10-year results of anastomoses of the left internal mammary artery to the anterior interventricular artery. Angiographic and radionuclide controls

The long term patency of left internal mammary artery graft is better than that of saphenous vein graft. The aim of this study was to determined if this high patency rate was accompanied by a satisfactory myocardial perfusion. Among 143 patients treated with an internal mammary artery graft on the left anterior descending artery between 1972 and 1976, 42 patients underwent coronary angiogram and exercise tomoscintigraphy (thallium 201) over 10 years after surgery. The left internal mammary artery was patent in 92% without any atheromatous lesions. The myocardial perfusion in the area supplied by the left anterior descending artery was normal in 74%. A slight ischemia appeared during exercise in 19% without any clinical symptoms. This long term study shows excellent anatomical results correlated with a good myocardial perfusion during exercise in most cases.     

Post-cholecystectomy amputation neuroma of the common bile duct with obstructive jaundice

Amputation neuroma of the common bile duct after surgery is a rare and mostly asymptomatic lesion. A 60-year old patient presented with obstructive jaundice three months after a cholecystectomy for symptomatic gallstones. Imaging investigations showed common extrahepatic bile duct stenosis. Surgical resection of the stricture with biliodigestive anastomosis was performed. Histological examination of the surgical specimen revealed an amputation neuroma. Despite its rarity, amputation neuroma of the common bile duct should be considered in patients with post-cholecystectomy syndrome following liver or extrahepatic bile duct surgical procedures.     

Anti-cardiolipin antibody from a patient with antiphospholipid syndrome (APS) recognizes only an epitope expressed by cardiolipin/beta 2-glycoprotein-I (beta 2GPI) complex and induces APS

OBJECTIVE: As the antiphospholipid syndrome (APS) is characterized by antibodies which bind negatively charged phospholipids either directly or mainly through different target epitopes located on the beta-2-glycoprotein-I (beta 2GPI) molecule, the aim of this study is to describe an additional target epitope for anti-cardiolipin binding. METHODS: The binding characteristics of affinity purified anti-cardiolipin antibodies from a patient with monoclonal gammopathy associated with clinically overt APS were studied; inhibition studies were also carried out. These antibodies were used for the active induction of experimental APS. RESULTS: The affinity purified anti-cardiolipin antibodies were found to bind a target epitope created by the complex of cardiolipin/beta 2GPI, while not reacting with a complex composed by another phospholipid (phosphatidylserine/beta 2GPI), as confirmed by direct binding and competition assays. Immunization of naive mice with this unique affinity purified anti-cardiolipin antibody resulted in the induction of experimental APS (thrombocytopenia, prolonged coagulation timed and fetal resorptions). The anti-cardiolipin/beta 2GPI injected mice developed high titers of mouse anti-cardiolipin/beta 2GPI antibodies with the same binding characteristics as the human antibody which was used for disease induction. CONCLUSION: APS is a unique syndrome that is characterized by a diversity of pathogenic anti-phospholipid antibodies which may explain the diversity of clinical manifestations reported in patients.     

Biodegradation of Titanium Implants After Long-Time Insertion Used for the Treatment of Fractured Upper and Lower Jaws Through Osteosynthesis: Element Analysis by Electron Microscopy and EDX or EELS

Twelve patients underwent an osteosynthesis with titanium to treat upper and lower jaw fractures. Six to 12 months later, the miniplates were removed. Tissue samples were analyzed by light and electron microscopy for detection of a metallosis. The analysis showed new bone formation like callus tissue around the miniplates. In some cases small, rounded deposits and accumulation of colloid-like particles located next to bigger titanium artifacts were detected in the cytoplasm of histiocytes and in the matrix of connective tissue. The titanium was identified by elemental analysis using EDX in SEM as well as by EELS and electron diffraction in TEM. Both kinds of particles contain titanium, but they seem to be different in composition and derivation. The bigger particles seem to consist of metallic titanium and sourced by working on the metallic implants during the implantation itself. On the other hand, the colloidal-like, small, rounded particles in tissue macrophages and outside the cells in the matrix of connective tissue are presumably of other origin; for example, they could be derived from biodegradation and chemical conversion of the metallic implants. The titanium miniplates were examined before and after implantation by using ESCA technique and revealed metallic titanium and different compositions with other elements. The amount of titanium load of the tissue was very low in most cases and presumably not of biomedical relevance.     

Observation learning of a motor task: who and when?

Observation contributes to motor learning. It was recently demonstrated that the observation of both a novice and an expert model (mixed observation) resulted in better learning of a complex spatiotemporal task than the observation of either a novice or an expert model. In experiment 1, we aimed to determine whether mixed observation better promotes learning due to the information that can be gained from two models who exhibit different skill levels or simply because multiple models, regardless of their level of expertise, better promote learning than would a single model. The results revealed that the observation of both an expert and a novice model resulted in better short-term retention than the observation of either two novice or two expert models. In experiment 2, we wanted to determine whether these benefits would last longer if physical practice trials were interspersed with observation. Mixed and (to some extent) expert observations resulted in better long-term retention than observation of a novice model. We suggest that alternating mixed/expert observation with physical practice trials makes one’s error more salient than when all observation trials are completed before one first starts performing the experimental task, which increases activation of the action observation network.     

Motivational Profiles for Physical Activity Practice in Adults with Type 2 Diabetes: A Self-Determination Theory Perspective

Drawing on Self-Determination Theory, this study explored the motivational profiles toward Physical Activity (PA) among adults with type 2 diabetes and the relationships between motivational profile, perceived competence and PA. Participants were 350 men and women (Mean age 62.77 years) who were interviewed on their motivations toward PA, perceived level of competence to practice, and PA practice. Cluster analyses reveal the existence of three distinct profiles: “High Combined” (ie, high scores on motivations ranging from intrinsic to external regulation, moderate level on amotivation), “Self-Determined” (ie, high scores on intrinsic, integrated, and identified regulations; low scores on other regulations), and “Moderate” (ie, moderate scores on all regulations). Participants with “High Combined” and “Self-Determined” profiles reported higher perceived competence and longer leisure-time PA practice in comparison to those with a “Moderate” profile. This study highlights the necessity of adopting a person-centered approach to better understand motivation toward PA among type 2 diabetics.     

Expanding the clinical spectrum of STIP1 homology and U-box containing protein 1-associated ataxia

Journal of Neurology - STUB1 has been first associated with autosomal recessive (SCAR16, MIM# 615768) and later with dominant forms of ataxia (SCA48, MIM# 618093). Pathogenic variations in STUB1...