We report the synthesis, structure, microstructure, chemical stability in H 2 O and CO 2 , and electrical transport properties of an oxide ion-conducting perovskite-related structure Ba 3 In 2 MO 8 (M = Zr, Ce, Zr 0.5 Ce 0.5 ). Powder Xray diffraction confirmed the formation of a simple cubic perovskite-like structure for

May-Thurner syndrome (MTS), also referred to as iliac vein compression syndrome, occurs when the iliac venous structures are compressed by iliac arterial structures against the underlying bony architecture [1,2]. In this case report, we report an embolic stroke in the setting of MTS and with a patent foramen ovale (PFO). CASE PRESENTATION:A 44 year old hispanic male with no significant past medical or surgical history presented with an abrupt onset of expressive aphasia that lasted for about one hour. At the time of evaluation, his symptoms had resolved. The patient otherwise denied any weakness, sensory loss, headaches, vomiting, nausea, twitching, decreased level of alertness, or hemibody/hemifacial numbness or tingling sensation. He did not meet criteria for IV tPA or any neurovascular intervention. He does not consume tobacco, alcohol, or use illicit drugs. He denied any family history of hypercoagulable disorders. Head computed tomography (CT) did not demonstrate hemorrhage and CT perfusion of the head and neck did not demonstrate any lesions or flow defects. The magnetic resonance imaging (MRI) revealed a left frontal lobe acute ischemic stroke. Cardioembolic work up was pursued. A transesophageal echocardiogram showed evidence of a positive bubble study and PFO. His Risk of Paradoxical Embolism (ROPE) score was calculated to be 8. To determine the origin of the embolism, venous ultrasound of the lower extremities was performed and demonstrated no signs of deep vein thrombosis. Furthermore, magnetic resonance venography (MRV) of the pelvis demonstrated narrowing of the left common iliac vein between the right common iliac artery and lumbar spine, consistent with MTS. It was concluded that the patient would require a PFO closure followed by catheter-based venogram with intravenous ultrasound (IVUS) of pelvic vasculature to confirm the diagnosis. IVUS demonstrated a 24% reduction in area of the left common iliac vein and 76% reduction in area of the left external iliac vein. He was treated with balloon venoplasty of the left external/common femoral vein as well as stent placement in the left external/common iliac vein. DISCUSSION:In patients aged 40-50: the rate of ischemic strokes doubled, 1 in 4 have MTS, and 1 in 5 have a PFO [1, 2, 3]. The combination of MTS and PFO can produce disabling consequences for patients. Therefore, proper clinical judgment should be used to determine the necessity of further imaging modalities. As in the case above, in a young male with no risk factors further invasive imaging should be performed to ensure proper diagnosis and management to prevent further disabling sequelae. CONCLUSIONS:In patients with no risk factors presenting with stroke symptomatology, proper imaging modality apart from lower extremity venous ultrasonography should be considered. The gold standard is catheter based venography to diagnose MTS.

INTRODUCTION: Mycoplasma pneumoniae (MP) is a common cause of community acquired pneumonia with an incidence of 1-3 per 1000 cases annually [1]. However, extrapulmonary manifestations of MP in the adult population are rare [3]. The mechanism behind injury is predicted to be caused by bacterial inflammation and vascular occlusion combined with an autoinflammatory response [2]. We present a case of a 21-year-old Hispanic male with rhabdomyolysis and peri-myocarditis caused by MP. CASE PRESENTATION:A 21-year-old Hispanic male with a past medical history of Kawasaki disease presented complaining of constant chest pain for two days. He endorsed subjective fever, dark urine, and myalgias. He had previously visited an urgent care and was prescribed ibuprofen and cyclobenzaprine to no avail. On physical exam, the patient was afebrile and tachypneic. Cardiac exam revealed tachycardia with no rubs, murmurs, or gallops. Lung fields were clear to auscultation bilaterally. Chest pain was not reproducible upon palpation. The abdomen was soft, nondistended, and without organomegaly. Initial labs revealed leukocytosis, transaminitis, elevated d-dimer, elevated troponins, elevated C-reactive protein, and elevated creatinine kinase. Admission chest x-ray was without infiltrates, cardiomegaly, or pneumothorax. Initial electrocardiogram demonstrated ST elevations in inferolateral leads. Emergent cardiac catheterization demonstrated normal coronary anatomy. CTA of the chest was negative for pulmonary embolism and aortic dissection. Original echocardiogram demonstrated normal ejection fraction. Respiratory pathogen panel was positive for MP IgM. Treatment for MP-induced rhabdomyolysis and peri-myocarditis with intravenous fluids and azithromycin was initiated. He experienced a transient systolic heart failure, managed with Bilevel Positive Airway Pressure. The rapid clearance of bacteria with proper antibiotics allowed the stunned myocardium to recuperate within 72 hours. At which point the patient experienced rapid clinical improvement and was discharged home in stable condition. DISCUSSION:The diagnosis of MP is difficult due to its cellular structure, its ability to be missed on routine blood cultures, and its ability to cause extrapulmonary manifestation via autoimmune dysfunction [2]. The case demonstrates a patient with rhabdomyolysis and peri-myocarditis with positive MP IgM. The patient also experienced rapid clinical improvement with clearance of bacteria by antibiotic administration. Thus, we were able to diagnose another rare manifestation of a MP infection causing rhabdomyolysis and peri-myocarditis.CONCLUSIONS: MP is difficult to isolate and has the ability to present with myriad symptomatology. Although MP is difficult to diagnose, it is easily treated. Therefore, MP should be considered in young patients due to its increased incidence in the younger population and unique presentations.