of a case of right intra-atrial rupture]

An unusual systolo-diastolic heart murmur was discovered fortuitously in a 39-year-old man undergoing a routine check-up. Transesophageal echocardiography gave the diagnosis of Valsalva sinus aneurysm ruptured into the right atrium. Cardiac surgery was successful. We reviewed the literature on this unusual condition, focusing on the pathophysiological, clinical, diagnostic and therapeutic aspects. Transesophageal echocardiography provides the diagnosis.