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In this study, we have investigated the properties of discontinuous-Co 80 Fe 20 /α-Fe 2 O 3 multilayers by AC impedance technology. The specific feature of the impedance spectra varies with of Co 80 Fe 20 layer characteristics, being related to isolated sate or percolation state of Co 80 Fe 20 cluster in α-Fe 2 O 3 matrix. The equivalent-circuit analysis implies that the carrier conduction is sensitive to the morphology and clusters density of the CoFe grains. Mechanism contributes for the AC conductivity is discussed.

In the context of increasing concern in occidental countries about dementing diseases in the geriatric population, an epidemiological study has been done in the city of Zaragoza, Spain. The sample, randomly selected from the census, was stratified by age and sex and included 1,134 elderly (aged 65 plus years) living in the community. In phase I, lay interviewers administered the Spanish versions of the Geriatric Mental State (GMS) and Mini-Mental Status Examination to the elderly. The individuals were considered to be "probable cases" on the basis of GMS "global" scores previously reported to be valid. These "probable cases" were then examined in phase II by standardized psychiatrists using both, the GMS and MEC, but also the History and Aetiology Schedule (HAS). A proportion of "probable normals" were also examined by the psychiatrists to assess the validity of the screening procedure in the community. The identified "cases" of dementia and "cases" of depression were then studied by the neurologists in what we call phase III. Specific project criteria for dementia were used but, in fact, all identified "cases" of dementia fulfilled DSM-III criteria. Some data of the application of the AGECAT computer program in both, phase I and phase II are now reported. The different severity levels of cognitive deficits according to AGECAT criteria are compared with clinical criteria. The advantages and disadvantages of the computer program in the detection of minor cognitive difficulties are discussed.

Objectifs Montrer l’apport et l’efficacite de l’IRM dans le syndrome de Guillain-Barre ou polyradiculonevrite aigue. Materiels et methodes L’IRM etait le dernier examen realise sur trois enfants âges respectivement de 16 mois, 31 mois et 10 ans. Les coupes sagittales en T1 sans puis avec injection IV de produits de contraste et T2 ont ete realisees. Resultats La forme classique du syndrome de Guillain-Barre est celle d’une paralysie progressive, ascendante, et symetrique des extremites, avec hyporeflexie ou areflexie osteo-tendineuse. La prise de contraste des racines nerveuses autour du cone medullaire et de la queue de cheval en IRM au cours d’un syndrome de Guillain-Barre (SGB) est bien connue. Nous rapportons trois cas pediatriques de syndrome de Guillain-Barre consecutifs diagnostiques dans la periode d’avril a juillet 2004 au Service de Radiologie de l’hopital Robert Debre a Paris. Conclusion L’IRM a permis de confirmer le diagnostic de SGB dans sa forme typique, en montrant une prise de contraste des racines de la queue de cheval et autour du cone terminal, et d’eliminer les diagnostics differentiels de paralysie aigue. Cela a permis une prise en charge rapide de ces trois enfants.

Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require immunomodulator based maintenance therapy. The experts discuss several factors potentially predictive for poor disease outcome (such as severe perianal fistulizing disease, severe stricturing/penetrating disease, severe growth retardation, panenteric disease, persistent severe disease despite adequate induction therapy), which may incite to an anti-TNF-based top down approach. These guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.

INTRODUCAO: A ataxia de Friedreich e uma doenca neurodegenerativa e os criterios clinicos diagnosticos para os casos tipicos incluem: a) idade de inicio precoce (< 20 ou 25 anos); b) heranca autossomica recessiva; c) ataxia progressiva; e d) abolicao dos reflexos tendinosos profundos. METODOS: Estudou-se a frequencia e o tamanho das expansoes GAA e a sua influencia nos achados neurologicos, idade de inicio e progressao da doenca, em 25 pacientes brasileiros com diagnostico clinico de ataxia de Friedreich - 19 tipicos e 6 atipicos, por PCR. RESULTADOS: Anormalidades sugestivas de comprometimento cerebelar, no ECG e a presenca de pes cavos ocorreram com maior frequencia nos casos tipicos; contudo, a resposta plantar e a fala mostraram-se mais frequentemente normal neste grupo, quando comparados casos tipicos e atipicos. A expansao GAA em homozigose foi detectada em 17 casos (68%) - todos tipicos e, em 8 (32%) (6 atipicos e 2 tipicos), nao foi observada nenhuma expansao, excluindo-se o diagnostico de ataxia de Friedreich. Deformidade de pes, anormalidades cardiacas e alguns achados neurologicos ocorreram mais frequentemente, nos casos com expansao GAA, contudo, sinais de comprometimento dos pares cranianos e alteracoes dos achados tomograficos foram detectados menos frequentemente do que em pacientes sem expansao. DISCUSSAO: A analise molecular e imprescindivel para o diagnostico de ataxia de Friedreich, nao so para os casos tipicos como tambem para os atipicos. Nao ha qualquer correlacao entre o genotipo e o fenotipo. O diagnostico baseado apenas nos achados clinicos e limitado, embora facilite a triagem para melhor selecionar os casos suspeitos que merecem ser testados. A dosagem serica da vitamin E e recomendada , especialmente nos casos sem expansao GAA.

OBJECTIVES: Eosinophilic esophagitis (EoE) represents a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. With few exceptions, 15 eosinophils per high-power field (peak value) in ≥1 biopsy specimens are considered a minimum threshold for a diagnosis of EoE. The disease is restricted to the esophagus, and other causes of esophageal eosinophilia should be excluded, specifically proton pump inhibitor-responsive esophageal eosinophilia. This position paper aims at providing practical guidelines for the management of children and adolescents with EoE.METHODS: Relevant literature from searches of PubMed, CINAHL, and recent guidelines was reviewed. In the absence of an evidence base, recommendations reflect the expert opinion of the authors. Final consensus was obtained during 3 face-to-face meetings of the Gastroenterology Committee and 1 teleconference.RESULTS: The cornerstone of treatment is an elimination diet (targeted or empiric elimination diet, amino acid-based formula) and/or swallowed, topical corticosteroids. Systemic corticosteroids are reserved for severe symptoms requiring rapid relief or where other treatments have failed. Esophageal dilatation is an option in children with EoE who have esophageal stenosis unresponsive to drug therapy. Maintenance treatment may be required in case of frequent relapse, although an optimal regimen still needs to be determined.CONCLUSIONS: EoE is a chronic, relapsing inflammatory disease with largely unquantified long-term consequences. Investigations and treatment are tailored to the individual and must not create more morbidity for the patient and family than the disease itself. Better maintenance treatment as well as biomarkers for assessing treatment response and predicting long-term complications is urgently needed.

OBJECTIVE: Primary gastrointestinal neuropathies are a heterogeneous group of enteric nervous system (ENS) disorders that continue to cause difficulties in diagnosis and histological interpretation. Recently, an international working group published guidelines for histological techniques and reporting, along with a classification of gastrointestinal neuromuscular pathology. The aim of this article was to review and summarize the key issues for pediatric gastroenterologists on the diagnostic workup of congenital ENS disorders. In addition, we provide further commentary on the continuing controversies in the field.RESULTS: Although the diagnostic criteria for Hirschsprung disease are well established, those for other forms of dysganglionosis remain ill-defined. Appropriate tissue sampling, handling, and expert interpretation are crucial to maximize diagnostic accuracy and reduce interobserver variability. The absence of validated age-related normal values for neuronal density, along with the lack of correlation between clinical and histological findings, result in significant diagnostic uncertainties while diagnosing quantitative aberrations such as hypoganglionosis or ultrashort Hirschsprung disease. Intestinal neuronal dysplasia remains a histological description of unclear significance.CONCLUSIONS: The evaluation of cellular quantitative or qualitative abnormalities of the ENS for clinical diagnosis remains complex. Such analysis should be carried out in laboratories that have the necessary expertise and access to their own validated reference values.